型糖尿病当口服药失败时__培训课件.pptVIP

克服胰岛素抵抗 存在于糖尿病治疗中的心理问题越来越受重视 患者与专家共同努力 其它装置和给药途径能使胰岛素的起始治疗容易一些吗？ DAWN 研究 社会支持和良好的情绪对有效地自我保健和血糖控制是至关重要的。 目前的糖尿病保健水平不包括与心理学内容相关的循证成分 改善糖尿病的预后需要将心理支持与医疗措施相结合 牛津国际糖尿病高级会议 恐吓患者的方法适得其反 由于专业人员缺乏心理社会方面的训练，他们在与患者的沟通中常常采用相反的策略，反而推迟了应有的治疗。 对专业人士的培训应该增加心理社会技巧方面的内容 评估现有的医疗性患者教育体系应该根据患者的临床结果和自我感觉。 建立既针对专业保健人员又针对患者的心理社会教育体系。 ? 胰岛素的其它给药方法 胰岛素笔 喷射式注射器 吸入胰岛素 胰岛素是2型糖尿病治疗的基本组分 多数2型糖尿病最终需要胰岛素治疗 已知对使用胰岛素抵触，原因既在于专业保健人员，也在于患者 当在血糖控制和自我感觉方面妥协时就无法开始胰岛素治疗 胰岛素治疗的障碍既可以通过加强糖尿病相关的心理治疗，也可以通过使用新型的胰岛素用药装置或新型胰岛素来克服。 总结和结论 * Title slide * While diet and exercise are essential components in the therapy of any individual with diabetes, they are frequently ineffective in achieving acceptable levels of glycemic control. There is currently no one size fits all ADA diet. The components of the diet are to limit the intake of fat to less than 30% of total calories, to eat regular meals as a way of distributing calories and glycemic excursions over the course of a day, and ensuring adequate intake of fiber. In overweight individuals, a weight loss program that seeks to achieve a loss of 5-15% of current body weight can be useful in restoring euglycemia. Exercise not only promotes weight loss, but also acts as an insulin sensitizer by activating glucose transporters within the myocyte cell membrane, promoting the uptake of glucose. * * * * * * A handling trial has been carried out in the US and the UK. 50 elderly patients in the UK (49 patients in the US) with Type 2 diabetes (on multiple oral agents) and no previous treatment with insulin were questioned on their thoughts about injecting and inhaling insulin. There was a marked preference for inhaled insulin compared to injections. * There is still a considerable gap between patients’ needs and existing products. Although it is clear that the improved glycaemic control achievable with intensive insulin regimens is beneficial to patients, this presupposes that patients will be able to maintain compliance with intensified insulin therapy. Ther