胰岛素泵资料定稿ppt课件.ppt

* * * * Studies show that intrapatient variability differs for insulins. The greatest intrapatient variability is with NPH, lesser for glargine and further decreased with detemir. CSII offers patients the least intrapatient variability. * * * * * * * * * 胰岛素量 人胰岛素, 胰岛素类似物 餐前大剂量增加10-20% 基础量增加10-20% The Rapid Onset and Short Duration of Action of Humalog? Is Otimal for CSII Zinman B et al. Diabetes 1997;46:440-443. Humalog Regular insulin 4 18 10 14 16 12 6 0 30 60 90 120 150 180 210 240 270 300 8 Time (min) Plasma Glucose (mmol/l) 4 18 10 14 16 12 6 0 30 60 90 120 150 180 210 240 270 300 8 Time (min) Plasma Glucose (mmol/l) 4 18 10 14 16 12 6 0 30 60 90 120 150 180 210 240 270 300 8 Time (min) Plasma Glucose (mmol/l) Results in type 1 patients following test meal Humalog? Used in CSII Reduces Postprandial Blood Glucose Across Studies *dinner postprandial ?dinner 2-hour postprandial ?mean 2-hour postprandial §test meal 2-hour postprandial Mean Postprandial Blood Glucose (mmol/L) Renner et al.* Johansson et al.? Melki et al.? 0.0001 Author Humalog Regular Human Insulin P value 8.3 0.001 8.1 9.6 8.26 9.90 0.001 7.2 Renner R et al. Diabetes Care 1999;22:784-788. Melki V et al. Diabetes Care 1998;21:977-982. Johansson UB et al. Diabetes Metab 2000;26:192-196. Raskin et al.§ 9.64 12.53 0.001 Raskin P et al. J Diabetes Compl 2001;15:295-300. Humalog? Use in CSII Consistently Reduces HbA1c In Clinical Trials Baseline Regular human insulin Humalog HbA1c (%) 6.5 7 7.5 8 8.5 A B C P=0.047 P=0.004 P0.02 C. Renner R et al. Diabetes Care 1999;22:784-788. D. Raskin P et al. Journal of Diabetes Its Complications 2001;15:295-300. A. Johansson UB et al. Diabetes Metab 2000;26:192-196. B. Zinman B et al. Diabetes 1997; 46:440-443. D P=0.004 Humalog? Does Not Increase Hypoglycemia When Used in CSII P value NS Mean Hypoglycemia Rate (episodes/patient/30 days) Renner et al. Johansson et al. Melki et al. NS NS Author Hum