糖尿病英文版资料讲解.ppt

Insulin is the key of therapy Insulin in small dosage is a simple、efficient 、safe therapy(0.1u/kg/h) NS 250ml+RI 25U/ iv, 15 drops/min Blood sugar 5 ? 6mmol/L/hr ingnition？： RI 20U/ iv route Presistent venous inflow (other approach) intermittent intervenous injection Intermittent intramuscular injection Correct acidosis (1) Influence of DKA ： Blood pH7.0 ，restain contractility of cardiac muscle The relationship of Blood pH and ventilatory pH7.2 ：hyperventilation ，Kussmaul’s respiration pH7.0 ：restrain expiratory center Insulin sensitivity Correct acidosis (2) Bad results of excessive alkali supplementary treatment : Blood pH↑，CSFpH still low; easy to get hydrocephalus Not good for oxidized hemoglobin to release oxygen ， and cause anoxemia of tissue Easy to get hypocalcemia Correct acidosis (3) Usually after transfusion : blood CO2，BP If blood pH7.1， HCO3-5mmol/L isosmotic sodium bicarbonate ：5％NaHCO3 84ml， or inject water to 200ml equal to 1.25%NaHCO3 Sodium lactate is not recommended Correct electrolyte disturbance Reason of low plasma potassium Restoration of circulating plasma volume Acidosis has been corrected Urine Glucose Hepatin Principle of potassium replacement Considering urine volume 、renal function and concentration of blood potassium ,moderately adding potassium to intravenous fluid Other measures Nurse Prevention and cure complications infection hydrocephalus Heart failure Kidney failure Removing precipitating factors Keystone Criteria of diagnosis of diabetes Methods of diagnosis Principle of treatment Type,characteristics,indications,contraindications,side effects of oral antidiabetic agents Principle of treatment of DKA 胡仁明 医学博士 华山医院内分泌科6622 复旦大学内分泌糖尿病研究所 6458 E-mail 红色的曲线为正常人血清胰岛素分泌曲线，而黄色的代表的是IGT时的胰岛素分泌曲线。在IGT时，血清胰岛素明显高于正常人，说明IGT时，已经有了胰岛素抵抗存在。 这是WHO1997年制定的糖尿病诊断标准图示。IGT的范围包含有部分的IFG患者。 磺酰脲类主要作用是刺激兴奋β细