Woo Vincent C
Section of Endocrinology and Metabolism, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
Clin Ther. 2017 Aug;39(8S2):S12-S33. doi: 10.1016/j.clinthera.2017.01.007. Epub 2017 Feb 7.
The treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) using insulin is not ideal at this time. Despite advances made with basal insulin analogues, many individuals achieve less than optimal glycemic control or are at risk for hypoglycemia. Currently available basal insulin analogues do not deliver steady, peakless, continuous insulin for >24 hours and are associated with adverse events, including hypoglycemia. The objective of this paper was to review the clinical efficacy and safety of upcoming long-acting insulin analogues such as insulin degludec and insulin glargine 300 U/mL (Gla-300).
A comprehensive literature search of PubMed and Google Scholar was conducted from 1966 to 2015. The search included randomized controlled trials that specifically assessed the efficacy and safety of insulin degludec and Gla-300 in patients with T1DM and T2DM.
The efficacy of insulin degludec and Gla-300 in achieving glycemic control has been reported in clinical trials in adults with T1DM and T2DM. Not only did a large number of patients succeed in meeting glycosylated hemoglobin targets, but they also experienced reductions in hypoglycemic events. These 2 therapies are associated with a reduced risk of nocturnal hypoglycemia and are generally well tolerated.
The long-acting insulin analogues insulin degludec and Gla-300 are promising therapies in the treatment of T1DM and T2DM. Their improved insulin delivery for >24 hours offers glycemic control with a good safety profile.
目前,使用胰岛素治疗1型糖尿病(T1DM)和2型糖尿病(T2DM)并不理想。尽管基础胰岛素类似物取得了进展,但许多患者的血糖控制仍未达到最佳水平,或有低血糖风险。目前可用的基础胰岛素类似物无法提供持续超过24小时的稳定、无峰值的持续胰岛素,且与包括低血糖在内的不良事件相关。本文的目的是综述即将上市的长效胰岛素类似物,如德谷胰岛素和甘精胰岛素300 U/mL(Gla-300)的临床疗效和安全性。
对1966年至2015年期间的PubMed和谷歌学术进行了全面的文献检索。检索包括专门评估德谷胰岛素和Gla-300在T1DM和T2DM患者中的疗效和安全性的随机对照试验。
在T1DM和T2DM成人患者的临床试验中,已报道了德谷胰岛素和Gla-300在实现血糖控制方面的疗效。不仅大量患者成功达到糖化血红蛋白目标,而且他们的低血糖事件也有所减少。这两种疗法与夜间低血糖风险降低相关,且总体耐受性良好。
长效胰岛素类似物德谷胰岛素和Gla-300是治疗T1DM和T2DM的有前景的疗法。它们超过24小时的改善胰岛素输送提供了良好安全性的血糖控制。