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Erschienen in: CME 1-2/2018

07.02.2018 | Typ-1-Diabetes | CME Fortbildung

Möglichkeiten und Grenzen der aktuellen Insulintherapie

Diabetes mellitus

verfasst von: Prof. Dr. med. Thomas Forst

Erschienen in: CME | Ausgabe 1-2/2018

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Zusammenfassung

Für viele Diabetespatienten ist eine Insulintherapie unverzichtbar. Dabei wird eine möglichst straffe Blutzuckereinstellung ohne Hypoglykämien und Gewichtszunahme angestrebt. Die exogene Insulinsubstitution ist aber bis heute mit erheblichen Limitationen verbunden, trotz vieler Neuerungen. Wie ist der Stand der Dinge? Und was könnte die Zukunft bringen?
Literatur
1.
Zurück zum Zitat Home PD: The pharmacokinetics and pharmacodynamics of rapid-acting insulin analogues and their clinical consequences. Diabetes Obes Metab 14:780–788, 2012CrossRefPubMed Home PD: The pharmacokinetics and pharmacodynamics of rapid-acting insulin analogues and their clinical consequences. Diabetes Obes Metab 14:780–788, 2012CrossRefPubMed
2.
Zurück zum Zitat Arnolds S, Rave K, Hövelmann U, Fischer A, Sert-Langeron C, Heise T: Insulin Glulisine has a faster onset of action than Insulin Aspart. Int J Obes Relat Metab Disord 58 (Supplement 1):A141, 2009 Arnolds S, Rave K, Hövelmann U, Fischer A, Sert-Langeron C, Heise T: Insulin Glulisine has a faster onset of action than Insulin Aspart. Int J Obes Relat Metab Disord 58 (Supplement 1):A141, 2009
3.
Zurück zum Zitat Heise T, Nosek L, Spitzer H, Heinemann L, Niemoller E, Frick AD, Becker RH: Insulin glulisine: a faster onset of action compared with insulin lispro. Diabetes Obes Metab 9:746–753, 2007CrossRefPubMed Heise T, Nosek L, Spitzer H, Heinemann L, Niemoller E, Frick AD, Becker RH: Insulin glulisine: a faster onset of action compared with insulin lispro. Diabetes Obes Metab 9:746–753, 2007CrossRefPubMed
4.
Zurück zum Zitat Kalra S, Gupta Y: Ultra-fast acting insulin analogues. Recent Pat Endocr Metab Immune Drug Discov 8:117–123, 2014CrossRefPubMed Kalra S, Gupta Y: Ultra-fast acting insulin analogues. Recent Pat Endocr Metab Immune Drug Discov 8:117–123, 2014CrossRefPubMed
5.
Zurück zum Zitat Biester T, Kordonouri O, Danne T: Pharmacological Properties of Faster-Acting Insulin Aspart. Curr Diab Rep 17:101, 2017CrossRefPubMed Biester T, Kordonouri O, Danne T: Pharmacological Properties of Faster-Acting Insulin Aspart. Curr Diab Rep 17:101, 2017CrossRefPubMed
6.
Zurück zum Zitat Bowering K, Case C, Harvey J, Reeves M, Sampson M, Strzinek R, Bretler DM, Bang RB, Bode BW: Faster Aspart Versus Insulin Aspart as Part of a Basal-Bolus Regimen in Inadequately Controlled Type 2 Diabetes: The onset 2 Trial. Diabetes Care 40:951–957, 2017CrossRefPubMed Bowering K, Case C, Harvey J, Reeves M, Sampson M, Strzinek R, Bretler DM, Bang RB, Bode BW: Faster Aspart Versus Insulin Aspart as Part of a Basal-Bolus Regimen in Inadequately Controlled Type 2 Diabetes: The onset 2 Trial. Diabetes Care 40:951–957, 2017CrossRefPubMed
7.
Zurück zum Zitat Russell-Jones D, Bode BW, De BC, Franek E, Heller SR, Mathieu C, Philis-Tsimikas A, Rose L, Woo VC, Osterskov AB, Graungaard T, Bergenstal RM: Fast-Acting Insulin Aspart Improves Glycemic Control in Basal-Bolus Treatment for Type 1 Diabetes: Results of a 26-Week Multicenter, Active-Controlled, Treat-to-Target, Randomized, Parallel-Group Trial (onset 1). Diabetes Care 40:943–950, 2017CrossRefPubMed Russell-Jones D, Bode BW, De BC, Franek E, Heller SR, Mathieu C, Philis-Tsimikas A, Rose L, Woo VC, Osterskov AB, Graungaard T, Bergenstal RM: Fast-Acting Insulin Aspart Improves Glycemic Control in Basal-Bolus Treatment for Type 1 Diabetes: Results of a 26-Week Multicenter, Active-Controlled, Treat-to-Target, Randomized, Parallel-Group Trial (onset 1). Diabetes Care 40:943–950, 2017CrossRefPubMed
