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【商业翻译】Importance of Postprandial Hyperglycemia an
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Importance of Postprandial Hyperglycemia and Postprandial Glycemic Control
Postprandial hyperglycemia is an important predictor of cardiovasCular events，even in early Type 2 diabetes．The lower the HbA1C，the more prominent the role of postprandial hyperglycemia．Postprandial hyperglycemia in Type 2 DM is characterized be deficiency of first-phase insulin release and failure to normally suppress glucagon Patients with Type 2 DM have increased postprandial glucose release：both endogenous and exogenous．The increased endogenous release is due to both glycogenolysis and gluconeogenesis．Non—oxidative glycolysis is increased，but glucose clearance and oxidation are decreased．Postprandial hyperglycemia may be assessed by frequent fingersticks，CGMS and，perhaps，1，5 anhydroglucitol．For patients with HbAIC<7.5％,therapeutic methods that address postprandial hyperglycemia are more successful than those that do not．HbA1C is only one assessment of glycemic contr01．and．especially in patients with HbAlC<7.5％，it does not adequately reflect glycemic variability．
Insulin pumps:why,who and how
Insulin pumps address the dawn phenomenon，glycemic variability，improve reproducibilty of insulin delivery，are safe，reduce severe hypoglycemia，and increase insulin bioavailability．Clinical trials using patients as their own controls，as well as randomized，controlled trials confirm improved glycemic contr01 and improved patient satisfaction with insulin Pumps．Patient selection is important：Paatients should be well-trained and well-motivated．They should have appropriarte expectations．Criteria for and against selection for pump therapy will be discussed．Dosing and how to prescribe basal rates and bolus schedules will also be discussed．The importance of bolus calculators，continuous glucose monitoring，and real-time glucose monitoring have all enhanced the technology of insulin pump therapy．The most recent available advance is”sensor-augmented pump therapy”．”Closed loop”insulin pump delivery has shown great promise in the non-prandial state．Control of postprandial hyperglycemia with a closed-loop system is the challenge of the future．
Insulin pumps in Adolescent
Insulin pumps address the dawn phenomenon，glycemic variability，improve reproducibilty of insulin delivery，are safe，reduce severe hypoglycemia，and increase insulin bioavailability．Clinical trials using patients as their own controls，as well as randomized，controlled trials confirm improved glycemic control and improved patient satisfaction with insulin pumps．Patient selection is important：Paatients should be well-trained and well-motivated．They should have appropriarte expectations．Criteria for and against selection for pump therapy will be discussed．Specifically，in adolescents，issues of body-image，hectic lifestyle and rebellion must be addressed．Eating may be especiallty unpredictable．Exercise is an important issue．Studies suggest that in adolescents,in addition to the pre-dawn increased insulin requirement，there is also in many adolescents，an increased jnsulin requirement at bedtime．Dosing and how to prescribe basal rates and bolus schedules will also be discussed．Adolescents often need more insulin than do adults of similar size．Due to erratic eating styles，"insulin stacking"may be an important issue．The importance of bolus calculators，continuous glucose monitoring，and real-time glucose monitoring have all enhanced the technology of insulin pump therapy．The most recent available advance is"sensor-augmented pump therapy"．"Closed 100p"insulin pump delivery has shown great promise in the non—prandial state．Control of postprandial hyperglycemia with a closed-loop system is the challenge of the future． Importance of Postprandial Hyperglycemia and Postprandial Glycemic Control
餐后高血糖的重要性与餐后血糖控制
Postprandial hyperglycemia is an important predictor of cardiovasCular events，even in early Type 2 diabetes．The lower the HbA1C，the more prominent the role of postprandial hyperglycemia．Postprandial hyperglycemia in Type 2 DM is characterized be deficiency of first-phase insulin release and failure to normally suppress glucagon Patients with Type 2 DM have increased postprandial glucose release：both endogenous and exogenous．The increased endogenous release is due to both glycogenolysis and gluconeogenesis．Non—oxidative glycolysis is increased，but glucose clearance and oxidation are decreased．Postprandial hyperglycemia may be assessed by frequent fingersticks，CGMS and，perhaps，1，5 anhydroglucitol．For patients with HbAIC<7.5％,therapeutic methods that address postprandial hyperglycemia are more successful than those that do not．HbA1C is only one assessment of glycemic contr01．and．especially in patients with HbAlC<7.5％，it does not adequately reflect glycemic variability．
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作者:admin@医学,生命科学 2011-02-16 17:12
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