Jani Rucha, Triplitt Curtis, Reasner Charles, Defronzo Ralph A
University of Texas Health Science Center, Diabetes Division, 7703 Floyd Curl Drive, San Antonio, Texas, 78229, USA.
Expert Opin Drug Deliv. 2007 Jan;4(1):63-76. doi: 10.1517/17425247.4.1.63.
The long-term benefits of tight glycemic control in preventing microvascular and macrovascular complications are well established in both Type 1 diabetes mellitus (Type 1 DM) and Type 2 diabetes mellitus (Type 2 DM). Nonetheless, achievement of recommended haemoglobin A1c (HbA(1c)) goals (< or = 6.5 - 7.0%) has remained elusive, especially in patients with diabetes who require insulin therapy. Delayed/suboptimal titration of insulin is partly related to poor acceptance of multiple injection regimen by both physicians and patients. EXUBERA (human insulin [rDNA origin]; Pfizer), the first approved inhaled insulin for the treatment of diabetic patients, has been shown to be safe and as effective as regular/rapidly acting insulin in improving glycemic control. In addition to controlling postprandial glucose excursions, EXUBERA exerts a major action to reduce fasting plasma glucose (FPG) concentration. Thus, it has the potential to be used as a monotherapy in Type 2 DM, as well as in combination with an insulin sensitizer in Type 2 DM or in combination with long-acting insulin in both Type 2 DM and Type 1 DM.
强化血糖控制在预防1型糖尿病(T1DM)和2型糖尿病(T2DM)微血管和大血管并发症方面的长期益处已得到充分证实。尽管如此,达到推荐的糖化血红蛋白(HbA1c)目标(≤6.5 - 7.0%)仍然难以实现,尤其是在需要胰岛素治疗的糖尿病患者中。胰岛素滴定延迟/未达最佳效果部分与医生和患者对多次注射方案的接受度低有关。首个获批用于治疗糖尿病患者的吸入性胰岛素——艾可拓(人胰岛素[rDNA来源];辉瑞公司),已被证明在改善血糖控制方面安全且与常规/速效胰岛素效果相当。除了控制餐后血糖波动外,艾可拓还具有降低空腹血糖(FPG)浓度的主要作用。因此,它有可能在T2DM中用作单药治疗,也可与胰岛素增敏剂联合用于T2DM,或与长效胰岛素联合用于T2DM和T1DM。