Drug induced diabetes mellitus ppt, A cukorbetegség kezelése. dr. Hosszúfalusi Nóra Semmelweis Egyetem III. sz. Belgyógyászati Klinika
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Intenzív konzervatív inzulin terápia napi többszöri inzulin injekció: a főétkezések előtt gyorshatású, éjszaka és esetleg reggel is elhúzódó hatású inzulin adása 2. Folyamatos inzulinadás pumpa segítségével 3. Kivárás a sc. A betegség természete, szövődményei, az optimális beállítás előnyei.
Soronkívüli étkezés társasági vacsora, fogadás, stb. De: tökéletes bázisinzulin kell! McKeage K et al.
Az előadások a következő témára: "Cardiovascularis kockázatcsökkentés a diabetológus szemével"— Előadás másolata: 1 Cardiovascularis kockázatcsökkentés a diabetológus szemével Balatonaliga, május The Verona Diabetes Complications Study showed that, in diabetic and non-diabetic subjects, insulin resistance is associated with several cardiovascular risk factors, including hyperglycaemia, dyslipidaemia and hypertension. The study identified insulin resistance as an independent risk factor for cardiovascular disease. HDL cholesterol concentrations are increased and there is a preponderence of small dense, atherogenic, LDL particles in patients. PAI-1 plasminogen activator inhibitor-1 : PAI-1 is a major regulator of plasminogen activation and plays an important role in blood clotting.
Kramer W. Exp Clin Endocrinol Diabetes. New approaches to the treatment of diabetes.
Bridgewater, NJ: Aventis Pharmaceuticals; Insulin glargine: a új gyógyszerek típusú cukorbetegség 2 of its therapeutic use as a long-acting agent for the management of type 1 and type 2 diabetes mellitus.
Pharmacokinetics and dynamics of s. Abstract Less hypoglycaemia with insulin glargine in intensive insulin therapy for type 1 diabetes. Diabetes Care. Insulin glargine: a review of its therapeutic use as a long-lasting agent for the management of type 1 and type 2 diabetes mellitus. Treatment to target study: insulin glargine vs NPH insulin added to oral therapy of type 2 diabetes.
Diabetes Drugs Made Simple
Successful control with less nocturnal hypoglycemia. Abstract P. Insulin glargine. The second profile shows, a more desirable profile with less fluctuations around the overall mean level References Russell-Jones Drug induced diabetes mellitus ppt et al.
Accepted for publication, Clinical Therapeutics 20 15 10 5 Russell-Jones D et al. References Russell-Jones D et al.
Clinical Therapeutics 29 Pancreas és Langerhans-sziget transzplantáció Kérdés: a DM vagy az immunszuppresszív kezelés veszélyei a nagyobbak? Így a dominánsan inzulinrezisztens, túlsúlyos betegeknél az inzulinsensitizerek biguanidok és glitazonok alkalmazása javasolt elsődlegesen — testre szabott kezelés.
Referenciák 1. Henry RR. Jones TA et al. Diabet Obes Metab ; 5: — Viberti GC. Int J Clin Pract ; — Insulin-sensitizer should be preferred Insulin secretagog is preferred? Non-secretagog készítmények I. Alpha-glucosidase-hydroxylase gátlók Acarbose, Miglitol B.
Insulin secretagog készítmények I. Sulfanylureák II. Meglitinid származékok pl. D-Phenylalanin származékok pl. DPP-4 dipeptidyl-peptidase-4 gátlók un. Rosiglitazon és pioglitazon nem [alig] hepatotoxikus testsúly növekedés, folyadék retenció!
Átírás 1 A cukorbetegség kezelése dr. Type 1 diabetes due to autoimmune b-cell destruction, usually leading to absolute insulin deficiency 2. Type 2 diabetes due to a progressive loss of b-cell insulin secretion frequently on the background of insulin resistance 3. Gestational diabetes mellitus GDM diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation 4.
Rosiglitazon mellett EKG sz. Hosszútávú hatékonyság főleg kombinációban jó Kombinálhatók: sulfanylurea készítményekkel és az újabb secretagog gyógyszerekkel is kombinálhatók elvben metforminnal is, de: GI mellékhatások hasonlóak!
A cukorbetegség kezelése
Glibenclamide kifejezetten elnyújtott hatás hypoglyk. Six young healthy subjects were given a 25, 50, or g oral glucose load or isoglycaemic intravenous glucose infusions. The g data is shown above. C-peptide may be a better measure of insulin secretion than plasma insulin, because C-peptide levels are not affected by hepatic insulin extraction.
This difference in C-peptide levels in response to oral vs intravenous glucose suggests that other factors incretinsand not merely the direct actions of plasma glucose, affect the insulin secretory response.
Incretin Effect 5. Nauck MA, et al. Incretin effects of increasing glucose loads in man calculated from venous insulin and C-peptide responses.
J Clin Endocrinol Drug induced diabetes mellitus ppt. It demonstrated that after a meal, Glucose began to rise. Baseline level was 83 ± 1. Glucose returned to baseline levels by minutes. Insulin followed a similar pattern. Glucagon, however, dropped to a low by 90 minutes, then increased to a level above that of the baseline level.
Adapted from Woerle HJ et al. Am J Physiol Endocrinol Metab. Reference: 1.
