Insulin Degludec: Ntev npaum li cas ib qho tshuaj caij nyoog ntev dhau los them tus nqi?

Philadelphia, PA Lub Rau Hli 2012 Insulin degludec, kev siv tshuaj kho mob ntev ntev tsim los ntawm Novo Nordisk, qhia tau tias qhov tsis muaj ntshav tsawg tsawg hauv cov neeg mob ntshav qab zib hom 2, thaum tib lub sijhawm txhim kho kev tswj ntshav qab zib ntau dua piv rau insulin glargine thaum lub sijhawm kuaj mob 52-lub lim tiam. Cov txiaj ntsig ntawm txoj kev kawm no, ntu 3a, tau nthuav tawm hauv Lub Rooj Sib Tham Txog Kev Mob Ntshav Qab Zib Asmeskas ntawm Kev Noj Qab Haus Huv (ADA) 72th.

Txoj kev tshawb no kuj qhia tau hais tias insulin degludec piv nrog insulin glargine tuaj yeem txo qhov kev pheej hmoo ntawm cov mob hnyav ntawm hypoglycemia 1.

"Nocturnal hypoglycemia, lossis hypoglycemia thaum pw tsaug zog, yog qhov teeb meem tshwj xeeb rau cov neeg muaj ntshav qab zib, vim tias cov xwm txheej zoo li no feem ntau tsis tuaj yeem kwv yees thiab lawv txoj kev txhim kho tsis yooj yim,", Bernard Zinman, tus kws sau txog txoj kev tshawb no thiab lub taub hau ntawm lub chaw Tus kws saib xyuas mob ntshav qab zib Mount Sinai Tsev Kho Mob thiab tus kws kho mob ntawm cov tshuaj hauv University of Toronto.

Hauv chav kawm ntawm qhov randomized no, qhib kev kawm los ua pov thawj qhov tsis muaj qhov tsis zoo ntawm kev sib piv ntawm cov tshuaj kawm, nrog kev kho rau lub hom phiaj glycemic, qhov ua tau zoo thiab kev nyab xeeb ntawm insulin degludec thiab insulin glargine tau piv. Ob qho tshuaj insulin tau muab tshuaj ib zaug ib hnub rau 1030 cov neeg laus muaj mob ntshav qab zib hom 2 uas yav dhau los tsis tau siv tshuaj insulin, uas tsis muaj tshuaj tiv thaiv glycemic thaum lub qhov ncauj kho nrog kev siv tshuaj tiv thaiv kab mob.

Txoj kev tshawb no 1 ntsuam:

Idence Qhov tshwm sim ntawm nocturnal hypoglycemia yog qhov tseem ceeb - 36% - qis dua thaum siv tshuaj insulin lub cev qhuav dej piv nrog insulin glargine (0.25 tus mob piv nrog 0.39 mob hauv ib tus neeg mob ib xyoos, p =0.04).

Total Tas nrho cov teeb meem pom tseeb tias muaj tus mob hypoglycemia yog 1.52 tus neeg mob piv nrog 1.85 tus neeg mob hauv ib tus neeg mob ib xyoos thaum siv insulin deglyudec thiab insulin glargine, feem ( p =0.11).

Overall Tag nrho qhov tshwm sim ntawm kev mob ntshav qab zib tsawg yog tsawg hauv ob pawg kho mob, tab sis nws tau qis qis nrog cov kua dej insulin ntau dua li ntawm insulin glargine (0.003 tus neeg mob piv nrog 0.023 kis rau tus neeg mob ib xyoo, p =0.02).

Ib xyoos tom qab, txoj kev tshawb no pom tias sib piv HbA tsawg dua. _1c thaum siv cov tshuaj insulin, degludec txheeb ze rau insulin glargine (-1.06% piv rau -1.19%). **

Asting Kev yoo cov piam thaj txo qis ntau dua thaum siv cov tshuaj insulin degludek piv nrog insulin glargine (-67.7 mg / dl tiv rov qab -59.5 mg / dl, kev kho qhov tshwm sim txawv kwv yees (EDT) -7.7 mg / dl , p = 0.005).

Tag nrho qhov xwm txheej ntawm qhov tshwm sim tsis zoo yog tsawg thiab tib yam hauv ob pawg 1.

