Poon Kitty, King Allen B
Diabetes Care Center, Salinas, CA, USA.
Drug Healthc Patient Saf. 2010;2:213-23. doi: 10.2147/DHPS.S7301. Epub 2010 Oct 28.
Diabetes mellitus is a growing public health concern in the US and worldwide. Insulin therapy is the cornerstone of diabetes therapy, and the use of basal insulins will increase as clinicians strive to help their patients reach glycemic goals. Basal insulins have been continually improved upon over the years, and the long-acting basal insulin analogs, glargine and detemir, have many pharmacokinetic and pharmacodynamic advantages over neutral protamine Hagedorn insulin, namely, less variable absorption profiles, a less pronounced peak in effect, and a longer duration of action. Overall, glargine and detemir do not differ greatly in their safety and efficacy profiles. Major differences between the two include lower within-subject variability, lower risk of hypoglycemia, and a weight-sparing effect with insulin detemir. This review summarizes data from the key pharmacokinetic and pharmacodynamic studies, as well as clinical and observational studies to elucidate the role of each basal insulin analog in therapy.
糖尿病在美国乃至全球都是一个日益受到关注的公共卫生问题。胰岛素治疗是糖尿病治疗的基石，随着临床医生努力帮助患者实现血糖目标，基础胰岛素的使用将会增加。多年来基础胰岛素一直在不断改进，长效基础胰岛素类似物甘精胰岛素和地特胰岛素，与中性精蛋白锌胰岛素相比，在药代动力学和药效学方面有许多优势，即吸收曲线变异性较小、作用峰值不那么明显、作用持续时间更长。总体而言，甘精胰岛素和地特胰岛素在安全性和疗效方面差异不大。两者之间的主要差异包括受试者内变异性较低、低血糖风险较低以及地特胰岛素具有减轻体重的作用。本综述总结了关键的药代动力学和药效学研究以及临床和观察性研究的数据，以阐明每种基础胰岛素类似物在治疗中的作用。
