餐后高血糖和心血管危險因素-展示頁
2025-06-04 22:09本頁面
【正文】 * NGT IGT DM Summary 1. Type 2 DM begins as a postprandial disease 2. Postprandial hyperglycemia contributes to elevations in HbA1c and plications 3. Treatment of postprandial hyperglycemia is critical to achieving optimal outes in type 2 DM 4. Nevertheless, treatment of postprandial hyperglycemia is inadequately addressed STOPNIDDM Study to Prevent Noninsulin Dependent Diabetes Mellitus STOP NIDDM Study design STOP NIDDM Placebo . (n=715) Acarbose 100mg . (n=714) –1 0 36 6 12 18 24 30 Months 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Visits Placebo n=1,429 3 months placebo 60 Closeout visit .: three times daily Chiasson JL, et al. Lancet 2022。13:676–686 300 200 100 0 Plasma glucose (mg/dl) 0600 1200 1800 2400 0600 Time (hours) Mealtime glucose spikes Fasting hyperglycemia Normal C H D M O R T A LI T Y0510152025 6 .0 6 .1 7 .9 8H b A 1 cIncidence (%)A LL C H D E V E N T S0510152025 6 .0 6 .1 7 .9 8H b A 1 cIncidence (%)Kuusisto et al, 1994 Glycemic Control and CHD CHD Mortality All CHD Events A Comparison of Hba1c Levels Achieved in the Conventional Versus Intensive Groups of Major Trials 10 9 8 7 6 5 0 1 2 3 4 5 6 7 8 9 10 Time from randomization (years) HbA1c DCCT Kumamoto Study 9 8 7 6 0 0 3 6 9 12 15 Median HbA1c (%) Time from randomization (years) UKPDS Conventional therapy Intensive therapy 12 11 10 9 8 7 6 5 0 12 24 36 48 60 72 Months HbA1c (%) FPG = fasting plasma glucose。110:637–41. Macro vascular disease Insulin sensitivity Insulin secretion Plasma glucose Micro vascular disease Impaired glucose tolerance Hyperglycemia Diagnosing glucose intolerance – criteria reflect a need for early intervention *Determined post 75g glucose load 2hPG: 2hour postchallenge plasma glucose, FPG: fast
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