极低出生体重新生儿皮下注射甘精胰岛素治疗短暂性新生儿糖尿病
Treatment of transient neonatal diabetes mellitus with subcutaneous insulin glargine in an extremely low birth weight neonate.
作者信息
Barone Joseph V, Tillman Emma M, Ferry Robert J
出版信息
J Pediatr Pharmacol Ther. 2011 Oct;16(4):291-7. doi: 10.5863/1551-6776-16.4.291.
Abstract
Neonatal diabetes mellitus (NDM) results from impaired insulin secretion. While rare, NDM presents complex challenges with regard to the management of glycemic control. NDM is classified as transient neonatal diabetes mellitus (TNDM) or permanent neonatal diabetes mellitus (PNDM). Determination of TNDM vs. PNDM is usually possible only after medical management has been initiated. Management of NDM begins with insulin; however, the correct dose, choice of formulation, and route of administration are complicated by the risk of neonatal hypoglycemia. For the first time, the successful management of TNDM in an extremely low birth weight (ELBW) neonate with the long-acting subcutaneous insulin analog, insulin glargine, is reported. In addition, potential pharmacokinetic barriers to treating ELBW neonates diagnosed with NDM with subcutaneous insulin products are discussed.
摘要
新生儿糖尿病（NDM）是由胰岛素分泌受损引起的。虽然罕见，但NDM在血糖控制管理方面带来了复杂的挑战。NDM分为短暂性新生儿糖尿病（TNDM）或永久性新生儿糖尿病（PNDM）。通常只有在开始药物治疗后才能确定是TNDM还是PNDM。NDM的治疗始于胰岛素；然而，由于新生儿低血糖的风险，正确的剂量、制剂选择和给药途径都很复杂。首次报道了使用长效皮下胰岛素类似物甘精胰岛素成功治疗极低出生体重（ELBW）新生儿的TNDM。此外，还讨论了用皮下胰岛素产品治疗诊断为NDM的ELBW新生儿时潜在的药代动力学障碍。
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