长效胰岛素类似物在儿童青少年1型糖尿病治疗中的价值  

Role of long-acting insulin analogues in the management of type 1 diabetes in children and adolescent

作　　者：顾熔[1] 杨涛[1] 顾威[2] Gu Rong;Yang Tao;Gu Wei(Department of Endocrinology,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Endocrinology,Children′s Hospital of Nanjing Medical University Nanjing 210008,China)

机构地区：[1]南京医科大学第一附属医院内分泌科,210029 [2]南京医科大学附属儿童医院内分泌科,210008

出　　处：《中华内分泌代谢杂志》2019年第4期345-349,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：流行病学调查显示,我国儿童青少年1型糖尿病发病率迅速增长,但整体血糖控制并不理想,由此导致较高的并发症发生率,威胁患儿的健康。既往研究结果显示,我国儿童青少年1型糖尿病血糖控制不佳可能与其使用的胰岛素治疗方案不够合理有关。基础-餐时胰岛素方案是儿童青少年1型糖尿病管理的重要方法,然而该方案在改善血糖控制的同时也带来较高的低血糖风险。基础胰岛素是基础-餐时胰岛素方案中的重要组分,对方案的疗效和安全性有举足轻重的影响。甘精胰岛素等长效胰岛素类似物具有良好的疗效/安全性特征,低血糖风险低于中性鱼精蛋白胰岛素(neutral protamine Hagedorn, NPH),是适合儿童青少年1型糖尿病患者基础胰岛素治疗的理想选择。A recent national wide epidemiological study showed that the incidence of type 1 diabetes mellitus(T1DM)was increased among children and adolescents in China. However, the glycemic control was not optimal, leading to high incidence of complications. Previous studies demonstrated that inappropriate insulin regimen was a major cause of sub-optimal glycemic control. Basal-bolus regimen recommended by international pediatric guidelines, significantly improved glycemic control with increased hypoglycemia risk. Given that basal insulin largely contributed to efficacy and safety profiles of base-bolus regimen, long-acting insulin analogues, such as insulin glargine(100U), have ideal efficacy/safety profiles, especially lower hypoglycemia risk compared with neutral protamine Hagedorn(NPH). Therefore, long-acting insulin analogues is a good choice for basal-bolus regimen treatment in children and adolescents with T1DM.

关 键 词：糖尿病 1型 儿童青少年 基础-餐时胰岛素方案 基础胰岛素 

分 类 号：R725.8[医药卫生—儿科]