Инсулин гларгин: фармакокинетические и фармакодинамические основы клинического эффекта

Гларгин стал первым длительно действующим аналогом инсулина, разработанным для удовлетворения потребности в базальном инсулине на протяжении суток в режиме одной инъекции. Фармакокинетика гларгина характеризуется биотрансформацией в метаболиты M1 и М2, что делает В-цепь молекулы гларгина идентичной В-цепи инсулина человека. Концентрации активных метаболитов М1 и М2 в плазме не имеют выраженного пика, что обусловливает более низкую вариабельность гликемии и риск гипогликемии по сравнению с НПХ-инсулином. По метаболической активности метаболиты М1 и М2 подобны инсулину гларгин, в то время как их митогенный эффект не превышает таковой у инсулина человека. Несмотря на то, что аффинность гларгина к рецептору инсулиноподобного фактора роста-1 значительно выше, чем у человеческого инсулина, in vivo гларгин не оказывает пролиферативный эффект благодаря быстрому преобразованию в метаболиты. Вариабельность фармакокинетики и фармакодинамики гларгина сопоставима с другими инсулинами. Указанные особенности имеют важное значение для клинической эффективности и безопасности применения гларгина.

сахарный диабет, инсулин, гларгин, метаболит M1 и М2, фармакокинетика, фармакодинамика, вариабельность действия инсулина, гипогликемии, митогенный эффект.

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