Lechleitner Monika, Hoppichler Friedrich
Landeskrankenhaus Hochzirl, Anna Dengel-Haus, Zirl, Austria.
Wien Med Wochenschr. 2011 Jun;161(11-12):300-4. doi: 10.1007/s10354-011-0889-3. Epub 2011 May 23.
Insulin therapy is a vital hormone replacement therapy in type 1 diabetes mellitus. In type 2 diabetes, insulin is indicated if glycaemic goals are not reached by oral anti diabetics, as well as for metabolic detoriation, co-morbidities, surgery, pregnancy or contradictions against oral anti diabetics. Insulin preparations are characterized by the onset of the insulin action, the peak profile and duration of action. Available are short acting, long-acting and premixed preparations of human insulin, and insulin analogues. The gold standard of insulin therapy in type 1 diabetes is functional insulin therapy with a basal-bolus insulin regimen and control and adaption of the therapy by the patient. Various insulin regimens are available for treating patients with type 2 diabetes, including basal insulin supported oral therapy, supplementary mealtime injection of short acting insulin or insulin analogues, conventional insulin therapy or a basal bolus procedure. The various insulin preparations and regimens make it possible to adapt the therapy according to the patient's individual need.
胰岛素治疗是1型糖尿病至关重要的激素替代疗法。在2型糖尿病中,如果口服降糖药无法实现血糖目标,以及出现代谢恶化、合并症、手术、妊娠或存在口服降糖药禁忌证时,则需使用胰岛素。胰岛素制剂的特点在于胰岛素作用的起效时间、峰值曲线和作用持续时间。有短效、长效和预混的人胰岛素制剂以及胰岛素类似物可供使用。1型糖尿病胰岛素治疗的金标准是采用基础 - 餐时胰岛素方案进行功能性胰岛素治疗,并由患者对治疗进行控制和调整。有多种胰岛素方案可用于治疗2型糖尿病患者,包括基础胰岛素支持的口服治疗、补充餐时短效胰岛素或胰岛素类似物注射、传统胰岛素治疗或基础 - 餐时方案。各种胰岛素制剂和方案使得根据患者的个体需求调整治疗成为可能。