糖尿病防治精品医学ppt课件

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1、糖尿病防治孝感市中医医院陈国祥主要内容1：糖尿病的概要2：糖尿病的危害3：糖尿病的治疗1饮食治疗2运动治疗3药物治疗糖尿病的概要ThecategoriesofFPGvaluesareasfollows:FPG<100mg/dl(5.5mmol/l)－正常血糖;FPG>100(5.5mmol/l)and<126mg/dl(7.0mmol/l)－空腹血糖异常（IFG）;FPG>126mg/dl(7.0mmol/l)－糖尿病(thediagnosismustbeconfirmed,asdescribeda

2、bove).ThecorrespondingcategorieswhentheOGTTisusedarethefollowing:2-hpostloadglucose(2-hPG)<140mg/dl(7.8mmol/l)－正常糖耐量2-hPG>140(7.8mmol/l)and<200mg/dl(11.1mmol/l)－糖耐量异常2-hPG>200mg/dl(11.1mmol/l)－糖尿病(thediagnosismustbeconfirmed,asdescribedabove)“狼来了!”,糖尿病

3、.糖尿病-世界21世纪大流行年199419951996200020102025T1DM0.12__0.140.180.24__T2DM0.99__1.181.572.16__总计(亿)1.101.251.321.752.402.99WHO2001糖尿病的危害急性危害糖尿病酮症酸中毒。糖尿病高渗性昏迷。低血糖昏迷。乳酸性酸中毒。糖尿病的慢性危害DiabeticretinopathyLeadingcauseofnewcasesofblindnessamongadults20–74yearsofage

4、DiabeticnephropathyMajorcauseofkidneyfailureCVdiseaseandstrokeDiabeticneuropathyMajorcauseoflowerextremityamputationsAccountforabout65%ofdeathsinpatientswithdiabetes糖尿病的多种系统损害NationalInstituteofDiabetesandDigestiveandKidneyDiseases.NationalDiabetesSt

5、atisticsfactsheet:generalinformationandnationalestimatesondiabetesintheUnitedStates,2005.Bethesda,MD:U.S.DepartmentofHealthandHumanServices,NationalInstituteofHealth,2005.糖尿病患者等同于有过心肌梗塞!DiabetesisCADequivalent!IncidenceDuringFollow-up(%)(n=69)无糖尿病,无心肌

6、梗塞病史无糖尿病,有心肌梗塞病史糖尿病,无心肌梗塞病史糖尿病,有心肌梗塞病史18.8HaffnerSMetal.NEnglJMed.1998;339:229–234.(n=1304)(n=169)(n=890)3.05.07.8323.545.020.2Eventsper100person-yr:P<.001*P<0.001†*NondiabeticswithvswithoutpriorMI.†DiabeticswithvswithoutpriorMI.糖耐量异常病人的死亡危险性增加Diagnos

7、eddiabetes(n=1275)Undiagnoseddiabetes(n=3071)Impairedglucosetolerance(n=2766)*Normalglucosetolerance(n=18,252)*Follow-up(years)Cumulativemortalityhazard(%)DECODEStudyGroup.DiabetesEpidemiology:CollaborativeanalysisOfDiagnosticcriteriainEuropeLancet.199

8、9;354:617-21.*2-houroralglucosetolerancetest(OGTT)IGT=impairedglucosetolerance201000246810DECODE:N=25,364aged≥30years糖尿病的治疗糖尿病发病自然进程NaturalProgressionofInsulinResistanceinPatientswithType2Diabetes1,2NormalglycemiaInsulinresistancerises