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国际糖尿病 >>EASD年会
[EASD2009]EASD专家采访预告(一)
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综合领域  来源:国际糖尿病 2009/9/23 19:43:00    加入收藏
内容概要:第45届欧洲糖尿病研究协会年会召开在即。现做出本网站采访预告,敬请持续关注!

EASD专家采访预告,敬请关注:

一.E.A.M. Gale   
 
1. 在临床实践中,除了皮下注射胰岛素之外,还有各种口服降糖药帮助患者控制血糖水平。用来评价口服降糖药治疗的安全性和有效性的指标有哪些?
2. 由于单一种口服降糖药可能无法有效地控制血糖在一个理想范围内,我们往往建议患者同时应用两种或更多种口服降糖药。口服降糖药联合治疗的原则是什么?
3. 动物试验提示烟碱可以预防自身免疫性糖尿病,但是著名的ENDIT研究结果并未发现其对预防1型糖尿病的发生有益处。据您所知,目前还有那些有希望能预防1型糖尿病的药物或方法?

1. In clinical practice, there are several kinds of oral antidiabetic agents (OADs) helping patients regulate blood glucose level besides insulin. Which are the criteria to evaluate the safety and effectiveness of OADs treatment?
2. The use of two or more sorts of OADs at the same time is often suggested. What are the principles of combination therapy of OADs?
3. Studies in animals suggest that autoimmune diabetes is preventable by Nicotinamide, but the results of the well-known ENDIT study failed to discover its benificial effects in preventing the onset of type 1 diabetes. As far as you know, are there any other promising medication or methods that might prevent type 1 diabetes? 

二.Peter J. Havel
1. 与正常人相比,糖尿病患者进食后肠道激素分泌改变的最主要特征是什么?
2. 您的演讲是关于减重手术的,有报道称减重手术能改善体重和代谢异常。请问您认为减重手术对糖代谢以及脂代谢的潜在效应是继发于体重减少的吗?
3. 当今大多数有关减重手术的研究是在严重肥胖或病态肥胖的患者中进行,而不管其是否合并糖尿病。是否有针对于非肥胖的糖尿病患者而正在进行或设计中的研究?
4. 在减重手术治疗糖尿病方面,您认为还有哪些方面需要改进?

1. Compared with the healthy individuals, what is the main characterist of the changes in postprandial gut hormone secretion in diabetic patients?
2. Your presentation is about bariatric surgery, which is demonstrated effective for weight loss and improved metabolic disorder. Are improved glucose and lipid metabolism related to weight loss at all?
3. Most of today’s studies pertaining to bariatric surgery are conducted among severe or morbidly obese patients, regardless whether or not they had diabetes. Have there been any studies being conducted or designed that aimed at non-obese diabetic patients?
4. What is the deficiency about bariatric surgery in your opinion?
 
三.M.E. Cooper
1. 糖尿病以慢性高血糖导致不可逆转的终末糖基化产物(AGEs)形成为特点。它们在糖尿病并发症发病机制中的重要性已被广泛接受。那么,AGEs对糖尿病大血管和微血管并发症是否有相同的发病机理?
2. 一直以来AGEs都被认为与氧化应激增加有关,后者是发生糖尿病并发症的主要因素。那么这两者到底是什么关系?氧化应激是AGEs形成上的一个重要早期通路,还是仅仅是最初病理过程的结果?
3. 在过去的几十年里,ACEI被许多研究证实对糖尿病肾病有益。你们最近的研究也发现ACEI能减少肾脏和血清中AGEs的堆积。在您看来,ACEI的这种肾脏保护作用是直接的,还是通过阻断AGE形成而发挥的?
1. Diabetes is characterized by chronic hyperglycemia which facilitates the irreversible formation of advanced glycation end products (AGEs). Their importance in the pathogenesis of diabetic complications has been widely accepted.  Therefore, are both macro- and microvascular complications bearing the same pathogenic mechanism of AGEs?
2. AGEs have long been associated with increased oxidative stress, which is recognized as a key component in the development of diabetic complications. So what’s the exact relationship between these two? Is oxidative stress an important early pathway of AGEs formation or merely a consequence of the primary pathogenic process?
3. ACEI has proven beneficial in diabetic renal disease through numerous studies during the past decades. And the findings of your present study has revealed that ACEI reduced the accumulation of renal and serum AGEs. From you point of view, is the renoprotection produced by ACEI’s direct function, or through the blockade of AGE formation?
 