* Txhais tau tias cov piam thaj hauv ntshav nyob rau ncua sij hawm txij thaum 011 mus txog 05:59 suav nrog.

Kws Tshuaj

Lub hauv paus ntsiab lus ntawm kev ua ntawm Degludek insulin yog tib yam li tib neeg txoj kev loj hlob. Cov suab thaj ua rau cov txiaj ntsig zoo li kev ua kom cov txheej txheem qab zib siv los ntawm cov ntaub so ntswg tom qab khi rau cov rog thiab cov leeg ua kom cov nqaij thiab tib lub sijhawm txo qis tus nqi ntawm cov piam thaj los ntawm lub siab.

Tom qab txhaj ib zaug xwb ntawm qhov kev daws hauv 24 teev, nws muaj cov teeb meem zoo ib yam nkaus. Lub sijhawm siv ntawm cov nyhuv yog ntau dua 42 teev nyob rau hauv qhov kev siv tshuaj ntau npaum li cas. Nws tsim nyog sau cia tias txoj kab kev sib raug zoo tau tsim los ntawm qhov nce ntxiv ntawm cov tshuaj thiab nws cov nyhuv hypoglycemic tag nrho.

Kev kuaj mob sib txawv hauv qhov chaw muab tshuaj ntawm Degludec insulin ntawm cov neeg mob cov hluas thiab cov laus tsis tau kuaj pom. Tsis tas li, kev tsim cov tshuaj tiv thaiv rau cov tshuaj insulin kuj tsis pom tom qab Deglyudec kev kho mob ntev ntev.

Cov nyhuv ntev ntev ntawm cov tshuaj yog vim cov qauv tshwj xeeb ntawm nws cov qauv. Tom qab cov thawj coj sc, ruaj khov soli mutxheers tau tsim, uas tsim ib hom ntawm "depot" rau cov kua dej hauv cov nqaij mos subcutaneous adipose.

Multihexamers maj mam cuam tshuam, uas ua rau kev tso tawm ntawm cov tshuaj hormones monemors. Yog li, maj mam thiab lub sijhawm ntev ntawm kev daws rau hauv cov ntshav khiav tshwm sim, uas ua kom muaj kev tiaj tus, lub sijhawm ntev ntawm kev ua thiab lub suab thaj ua kom ruaj khov.

Hauv cov ntshav, CSS tau tiav ob lossis peb hnub tom qab txhaj tshuaj. Qhov faib tawm ntawm cov tshuaj muaj raws li nram no: kev sib raug zoo ntawm Degludek nrog albumin -> 99%. Yog tias cov tshuaj tau noj tshuaj subcutaneously, tom qab ntawd nws cov ntshav cov ntsiab lus yog sib npaug nrog cov tshuaj muab rau hauv cov tshuaj kho.

Qhov rhuav tshem ntawm cov tshuaj yog tib yam li nyob rau hauv rooj plaub ntawm tib neeg cov tshuaj insulin. Txhua lub cev tsim tawm hauv cov txheej txheem tsis muaj zog.

Tom qab kev tswj hwm ntawm T1 / 2 yog txiav txim siab los ntawm lub sijhawm nws nqus los ntawm cov nqaij mos subcutaneous, uas ntev li 25 teev, tsis hais noj ntau npaum li cas.

Tus tub los ntxhais ntawm cov neeg mob tsis cuam tshuam rau qhov pharmacokinetics ntawm insulin Degludec. Tsis tas li ntawd, tsis muaj qhov tshwj xeeb txawv hauv kev kho mob insulin rau cov tub ntxhais hluas, cov neeg laus thiab cov neeg mob ntshav qab zib ua rau lub siab thiab lub raum tsis ua haujlwm.

Hais txog cov menyuam yaus (6-11 xyoo) thiab cov hluas (12-18 xyoo) uas muaj ntshav qab zib hom 1, pharmacokinetics ntawm insulin Degludec zoo tib yam rau cov neeg laus. Txawm li cas los xij, nrog kev txhaj tshuaj ib zaug hauv cov neeg mob uas muaj ntshav qab zib hom 1, tag nrho cov tshuaj ntawm cov tshuaj hauv cov neeg mob hnub nyoog qis dua 18 xyoo yog ntau dua li cov ntshav qab zib cov laus.

