Amylin制药公司、Eli Lilly and Company公司和Alkermes公司宣布了一项临床研究的可喜阳性结果，此项研究用随机的方式让患者每周服用一次exenatide（Ⅰ）或服用Lantus（insulin glargine）（Ⅱ），并比较其疗效差异。AIC（糖化血红蛋...Amylin制药公司、Eli Lilly and Company公司和Alkermes公司宣布了一项临床研究的可喜阳性结果，此项研究用随机的方式让患者每周服用一次exenatide（Ⅰ）或服用Lantus（insulin glargine）（Ⅱ），并比较其疗效差异。AIC（糖化血红蛋白）在较长时间内（超过三个月）可以衡量平均血糖，在此项研究中将其作为平均血糖的衡量指标。经过26周的治疗，展开更多
The pragmatic therapy of diabetes which is to achieve satisfactory glycemic control emerges from author’s laboratory research. Cell culture studies convincingly demonstrated that high glucose levels above 200 mg/dL (...The pragmatic therapy of diabetes which is to achieve satisfactory glycemic control emerges from author’s laboratory research. Cell culture studies convincingly demonstrated that high glucose levels above 200 mg/dL (> 11.1 mmol/L) cause damage to vascular endothelial cells. The severity of damage increases with duration of exposure of cultured endothelial cells to high glucose. This glucose-induced endothelial cell damage is mitigated by exposure of the endothelial cells to insulin in the presence of high glucose. There is abundant evidence, including that of author, that insulin treatment prevents diabetes-related microvascular complications including nephropathy and renal failure. Even by taking insulin multiple times, glucose level may reach normal level but only for a short time, because endogenous insulin response is insufficient. Manipulation by oral antidiabetic agents to enhance endogenous insulin release, or increase insulin sensitivity, results in exhaustion of the beta cells, thus changing an easily controllable glycemic state to a pathological uncontrollable glycemic state over the years. Even more troublesome is the lack of established information about the glucose levels that are safe for patients who have diabetes. By the term safe glucose level author means a glucose level which is least toxic to microvascular system and not likely to cause neuropathy, foot ulcer, gangrene, sexual dysfunction, and kidney failure. To achieve that glucose control is a formidable task for the patients as well as the doctors and nurses. Nevertheless, persistence is essential in diabetes management. Thus, on one hand patients must be astute in their care and doctors and nurses must be diligent in implementing and maintaining optimal glucose control in their patients. Both parties must be cohesive to achieve only one goal, which is to keep patients learn to cope with diabetes and thrive. Randomized clinical trials of glycemic control comparing one insulin against another, or insulin against oral hypoglycemic agents is not ethical. Such clinical trials will shed no light in improving diabetes care. On the other hand, it may prove to be detrimental.展开更多
文摘Amylin制药公司、Eli Lilly and Company公司和Alkermes公司宣布了一项临床研究的可喜阳性结果，此项研究用随机的方式让患者每周服用一次exenatide（Ⅰ）或服用Lantus（insulin glargine）（Ⅱ），并比较其疗效差异。AIC（糖化血红蛋白）在较长时间内（超过三个月）可以衡量平均血糖，在此项研究中将其作为平均血糖的衡量指标。经过26周的治疗，
文摘The pragmatic therapy of diabetes which is to achieve satisfactory glycemic control emerges from author’s laboratory research. Cell culture studies convincingly demonstrated that high glucose levels above 200 mg/dL (> 11.1 mmol/L) cause damage to vascular endothelial cells. The severity of damage increases with duration of exposure of cultured endothelial cells to high glucose. This glucose-induced endothelial cell damage is mitigated by exposure of the endothelial cells to insulin in the presence of high glucose. There is abundant evidence, including that of author, that insulin treatment prevents diabetes-related microvascular complications including nephropathy and renal failure. Even by taking insulin multiple times, glucose level may reach normal level but only for a short time, because endogenous insulin response is insufficient. Manipulation by oral antidiabetic agents to enhance endogenous insulin release, or increase insulin sensitivity, results in exhaustion of the beta cells, thus changing an easily controllable glycemic state to a pathological uncontrollable glycemic state over the years. Even more troublesome is the lack of established information about the glucose levels that are safe for patients who have diabetes. By the term safe glucose level author means a glucose level which is least toxic to microvascular system and not likely to cause neuropathy, foot ulcer, gangrene, sexual dysfunction, and kidney failure. To achieve that glucose control is a formidable task for the patients as well as the doctors and nurses. Nevertheless, persistence is essential in diabetes management. Thus, on one hand patients must be astute in their care and doctors and nurses must be diligent in implementing and maintaining optimal glucose control in their patients. Both parties must be cohesive to achieve only one goal, which is to keep patients learn to cope with diabetes and thrive. Randomized clinical trials of glycemic control comparing one insulin against another, or insulin against oral hypoglycemic agents is not ethical. Such clinical trials will shed no light in improving diabetes care. On the other hand, it may prove to be detrimental.
