董爱梅胰岛素泵—培训课件.ppt

* * * * * * * * * 3 Normal Pancreas Simplest level - a small amount of glucose, measurable in millimoles, circulates in the blood continually. After eating, the normal pancreas secretes insulin in response to glucose need. In the diabetic state, the balance of insulin and glucose is disrupted, putting patients at risk for hyperglycemia. * 每天4次注射 更符合生理的方式. 在进餐和运动方面获得更队的自由度 生活自由，控制水平有所提高 但是每天4-获5次注射非常不方便. 病人的依从性成为很大的问题 问题的原因是试图用不符合生理模式的方法来解决生理问题 解决这个难题的关键是控制胰岛素作用的差异性 REF: Diabetes Care 22 Supplement 2 1999 p b43 Basal/Bolus Insulin Absorption Pattern With Standard Insulin Preparations This graph demonstrates insulin delivery patterns with standard insulin preparations. In the commonly used basal/bolus approach, the goal is to maintain a steady state of insulin with a long-acting insulin taken at bedtime, and bolus doses of regular insulin prior to each meal. In this pattern, regular insulin is taken before meals at 8:00 AM, noon, and 5:00 PM. NPH/lente insulin is then taken at bedtime. NPH/lente is an intermediate-acting insulin with a duration that does not cover a full 24 hours. Regular insulin has the disadvantage of peaking somewhat later than the peak for glucose uptake following a meal. Further, even though it is short-acting, insulin levels are sustained following meals, and this may lead to hypoglycemic episodes between meals. 每天4次注射 更符合生理的方式. 在进餐和运动方面获得更队的自由度 生活自由，控制水平有所提高 但是每天4-获5次注射非常不方便. 病人的依从性成为很大的问题 问题的原因是试图用不符合生理模式的方法来解决生理问题 解决这个难题的关键是控制胰岛素作用的差异性 REF: Diabetes Care 22 Supplement 2 1999 p b43 Slide 3-22 * The ideal way of delivering basal and bolus is to first determine what the body needs for basal and bolus, and then to be able to match that in an ever-varying, adjustable form, so that the body has that insulin available as it needed it. You can adjust that insulin to meet the body’s needs. Slide 3-23 * * * * * * 晚餐前血糖在目标范围内时开始 6：00PM，晚餐，餐前量。 餐后两小时(8点钟左右)，检测血糖。目标值是不超过晚餐前血糖50 mg/dl (2.8mmol/L)。如果超过，要停止测试，与您的医生讨论您的餐前量。 11：00PM检测