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引用次数: 14

摘要

严格控制血糖在降低糖尿病相关结果中的重要性已得到充分认识。然而,尽管有多种可用的治疗方案,临床经验表明,糖尿病患者经常无法实现良好的血糖控制。相反,患者的血糖水平往往控制不佳,难以预测。在胰岛素治疗的患者中,其中一个原因可能是外源性注射胰岛素的内在可变作用。例如,目前可获得的旨在提供持续基础循环胰岛素水平的长效胰岛素制剂,在受试者之间和受试者体内的作用都存在显著差异。不可预测的胰岛素作用导致血糖控制不稳定,这除了增加低血糖的风险外,还被证明是死亡的独立危险因素。希望长效胰岛素制剂的进展将为患者提供显著的益处,改善控制和减少可变性。在药理学和临床研究中,一种新的长效类似物,地特米胰岛素,已被证明比其他基础胰岛素制剂具有更小的可变性。地特米胰岛素提供的胰岛素反应的可预测性的提高可能与许多临床益处有关,包括降低低血糖和体重增加。
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Insulin detemir: improving the predictability of glycaemic control.

The importance of strict glycaemic control in reducing diabetes-related outcomes is well recognised. Yet, despite the range of available treatment options, clinical experience suggests that individuals with diabetes frequently fail to achieve good glucose control. Instead, patients often have poorly controlled, unpredictable blood glucose levels. In insulin-treated patients, one of the reasons for this may be the inherently variable action of exogenously injected insulin. For example, the currently available longer-lasting insulin preparations that aim to provide a continuous basal level of circulating insulin are associated with markedly variable action both between and within subjects. Unpredictable insulin action contributes to variable blood glucose control, which in addition to increasing the risk of hypoglycaemia has also been shown to be an independent risk factor for mortality. It is hoped that advances in longer-lasting insulin preparations will provide significant benefits to patients, improving control and reducing variability. A new, long-lasting analogue, insulin detemir, has been shown to be significantly less variable than other basal insulin preparations in pharmacological and clinical studies. The improved predictability in insulin response offered by insulin detemir may be associated with a number of clinical benefits including a reduction in hypoglycaemia and weight gain.

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