References

diaendo

Сахарный диабет

Diabetes mellitus

2072-03512072-0378

Endocrinology research centre

10.14341/DM2014291-104

diaendo-6605

Research Article

Диагностика, контроль, лечение

Diagnosis, control, treatment

Инсулин деглудек ? новый аналог инсулина сверхдлительного действия

Insulin degludec is a new ultra-long-acting insulin analogue

Дедов

Иван Иванович

Dedov

Ivan Ivanovich

доктор медицинских наук, профессор, академик РАН, Директор ФГБУ ЭНЦ

MD, PhD, professor, fellow of Russian Academy of Sciences, Head of Endocrinology Research Centre

dedov@endocrincentr.ru

Шестакова

Марина Владимировна

Shestakova

Marina Vladimirovna

доктор медицинских наук, профессор, член-корреспондент РАН, Директор Института диабета ФГБУ ЭНЦ

MD, PhD, professor, corresponding fellow of Russian Academy of Sciences, Head of Diabetes Institution in Endocrinology Research Centre

nephro@endocrincentr.ru

ФГБУ "Эндокринологический научный центр" Минздрава России, МоскваРоссияEndocrinology Research Centre, MoscowRussian Federation

2014

03062014

17291104

2014

Дедов И.И., Шестакова М.В.

Dedov I.I., Shestakova M.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.dia-endojournals.ru/jour/article/view/6605

Достижение оптимального гликемического контроля является важным аспектом предупреждения и замедления прогрессирования ассоциированных с сахарным диабетом осложнений, а также снижения стоимости их лечения. Аналоги инсулина длительного действия гларгин и детемир, в отличие от инсулина НПХ, позволяют улучшить гликемический контроль при более низком риске гипогликемий. Однако страх развития гипогликемии и увеличения веса, а также сложность используемого режима все еще являются основными барьерами, препятствующими своевременной инициации и интенсификации инсулинотерапии. Инсулин деглудек (Тресиба?) ? новый аналог инсулина сверхдлительного действия. После подкожного введения деглудек образует депо растворимых мультигексамеров, которые постепенно всасываются в кровоток, обеспечивая ровный, стабильный сахароснижающий эффект длительностью более 42 ч и низкую интра-индивидуальную вариабельность, в отличие от ныне используемых аналогов базального инсулина ? инсулинов гларгин и детемир. В семи рандомизированных открытых контролируемых исследованях 3-й фазы длительностью 26 или 52 недели, выполненных в дизайне с терапией до достижения цели (не выше), у пациентов с сахарным диабетом 1 и 2 типа инсулин деглудек обеспечил достижение такого же гликемического контроля, что и инсулин гларгин, при более низком риске ночных гипогликемий и хорошем профиле безопасности. Кроме того, исследования, изучавшие гибкий режим дозирования инсулина деглудек у пациентов с сахарным диабетом 1 типа, показали возможность изменения времени введения инсулина без ущерба для гликемического контроля и безопасности терапии.

Achieving optimal glycemic control is an important aspect of preventing and slowing the progression of diabetes-associated complications, and reducing the cost of their treatment. Long-acting insulin analogues, glargine and detemir, provide better metabolic control with reduced risk of hypoglycaemia as compared to NPH insulin. However, fear of hypoglycaemia and weight gain, as well as the complexity of regimen, are still the most important barriers to well-timed initiation and intensification of insulin therapy. Insulin degludec (Tresiba?) is a new ultra-long-acting insulin analogue. After subcutaneous injection degludec forms repository of soluble multi-hexamers, which are gradually absorbed to the bloodstream, providing a flat, stable antihyperglycemic effect lasting more than 42 h, and low intra-individual variability as opposed to currently used basal insulin analogues, insulin glargine and insulin detemir. In the seven randomized, open label, controlled phase 3 trials lasting 26 or 52 weeks, using treat-to-target (no more) non-inferiority design, insulin degludec provided glycemic control similar to that of insulin glargine with lower risk of nocturnal hypoglycaemia and good safety profile in patients with type 1 or 2 diabetes. Furthermore, trials examining a flexible dosing regimen of insulin degludec in patients with type 1 or 2 diabetes have shown that it is possible to vary the injection time without compromising glycemic control or safety of the therapy.

сахарный диабетгликемический контрольбазальный инсулиндеглудекгипогликемия

diabetes mellitusglycemic controlbasal insulindegludechypoglycaemia

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The authors declare that there are no conflicts of interest present.