百泌达 幻灯.ppt

* 百泌达和2型糖尿病治疗 独特的作用机制: GLP-1 受体激动剂 改善 β 细胞功能 卓越的、持久的血糖控制 低血糖发生率低 固定剂量 – 起始方便、治疗简单 适用于单用二甲双胍、磺酰脲类，以及二甲双胍合用磺酰脲类降糖药物，血糖仍控制不佳的2型糖尿病患者 谢谢 DISCUSSION Median HbA1c increased over 6 years following randomisation for all treatment groups included in the secondary UKPDS analysis. Patients treated with glibenclamide, metformin, chlorpropamide, or insulin had a decline in HbA1c during the first year following randomisation. BACKGROUND The UKPDS followed 753 subjects with newly diagnosed type 2 diabetes in a randomised controlled trial of conventional therapy (predominantly diet) versus intensive blood-glucose control with metformin (aiming for fasting plasma glucose below 6 mmol/L) over 10 years. A secondary analysis compared 342 subjects allocated metformin with 951 overweight subjects allocated intensive blood-glucose control with chlorpropamide (n=265), glibenclamide (n=277), or insulin (n=409). The median HbA1c during the 10 years of follow-up was 7.4% in the metformin group and 8.0% in the conventional treatment group. The patients assigned intensive control with sulphonylurea or insulin had similar HbA1c to the metformin group. DISCUSSION By decreasing beta-cell workload and improving beta-cell response, the incretin glucagon-like peptide 1 (GLP-1) is an important regulator of glucose homeostasis A thorough understanding of the 5 GLP-1 glucoregulatory effects is important to assess the value of GLP-1 in controlling glucose levels, particularly during the postprandial period Upon ingestion of food, GLP-1 is secreted in into the bloodstream and enhances glucose dependent insulin secretion from beta-cells GLP-1 suppresses inappropriately elevated glucagon secretion from alpha cells Lower levels of glucagon lead to a reduction of glucose output from the liver and indirectly reduce the beta-cell workload By slowing the gastric emptying rate, GLP-1 slows the release of nutrients into the gut allowing more time to control the postprandial increase in glucose levels GLP-