9-胰島素泵治療介绍.ppt

胰岛素泵治疗;内容 ;为什么血糖要保持在正常范围内？;糖尿病的发病率;*Based on DCCT data Skyler J. Endocrinol Metab Clin North Am. 1996;25:243-254. ;OAD + 基础胰岛素;胰岛素强化治疗;胰岛素泵的应用背景;胰岛素泵的应用背景;强化治疗对糖尿病并发症的相关风险性;Skyler, J: Chronic Complications of Diabetes Endo Met Cl N Am, vol 25, 2, p.243- 254, June 1996 Adapted from DCCT Research Group: N England Journal of Medicine. 1993;329:977-986. *Endocrine Practice 2002, 8 (supp 1), pg. 7. AACE recommends less than or equal to 6.5 HbA1c. Minshall M, Roze S, Palmer A, et al. Treating diabetes to accepted standards of care: a 10-year projection of the estimated economic and health impact in patients with type 1 and type 2 diabetes in the US. Clin Ther. 2005;27:940–950.;EDIC —— 1型糖尿病和心血管事件;0.12;a;EDIC —— 1型糖尿病和心血管事件;;Stratton IM, et al. BMJ. 2000;321:405-412.;UKPDS流行病学资料 2型糖尿病患者A1C 和并发症风险;*AAFP: goals for self-monitoring of blood glucose. American Diabetes Association. Diabetes Care. 2003;26(suppl 1):S33–S50. American College of Endocrinology. Endocr Pract. 2002;8(suppl 1):40–82. American Academy of Family Physicians. SMBG monograph. Available at: /smbgmonograph.xml. Accessed October 13, 2004.;;胰岛素泵的发展历史及应用背景;糖尿病治疗的历史;常规治疗（ ICT ） 小于3次的固定胰岛素剂量注射 每日多次注射（MDI） 每日3次以上的胰岛素注射 高血糖时额外注射胰岛素来校正 用注射来调整基础率/大剂量 用中长效胰岛素补充基础率如 glargine,NPH,ultralente等 用短效胰岛素来对付餐前大剂量和高血糖 用胰岛素泵来调整基础率/大剂量（CSII） 灵活的基础率设置 可调的餐前大剂量 ;什么是胰岛素泵……;胰岛素泵技术的发展 ;胰岛素泵（Insulin Pump）;胰岛素泵的使用原理;健康的胰腺自动释放胰岛素，平均每10－14分钟，释放的数量契合体内血糖水平的变化.;传统治疗:NPH 和短效胰岛素;强化治疗:  来得时联合速效胰岛素每天多次注射;1. Lauritzen T, Pramming S, Deckert T, Binder C. Pharmacokinetics of Continuous Subcutaneous Insulin Infusion. Diabetologia 1983; 24: 326-9. Scholtz HE, et al. An assessment of the variability in the pharmacodynamics (glucose lowering effect) of HOE901 (glargine-Lantus) compared to NPH and ultralente human insulins using the euglycaemic clamp technique. Abstract 0882. Poster Event D: 1999, Brussels, Belgium. 2. Time Activity Profiles of Lilly Insulins. /using_insulin/what_types_of_insulin.jsp Note: Schematic representation only.;注