1、Post Prandial Hyperglycemia: A Significant Cardiovascular Risk Factor 21:141431.Developed countriesDevelopingcountriesWorldtotalPrevalence (%)0246820252000CVD drives the economic burden of type 2 diabetesCVD: cardiovascular diseaseNichols GA, Brown JB. Diabetes Care 2002;25:4826.Copyright 2002 Ameri
2、can Diabetes Association; reprinted with permission from The American Diabetes Association.1086420Cost in 1999 (x1,000 US$)No CVD,no diabetesn=13,286No CVD,diabetesn=11,130CVD,no diabetesn=2,894CVD anddiabetesn=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%21.1%28.0%50.9
3、%PharmacyOutpatientInpatientPathophysiology of type 2 diabetesJanka HU. Fortschr Med 1992;110:63741.Macro-vasculardiseaseInsulin sensitivityInsulin secretionPlasma glucoseMicro-vasculardiseaseImpaired glucose tolerance HyperglycemiaDiagnosing glucose intolerance criteria reflect a need for early int
4、ervention*Determined post 75g glucose load2h-PG: 2-hour postchallenge plasma glucose, FPG: fasting plasma glucose, IFG: impaired fasting glucose, IGT: impaired glucose tolerance World Health Organization, 1999.Diagnosis Venous plasmaglucose concentration(mmol/L) DiabetesFPG or 7.02h-PG* 11.1 IGTFPG
5、(if measured) and 7.8 and 6.1 and 7.02h-PG* (if measured) 7.8FPG and 2h-PG values identify different people with diabetes2h-PG: 2-hour postchallenge plasma glucose, FPG: fasting plasma glucoseDECODE Study Group. BMJ 1998;317:3715.FPG40%Both FPG and 2h-PG28%Younger, more obesepeopleOlder,leanerpeople
6、2h-PG32%The Relative Contribution of FPG and Mealtime Glucose Spikes to 24-hour Glycemic LevelRiddle MC. Diabetes Care 1990;13:6766863002001000Plasma glucose (mg/dl)0600 1200 1800 2400 0600Time (hours)MealtimeglucosespikesFastinghyperglycemiaNormalKuusisto et al, 1994Glycemic Control and CHDCHD Mort
7、ality All CHD EventsA Comparison of Hba1c Levels Achieved in the Conventional Versus Intensive Groups of Major Trials10987650 1 2 3 4 5 6 7 8 9 10Time from randomization (years)HbA1cDCCT Kumamoto Study987600 3 6 9 12 15Median HbA1c(%)Time from randomization (years)UKPDSConventional therapyIntensive therapy121110987650 12 24 36 48 60 72MonthsHbA1c (%)FPG = fasting plasma glucose; PPG = postprandial plasma glucose.HbA1CPPGFPG +=