Nws yog qhov tsim nyog tias qhov kev siv tas mus li ntawm Degludec insulin tsis cuam tshuam rau qhov kev ua me nyuam rov qab thiab tsis muaj lub cev tsis zoo rau tib neeg lub cev.

Thiab qhov piv ntawm mitogenic thiab metabolic kev ua si ntawm Degludek thiab tib neeg insulin yog tib yam.

Pharmacological pab pawg ntawm cov tshuaj Insulin degludec

Tib neeg cov tshuaj insulin analogue, ua haujlwm ntev hauv kev dej qis rau cov kua dej ua los ntawm cov khoom siv DNA thev naus laus zis siv kev lim Kev pabcuam Saccharomyces.

Cov nyhuv pharmacological ntawm insulin degludec tau pom zoo ib yam li cov nyhuv ntawm tib neeg insulin los ntawm kev khi tshwj xeeb thiab kev cuam tshuam nrog kev txais ntawm tib neeg cov tshuaj insulin.

Cov nyhuv ntawm hypoglycemic ntawm degludec insulin yog vim muaj kev siv ntau dua ntawm cov suab thaj los ntawm cov ntaub so ntswg tom qab khi rau cov leeg thiab cov roj ntsha ua kom lub zog thiab ib qho kev txo qis hauv cov ntshav qabzib ntau lawm los ntawm lub siab.

Thaum lub sijhawm 24-teev tshuaj xyuas qhov kev pabcuam hypoglycemic ntawm insulin degludec hauv cov neeg mob uas tau txais kev txhaj tshuaj 1 zaug nyob rau ib hnub, pom ib qho kev tsis sib luag ntawm thawj 12 thiab 12-teev.

Lub sijhawm ua haujlwm ntawm cov tshuaj insulin degludec yog ntau dua 42 teev nyob rau ntawm txoj kev kho siv ntau.

Txoj kab sib txuas ntawm kev nce ntxiv ntawm qhov koob tshuaj ntawm degludec insulin thiab nws cov txiaj ntsig hypoglycemic dav tau ua pov thawj.

Tsis muaj qhov sib txawv hauv qhov chaw kho mob hauv cov chaw muag tshuaj ntawm cov tshuaj insulin degludec ntawm cov neeg mob laus thiab cov neeg mob hluas.

Tsis muaj qhov tseem ceeb ntawm cov tshuaj tiv thaiv rau cov tshuaj insulin tau kuaj pom tom qab kho nrog degludec insulin rau ib ncua sijhawm.

Kev Tsis Txaus Siab Lub caij nyoog ntev ua haujlwm ntawm cov tshuaj insulin degludec yog vim tus qauv tshwj xeeb tsim ntawm nws cov molecule. Tom qab txhaj tshuaj subcutaneous, soluble ruaj khov multhexamers yog tsim uas tsim cov duab tshav ntawm cov kua dej hauv cov nqaij subcutaneous adipose. Multihexamers maj mam sib cais, tso tawm degludec insulin monomers, uas ua rau cov tshuaj qeeb thiab lub sijhawm tso tawm cov tshuaj mus rau hauv cov ntshav, muab cov ntaub ntawv ntev ntev ntawm kev ua thiab cov nyhuv hypoglycemic ruaj khov.

C_SS hauv cov ntshav ntshav tau tiav 2-3 hnub tom qab kev tswj hwm ntawm insulin degludec.

Kev xa Khoom. Kev sib txuas ntawm insulin degludec nrog cov plasma protein (albumin) yog> 99%. Nrog kev tswj hwm sc, tag nrho cov ntshav ntshav feem ntau yog ib feem ntawm cov koob tshuaj uas tau muab hauv cov tshuaj kho kom haum.

Kev zom zaub mov. Qhov kev ua kom tsis txawv ntawm cov tshuaj insulin degludec zoo ib yam li tib neeg cov insulin, tag nrho cov metabolites tsim kho tsis ua haujlwm.

