Wolffenbuttel B H, Heine R J
Academisch Ziekenhuis, afd. Endocrinologie en Stofwisselingsziekten, Maastricht.
Ned Tijdschr Geneeskd. 1998 Feb 21;142(8):397-400.
Patients with diabetes mellitus type I usually are treated with a multiple injection regimen comprising rapid-acting insulin before meals and intermediate-acting insulin at bedtime. Recently, the rapid-acting insulin analogue insulin LISPRO was introduced on the Dutch market. This form of insulin is very rapidly taken up into the bloodstream from the subcutaneous tissue. The advantages of the use of insulin LISPRO are the comfort of injecting the insulin just before a meal, the more rapid correction of incidental hyperglycaemia and the slightly lower incidence of (nocturnal) hypoglycaemia in comparison with conventional rapid-acting insulin. There is no argument in favour of switching diabetics to insulin LISPRO if they are well-controlled with normal rapid-acting insulin and have few episodes of hypoglycaemia. In some persons the duration of action of insulin LISPRO may be too short, leading to preprandial hyperglycaemia. This can be avoided by using a second injection of intermediate-acting insulin, either before breakfast or before lunch.
I型糖尿病患者通常采用多次注射方案治疗，包括在饭前注射速效胰岛素以及在睡前注射中效胰岛素。最近，速效胰岛素类似物赖脯胰岛素已在荷兰市场推出。这种形式的胰岛素能非常迅速地从皮下组织吸收进入血液循环。使用赖脯胰岛素的优点包括：在饭前即刻注射胰岛素时的便利性、能更迅速地纠正偶发性高血糖，以及与传统速效胰岛素相比，（夜间）低血糖的发生率略低。如果糖尿病患者使用常规速效胰岛素控制良好且低血糖发作较少，就没有理由转而使用赖脯胰岛素。在一些人身上，赖脯胰岛素的作用持续时间可能过短，导致餐前高血糖。这可以通过在早餐前或午餐前额外注射一次中效胰岛素来避免。
