精准降血糖-郑涛—培训课件.ppt

* Sitagliptin overview * * GLP-1促进胰岛素分泌，抑制胰高血糖素，从而降低血糖； 当血糖降到正常水平，则胰岛素不再释放，胰高血糖素不再被抑制。 1/Nauck 1993B, p 741, C1, ?1, L1-3, 18-20, C2, L1; p 742, C1, ?2, L1-4, ?5, L1-6, C2, ?2, L1-3, ?3, L10-11; p 742, C1, ?4, L1,2; p 741, Abstract, C1, ?1, L10-12;p 742, C1, ?1, L1-3, Table 1 1/Nauck 1993B, p 742, C1, ?2, L1-5 1/Nauck 1993B, p 743, C1, ?1, L3-6,9-11, ?2, L1-3, C2, ?2, L1-2,4-6, Fig 1, Panels 12, Fig 2, Panel 2 1/Nauck 1993B, p 742, C1, ?5, L1-5; p 743, Fig 1, Panels 12, Fig 2, Panel 2; C1, ?2, L1-3, C2, ?2, L4-6 p 742, C1, ?2, L1-4 Reference Nauck MA, Kleine N, ?rskov C et al. Normalization of fasting hyperglycaemia by exogenous glucagon-like peptide 1 (7-36 amide) in type 2 (non-insulin-dependent) diabetic patients. Diabetologia 1993;36:741–744. * References: 1. Brubaker PL, Drucker DJ. Minireview: Glucagon-like peptides regulate cell proliferation and apoptosis in the pancreas, gut, and central nervous system. Endocrinology. 2004;145:2653–2659. 2. Ahrén B. Gut peptides and type 2 diabetes mellitus treatment. Curr Diab Rep. 2003;3:365–372. 3. Zander M, Madsbad S, Madsen JL, Holst JJ. Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and β-cell function in type 2 diabetes: A parallel-group study. Lancet. 2002;359:824–830. 4. Drucker DJ. Biological actions and therapeutic potential of the glucagon-like peptides. Gastroenterology. 2002;122:531–544. 5. Buse JB, Polonsky KS, Burant CF. Type 2 diabetes mellitus. In: Larsen PR, Kronenberg HM, et al, eds. Williams Textbook of Endocrinology. 10th ed. Philadelphia, Pa: Saunders; 2003:1427–1483. 6. Drucker DJ. Enhancing incretin action for the treatment of type 2 diabetes. Diabetes Care. 2003;26:2929–2940. 肠道是人体最大的内分泌器官。它以全天分泌，餐后增强的方式，释放肠促胰岛激素( Incretin)， 包括GLP-1和GIP，与胰岛b 细胞及a 细胞相应受体结合，促进b 细胞分泌胰岛素，同时抑制a 细胞释放胰高血糖素。 从而增加肌肉脂肪组织的糖摄取，减少肝脏糖输出，起到降血糖的作用。 GLP-1和GIP在体内迅速被DPP-4酶降解，数分钟即失活了。捷诺维是全球首创的DPP-4抑制剂，24小时抑制DPP-4酶的活性，维持GLP-1的高活性。 GLP-1，是生理性激素，它对于血糖的控制，是真正葡萄糖依赖性