糖尿病干预新概念—培训课件.ppt

* The management of type 2 diabetes is approached in a stepwise manner starting with diet and exercise. Despite the established benefits of lifestyle intervention, this strategy is usually difficult to maintain over time.1 When first-line intervention strategies fail, the next step usually involves the addition of antidiabetic agent monotherapy.1 When HbA1c levels start to rise, the oral antidiabetic agent is uptitrated to the maximum effective dose.1 As type 2 diabetes progresses, other oral antidiabetic agents are added until, ultimately, insulin is required to maintain effective control.1 This approach often leads to unacceptable delays in changing therapy and prolonged periods of hyperglycemia that increase the risk of developing complications. Despite the need for intensive management strategies to delay further disease progression and maintain glycemic control, studies have shown that most patients do not achieve HbA1c goals.2,3 Approximately 25% of patients in the UKPDS who were treated with a single antidiabetes agent achieved their glycemic goals after 9 years and ultimately a multifaceted treatment approach was required.4 1. Campbell IW. Need for intensive early glycaemic control in patients with type 2 diabetes. Br J Cardiol 2000;7:625–31. 2. Saydah SH, et al. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA 2004;291:335–42.3. Liebl A, et al. Evaluation of risk factors for development of complications in Type II diabetes in Europe. Diabetologia 2002;45:S23–8.4. Turner RC, et al. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA 1999;281:2005–12. * ADA/EASD: Metabolic Management of Type 2 Diabetes This algorithm is part of a consensus statement by the ADA and European Association for the Study of Diabetes (EASD) for the management of h