7/29/2019 Analogue Insulin, The New Tools to Challenges Diabetes

1/49

7/29/2019 Analogue Insulin, The New Tools to Challenges Diabetes

2/49

Presentation Point of View

1. Rationality of Insulin Therapy for Type 2 DM

2. What is Analogue Insulin?

3. How & strategy of Insulin treatment ?4. Barrier of using insulin

5. Take Home Message

7/29/2019 Analogue Insulin, The New Tools to Challenges Diabetes

3/49

Normal islet cell

Deposition of amyloid

in T2DM

Natural History of Type 2 DM

7/29/2019 Analogue Insulin, The New Tools to Challenges Diabetes

4/49

Insulin

7/29/2019 Analogue Insulin, The New Tools to Challenges Diabetes

5/49

OAD :Kegagalan sekunder sesudah beberapa tahun

ADOPT: Kahn SE et al. N Engl J Med2006;355:2427-43.

8.0

7.6

7.2

6.8

6.4

6.0

0

0 1 2 3 4 5

Time (Years)

HbA1c

(%

)

Rosiglitazone

Metformin

Glybenclamide

ADOPT study

7/29/2019 Analogue Insulin, The New Tools to Challenges Diabetes

6/49

UKPDS 57:Adapted from Wright A et al. Diabetes Care 2002;25:330-6.

Early Addition of Insulin

Can Optimize Glycemic Control

50

25

0

p=0.011

ProportionofPatientswithHbA1c