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健康受试者十二指肠直接给予大剂量门冬胰岛素后的血清门冬胰岛素浓度:一项开放标签、单盲且无对照的探索性试验。

Serum insulin aspart concentrations following high-dose insulin aspart administered directly into the duodenum of healthy subjects: an open-labeled, single-blinded, and uncontrolled exploratory trial.

作者信息

Ihlo Charlotte A, Aksglaede Karin Bak, Laursen Torben, Lauritzen Torsten, Christiansen Jens Sandahl

机构信息

Department of Endocrinology M, Aarhus University Hospital, Aarhus Sygehus, Nørrebrogade, Aarhus, Denmark.

出版信息

J Diabetes Sci Technol. 2009 Sep 1;3(5):1183-91. doi: 10.1177/193229680900300525.

Abstract

OBJECTIVE

The goal of this study was to determine the bioavailability of high-dose insulin aspart administered directly into the duodenum of healthy subjects.

METHODS

In a pilot study, four subjects each received four escalating doses of a 1-ml solution of insulin aspart (100, 300, 600, and 1000 IU, respectively) directly into the duodenum. In the following main study, eight subjects each received two identical doses of insulin aspart of 1000 IU, in 4- and 8-ml solutions, respectively, directly into the duodenum. Subjects in the main study also received an intravenous and a subcutaneous injection of 4 to 6 IU of insulin aspart.

RESULTS

A considerable number of samples and, in some cases, consecutive samples revealed significantly increased concentrations of serum insulin aspart. Despite the significant serum insulin aspart concentrations, no significant changes of plasma glucose were measured. Moreover, no significant suppression of endogenous insulin secretion was detected, as assessed by the levels of serum human insulin.

CONCLUSIONS

Administration of high-dose insulin aspart directly into the duodenum of healthy subjects resulted in significantly increased serum insulin aspart concentrations in a high number of consecutive samples using a specific enzyme-linked immunosorbent assay. However, no significant changes in the levels of plasma glucose or serum human insulin were observed. Thus, the study did not provide any evidence of biological activity of the original insulin aspart molecule after high-dose administration directly into the duodenum.

摘要

目的

本研究的目的是确定将大剂量门冬胰岛素直接注入健康受试者十二指肠后的生物利用度。

方法

在一项先导研究中,四名受试者分别接受了四次递增剂量的1毫升门冬胰岛素溶液(分别为100、300、600和1000国际单位),直接注入十二指肠。在接下来的主要研究中,八名受试者分别接受了两次相同剂量的1000国际单位门冬胰岛素,分别以4毫升和8毫升溶液直接注入十二指肠。主要研究中的受试者还接受了4至6国际单位门冬胰岛素的静脉注射和皮下注射。

结果

相当数量的样本,在某些情况下是连续样本,显示血清门冬胰岛素浓度显著升高。尽管血清门冬胰岛素浓度显著,但未测得血浆葡萄糖有显著变化。此外,通过血清人胰岛素水平评估,未检测到内源性胰岛素分泌受到显著抑制。

结论

使用特定的酶联免疫吸附测定法,将大剂量门冬胰岛素直接注入健康受试者的十二指肠,导致大量连续样本中的血清门冬胰岛素浓度显著升高。然而,未观察到血浆葡萄糖水平或血清人胰岛素水平有显著变化。因此,该研究没有提供任何证据表明大剂量直接注入十二指肠后门冬胰岛素原始分子具有生物活性。

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Alternative routes of insulin delivery.胰岛素递送的替代途径。
Diabet Med. 2003 Nov;20(11):886-98. doi: 10.1046/j.1464-5491.2003.01076.x.
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Development of oral insulin: progress and current status.口服胰岛素的研发:进展与现状
Diabetes Metab Res Rev. 2002 Jan-Feb;18 Suppl 1:S29-37. doi: 10.1002/dmrr.207.

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