針對糖尿病病理生理缺陷的雙相調控-默沙東ppt課件-全文預覽
【正文】 服2小時后 顯著升高T2DM患者胰島素、降低胰高糖素,格列吡嗪,24周捷諾維單藥治療促進T2DM患者胰島功能指標的恢復,西格列汀(捷諾維?)改善 胰島素原/胰島素比值，HOMA?,Allpatientstreated population. HOMAβ = homeostasis model assessmentβ.,Raz et al. Diabetologia. 2006。 ** P0.05 vs 生理鹽水和GIP. Data are (mean 177。20:876–913 2）Farilla L et al Endocrinology 2003。20:876–913.,“Gutderived factors that increase glucosestimulated insulin secretion” In ● cre ● tin Intestine Secretion Insulin,Creutzfeldt. Diabetologia. 1985。ller WA et al. N Engl J Med. 1970。48:1700–1713,內 容,β細胞功能異常 α細胞功能異常 胰島功能異常的再認識 腸促胰素調控α β細胞治療T2DM 西格列汀(捷諾維?) 臨床應用價值 小結與展望,“雙激素”假說,Roger Unger,Lelio Orci,糖尿病中高血糖的雙激素假說 1975,胰島功能異常 包括β細胞及α細胞功能異常,糖代謝平衡(glucose homeostasis) 由胰島分泌相反作用的2類激素來維持：β細胞分泌胰島素，α細胞分泌胰高糖素，預防高血糖和低血糖1,2 2型糖尿病的標志(hallmark)包括胰島素分泌障礙及胰高糖素分泌增多，是雙激素缺陷(bihormonal)，這種異常見于IGT及疾病早期35,1) Unger RH. Metabolism 1974,23:581~93 2)Meece J. Curr Med Res Opin. 2007, 23(4):93344 3)Larsson H, et al. Diabetologia, 2000,43: 194~202 3) Ahr233。326:2298,p 0.02,T2DM中a細胞對葡萄糖的敏感性降低,AGRarg= 25分鐘對精氨酸的平均急性胰高糖素反應；。76:13181328. 4. Marchetti P et al. J Clin Endocrinol Metab. 2004。細胞功能反映2型糖尿病疾病進程, 4~ 5%/ 年,223。104: 787~94,2型糖尿病的進展,IGT,糖尿病診斷,胰島β細胞功能,50%,223。25:B32–B46. 2. Buse JB et al. Williams Textbook of Endocrinology. 10th ed. Philadelphia, Pa. Saunders. 2003. p. 16271683. 3. Ward WK et al. J Clin Invest. 1984。48:17001713,IGT階段即存在α細胞過度分泌胰高糖素,Kelley D, Moran M, et al. Role of reduced suppression of glucose production and diminished early insulin release in impaired glucose tolerance. N Engl J Med 1992。74:1318–1328. Dunning B, et al. Diabetologia. 2005。U/mL),胰高糖素 (pg/mL),進餐,時間
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