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1、PostPrandialHyperglycemia: ASignificantCardiovascularRiskFactor&TreatablePrecedentofType2DiabetesDiagnosticCriteriaforType2DMPathophysiologyoftype2DMPostPrandialHyperglycemia(PPH)anddiabeticcomplicationsPreventionofType2DMTheincreasingglobalburdenofdiabetesPopulati
2、onaged>20years KingH,etal.DiabetesCare1998;21:1414–31.DevelopedcountriesDeveloping countriesWorld totalPrevalence(%)0246820252000CVDdrivestheeconomicburdenoftype2diabetesCVD:cardiovasculardisease NicholsGA,BrownJB.DiabetesCare2002;25:482–6. Copyright©2002AmericanDi
3、abetesAssociation;reprintedwithpermissionfrom TheAmericanDiabetesAssociation.1086420Costin1999(x1,000US$)NoCVD, nodiabetesn=13,286NoCVD, diabetesn=11,130CVD,nodiabetesn=2,894CVDand diabetesn=5,050$2,562$4,402$6,396$10,17231.9%48.1%20.0%28.6%40.3%31.2%17.2%31.8%51.0
4、%21.1%28.0%50.9%PharmacyOutpatientInpatientPathophysiologyoftype2diabetesJankaHU.FortschrMed1992;110:637–41.Macro- vascular diseaseInsulinsensitivityInsulinsecretionPlasmaglucoseMicro- vascular diseaseImpairedglucosetoleranceHyperglycemiaDiagnosingglucoseintoleranc
5、e– criteriareflectaneedforearlyintervention*Determinedpost75gglucoseload 2h-PG:2-hourpostchallengeplasmaglucose,FPG:fastingplasmaglucose,IFG:impairedfastingglucose,IGT:impairedglucosetolerance WorldHealthOrganization,1999.DiagnosisVenousplasma glucoseconcentration
6、(mmol/L)DiabetesFPGor>7.02h-PG*>11.1IGTFPG(ifmeasured)and<7.02h-PG*>7.8and<11.1IFGFPGand>6.1and<7.02h-PG*(ifmeasured)<7.8FPGand2h-PGvaluesidentify differentpeoplewithdiabetes2h-PG:2-hourpostchallengeplasmaglucose,FPG:fastingplasmaglucose DECODEStudyGroup.BMJ1998;31
7、7:371–5.FPG 40%BothFPGand 2h-PG 28%Younger,moreobese peopleOlder,leaner people2h-PG 32%TheRelativeContributionofFPGandMealtimeGlucoseSpikesto24-hourGlycemicLevelRiddleMC.DiabetesCare1990;13:676–6863002001000Plasmaglucose(mg/dl)06001200180024000600Time(hours)Mealt
8、ime glucose spikesFasting hyperglycemiaNormalKuusistoetal,1994GlycemicControlandCHDCHDMortalityAllCHDEventsAComparisonofHba1cLevelsAchievedintheC
