Suppr超能文献

胰岛素类似物在2型糖尿病治疗中的应用及未来展望

Insulin analogs in the treatment of type II diabetes and future perspectives.

作者信息

Sebastian Sneha Annie, Co Edzel Lorraine, Mehendale Meghana, Hameed Maha

机构信息

Azeezia Medical College, Kollam, Kerala, India.

University of Santo Tomas, Faculty of Medicine and Surgery, Manila, Philippines.

出版信息

Dis Mon. 2023 Mar;69(3):101417. doi: 10.1016/j.disamonth.2022.101417. Epub 2022 Apr 27.

Abstract

The discovery of insulin by Banting and Best marked 100 years in 2021, and it was a life-saving treatment modality for type II diabetes mellitus (T2DM). Insulin is a natural hormone that has been used extensively in T2DM patients since its discovery. Currently, insulin analogs are also available in different formulations for T2DM management, overcoming the limitations of human insulin with better safety and side effect profiles. The insulin analogs like the rapid-acting analogs (Aspart, lispro, glulisine), the long-acting basal analogs (Glargine, detemir), the ultra-long acting (Insulin degludec), and the premixed insulin analog formulations (75% Neutral protamine lispro, 25% lispro; 50% neutral protamine lispro, 50% lispro; 70% protamine aspart, 30% aspart) have been prepared through genetic engineering while preserving the basic insulin profile. A large number of studies have demonstrated their clinical effects on glycated hemoglobin test (HbA1c) in achieving glycemic control and thereby lowering the microvascular and macrovascular complications of T2DM with less traditional side effects of regular human insulin, mainly the risk of hypoglycemia, postprandial glycemic excursions, and weight gain. This review explores the currently available insulin analogs, their clinical implications, pharmacokinetics (PK), pharmacodynamics (PD), safety profile, and cost-effectiveness. We also discuss the future developments in the management of T2DM, especially the scientific advancements surrounding the novel insulin formulations, including the biosimilar insulin, and the innovative insulin delivery methods, such as oral and inhaled insulin.

摘要

2021年是班廷和贝斯特发现胰岛素100周年,胰岛素是治疗2型糖尿病(T2DM)的一种挽救生命的治疗方式。胰岛素是一种天然激素,自发现以来已在T2DM患者中广泛使用。目前,胰岛素类似物也有不同剂型可用于T2DM的管理,克服了人胰岛素的局限性,具有更好的安全性和副作用特征。速效类似物(门冬胰岛素、赖脯胰岛素、谷赖胰岛素)、长效基础类似物(甘精胰岛素、地特胰岛素)、超长效(德谷胰岛素)以及预混胰岛素类似物制剂(75% 中性鱼精蛋白锌赖脯胰岛素、25% 赖脯胰岛素;50% 中性鱼精蛋白锌赖脯胰岛素、50% 赖脯胰岛素;70% 精蛋白锌门冬胰岛素、30% 门冬胰岛素)等胰岛素类似物已通过基因工程制备,同时保留了基本的胰岛素特性。大量研究已证明它们对糖化血红蛋白检测(HbA1c)的临床效果,可实现血糖控制,从而降低T2DM的微血管和大血管并发症,且较少出现常规人胰岛素的传统副作用,主要是低血糖风险、餐后血糖波动和体重增加。本综述探讨了目前可用的胰岛素类似物、它们的临床意义、药代动力学(PK)、药效学(PD)、安全性概况和成本效益。我们还讨论了T2DM管理的未来发展,特别是围绕新型胰岛素制剂的科学进展,包括生物类似物胰岛素,以及创新的胰岛素给药方法,如口服和吸入胰岛素。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验