dijabetes tip 2
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7/25/2019 Dijabetes Tip 2
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(HbA1c), /.
HbA1c
HbA1c 6.5%
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(
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HbA1c .
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HbA1c 6.5% HbA1c < 6.5%
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HbA1c 6.5%
HbA1c 7.5% HbA1c < 7.5%
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DPP-4
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DPP-4()
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( , , , ). GLP-1
6
( )
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HbA1c 6.5%
HbA1c < 6.5%
DPP-4 8
9,
4+ DPP-4
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HbA1c < 7.5%
HbA1c 7.5% HbA1c < 7.5%
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HbA1c 7.5%
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() .
> 130 mol/l (GFR) < 45 ml/min/1.73 m2
> 150 mol/l GFR < 30ml/min/1.73 m2
, GFR < 45 ml/min/1.73 m2
, .
( )
. , .
DPP-4
DPP-4 HbA1c 0.5 6 .
DPP-4 , DPP-4 :
-
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GLP-1 ( )
GLP-1 HbA1c 1 3% 6 .
GLP-1 .
.
HbA1c < 7.5% ( ), .
( ).
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() ( HbA1c 9 0%)
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. 11
()
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( HDL-C TG) .
TG, ( HDL-C TG).
:
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TG > 4.5mmol/l (
),
( ,
)
http://www.dtu.ox.ac.uk/http://www.dtu.ox.ac.uk/http://www.dtu.ox.ac.uk/ -
7/25/2019 Dijabetes Tip 2
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. 12
, -, -3
TG=2.3-4.5 mmol/l ,
1-3
( 40 mg)
,
< 4.0mmol/l (HDL-C 1.4 mmol/l) LDL-C < 2.0 mmol/l. :
80 mg
(HDL-C 1.4 mmol/l
.
-3 ( ).
50 < 145/90 mmHg
50
- (75mg) , ,
2
1 (NICE
technology appraisal guidance 94) ( )
(NICE technology appraisal guidance 132)
2
(NICE technology appraisal guidance 90)
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7/25/2019 Dijabetes Tip 2
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, , < 130/80 mmHg
, < 140/80 mmHg
.
4-6 ( ).
. > , :1 > 150/90 mmHg2 > 140/80 mmHg
2 > 130/80 mmHg ,
.
(www.nice.org.uk/CG34) , CCB.
( ),
II
( )
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7/25/2019 Dijabetes Tip 2
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. 14
, :
ACR ( , )
GFR.
ACR1e (
/):
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,
,
(ACR > 100 mg/mmol),
ACR
, ,
GFR ,
,
( ).
II .
< 130/80mmHg
ACR( )
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,
.
ACR = albumin:creatinine ratio ( :); AER = albumin excretion rate ( ); = 1ACR = ACR > 2.5 mg/mmol > 3.5 mg/mmol
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: : - (NICE clinical guideline 96), www.nice.org.uk/guidance/CG96 www.endocrinology.org.mk
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http://www.nice.org.uk/guidance/CG96http://www.nice.org.uk/guidance/CG96http://www.nice.org.uk/guidance/CG96http://www.nice.org.uk/guidance/CG96 -
7/25/2019 Dijabetes Tip 2
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