从餐后血糖机制特点探讨适合中国患者的胰岛素治疗方案

To Explore the Optimal Insulin Regimen for Chinese Patients from the Mechanism of Postprandial Hyperglycemia

餐后血糖的内在机制是胰岛素早时相分泌不足,导致无法抑制肝糖异生和肝糖原分解,最终肝脏内源性葡萄糖输出增加,促进餐后高血糖,这一点在中国人群中尤为突出。因此,中国人群的血糖管理重点在餐后血糖,而且越来越多的循证医学显示餐后高血糖显著影响糖尿病慢性并发症的发生发展,增加心血管疾病死亡风险。本文从餐后血糖升高的病理生理机制及中国2型糖尿病患者的血糖特点和成因入手进行分析,结合当前降糖药物特点,探讨适合中国患者的胰岛素治疗方案。

The early-stage insufficiency of insulin secretion contributed to uncontrolled postprandial hyperglycemia. Its intrinsic mechanism was the failure to inhibit the hepatic gluconeogenesis and hepatic glycogenolysis by insulin, which was followed by the elevated endogenous glucose output and postprandial hyperglycemia. Postprandial hyperglycemia is significantly prominent in Chinese population, so glucose management should focus on postprandial hyperglycemia. Moreover, there are increasing evidences that postprandial hyperglycemia contributed to occurrence and development of diabetic complications and cardiovascular mortality. This article aimed to explore the optimized insulin therapy for Chinese patients, by insight into pathophysiological mechanism of postprandial hyperglycemia. Furthermore, the pathogenesis of hyperglycemia and characteristics of oral antidiabetic drugs on Chinese type 2 diabetes has also been included in this article.