Department of Internal Medicine, Section of Internal Medicine, Endocrinology and Metabolism, University of Perugia, Perugia, Italy.
Diabetes Care. 2011 Jun;34(6):1312-4. doi: 10.2337/dc10-1911. Epub 2011 Apr 15.
To compare the pharmacokinetics and pharmacodynamics of NPH, glargine, and detemir insulins in type 2 diabetic subjects.
This study used a single-blind, three-way, cross-over design. A total of 18 type 2 diabetic subjects underwent a euglycemic clamp for 32 h after a subcutaneous injection of 0.4 units/kg at 2200 h of either NPH, glargine, or detemir after 1 week of bedtime treatment with each insulin.
The glucose infusion rate area under the curve(0-32 h) was greater for glargine than for detemir and NPH (1,538 ± 688; 1,081 ± 785; and 1,170 ± 703 mg/kg, respectively; P < 0.05). Glargine suppressed endogenous glucose production more than detemir (P < 0.05) and similarly to NPH (P = 0.16). Glucagon, C-peptide, free fatty acids, and β-hydroxy-butyrate were more suppressed with glargine than detemir. All 18 subjects completed the glargine study, but two subjects on NPH and three on detemir interrupted the study because of plasma glucose >150 mg/dL.
Compared with NPH and detemir, glargine provided greater metabolic activity and superior glucose control for up to 32 h.
比较 NPH、甘精胰岛素和地特胰岛素在 2 型糖尿病患者中的药代动力学和药效学。
本研究采用单盲、三向、交叉设计。18 例 2 型糖尿病患者在睡前接受 NPH、甘精胰岛素或地特胰岛素治疗 1 周后，于 2200 时分别皮下注射 0.4 单位/公斤，在 32 小时的时间内进行了一次血糖钳夹实验。
甘精胰岛素的葡萄糖输注率曲线下面积（0-32 h）大于地特胰岛素和 NPH（分别为 1538±688、1081±785 和 1170±703 mg/kg；P<0.05）。甘精胰岛素比地特胰岛素更能抑制内源性葡萄糖生成（P<0.05），与 NPH 相似（P=0.16）。甘精胰岛素能更有效地抑制胰高血糖素、C 肽、游离脂肪酸和β-羟丁酸。所有 18 例患者均完成了甘精胰岛素研究，但有 2 例 NPH 组和 3 例地特胰岛素组因血糖>150 mg/dL 而中断研究。
与 NPH 和地特胰岛素相比，甘精胰岛素提供了更大的代谢活性和长达 32 小时的更好的血糖控制。
