糖尿病新进展ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,#,糖尿病新进展ppt,糖尿病新进展ppt,第1页,提要,改进胰岛微环境治疗糖尿病,糖尿病冠心病患者治疗,性激素与糖尿病,含糖饮料与糖尿病,糖尿病与肿瘤,糖尿病新进展ppt,第2页,改进胰岛微环境治疗糖尿病,糖尿病新进展ppt,第3页,胰岛,细胞代谢,胰腺起源于胚胎时期胰腺背段和腹部胚芽,胰岛,细胞质量动力学改变受代谢原因影响，经过其新生或再生、凋亡或坏死保持动态平衡,成年胰岛正常,细胞是迟缓更新组织，大鼠增生率,3%,左右，其目标反抗,细胞正常丧失、体重增加和胰岛素抵抗功效性负担,糖尿病新进展ppt,第4页,胰岛,细胞质量动力学改变受代谢原因影响，经过其新生或再生、凋亡或坏死保持动态平衡，而当凋亡占优势时,细胞急剧降低,功效缺点,造成,2,型糖尿病发生。,阻止,细胞破坏、促进,细胞再生长是治疗糖尿病主要办法。,糖尿病新进展ppt,第5页,胰岛微环境,葡萄糖毒性,血管内皮细胞功效紊乱,炎症因子,胰岛,细胞,凋亡,脂代谢紊乱,氧化应激,(,线粒体、内质网）,胰淀粉素,糖尿病新进展ppt,第6页,恢复,细胞数量,改进胰岛素抵抗：噻唑烷二酮、二甲双胍调脂、降压,早期胰岛素治疗,抗氧化应激,GLP-1,及类似物,PDX-1,干细胞移植,其它移植,糖尿病新进展ppt,第7页,骨髓干细胞移植,起源于骨髓干细胞在患者胰岛微环境中可促进内源性,细胞团再生,糖尿病新进展ppt,第8页,Case 1,男,46,病史,4,年,BMI 25.6,其母有,DM,口服药,胰岛素,格化止,0.5tid,，拜唐苹,50mg tid,文迪亚,4mg qd,R 4u 4u 4u,，来得时,12u,格化止,0.25tid,，拜唐苹,50mg tid,文迪亚,4mg qd,来得时,12u,拜唐苹,50mg tid,文迪亚,4mg qd,来得时,14u,拜唐苹,50mg tid,文迪亚,4mg qd,来得时,10u,拜唐苹,50mg bid,文迪亚,4mg qd,来得时,10,u,文迪亚,4mg qd,停,文迪亚,4mg qd,停,糖尿病新进展ppt,第9页,糖尿病新进展ppt,第10页,糖尿病新进展ppt,第11页,糖尿病新进展ppt,第12页,糖尿病新进展ppt,第13页,糖尿病新进展ppt,第14页,糖尿病新进展ppt,第15页,C-Peptide Levels and Insulin IndependenceFollowing Autologous NonmyeloablativeHematopoietic Stem Cell Transplantationin Newly Diagnosed Type 1 Diabetes Mellitus,糖尿病新进展ppt,第16页,JAMA.;301(15):1573-1579,糖尿病新进展ppt,第17页,糖尿病新进展ppt,第18页,糖尿病冠心病患者治疗,糖尿病新进展ppt,第19页,A Randomized Trial of Therapies for Type 2 Diabetesand Coronary Artery Disease,First hypothesis was that prompt revascularization,(either surgical or catheter-based)would reduce long-term rates of death and cardiovascular events,as compared with medical therapy alone.,Second hypothesis was that a strategy of insulin sensitization(with a targetlevel for glycated hemoglobin of less than 7.0%)would reduce long-term rates of death and cardiovascular,events,as compared with a strategy of insulin provision,N Engl J Med;360:2503-15,.,糖尿病新进展ppt,第20页,糖尿病新进展ppt,第21页,糖尿病新进展ppt,第22页,糖尿病新进展ppt,第23页,糖尿病新进展ppt,第24页,糖尿病新进展ppt,第25页,糖尿病新进展ppt,第26页,性激素与糖尿病,糖尿病新进展ppt,第27页,Sex HormoneBinding Globulin andRisk of Type 2 Diabetes in Women and Men,Hormonebinding globulin(SHBG)was thought to be the binding of circulating hormones,SHBG may directly mediate cell-surface signaling,cellular delivery,maintenance of glucose homeostasis.,糖尿病新进展ppt,第28页,Study Population,The Womens Health Study,begun in 1993,is a randomized,double-blind,placebo-controlled,2-by-2 factorial study of low-dose aspirin and vitamin,E for the primary prevention of cardiovascular disease and cancer in 39,876 female health professionals in the United States who,at enrollment,were 45 years of age or older and did not have diabetes,During a 10-year follow-up period,糖尿病新进展ppt,第29页,糖尿病新进展ppt,第30页,糖尿病新进展ppt,第31页,