Valensi P, Zirinis P, Nicolas P, Perret G, Sandre-Banon D, Attali J R
Service d'Endocrinologie-Diabétologie-Nutrition, Université Paris-Nord, BONDY, France.
Pathol Biol (Paris). 1996 Apr;44(4):235-40.
The bioavailability of rapid-acting insulin administered as a nasal spray was studied in 6 type 1 (insulin-dependent) diabetic patients. They received long-acting bovine insulin (Ultratardum 40 U/ml, Organon) as basal treatment at 8 a.m. Rapid-acting insulin was also administered at 8 a.m., then at noon and 6 p.m, subcutaneously on day 1 as a 100 U/ml solution and intranasally by aerosol spray as a 100 U/ml and 500 U/ml with 1% (w/v) 9 lauryl ether solution on day 2 and day 3 respectively. On days 2 and 3, the dose of insulin was at least nine times higher than the subcutaneous dose on day 1. Free and total plasma insulin concentrations were assayed after the noon insulin administration. The peaks of the free and total plasma insulin levels were reached earlier and the return to basal levels was obtained earlier after nasal insulin administration than after insulin injected subcutaneously. The bioavailability of nasal spray insulin versus subcutaneous insulin with a 100 U/ml insulin solution was similar to that with a 500 U/ml insulin solution: 5.14 +/- 0.38% (m +/- SEM) and 4.64 +/- 0.46% according to the total plasma insulin level. This study suggests that the bioavailability of nasal spray insulin is not increased by increasing insulin concentration in our experimental conditions.
在6名1型(胰岛素依赖型)糖尿病患者中研究了经鼻喷雾给药的速效胰岛素的生物利用度。他们于上午8点接受长效牛胰岛素(优泌林40 U/ml,欧加农公司)作为基础治疗。速效胰岛素也于上午8点给药,然后在第1天的中午和下午6点皮下注射100 U/ml溶液,在第2天和第3天分别经鼻喷雾给予100 U/ml和500 U/ml并含1%(w/v)月桂醚溶液。在第2天和第3天,胰岛素剂量至少比第1天的皮下剂量高9倍。在中午胰岛素给药后测定游离和总血浆胰岛素浓度。与皮下注射胰岛素相比,经鼻给予胰岛素后游离和总血浆胰岛素水平的峰值出现更早,且恢复到基础水平也更早。100 U/ml胰岛素溶液经鼻喷雾胰岛素与皮下胰岛素的生物利用度和500 U/ml胰岛素溶液相似:根据总血浆胰岛素水平分别为5.14±0.38%(m±SEM)和4.64±0.46%。本研究表明,在我们的实验条件下,增加胰岛素浓度并不会提高经鼻喷雾胰岛素的生物利用度。