glp-1糖尿病治疗的新希望.ppt

GLP-1
糖尿病患者的新希望
整理课件
糖尿病为进展性疾病，特征表现为：
β细胞功能下降
血糖控制恶化
微血管并发症
大血管并发症风险增加
在控制血糖的治疗中，医生、患者将面临着：
低血糖风险增加
体重增加
复杂的治疗方案
自我监测的需求增加
2型糖尿病治疗面临的挑战
随着时间的延长，血糖控制逐渐恶化
% – upper limit of normal range
Median HbA1c (%)
Conventional*
Glibenclamide
Metformin
Insulin
UKPDS
6
7
8
9
Years from randomisation
2
4
6
8
10
0



Recommended treatment target <%†
8
6

7

Time (years)
0
2
3
4
5
1
ADOPT
Metformin
Glibenclamide
Rosiglitazone
*Diet initially then sulphonylureas, insulin and/or metformin if FPG>15 mmol/L; †ADA clinical practice recommendations. UKPDS 34, n=1704
UKPDS 34. Lancet 1998:352:854–65; Kahn et al (ADOPT). NEJM 2006;355(23):2427–43
体重增加
Glibenclamide (n=277)
Years from randomisation
Insulin (n=409)
Metformin (n=342)
Conventional treatment (n=411); diet initially then sulphonylureas, insulin and/or metformin if FPG >15 mmol/L
UKPDS: up to 8 kg in 12 years
ADOPT: up to kg in 5 years
Weight (kg)
Rosiglitazone, ( to )
Metformin, - (- to -)**
Glibenclamide, - (- to )**
Change in weight (kg)
0
1
5
0
3
6
9
12
8
7
6
4
3
2
Years
0
1
2
3
4
5
96
92
88
0
100
UKPDS 34. Lancet 1998:352:854–65. n=at baseline; Kahn et al (ADOPT). NEJM 2006;355(23):2427–43
低血糖
p< glibenclamide vs. rosiglitazone
Patients with hypoglycaemia** (%)
10
39
0
5
10
15
20
25
30
35
40
45
Rosiglitazone
Metformin
Glibenclamide
12
Hypoglycaemia, events/patient/year*
0
5
10
20
Glargine