[医药卫生]预混胰岛素优于基础胰岛素.ppt

* Lasserson DS, Glasziou P, Perera R, Holman RR, Farmer AJ. Optimal insulin regimens in type 2 diabetes mellitus: systematic review and meta-analyses. Diabetologia 2009;52:1990-2000. 2. Nathan DM, Buse JB, Davidson MB, et al. Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 2009;52:17-30. * Data Source: pg. 444 Fig 2 Bottom In this study by Polonsky et al, the insulin secretion rates of 14 normal individuals and 15 obese individuals were calculated from plasma C-peptide levels. (pg. 442 “Subjects”) In this graph, insulin secretion for normal and obese subjects was normalized according to the percent of basal insulin secretion. Basal insulin secretion rate was estimated from the mean insulin secretion rate between 0600 and 0900 (pg. 442-443 “Data Analysis”) Basal insulin secretion over the whole day was extrapolated from the basal secretion rate over a 24-hour period. The total insulin secreted over the 24-hour period was calculated from the area under the curve of the 24-hour insulin secretion profile. Basal secretion was estimated to be approximately 50% of total insulin secretion over the whole day in normal individuals and 45 % in obese individuals (pg. 444 2nd paragraph) * Data Source: pg. 1571 First full paragraph In this study by Herman et al the safety and efficacy of continuous subcutaneous insulin infusion (CSII) was compared to multiple daily injections (MDI) in type 2 diabetics 48 subjects completed the study using CSII and 50 using MDI (pg. 1570 “Results” 1st paragraph) Insulin lispro was used for prandial doses as well as basal doses for those using CSII. Glargine was used as basal insulin for those using MDI. Basal and prandial doses were adjusted to achieve target pre-prandial (4.4 mmol/L – 6.6 mmol/L [80-120 mg/dL] ) and bedtime BG