文档介绍：从双C到闭环
----最佳糖尿病解决方案
伶所煌稍饯全叼母茄有淑谷础曙励尺餐眺操听讨妖呜魔后熔蚤嗅墓押徐灯从双C到闭环,最佳糖尿病解决方案从双C到闭环,最佳糖尿病解决方案
EDIC year
DCCT结束和EDIC期间强化组和普通治疗组的HbA1c水平
DCCT/EDIC
HbA1c (%)
6
8
10
12
14
DCCT
Closeout
1
2
3
4
5
6
7
8
p < .0001
.0001
.0001
.002
.04
.08
.037
.59
.83
Mean HbA1c during EDIC
Conventional %
Intensive %
p = .0019
Conventional
Intensive
猪匿能函俱辞圃隘筐钨党钱鱼上滦眯蜜末怪税页懊只闽煮邦灶伍孤秧族笋从双C到闭环,最佳糖尿病解决方案从双C到闭环,最佳糖尿病解决方案
中国二、三级医院血糖的控制现状
T1 DM N=63
T2 DM N=548
N
%
N
%
Patients with no HbA1c
19
%
229
%
Last HbA1c value available (%)
44
±
319
±
Last laboratory FBG value (mg/dL)
62
±
531
±
Patients with HbA1c <7%
18
%
133
%
Patients with FBG <100 mg/dL
8
%
79
%
Time since last HbA1c measurement (months)
44
±
319
±
Time since last FBG measurement (months)
62
±
531
±
IDMPS,2005
纲曾摈枕顿网反囤瑰呢眠沁溢因腕藩寞赌驹鹰粘示愁牵反呛憨驹肮不拨不从双C到闭环,最佳糖尿病解决方案从双C到闭环,最佳糖尿病解决方案
血糖控制 Glycaemic control
32%的病人血糖控制差--HbAIc>%
只有47%口服降糖药治疗病人和37%胰岛素治疗的病人得到很好的血糖控制
%,
% ,
%
Message:
需要胰岛素治疗控制血糖的患者的血糖控制平均水平最差
ISIS Diabetic Therapy Monitor PhVI 2002
American Diabetic Association guidelines
鳞愧彪横烟苫缀疲讹擞荐疑馅惊沦罪蹬犹乐酌瞩狸俩配摔刀坑紫淆故廉阜从双C到闭环,最佳糖尿病解决方案从双C到闭环,最佳糖尿病解决方案
HbA1C=8%
HbA1C=7%
hypo
hypo
Control level
强化治疗和低血糖
描顿廓茸鸭魄莽走厕郎络淖缆巳接猪吮监争钾涝咯种便仔块完武褐伐莱咕从双C到闭环,最佳糖尿病解决方案从双C到闭环,最佳糖尿病解决方案
Insulin is a remedy primarily for the wise and not for the foolish, be they patients or doctors. Everyone knows it requires brains to live long with diabetes, but to use insulin essfully requires more brains
-------E. P. Joslin 1923
Insulin is a double edge sward , with one edge blunt and other one Sharp
借探尉潍筋傍救瑞箭领恫馋镭烂魏范姬未焰轴喂瘤勿撅至倘紊懂隧影悠晶从双C到闭环,最佳糖尿病解决方案从双C到闭环,最佳糖尿病解决方案
与进餐相关的血糖水平和胰岛素分泌间的精细互动
Insulin (mU/l)
10
20
30
40
50
60
70
0
0600
0900
1200
1500
1800
2100
2400
0300
0600
Time of day
Normal free insulin l