8.
Zurück zum Zitat Bode BW, Johnson JA, Hyveled L, Tamer SC, Demissie M: Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion. Diabetes Technol Ther 19:25–33, 2017CrossRefPubMedPubMedCentral Bode BW, Johnson JA, Hyveled L, Tamer SC, Demissie M: Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion. Diabetes Technol Ther 19:25–33, 2017CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Becker RH, Nowotny I, Teichert L, Bergmann K, Kapitza C: Low within- and between-day variability in exposure to new insulin glargine 300 U/ml. Diabetes Obes Metab 17:261–267, 2015CrossRefPubMedPubMedCentral Becker RH, Nowotny I, Teichert L, Bergmann K, Kapitza C: Low within- and between-day variability in exposure to new insulin glargine 300 U/ml. Diabetes Obes Metab 17:261–267, 2015CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Becker RH, Nowotny I, Teichert L, Bergmann K, Kapitza C: Low within- and between-day variability in exposure to new insulin glargine 300 U/ml. Diabetes Obes Metab 17:261–267, 2015CrossRefPubMedPubMedCentral Becker RH, Nowotny I, Teichert L, Bergmann K, Kapitza C: Low within- and between-day variability in exposure to new insulin glargine 300 U/ml. Diabetes Obes Metab 17:261–267, 2015CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Rossetti P, Ampudia-Blasco FJ, Ascaso JF: Old and new basal insulin formulations: understanding pharmacodynamics is still relevant in clinical practice. Diabetes Obes Metab 16:695–706, 2014CrossRefPubMed Rossetti P, Ampudia-Blasco FJ, Ascaso JF: Old and new basal insulin formulations: understanding pharmacodynamics is still relevant in clinical practice. Diabetes Obes Metab 16:695–706, 2014CrossRefPubMed
12.
Zurück zum Zitat Heise T, Nosek L, Ronn BB, Endahl L, Heinemann L, Kapitza C, Draeger E: Lower within-subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1 diabetes. Diabetes 53:1614–1620, 2004CrossRefPubMed Heise T, Nosek L, Ronn BB, Endahl L, Heinemann L, Kapitza C, Draeger E: Lower within-subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1 diabetes. Diabetes 53:1614–1620, 2004CrossRefPubMed
13.
Zurück zum Zitat Horvath K, Jeitler K, Berghold A, Ebrahim SH, Gratzer TW, Plank J, Kaiser T, Pieber TR, Siebenhofer A: Long-acting insulin analogues versus NPH insulin (human isophane insulin) for type 2 diabetes mellitus. Cochrane Database Syst RevCD005613, 2007 Horvath K, Jeitler K, Berghold A, Ebrahim SH, Gratzer TW, Plank J, Kaiser T, Pieber TR, Siebenhofer A: Long-acting insulin analogues versus NPH insulin (human isophane insulin) for type 2 diabetes mellitus. Cochrane Database Syst RevCD005613, 2007
14.
Zurück zum Zitat Gerstein HC, Bosch J, Dagenais GR, Diaz R, Jung H, Maggioni AP, Pogue J, Probstfield J, Ramachandran A, Riddle MC, Ryden LE, Yusuf S: Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med 367:319–328, 2012CrossRefPubMed Gerstein HC, Bosch J, Dagenais GR, Diaz R, Jung H, Maggioni AP, Pogue J, Probstfield J, Ramachandran A, Riddle MC, Ryden LE, Yusuf S: Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med 367:319–328, 2012CrossRefPubMed
15.
Zurück zum Zitat Sutton G, Minguet J, Ferrero C, Bramlage P: U300, a novel long-acting insulin formulation. Expert Opin Biol Ther 14:1849–1860, 2014CrossRefPubMed Sutton G, Minguet J, Ferrero C, Bramlage P: U300, a novel long-acting insulin formulation. Expert Opin Biol Ther 14:1849–1860, 2014CrossRefPubMed
16.