Pathways for glucose disposal after meal ingestion in humans. These abnormalities contribute markedly to hyperglycemia both at the level of body tissues where insulin is not sufficient to drive glucose uptake and at the level of the liver where increased glucagon and decreased insulin cause the liver to inappropriately release glucose into the blood, thereby causing fasting hyperglycemia or increasing postprandial hyperglycemia.
Adapted from Müller WA et al. N Engl J Med. References: 1. Abnormal alpha-cell function in diabetes. Response to carbohydrate and protein ingestion.
Del Prato S. Loss of early insulin secretion leads to postprandial hyperglycemia. J Clin Invest. Adapted from Lebovitz HE et al. Their blood glucose levels were monitored throughout the infusion period. However, GLP-1 infusion induced a significant reduction of both overnight from 7. Islets were maintained in culture for five days in the presence or absence of GLP At day 1, islets maintained their physiologic spherical shape panel A. By day 3, many islets showed a progressive loss of structure, losing the acellular membrane that surrounds them panel C.
At day 5, the three-dimensional structure of many cell aggregates had deteriorated to a two-dimensional structure typical of a cell monolayer panel E. In contrast, islets treated with GLP-1 retained their three-dimensional organization for a longer period of time panels B, D, and F. Reference 1. Glucagon-like peptide inhibits cell apoptosis and improves glucose responsiveness of freshly isolated human islets.
Endocrinology ;— Beta-cell mass and pancreatic functions were assessed on Day 7 and at 2 months.
Results from the GLP-1 injection are shown here. The GK rat is a genetic model of type 2 diabetes in which basal drug induced diabetes mellitus ppt is first detectable three weeks after birth. The histological sections of rat pancreas were immunostained for insulin using a peroxidase indirect labeling technique.
Vilsbøll T et al. The terminal half-life of exenatide ranges from ~ hours. Exenatide shares some of the glucoregulatory effects with endogenous GLP Regulatory Peptides. GLP -amide was injected at four different doses: 0. GLP-1 half-life values ranged from 4.
Exendin-4 half-life values ranged from 90 ± 3 min to ± 13 min. Its longer plasma half-life may render exendin-4 an attractive prospect for the treatment of diabetes.
Adapted from Parkes D, et al. Drug Dev Res. Diabetesben a DPP-4 enzimek működése fokozott így lecsökken az aktivált inkretinek mennyisége, és felborul a CH-háztartás egyensúlya.
Az inkretinek a pancreas alfa és béta sejtjeire egyaránt hatnak. A korábban alkalmazott OAD-ok csak a béta sejt funkciót javították inzulin termelés, vagy inzulin iránti érzékenység fokozódás. A Galvus és az Eucreas azonban hat az alfa sejtekre is, csökkentve a glikagon termelést.
Ezen kettős, fiziológiás hatás vezet a CH egyensúly létrejöttéhez. Abstract OR. Adapted from Deacon CF, et al. Eligible patients were either not on antihyperglycemic therapy HbA1c 6.
Mean baseline HbA1c levels ranged from 7.
Látták: Átírás 1 Glükóz és HbA1c módszerek bizonyítékokon alapuló alkalmazása diabetes mellitus laboratóriumi diagnosztikájában és gondozásában. American Diabetes Association Hátterében az inzulin szekréció defektusa vagy szöveteken való hatástalansága vagy mindkettő állhat. Classification and Diagnosis.
Modified intent-to-treat, last-observation-carried-forward LOCF analysis of results for placebo-subtracted changes from baseline at week Adapted from Herman GA et al. Poster P. The slide shows this pattern in the group on sitagliptin mg QD according to the per-protocol analysis of completers without data carried forward non-LOCF.
- Kezelése 2 típusú diabetes mellitus hagyományos módszerekkel
- Necrobiosis lipoidica causes
- Cardiovascularis kockázatcsökkentés a diabetológus szemével - ppt letölteni
- A cukorbetegség kezelése - ppt letölteni
- Стратмор пожал плечами: - Так или иначе, уже слишком поздно.
- Это невозможно.
A greater reduction 0. The greatest reduction 1. The investigators enrolled 28 patients with type 2 diabetes and inadequate glycemic control mean baseline HbA1c 7. Patients were randomized to receive 4 weeks of therapy with either placebo plus the prior dose of metformin, or sitagliptin 50 mg BID plus the prior dose of metformin period 1. At the end of period 1, patients underwent hour blood sampling and then were crossed over to the alternate regimen for 4 weeks period 2.
Cardiovascularis kockázatcsökkentés a diabetológus szemével
The primary efficacy endpoint was hour weighted mean glucose WMG ; secondary endpoints included mean daily glucose and FPG. Safety was also assessed in the trial. Among patients who received sitagliptin during period 1, a substantial carryover effect was seen during placebo drug induced diabetes mellitus ppt in period 2. Because the results from period 1 were not confounded by the carryover effect, these data are presented on the slide. Importantly, glucose levels were reduced throughout the day during both the postprandial and fasting periods.
A cukorbetegség kezelése. dr. Hosszúfalusi Nóra Semmelweis Egyetem III. sz. Belgyógyászati Klinika
Adapted from Brazg RL et al. Effect of adding MK to on-going metformin therapy in type 2 diabetic patients who have inadequate glycemic drug induced diabetes mellitus ppt on metformin.
Protocol MF mg b.
