Department of Internal Medicine, Section of Internal Medicine, Endocrinology and Metabolism, University of Perugia, Perugia, Italy.
Diabetes Care. 2011 Dec;34(12):2521-3. doi: 10.2337/dc11-1064. Epub 2011 Oct 4.
To assess the role of adiposity on the pharmacodynamics of basal insulins NPH, detemir, and glargine in type 2 diabetes mellitus (T2DM), as estimated by glucose infusion rate (GIR) and endogenous glucose production (EGP) rate in the euglycemic clamp.
We examined the variables that best predicted GIR and EGP in 32-h clamp studies after treatment with subcutaneous injection of 0.4 units/kg NPH, detemir, and glargine in 18 T2DM subjects (crossover).
A multiple regression analysis revealed that BMI best predicted GIR variation during the clamp. BMI was inversely correlated with GIR in all three insulin treatments, but was statistically significant in detemir treatment only. BMI correlated positively with residual suppression of EGP in detemir, but not with glargine and NPH treatments.
Adiposity blunts the pharmacodynamics of all basal insulins in T2DM. However, as adiposity increases, the effect of detemir is lower versus NPH and glargine.
评估肥胖对 2 型糖尿病患者基础胰岛素 NPH、地特胰岛素和甘精胰岛素药效学的影响，通过葡萄糖输注率（GIR）和正葡萄糖生成率（EGP）在正常血糖钳夹试验中进行评估。
我们在 18 例 2 型糖尿病患者（交叉）中，检查了在皮下注射 0.4 单位/公斤 NPH、地特胰岛素和甘精胰岛素后 32 小时钳夹研究中，能最好预测 GIR 和 EGP 的变量。
多元回归分析显示，BMI 能最好地预测钳夹期间 GIR 的变化。BMI 与三种胰岛素治疗中的 GIR 呈负相关，但仅在地特胰岛素治疗中具有统计学意义。BMI 与地特胰岛素治疗中残留的 EGP 抑制呈正相关，但与甘精胰岛素和 NPH 治疗无关。
肥胖会削弱所有基础胰岛素在 2 型糖尿病患者中的药效学。然而，随着肥胖程度的增加，地特胰岛素的效果比 NPH 和甘精胰岛素更低。
