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1、糖尿病发病机理与治疗药物进展南京中医药大学国家规范化中药药理实验室朱荃AphorismWehavetwoendswithacommonlink; Withonewesit,withonewethink. Successdependsonwhichweuse; Headswewin,tailswelose!--Authorunknown荷兰50岁以上糖尿病的病死率前言我國的發病情況中國80年代<1%,目前升到3.6-5%，其中60歲以上達6%，發病人數也由80年代的6百萬目前增加到3千萬。老年糖尿病患者中90%以上為2型糖尿病.截今為止，
2、該病尚無根治的辦法.近年來許多國家崇尚自然療法，中醫藥日益受到青睞.胰岛素的发现C.H.Best.Banting'sandBest'sexperimentswerecrudelyconductedanddidnotsubstantiateBanting'sidea,whichwasphysiologicallyincorrect.Buttheirapparentlyfavourableresultsencouragedgreaterefforts,whichculminatedinthewinterof1921-22inthedisco
3、veryofinsulinbyateamofresearchersthatincludedMacleod,Banting,J.B.CollipandBest.人类第一次用胰腺提取物治疗糖尿病----多伦多大学年轻学者Banting,SirFrederickGrant 等,在狗实验成功的基础上完成的nightof31Oct1920胰岛素的发现者们结构胰岛素的空间构型胰岛β细胞分泌胰岛素IsletsofLangerhans,specializedcellslocatedinhumanpancreasthatsecreteinsulin,gl
4、ucagon,andgastrin.Pancreas胰岛素的药理作用糖代谢增加葡萄糖的转运氧化和酵解促进糖原的合成与贮存，抑制糖原分解和异生胰岛素受体与葡萄糖葡萄糖的氧化与酵解胰岛素的药理作用脂肪代谢增加脂肪酸的转运，促进脂肪合成抑制其分解，减少游离脂肪酸和酮体的生成胰岛素的药理作用蛋白质代谢增加氨基酸的转运和蛋白质的合成抑制蛋白质的分解胰岛素的药理作用胰岛素的药理作用胰岛素的药理作用胰岛素的药理作用一、二型糖尿病对葡萄糖的利用Resistin,Obesity,andInsulinResistance—TheEmergingRoleof
5、theAdipocyteasanEndocrineOrganWhyhastheincidenceoftype2diabetesincreasedsorapidly?Considerableepidemiologicevidencepointstoexcesscaloricintakeandphysicalinactivityasthemajorreasons.Achronicimbalancebetweenenergyexpenditureandenergyintakecausesobesity,whichisoneofthemostp
6、otentriskfactorsforinsulinresistanceandtype2diabetes.Adipocyte--thepathwaysresponsibleforenergybalanceRecentstudieshavetransformedourthinkingabouttheadipocyte.Itisnolongerregardedasapassivedepotforstoringexcessenergyintheformoftriglyceride,butasacellthatactivelyregulates
7、thepathwaysresponsibleforenergybalanceandwhoseactivityiscontrolledbyacomplexnetworkofhormonalandneuronalsignals(Figure1).Indeed,theadipocytesecreteschemicalmessengersthatincludeleptin,tumornecrosisfactor,angiotensinogen,andadiponectin.2leptinissecretedbytriglyceride-lade
8、nadipocytes,travelsthroughthecirculation,crossestheblood–brainbarrier,andreachesthehypothalamus,whereit
