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胰岛素不良事件

Insulin Adverse Events.

作者信息

Ludvigsson Johnny

机构信息

Crown Princess Victoria Children´s Hospital and Div of Pediatrics, Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden, E-mail:

出版信息

Pediatr Endocrinol Rev. 2020 Mar;17(Suppl 1):183-190. doi: 10.17458/per.vol17.2020.l.insulinadverseevents.

Abstract

The negative consequencies of diabetes treatment are traditionally regarded as caused by a disastrous treatment rather than adverse events of the insulin preparations. However, hypoglycemia, changes at the injection site (lipatrophy, lipoma), insulin allergy, obesity and increased risk of certain forms of cancer can easily be regarded as adverse events of the drug, and needle-phobia, psychological problems, increased risk of suicide are adverse events related to insulin and its administration. Also macroangiopathy and even microangiopathy to some extent can be regarded as adverse events as the most crucial part of the treatment of Type 1 diabetes is the insulin treatment. There is still room for improvments of insulin as a drug. We need insulins with more predictable absorption and kinetics, leading to more stable near-normal blood glucose, less risk of hypoglycemia, less effect in periphery and more effect on the liver, and less risk of vascular complications, obesity, cancer.

摘要

传统上认为糖尿病治疗的负面后果是由灾难性治疗导致的,而非胰岛素制剂的不良事件。然而,低血糖、注射部位变化(脂肪萎缩、脂肪瘤)、胰岛素过敏、肥胖以及某些癌症形式风险增加,都很容易被视为药物的不良事件,而针头恐惧症、心理问题、自杀风险增加则是与胰岛素及其给药相关的不良事件。此外,大血管病变甚至在一定程度上的微血管病变也可被视为不良事件,因为1型糖尿病治疗的关键部分是胰岛素治疗。胰岛素作为一种药物仍有改进空间。我们需要吸收和动力学更可预测的胰岛素,从而使血糖更稳定地接近正常水平,低血糖风险更低,外周作用更小,对肝脏作用更大,血管并发症、肥胖、癌症风险更低。

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