Muñoz Torres Manuel
UGC Endocrinología y Nutrición, Hospital Universitario San Cecilio, Granada, España.
Endocrinol Nutr. 2014 Mar;61(3):153-9. doi: 10.1016/j.endonu.2013.03.012. Epub 2013 Jul 25.
Degludec is the most recent molecule of the ultra-long-acting basal insulin analogues approved for human use. It forms soluble multihexamers which after subcutaneous injection are converted into monomers, and are thus slowly and continuously absorbed into the bloodstream. This absorption mechanism confers degludec an ultra-long and stable action profile, with no concentration peaks. This paper discusses the most recent studies in patients with type 1 and 2 diabetes mellitus, which showed degludec to be non inferior in decreasing HbA1c, ensuring optimum glycemic control similar to that achieved with insulin glargine or detemir. Degludec also had an improved safety profile, as it was associated to a significantly lower rate of nocturnal hypoglycemia in both types of diabetes and to a potentially lower overall hypoglycemia rate in type 2 DM. Degludec also opens the possibility to use more flexible regimens.
德谷胰岛素是最新获批用于人类的超长效基础胰岛素类似物。它形成可溶性多聚六聚体，皮下注射后转化为单体，从而缓慢且持续地被吸收进入血液循环。这种吸收机制赋予德谷胰岛素超长效且稳定的作用模式，没有浓度峰值。本文讨论了针对1型和2型糖尿病患者的最新研究，这些研究表明德谷胰岛素在降低糖化血红蛋白方面并不逊色，能确保实现与甘精胰岛素或地特胰岛素相似的最佳血糖控制。德谷胰岛素的安全性也有所改善，因为在两种类型的糖尿病中，它与夜间低血糖发生率显著降低相关，在2型糖尿病中总体低血糖发生率可能更低。德谷胰岛素还为采用更灵活的治疗方案提供了可能性。
