?????? ?????????-Insulin resistance

1
(No Transcript)
2
(No Transcript)
3
????????????

• ?-150 ????? ??? ?????? ????? ??? 2 ?????.
• ???? ?? ???? ??????? ????? ?????? ?? ???? ?? ???
  2025, ??? ?????? ???? ?? ????? ???.

4
?????? ?????????-Insulin resistance
????? ??? ?? ?????? ????????? ???? ???????
????? ????????? ??????? ?? ???????.
5
(No Transcript)
6
Normal physiology of glucose homeostasis
Carbohydrate
Gut
Digestive enzymes
Regulation of lipolysis
Pancreas
Blood Glucose
Insulin
Adiposetissue
hepatic glucose production and storage of
glycogen
Muscle
Liver
Insulin-stimulated glucose uptake
7
Abnormal physiology of glucose homeostasis
Carbohydrate
Compensatory Increase in Insulin secretion
Gut
Digestive enzymes
Excessive fat Breakdown Leading to increase in
free Fatty acids
Pancreas
Blood Glucose
Insulin
Adiposetissue
Excess Glucose production
Muscle
Liver
Decrease insulin-dependent glucose uptake
8
The natural history of insulin resistance,
progressing from impaired glucose tolerance to
overt type 2 diabetes.
9
The natural history of insulin resistance,
progressing from impaired glucose tolerance to
overt type 2 diabetes.
10

• ??????? ??????? ????????? ?????? ??? 2
• ?????? ??????.
• ?????? ???????? ????? ??????? ??????.

11
(No Transcript)
12
(No Transcript)
13

• .

??????? ????????? ??????? ????????? ?????? ??? 2
14
The insulin resistance syndrome and its components
Central/abdominal obesity
Hyperinsulinemia
Type 2 diabetes
Insulin resistance syndrome
Coronary heart disease
Hypertension
Dyslipidemia
Groop et al. Front Horm Res 1997 22131156.
15
?????? ?????????

• ???? ??? ?? ?? ????? ????? ???? ???????
  ??????????
• ???? ?????????? ??? ??????? ??????? ???????
  ??????.

16
(No Transcript)
17
Stepped management of type 2 diabetes
18
Commonly-used oral anti-diabetic agents

• Sulfonylureas glibenclamide
• Thiazolidinediones - avandia
• Biguanides metformin
• a-Glucosidase inhibitors acarbose

19
(No Transcript)
20

• ????? ?????? ?????. v
• 2. ???? ?????? ??????? ??????? v
• 3. ????? ??? 1 v
• ?????
• ????? ?????????
• ??????
• ?????
• ???????
• 4. ????? ??? 2 v
• ??????? ????? ??? 2
• ?????? ????????? ??????? ?????? ??????.
• ?????? ??????? ?????????.
• ???????
• ????? ??????
• 5. ??????? ???? ??????? ?????????.