型糖尿病早防早控要点.ppt

2型糖尿病早防早控目录?“代谢记忆效应”-早期干预血糖的获益?早期干预高血糖使心血管获益成为可能?早期诊断的方法—早期血糖干预前移降糖治疗与血管并发症的关系?% 能否带来更多获益?更多获益?((HbA1c HbA1c % %降到降到 7%) 7%)ORD---ADVANCE---VADTVADT? %? %?%%%%%%%ORDADVANCE强化组HbA1cADVANCE/ACCORD/VADT研究不同的降糖达标策略Downloaded from December 18, 2008 The Action to Control Cardiovascular Risk in Diabetes Study Group*N ENGL J MED 358:2545-2559, 2008 The ADVANCE Collaborative Group,N ENGL J MED 2008,358:2560-72603%1140%%VADT6239%1035%%ACCORD6642%832%%ADVANCE5339%*%年龄(岁)女性病程(年)CVD病史收缩压mmHgHbA1c%胆固醇mol/LBMI kg/m2当前抽烟UKPDS特征* Calculated HbA1cADVANCE/ACCORD/VADT研究针对的病人群不同于UKPDS研究Downloaded from December 18, 2008 The Action to Control Cardiovascular Risk in Diabetes Study Group*N ENGL J MED 358:2545-2559, 2008 The ADVANCE Collaborative Group,N ENGL J MED 2008,358:2560-72-_21%肾脏事件p===-_P=%10%10%主要终点RRRp===%22%7%全因死亡率RRRP===%35%12%ORD研究ADVANCE研究ADVANCE/ACCORD/VADT研究Downloaded from December 18, 2008 The Action to Control Cardiovascular Risk in Diabetes Study Group*N ENGL J MED 358:2545-2559, 2008 The ADVANCE Collaborative Group,N ENGL J MED 2008,358:2560-72Derived from presentations by: Bob Byington, PhD; PI, ACCORD Coordinating Center; Wake Forest University School of MedicineHertzel Gerstein, MD; Chair, Glycemia Working Group; McMaster UniversityWilliam C. Cushman, MD; Chair, Blood Pressure Working Group; Memphis Veterans Affairs Medical CenterHenry Ginsberg, MD; Chair, Lipid Working Group; Columbia UniversityCharleston, SC; January 2003一片哗然声中,ORD/VADT/ADVANCE揭示安全降糖达标的重要性安全降糖达标的关键因素合理的降糖方案避免严重低血糖避免体重明显增加?关注降糖药物的心脏安全性EASD Plenary Session