Reiband H K, Schmidt S, Ranjan A, Holst J J, Madsbad S, Nørgaard K
Department of Endocrinology, Copenhagen University Hospital, Hvidovre, Denmark.
Danish Diabetes Academy, Odense University Hospital, Odense, Denmark.
Diabetes Metab Res Rev. 2015 Oct;31(7):672-9. doi: 10.1002/dmrr.2632. Epub 2015 Feb 12.
Intensive insulin treatment in type 1 diabetes reduces the incidence and slows the progression of microvascular and macrovascular complications; however, it is associated with an increased risk of hypoglycaemia and weight gain. In this review, we propose dual-hormone treatment with insulin and glucagon as a method for achieving near normalization of blood glucose levels without increasing hypoglycaemia frequency and weight gain. We briefly summarize glucagon pathophysiology in type 1 diabetes as well as the current applications of glucagon for the treatment of hypoglycaemia. Until now, the use of glucagon has been limited by the need for reconstitution immediately before use, because of instability of the available compounds; however, stabile compounds are soon to be launched and will render long-term intensive dual-hormone treatment in type 1 diabetes possible.
1型糖尿病强化胰岛素治疗可降低微血管和大血管并发症的发生率并减缓其进展；然而，它与低血糖风险增加和体重增加有关。在本综述中，我们提出胰岛素和胰高血糖素联合激素治疗作为一种在不增加低血糖发生频率和体重增加的情况下实现血糖水平接近正常化的方法。我们简要总结了1型糖尿病中胰高血糖素的病理生理学以及胰高血糖素目前在低血糖治疗中的应用。到目前为止，由于现有化合物的不稳定性，胰高血糖素的使用受到使用前需立即复溶的限制；然而，稳定的化合物即将推出，这将使1型糖尿病的长期强化双激素治疗成为可能。
