2

126 mg/dL

Adapted from International Diabetes Center (IDC), Minneapolis, Minnesota.

IR

OAD

.SU

(OHA)

(OAD)

.SU
.

(AHA)

KATP

[ATP]
[ADP]

Ca2+

-40 mV

Ca2+

KATP

Ca2+

-40 mV

Ca2+


SUR1
SUR2A
SUR2B

Kir6.2

Physiologic Role of KATP Channels

Cells

Basal state of
KATP channel

Pancreatic Open
Cardiac
muscle

Closed

Stimulus

Effect

Glucose
closes
Ischemia
and hypoxia
open

Insulin
secretion
1. Reduce energy
consumption
2. Increase
arrhythmias

3. Ischemic
preconditioning
Vascular
smooth
muscle

Closed

Ischemia
and hypoxia
open

From Gross GJ, Fryer RM. Circ Res. 1999;84:973-979.

Murry CE, Jennings RB, Reimer KA. Circulation. 1986;74:1124-1136.
ORourke B. Circ Res. 2000;87:845-855.

Vasodilatation

KATP


(on SUR) IC50

SUR1

SUR2A

50 nM
10 M
260 nM
3 nM
3 nM
98nM

480 nM
27 nM
3 nM

HbA1c (%)
20
10
0
-.25
-.5
-.75
-1
-1.25
-1.5
-1.75
-2

500mg
(n=73)

1,000mg
(n=73)

1,500mg 2,000mg
(n=76) (n=73)

500~2000mg
--

2000mg

HbA1c 2%
Garber AJ, Duncan TG, Goodman AM, et al,
Am J Med 1997; 103(6): 491-497

-
-

- , 0.03/
-
-

-
(Acarbose)(Miglitol)
(Voglibose)(Emiglitate)

In

50mg

100mg

50mg tid

100mg tid200mg tid


800

700

600
500

400

300
(pmol200
/min)100
6am

(n=14)
2
(n=16)

10am

2pm

Polonsky KS et. al N. Engl. J. Med. 1988

6pm

10pm

2am

6am

8%92%
-

Troglitazone
Rosiglitazone
Pioglitazone

Troglitazone

PPAR

4~5%
Hb

Starlings2

100

OGTT

(mU/l)

80
60
40

20
0

(mg/dl)
80
120

160

Matthaei S, et al. Endocr Rev

21:585,2000

200

90

BMI18.5-23kg/m2
BMI2325kg/m2
BMI>25
>90cm()
>80cm()

BMI18.5-25kg/m2
BMI2530kg/m2
BMI>30
>102cm()
>88cm()

*National Heart, Lung and Blood Institute(NHLB) of NIH published clinical guidelines
on identification,evaluation and treatment of overweight and obesity in adults, 1998

(/)(//)

2
(mmol/L)

4.46.1
4.48.0

7.0
10.0

>7.0
>10.0

<6.5

HbA1c(%)

<130/80

(mmHg)

BMI(kg/m2)

<25
<24

6.57.5
>130/80
<140/90
<27
<26

>7.5
140/90
27
26

TC(mmol/L)

<4.5

4.5

HDL-C(mmol/L)

>1.1

1.10.9

<0.9

TG(mmol/L)

<1.5

<2.2

2.2

LDL-C(calculated)

<3.0

2.54.0

>4.0

6.0