Mesa Jordi
Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d'Hebron, Barcelona, España.
Med Clin (Barc). 2015 Jul 20;145(2):70-5. doi: 10.1016/j.medcli.2014.04.024. Epub 2014 Sep 4.
Since its discovery almost a century ago, insulin remains the mainstay of treatment of patients with type 1 diabetes mellitus. Although progress in the synthesis of new formulations has been remarkable, the physiological profile of insulin is still different from that observed with preparations available nowadays. In the last decade, the introduction into clinical practice of insulin analogues has allowed significantly improvement in glycemic control and has facilitated the spread of basal/bolus patterns, the most physiological ones until now. Despite the benefits of basal analogues, glycemia often varies considerably when used as a single daily injection and this is why new molecules have been further investigated. Improvement has been achieved especially in terms of duration and rate of hypoglycemia, the main limiting factor of intensive therapy. This article reviews the available data concerning the new basal insulin analogues, degludec, pegylated lispro and glargine U300, and new formulations currently under development.
自近一个世纪前被发现以来，胰岛素仍然是1型糖尿病患者治疗的主要手段。尽管新制剂合成方面取得了显著进展，但胰岛素的生理特性仍与目前可用制剂所观察到的不同。在过去十年中，胰岛素类似物引入临床实践显著改善了血糖控制，并促进了基础/餐时给药模式的推广，这是迄今为止最符合生理状态的给药模式。尽管基础胰岛素类似物有诸多益处，但当每日单次注射使用时，血糖水平往往仍会有很大波动，这就是为何人们进一步研究新型分子的原因。尤其在低血糖持续时间和发生率方面取得了改善，而低血糖是强化治疗的主要限制因素。本文综述了有关新型基础胰岛素类似物德谷胰岛素、聚乙二醇化赖脯胰岛素和甘精胰岛素U300的现有数据，以及目前正在研发的新制剂。