四.Jeff Johnson
1. 您最近的回顾性研究发现高剂量磺脲类药物与新诊断的2型糖尿病患者死亡率增加相关,但并未发现二甲双胍剂量与死亡率增加相关。您是否发现这两种降糖药之间对死亡率的影响有什么不同吗?
2. 如何判断高剂量磺脲类药物增加死亡率是通过其特殊药理作用所致,还是由于其增加了例如低血糖等风险的后果所致?
3. 您的研究提示降糖的方式和达到理想血糖目标同等重要。医生最初应用口服降糖药治疗新诊断2型糖尿病时,往往被建议应用二甲双胍而非磺脲类。那么是否有证据表明在降低总体死亡率方面,噻唑烷二酮类、磺脲类或二甲双胍有何差异?


1. Your recent retrospective study found higher exposure to sulfonylureas was associated with increased mortality in newly diagnosed type 2 diabetic patients, but the same relationship was not observed with metformin. Have you observed any difference of the mortality beteween these two kinds of oral agents?
2. How can you determine the elevated mortaliy of higher exposure to sulfonylureas was caused by their specific pharmaceutic effects or their consequence like higher risk of hypoglycemia?
3. Your study has implies that the manner in which blood glucose level lowered may be as important as achieving ideal glucose targets. When initiating oral antidiabetic therapy in newly diagnosed T2DM patients, physicians always recommend to use metformin over sulfonylureas. So are there any evidence about overall mortality among thiazolidinediones, sulfonylureas and metformin?
 
五.U. Smith
1. 在胰岛素抵抗的个体或2型糖尿病患者中,胰岛素的细胞内作用在肿瘤发生方面可有改变?
2. 胰岛素样生长因子-I(IDF-I)是一种调节细胞生长和存活的多功能肽,并且有些研究发现其与某些恶性肿瘤的发生相关。请问您循环中IGF-I水平升高与胰岛素抵抗有关吗?
3. 一些研究提示糖尿病患者可能是由于体重原因致使发生肿瘤的风险增加。是否曾有证据提示激素水平在肿瘤发生中也发挥重要作用?
4. 研究发现脂联素与胰岛素具有相似的靶组织,且脂联素与胰岛素抵抗之间有相关性。我们知道,胰岛素抵抗是糖尿病、高血压、高血脂等代谢紊乱的共同因素,那么您认为脂联素是否可以作为胰岛素抵抗的治疗靶点,从而成为代谢性疾病的治疗靶点之一?
5. 在今年ADA年会上,EASD/ADA/IDF三大学会联合推荐HbA1c作为糖尿病诊断新指标,且采用≥6.5%作为诊断糖尿病的切点。对此,您认为这一推荐在临床工作中的可行性如何?(在中国是否可行?)这一切点是否同样适用于中国人群?


1. Are there any changes of insulin’s intracellular function in individuals with insulin resistance or type 2 diabetes, in terms of cancer development?
2. IGF-I is a multi-functional regulatory peptides of cell growth and survival, and has been implicated in the development of some malignancies by several studies. Does the elevated level of IGF-I in circulation has something to do with insulin resistance?
3. Some researches suggest that people with diabetes are at greater risk of developing cancer, possibly due to their obesity. Have there ever been any evidences that hormone changes also play a crucial role in cancer development?
4. It has been found that adiponectin and insulin not only have similar target tissues but also are correlated with each other. As we know, insulin is the common factor of metabolic disorder, such as diabetes, hypertension, and hyperlipemia. If adiponectin could be one of the therapuetic targets for insulin resistance and then for metabolic diseases ?
5. HbA1c is recommended to dignose diabetes by EASD/IDF/ADA and 6.5% is the cutpoint for the diagnosis. What do you think about the feasibility of this recommendation? Could the cutpoint of HbA1c 6.5% be also applied to Chinese population?

 
六.D.R. Matthews
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