Chaw Sau Ntawv. T_1/2 tom qab sc txhaj tshuaj ntawm cov tshuaj insulin, degludec yog txiav txim siab los ntawm nws qhov nqus nqus dej los ntawm cov nqaij mos subcutaneous, kwv yees li 25 teev, thiab tsis yog koob tshuaj.

Cov pab pawg neeg tshwj xeeb

Tsis muaj qhov sib txawv hauv cov khoom lag luam pharmacokinetic kho ntawm degludec insulin nyob ntawm tus tub los ntxhais ntawm cov neeg mob.

Cov neeg laus, cov neeg mob ntawm cov pab pawg sib txawv, cov neeg mob uas lub raum tsis ua haujlwm lossis mob rau daim siab. Tsis muaj qhov sib txawv hauv tsev kho mob tau pom nyob hauv pharmacokinetics ntawm kev noj tshuaj insulin degludec ntawm cov neeg laus thiab cov neeg mob hluas, ntawm cov neeg mob ntawm cov pab pawg sib txawv, ntawm cov neeg mob uas tsis zoo mob raum thiab mob siab, thiab cov neeg mob noj qab haus huv.

Menyuam yaus thiab tub ntxhais hluas. Cov chaw muag tshuaj ntawm insulin degludec hauv txoj kev tshawb fawb hauv cov menyuam yaus (6-11 xyoo) thiab cov neeg hluas (12-18 xyoo) uas muaj ntshav qab zib hom mellitus piv rau cov neeg mob hauv cov neeg laus. Tawm tsam keeb kwm ntawm kev siv ib zaug ntawm cov tshuaj rau cov neeg mob uas muaj hom 1 mob ntshav qab zib mellitus, nws tau pom tias tag nrho cov tshuaj tiv thaiv cov tshuaj hauv cov menyuam yaus thiab cov hluas yog muaj ntau dua piv rau cov neeg mob hauv cov neeg laus.

Cov ntaub ntawv los ntawm kev tshawb fawb txog kev nyab xeeb preclinical. Cov ntaub ntawv pov thawj raws li kev tshawb fawb ntawm pharmacological kev nyab xeeb, tshuaj lom ntawm kev rov ua dua, lub peev xwm carcinogenic, muaj tshuaj lom rau ntawm kev ua me nyuam, tsis qhia txog kev phom sij ntawm degludec insulin rau tib neeg. Qhov piv ntawm metabolic thiab mitogenic kev ua ntawm degludec insulin rau tib neeg insulin yog qhov zoo.

Mob ntshav qab zib rau cov neeg laus.

Ua rau txhua tus neeg nkag siab zoo rau kev noj cov hlab ntsha insulin, cov menyuam yaus hnub nyoog qis dua 18 xyoo, lub sijhawm cev xeeb tub thiab pub niam mis (tsis muaj kev paub txog cov tshuaj hauv cov menyuam yaus, pojniam thaum lub sijhawm cev xeeb tub thiab kev pub niam mis).

Kev siv cov tshuaj insulin degludec thaum cev xeeb tub thiab kev pub niam mis yog contraindicated, vim hais tias Tsis muaj qhov kev sim tshuaj nrog kev siv nws thaum lub sijhawm no.

Kuj tsis paub meej tias insulin degludec ua rau niam cov kua mis tawm ntawm tus poj niam.

FDA Fetal Action Qeb - C.

Cov kev mob tshwm sim feem ntau tau tshaj tawm thaum lub sij hawm kho nrog degludec insulin yog hypoglycemia, thiab kev fab tshuaj tsis haum tuaj yeem loj hlob, suav nrog yam tam, suav nrog tus neeg mob uas muaj feem yuav tuag taus.

Tag nrho cov kev mob tshwm sim hauv qab no, raws li cov ntaub ntawv sim saib mob, raug cais raws MedDRA thiab kab mob hauv lub cev. Qhov tshwm sim ntawm cov kev mob tshwm sim tau txheeb xyuas raws li ntau dhau los (> 1/10), feem ntau (> 1/100 txog 1/1000 txog 1/10000 rau ®

Insulin Degludec: Ntev npaum li cas ib qho tshuaj caij nyoog ntev dhau los them tus nqi?

