课件：2型糖尿病的一体化治疗方案.ppt

2型糖尿病的胰岛素替代治疗 Beta细胞功能 时间 (年) 诊断 口服药治疗 胰岛素补充治疗 胰岛素替代治疗 胰岛素强化治疗 诺和锐30每日三次 诺和锐+诺和平 胰岛素泵 诺和龙单用 诺和龙+二甲双胍/TZD/阿卡波糖 OAD（诺和龙+二甲双胍/TZD/阿卡波糖）+诺和平 OAD+诺和灵30R/50R/锐30 诺和灵30R/50R/锐30 bid 诺和锐30每日三次 诺和锐+诺和平 胰岛素泵 总结 中国2型糖尿病现状令人担忧； 多种循证医学研究都提示应该尽早强化降糖，以减少糖尿病各种并发症； 2型糖尿病的治疗依赖胰岛B细胞功能。 * IDF 2009年发表的数据显示，到2010年全球糖尿病患者将达到2.85亿，而预计在2030年全球糖尿病患者人数将高达4.38亿，较2010年增长了近65%。 亚洲增长91%,北美洲增长59%，南美洲增长88%，非洲增长98%，大洋洲近59%，欧洲增长16%等。 * * HbA1c 10 years change * Response rate of PPG is lower than that of FPG. * 在北京, 上海, 天津, 重庆4个省市的10家中心医院，调查了3469例住院的2型患者慢性血管并发症的发病率及危险因素。 OBJECTIVE: To provide an epidemiological description and risk factors of chronic vascular complications of type 2 diabetic in-patients in four municipalities including Beijing, Shanghai, Tianjin, and Chongqing. METHODS: Data of the study came from 3,469 Type 2 diabetic in-patients from 1991 to 2000 in 10 medical centers of Beijing, Shanghai, Tianjin, and Chongqing. A variety of parameters of in-patients were evaluated retrospectively to know the prevalence and risk factors of chronic vascular complications in the study patients. RESULTS: Overall, the detailed prevalence of chronic vascular complications is listed as follows: diabetic retinopathy 31.5%, diabetic nephropathy 39.7%, diabetic neuropathy 51.1%, hypertension 41.8%, coronary heart disease (CHD) 25.1%, cerebral vascular disease (CVD) 17.3%, vessel complication of lower limbs 9.3%. Multivariate logistic regression analysis shows that diabetes family history, duration of diabetes ( 5 years), and systolic blood pressure ( 125 mmHg) are the risk factors for diabetic retinopathy; duration of diabetes ( 5 years), systolic blood pressure ( 125 mmHg), LDL-C ( 3.12 mmol/L), and triglyceride ( 1.70 mmol/L) are the risk factors for diabetic nephropathy; age ( 45 years), duration of diabetes ( 5 years), HbA1C ( 7.0%), systolic blood pressure ( 125 mmHg), and LDL-C ( 3.12 mmol/L), are the risk factors for CHD; age ( 45 years), duration of diabetes ( 5 years), systolic blood pressur