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糖尿病之治療飲食 王鳳英副教授 國立新竹教育大學. 糖尿病之主要現象. 尿中有糖 身體組織對葡萄糖之利用降低 脂肪和蛋白質之代謝利用也不正常 可能因胰島素功能不全、內分泌失調及葡萄糖耐量異常所使然 為一新陳代謝疾病。. 胰島素 (insulin). 胰島素乃是由胰臟 (pancreas) 之蘭格罕氏小島的 β- 細胞 (Langerhan’s islets of βcell) 所分泌,為一含鋅、鎳、鎘之結晶性蛋白質 其主要作用是促進葡萄糖轉變成肝醣 使血糖降低 在組織細胞中能促使葡萄糖氧化 並維持血糖濃度 對於脂肪組織也能促使脂肪內葡萄糖增加 - PowerPoint PPT Presentation
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(insulin)
(pancreas)-(Langerhans islets of cell)
(gluconeogenetic)(cAMP)
(glycogenesis)(lipogenesis)(DNA)(RNA)
1.(Glucagon)(glycogen)2. (Adrenal corticosteroids)(Adrenal gland)(gluconeogenesis)3. (Epinephrine)
4. (Growth hormone)5. (Adrenocorticotropic hormone, ACTH)6. (Thyroxine)(thyroid gland)
180 mL/dl
(20%)(40)
(Insulin dependent diabetic mellitus ; IDDM) Type I(Human lymphocyte antigen, HLA)(ketosis)(Non-insulin dependent diabetic mellitus ; NIDDM) Type II
40 40 75% 60-90%
(Polyphagia)(Polydipsia)(Polyuria)
-A(TCA cycle)-
(Insulin shock)(Hypoglycemia)(Diabetic acidosis and coma)(Small vessel disease)
---12004 (1)45() (2)45 120%(BMI)25kg/
---29 (140/90Hg) 35mg/dl250mg/dl
(Hyperglycemia)(Fast Blood SugarFBS)1280-120 mg/dl(D.M.)140 mg/dl1997126 mg/dl
40%()1.75 g0.5123450.5-121-23160-180 mg/dl
(Ketouria)(ketone body) -
(Glucosylate hemoglobin)A5%10%(Glycosuria)
(Hyperlipidemia)(Ketonemia)(Ketouria)
(Hyperaminoacidemia)
(1)
(Regular insulinRI)(Neutral protamine hagedornNPH)(Lente insulinLI)(Globin insulinGI)(Protamine zinc insulinPZI)
-(Sulfonylureas)(Diabinese)(Dymelor)(Biguanide)(Phenformin)(Metformin)
351.0-1.212-20%
50-60%50-60%35%30%10%
4040 g(Nonnutritive sweetness)
40%40%10%
()()()
()3-4
300030007.5140/90mmHg240030006
()()
(Glycemic index)50 50GI= 100% 50
()()
6%6%
(4.4)(Hypoglycemia)
(10)(120)
() 2/5 1/5 2/5 1/5 2/5 2/5 1/7 2/7 1/7 2/7 1/7 1/7 2/7 1/7 2/7 1/7() 1/7 2/7 1/7 2/7 1/7NPHRI 2/10 1/10 2/10 1/10 3/10 1/10PZIRI 1/3 1/3 1/3
4-6%(Glycolylated hemoglobin HbA1CHbA1C)
(LDL)(HDL)
(Acidosis)
(Starvation ketosis)()(200 mg/dl)
(Glomerulosclerosis)
(10-20 g)100 mg/dl
250 mg/dl150 mg/dl
123
5%
: () = (-80) 0.710 %: () = (-70) 0.610 %() = 22 ()2
1 = 15= 1/4 = 1/4 = 1/10 = 1 = 1 = 1 = 1/2 = 1/2 = 1/2 = 2 = 4 = 7 = 2() = 10= 1/4 (
1 =15=1 = 1() = = 1/6 () = 1() = 1/2 = 1() = 1() =1 = 1 = 1 () = 5 = 9 = 13 = 3 = 9 = 6 = 1 = = 1
1= 1()= 1 = 1 = 1() = 3 = 2 = 1()
1= 1 = 1 = 1 = 1 = 2 = 1() = 2 = 5 = 2 = 5 = 10