胰岛素治疗方案应用(研)ppt课件.ppt

* Diabetes Res Clin Pract. 2005 Jul;69(1):14-21. Epub 2004 Dec 22. Links Characteristics of basal insulin requirements by age and gender in Type-1 diabetes patients using insulin pump therapy. Scheiner G, Boyer BA. Integrated Diabetes Services, 333 E. Lancaster Avenue, Suite 204, Wynnewood, PA 19096, USA. garyscheiner@prodigy.net Establishment of appropriate basal insulin levels is an essential component of intensive insulin therapy. While the existence of a dawn phenomenon is widely recognized, the present study sought to establish whether diurnal basal insulin patterns exist in Type-1 diabetes, and whether these patterns vary by age and gender. Participant data was drawn from 322 Type-1 insulin pump users treated at a private diabetes education practice in suburban Philadelphia. All participants completed a battery of fasting tests designed to match basal insulin levels to endogenous glucose production and insulin sensitivity. Analysis of resultant basal patterns revealed significant differences between juvenile (age or =20) and adult (age 20) basal insulin patterns. The younger group exhibited a more pronounced and sustained night-time peak; the older group exhibiting a briefer and less pronounced early-morning peak. Lower overall basal insulin requirements were found in the youngest (age or =10) and oldest (age 60) groups. No noteworthy gender differences were found. Results can serve as a guide for clinicians when initiating and fine-tuning patients who utilize basal/bolus insulin therapy. PMID:[PubMed - indexed for MEDLINE] 设定合适的基础胰岛素水平是强化胰岛素治疗的一个必要组分。在广泛意识到黎明现象的存在时，本研究为了明确1型糖尿病患者中是否存在双相基础胰岛素形式，以及这些形式是否随着年龄和性别而改变。研究收集了322名使用胰岛素泵治疗的1型糖尿病患者的数据。所有参试者完成了一组空腹血糖测试，旨在使基础胰岛素水平与内源性葡萄糖产量和胰岛素敏感性相匹配。该研究结果可作为利用基础/餐时胰岛素治疗患者开始和调节基础胰岛素水平的一个指导。 * * * * * * * * 这是诺和锐的分子结构图,它是有门冬氨酸替代人胰岛素B28的脯氨酸而形成的生物合成的人胰岛素类似物。目前药用的胰岛素为含锌的六聚体，吸收和 代谢比单体慢 胰岛素B链第28位是容易聚合的关键部位(B28是脯氨酸)，使用基因重组技术,将该位置氨基酸进行替换 替换后使其表现出单体胰岛素的特性--- 与锌离子的亲和力较低, 吸收快, 代谢快，作用时间短 * In solution insulin as