Zurück zum Zitat Riddle MC, Yki-Jarvinen H, Bolli GB, Ziemen M, Muehlen-Bartmer I, Cissokho S, Home PD: One-year sustained glycaemic control and less hypoglycaemia with new insulin glargine 300 U/ml compared with 100 U/ml in people with type 2 diabetes using basal plus meal-time insulin: the EDITION 1 12-month randomized trial, including 6-month extension. Diabetes Obes Metab 17:835–842, 2015CrossRefPubMedPubMedCentral Riddle MC, Yki-Jarvinen H, Bolli GB, Ziemen M, Muehlen-Bartmer I, Cissokho S, Home PD: One-year sustained glycaemic control and less hypoglycaemia with new insulin glargine 300 U/ml compared with 100 U/ml in people with type 2 diabetes using basal plus meal-time insulin: the EDITION 1 12-month randomized trial, including 6-month extension. Diabetes Obes Metab 17:835–842, 2015CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Hordern SV, Wright JE, Umpleby AM, Shojaee-Moradie F, Amiss J, Russell-Jones DL: Comparison of the effects on glucose and lipid metabolism of equipotent doses of insulin detemir and NPH insulin with a 16-h euglycaemic clamp. Int J Obes Relat Metab Disord 48:420–426, 2005 Hordern SV, Wright JE, Umpleby AM, Shojaee-Moradie F, Amiss J, Russell-Jones DL: Comparison of the effects on glucose and lipid metabolism of equipotent doses of insulin detemir and NPH insulin with a 16-h euglycaemic clamp. Int J Obes Relat Metab Disord 48:420–426, 2005
18.
Zurück zum Zitat Home P, Kurtzhals P: Insulin detemir: from concept to clinical experience. Expert Opin Pharmacother 7:325–343, 2006CrossRefPubMed Home P, Kurtzhals P: Insulin detemir: from concept to clinical experience. Expert Opin Pharmacother 7:325–343, 2006CrossRefPubMed
19.
Zurück zum Zitat Heise T, Hermanski L, Nosek L, Feldman A, Rasmussen S, Haahr H: Insulin degludec: four times lower pharmacodynamic variability than insulin glargine under steady-state conditions in type 1 diabetes. Diabetes Obes Metab 14:859–864, 2012CrossRefPubMed Heise T, Hermanski L, Nosek L, Feldman A, Rasmussen S, Haahr H: Insulin degludec: four times lower pharmacodynamic variability than insulin glargine under steady-state conditions in type 1 diabetes. Diabetes Obes Metab 14:859–864, 2012CrossRefPubMed
20.
Zurück zum Zitat Heller S, Buse J, Fisher M, Garg S, Marre M, Merker L, Renard E, Russell-Jones D, Philotheou A, Francisco AM, Pei H, Bode B: Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 1 diabetes (BEGIN Basal-Bolus Type 1): a phase 3, randomised, open-label, treat-to-target non-inferiority trial. Lancet 379:1489–1497, 2012CrossRefPubMed Heller S, Buse J, Fisher M, Garg S, Marre M, Merker L, Renard E, Russell-Jones D, Philotheou A, Francisco AM, Pei H, Bode B: Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 1 diabetes (BEGIN Basal-Bolus Type 1): a phase 3, randomised, open-label, treat-to-target non-inferiority trial. Lancet 379:1489–1497, 2012CrossRefPubMed
21.
Zurück zum Zitat Zinman B, Philis-Tsimikas A, Cariou B, Handelsman Y, Rodbard HW, Johansen T, Endahl L, Mathieu C: Insulin degludec versus insulin glargine in insulin-naive patients with type 2 diabetes: a 1-year, randomized, treat-to-target trial (BEGIN Once Long). Diabetes Care 35:2464–2471, 2012CrossRefPubMedPubMedCentral Zinman B, Philis-Tsimikas A, Cariou B, Handelsman Y, Rodbard HW, Johansen T, Endahl L, Mathieu C: Insulin degludec versus insulin glargine in insulin-naive patients with type 2 diabetes: a 1-year, randomized, treat-to-target trial (BEGIN Once Long). Diabetes Care 35:2464–2471, 2012CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Meneghini L, Atkin SL, Gough SC, Raz I, Blonde L, Shestakova M, Bain S, Johansen T, Begtrup K, Birkeland KI: The efficacy and safety of insulin degludec given in variable once-daily dosing intervals compared with insulin glargine and insulin degludec dosed at the same time daily: a 