Kev ua haujlwm ntawm tib neeg lub cev tsis tuaj yeem ua tau yam tsis muaj insulin. Qhov no yog cov tshuaj hormones tsim nyog rau kev ua cov kua nplaum, uas los nrog zaub mov, los ua lub zog.

Rau ntau yam laj thawj, qee cov tib neeg muaj insulin tsis txaus. Hauv qhov no, muaj kev xav tau ntawm kev qhia txog khoom neeg tsim cov tshuaj lom neeg rau hauv lub cev. Rau cov hom phiaj no, insulin Degludek feem ntau siv.

Cov tshuaj yog tib neeg cov tshuaj insulin uas muaj lub zog ntev ntxiv. Cov khoom lag luam yog tsim los ntawm kev tso tawm DNA biotechnology siv Saccharomyces cerevisiae lim.

Lub hauv paus ntsiab lus ntawm kev ua ntawm Degludek insulin yog tib yam li tib neeg txoj kev loj hlob. Cov suab thaj ua rau cov txiaj ntsig zoo li kev ua kom cov txheej txheem qab zib siv los ntawm cov ntaub so ntswg tom qab khi rau cov rog thiab cov leeg ua kom cov nqaij thiab tib lub sijhawm txo qis tus nqi ntawm cov piam thaj los ntawm lub siab.

Tom qab txhaj ib zaug xwb ntawm qhov kev daws hauv 24 teev, nws muaj cov teeb meem zoo ib yam nkaus. Lub sijhawm siv ntawm cov nyhuv yog ntau dua 42 teev nyob rau hauv qhov kev siv tshuaj ntau npaum li cas. Nws yog tsim nyog sau cia tias txoj kab kev sib raug zoo tau tsim los ntawm qhov nce ntawm cov tshuaj thiab nws cov nyhuv hypoglycemic tag nrho.

Kev kuaj mob sib txawv hauv qhov chaw muab tshuaj ntawm Degludec insulin ntawm cov neeg mob cov hluas thiab cov laus tsis tau kuaj pom. Tsis tas li, kev tsim cov tshuaj tiv thaiv rau cov tshuaj insulin kuj tsis pom tom qab Deglyudec kev kho mob ntev ntev.

Cov nyhuv ntev ntev ntawm cov tshuaj yog vim cov qauv tshwj xeeb ntawm nws cov qauv. Tom qab cov thawj coj sc, ruaj khov soli mutxheers tau tsim, uas tsim ib hom ntawm "depot" rau cov kua dej hauv cov nqaij mos subcutaneous adipose.

Multihexamers maj mam cuam tshuam, uas ua rau kev tso tawm ntawm cov tshuaj hormones monemors. Yog li, maj mam thiab lub sijhawm ntev ntawm kev daws rau hauv cov ntshav khiav tshwm sim, uas ua kom muaj kev tiaj tus, lub sijhawm ntev ntawm kev ua thiab lub suab thaj ua kom ruaj khov.

Hauv cov ntshav, CSS tau tiav ob lossis peb hnub tom qab txhaj tshuaj. Qhov faib tawm ntawm cov tshuaj muaj raws li nram no: kev sib raug zoo ntawm Degludek nrog albumin -> 99%. Yog tias cov tshuaj tau noj tshuaj subcutaneously, tom qab ntawd nws cov ntshav cov ntsiab lus yog sib npaug nrog cov tshuaj muab rau hauv cov tshuaj kho.

Qhov rhuav tshem ntawm cov tshuaj yog tib yam li nyob rau hauv tib neeg ntawm insulin. Txhua lub cev tsim tawm hauv cov txheej txheem tsis muaj zog.

Tom qab kev tswj hwm ntawm T1 / 2 yog txiav txim siab los ntawm lub sijhawm nws nqus los ntawm cov nqaij mos subcutaneous, uas ntev li 25 teev, tsis hais noj ntau npaum li cas.

Tus tub los ntxhais ntawm cov neeg mob tsis cuam tshuam rau qhov pharmacokinetics ntawm insulin Degludec. Tsis tas li ntawd, tsis muaj qhov tshwj xeeb txawv hauv kev kho mob insulin rau cov tub ntxhais hluas, cov neeg laus thiab cov neeg mob ntshav qab zib ua rau lub siab thiab lub raum tsis ua haujlwm.

