Fleming Laurie W, Fleming Joshua W, Davis Courtney S
Department of Pharmacy Practice, School of Pharmacy, University of Mississippi, Jackson, Mississippi.
J Am Assoc Nurse Pract. 2015 Oct;27(10):597-601. doi: 10.1002/2327-6924.12247. Epub 2015 Mar 12.
The purpose of this article is to educate nurse practitioners about Afrezza.
A comprehensive literature search was conducted using MEDLINE for clinical trial data. Information from the Centers of Disease Control and Prevention, World Health Organization, clinical guidelines, Food and Drug Administration labeling, briefings, and press releases was also utilized.
Afrezza represents a promising noninjectable insulin delivery option for type 1 and type 2 diabetes mellitus. According to clinical trial evidence, it appears to be efficacious and comparable to currently available prandial insulin options, and based on current data, it appears to be a safe alternative to injectable insulin with high treatment satisfaction.
Afrezza may offer an alternative for insulin naïve patients who are hesitant about initiating traditional insulin. It may cause less weight gain when compared to subcutaneous mealtime insulin with a more rapid absorption and elimination profile, but more long-term studies are needed. Afrezza is limited in type 1 diabetes to use in combination with basal insulin. It is not recommended in the treatment of diabetic ketoacidosis or for patients who smoke. It is contraindicated during hypoglycemic episodes, in chronic lung diseases, or in those with hypersensitivity to regular human insulin or any of the excipients in Afrezza.
本文旨在对执业护士进行有关Afrezza的培训。
使用MEDLINE进行了全面的文献检索以获取临床试验数据。还利用了疾病控制与预防中心、世界卫生组织的信息、临床指南、食品药品监督管理局的标签、简报及新闻稿。
对于1型和2型糖尿病患者，Afrezza是一种有前景的非注射胰岛素给药选择。根据临床试验证据，它似乎有效且与目前可用的餐时胰岛素选择相当，并且基于当前数据，它似乎是一种安全的可替代注射胰岛素的药物，患者治疗满意度高。
Afrezza可能为那些对开始使用传统胰岛素犹豫不决的初治胰岛素患者提供一种选择。与皮下餐时胰岛素相比，它可能导致体重增加较少，吸收和消除更快，但需要更多的长期研究。在1型糖尿病中，Afrezza仅限于与基础胰岛素联合使用。不推荐用于治疗糖尿病酮症酸中毒或吸烟患者。在低血糖发作期间、慢性肺部疾病患者或对常规人胰岛素或Afrezza中的任何辅料过敏的患者中禁用。
