糖尿病的胰岛素治疗.ppt

**??NovoRapid?hasadvantagesoversolublehumaninsulinforsolvingvarioustypesofproblemsThedecisiontoswitchto,orstart,NovoRapid?maybemadewithaviewtoimprovingglycaemiccontrol,reducinghypoglycaemia,orremovingrestrictionsindietorlifestyle,dependingontheneedsoftheindividualPostprandialhyperglycaemiaisoftenundetected,sinceclinicalmeasurementsareroutinelyperformedinthefastingstateandpatientsmaynotroutinelymeasuretheirbloodglucoseaftermeals.However,somepatientshaveelevatedHbA1clevelsdespitenormalormildlyelevatedFPGlevels,andothersmayhavepostprandialhyperglycaemiainconjunctionwithnormalHbA1clevels.Intheseindividuals,undetectedpostprandialhyperglycaemiaispossibleand,aftercheckingthepatientisadheringtotheirexistingmedicationregimen,NovoRapid?therapyshouldbeconsidered.?TherapidonsetandshortdurationofactionofNovoRapid?givebettercontrolofPPGexcursionsthansolublehumaninsulininType1diabetes.PPGexcursionsareupto38%lowerwithNovoRapid?thanwithsolublehumaninsulininjected30minutesbeforemeals,whencomparedona1:1unitbasis(p0.02).TheresultingPPGvalueis1.5mmol/l(27mg/dl)lower.Therefore,patientswithType1diabeteswhohavepostprandialhyperglycaemiaaregoodcandidatesforNovoRapid?therapy**UsingNovoRapid?inpeoplewithType2diabetesNovoRapid?isasuitablebolusinsulinforpeoplewithType2diabeteswhoarestartingorchangingtothree-times-dailymeal-relatedinsulintherapyorwhorequirebasal-bolustreatment.Giventhreetimesdailywithmeals,NovoRapid?canimproveglycaemiccontrolbeyondthatofmaximumOHAtherapyandmaybeofparticularbenefitinpatientswhohavedifficultymanagingcertainaspectsoftheirlifestyle.PPGcontrolwithNovoRapid?issuperiortothatobtainedwithsolublehumaninsulin**Basal-bolustherapyofferstheinterestedandinformedpatienttheopt