26-week, randomized, open-label, parallel-group, treat-to-target trial in individuals with type 2 diabetes. Diabetes Care 36:858–864, 2013CrossRefPubMedPubMedCentral Meneghini L, Atkin SL, Gough SC, Raz I, Blonde L, Shestakova M, Bain S, Johansen T, Begtrup K, Birkeland KI: The efficacy and safety of insulin degludec given in variable once-daily dosing intervals compared with insulin glargine and insulin degludec dosed at the same time daily: a 26-week, randomized, open-label, parallel-group, treat-to-target trial in individuals with type 2 diabetes. Diabetes Care 36:858–864, 2013CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Mathieu C, Hollander P, Miranda-Palma B, Cooper J, Franek E, Russell-Jones D, Larsen J, Tamer SC, Bain SC: Efficacy and safety of insulin degludec in a flexible dosing regimen vs insulin glargine in patients with type 1 diabetes (BEGIN: Flex T1): a 26-week randomized, treat-to-target trial with a 26-week extension. J Clin Endocrinol Metab 98:1154–1162, 2013CrossRefPubMedPubMedCentral Mathieu C, Hollander P, Miranda-Palma B, Cooper J, Franek E, Russell-Jones D, Larsen J, Tamer SC, Bain SC: Efficacy and safety of insulin degludec in a flexible dosing regimen vs insulin glargine in patients with type 1 diabetes (BEGIN: Flex T1): a 26-week randomized, treat-to-target trial with a 26-week extension. J Clin Endocrinol Metab 98:1154–1162, 2013CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Marso SP, McGuire DK, Zinman B, Poulter NR, Emerson SS, Pieber TR, Pratley RE, Haahr PM, Lange M, Brown-Frandsen K, Moses A, Skibsted S, Kvist K, Buse JB: Efficacy and Safety of Degludec versus Glargine in Type 2 Diabetes. N Engl J Med 377:723–732, 2017CrossRefPubMed Marso SP, McGuire DK, Zinman B, Poulter NR, Emerson SS, Pieber TR, Pratley RE, Haahr PM, Lange M, Brown-Frandsen K, Moses A, Skibsted S, Kvist K, Buse JB: Efficacy and Safety of Degludec versus Glargine in Type 2 Diabetes. N Engl J Med 377:723–732, 2017CrossRefPubMed
25.
Zurück zum Zitat Matteucci E, Giampietro O, Covolan V, Giustarini D, Fanti P, Rossi R: Insulin administration: present strategies and future directions for a noninvasive (possibly more physiological) delivery. Drug Des Devel Ther 9:3109–3118, 2015CrossRefPubMedPubMedCentral Matteucci E, Giampietro O, Covolan V, Giustarini D, Fanti P, Rossi R: Insulin administration: present strategies and future directions for a noninvasive (possibly more physiological) delivery. Drug Des Devel Ther 9:3109–3118, 2015CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Hordern SV, Wright JE, Umpleby AM, Shojaee-Moradie F, Amiss J, Russell-Jones DL: Comparison of the effects on glucose and lipid metabolism of equipotent doses of insulin detemir and NPH insulin with a 16-h euglycaemic clamp. Diabetologia 48:420–426, 2005CrossRefPubMed Hordern SV, Wright JE, Umpleby AM, Shojaee-Moradie F, Amiss J, Russell-Jones DL: Comparison of the effects on glucose and lipid metabolism of equipotent doses of insulin detemir and NPH insulin with a 16-h euglycaemic clamp. Diabetologia 48:420–426, 2005CrossRefPubMed
27.
Zurück zum Zitat Herring R, Jones RH, Russell-Jones DL: Hepatoselectivity and the evolution of insulin. Diabetes Obes Metab 16:1–8, 2014CrossRefPubMed Herring R, Jones RH, Russell-Jones DL: Hepatoselectivity and the evolution of insulin. Diabetes Obes Metab 16:1–8, 2014CrossRefPubMed
Metadaten
Titel
Möglichkeiten und Grenzen der aktuellen Insulintherapie
Diabetes mellitus
verfasst von
Prof. Dr. med. Thomas Forst
Publikationsdatum
07.02.2018
Verlag
Springer Medizin
Erschienen in
CME / Ausgabe 1-2/2018
Print ISSN: 1614-371X
Elektronische ISSN: 1614-3744
DOI
https://doi.org/10.1007/s11298-018-6417-7

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