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2型糖尿病的胰岛素治疗:临床疗效、患者报告结局及依从性挑战的见解

Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges.

作者信息

Emad-Eldin Mahmoud, Balata Gehan F, Elshorbagy Eman A, Hamed Mona S, Attia Mohamed S

机构信息

Department of Pharmacy Practice, Faculty of Pharmacy, Zagazig University, Zagazig HFQM+872, Al-Sharqia Governorate, Egypt.

Department of Pharmacy Practice, Faculty of Pharmacy, Heliopolis University, Cairo 44519, Egypt.

出版信息

World J Diabetes. 2024 May 15;15(5):828-852. doi: 10.4239/wjd.v15.i5.828.

Abstract

Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease progresses. Over the past century, insulin formulations have undergone significant modifications and bioengineering, resulting in a diverse range of available insulin products. These products show distinct pharmacokinetic and pharmacodynamic profiles. Consequently, various insulin regimens have em-erged for the management of type 2 diabetes, including premixed formulations and combinations of basal and bolus insulins. The utilization of different insulin regimens yields disparate clinical outcomes, adverse events, and, notably, patient-reported outcomes (PROs). PROs provide valuable insights from the patient's perspective, serving as a valuable mine of information for enhancing healthcare and informing clinical decisions. Adherence to insulin therapy, a critical patient-reported outcome, significantly affects clinical outcomes and is influenced by multiple factors. This review provides insights into the clinical effectiveness of various insulin preparations, PROs, and factors impacting insulin therapy adherence, with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.

摘要

随着2型糖尿病病情的发展,胰岛素治疗在其管理中起着至关重要的作用。在过去的一个世纪里,胰岛素制剂经历了重大的改良和生物工程改造,产生了各种各样的可用胰岛素产品。这些产品呈现出不同的药代动力学和药效学特征。因此,出现了各种用于管理2型糖尿病的胰岛素治疗方案,包括预混制剂以及基础胰岛素和餐时胰岛素的联合使用。不同胰岛素治疗方案的使用会产生不同的临床结果、不良事件,尤其是患者报告的结果(PROs)。PROs从患者的角度提供了有价值的见解,是改善医疗保健和为临床决策提供信息的宝贵信息来源。坚持胰岛素治疗是一项关键的患者报告结果,它会显著影响临床结果,并受多种因素影响。本综述深入探讨了各种胰岛素制剂的临床有效性、PROs以及影响胰岛素治疗依从性的因素,旨在改善医疗实践,并为2型糖尿病患者的临床决策提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d66a/11099362/484379c2998b/WJD-15-828-g001.jpg

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