Hais txog cov menyuam yaus (6-11 xyoo) thiab cov hluas (12-18 xyoo) uas muaj ntshav qab zib hom 1, pharmacokinetics ntawm insulin Degludec zoo tib yam rau cov neeg laus. Txawm li cas los xij, nrog kev txhaj tshuaj ib zaug hauv cov neeg mob uas muaj ntshav qab zib hom 1, tag nrho cov tshuaj ntawm cov tshuaj hauv cov neeg mob hnub nyoog qis dua 18 xyoo yog ntau dua li cov ntshav qab zib cov laus.

Nws yog ib qho tsim nyog hais tias kev siv tas mus li ntawm Degludek insulin tsis cuam tshuam rau kev ua me nyuam rov qab thiab tsis muaj lub cev tsis zoo rau tib neeg lub cev.

Thiab qhov piv ntawm mitogenic thiab metabolic kev ua ub no ntawm Degludek thiab tib neeg insulin yog tib yam.

Cov tshuaj insulin ntev ntev - Glargin lossis Degludek

Sau los ntawm Alla thaum lub Kaum Ib Hlis 7, 2017. Tshaj tawm hauv Xov Xwm Kho

Hauv lub cev noj qab nyob zoo, cov tshuaj insulin yog qhov tsis pub dhau (qhov tseem ceeb tawm) thiab pib tsim thaum nws yog qhov yuav tsum txo qis cov piam thaj hauv cov ntshav (piv txwv, tom qab noj mov). Yog tias muaj qhov tsis txaus ntseeg ntawm insulin hauv tib neeg lub cev, nws yuav tsum tau txhaj tshuaj insulin los ntawm kev txhaj tshuaj, uas yog, kev kho mob insulin.

Lub luag haujlwm ntawm cov tshuaj insulin ntev (ntev ntev), uas tsim tawm hauv cov qauv ntawm cov npiv, yog ib qho kev xav ntawm lub ntsiab (txuas ntxiv) pancreatic secretion.

Lub hom phiaj tseem ceeb ntawm cov tshuaj yog kom tswj tau qhov tseem ceeb cov tshuaj nyob hauv cov ntshav rau lub sijhawm ntev txaus. Yog li, nws hu ua insulin basal.

Qhov tshuaj hormones no feem ntau muab faib ua ob hom: tshuaj (NPH) nrog kev ua ntev thiab cov duab sib txig sib xyaw.

Rau cov mob ntshav qab zib, tib neeg NPH insulin thiab nws cov yeeb yam ntev (analogues) kuj tseem muaj. Cov lus hauv qab no qhia cov kev sib txawv tseem ceeb ntawm cov tshuaj no.

Thaum lub Cuaj Hlis 2015, qhov tshiab ntawm Abasaglar ua yeeb yam ntev ntev tau tshaj tawm, uas yuav luag zoo tib yam rau Lantus ubiquitous.

Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA, Asmeskas FDA) - Lub koomhaum tseemfwv qib siab mus rau Tebchaws Meskas Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv hauv xyoo 2016 tau pom zoo txuas ntxiv cov tshuaj insulin ntev, Toujeo. Cov khoom no muaj nyob rau hauv cov lag luam hauv tsev thiab ua pov thawj nws cov hauj lwm zoo hauv kev kho mob ntshav qab zib.

Qhov no yog ib hom qauv ntawm cov hluavtaws insulin qauv tsim qauv ntawm tib neeg insulin, tab sis enriched nrog protamine (ntses protein) kom qeeb nws cov nyhuv. NPH tau pos huab. Yog li ntawd, ua ntej tswj hwm, nws yuav tsum tau ua tib zoo tig los sib tov kom zoo.

NPH yog daim ntawv qis tshaj plaws ntawm kev siv tshuaj insulin. Hmoov tsis zoo, nws ua rau muaj kev pheej hmoo siab ntau ntawm hypoglycemia thiab qhov hnyav nce, vim tias nws muaj qhov tshaj tawm hauv kev ua si (txawm hais tias nws cov nyhuv yog maj mam thiab tsis nrawm li ntawm cov tshuaj insulin hauv ib lub cev).

Cov neeg mob ntshav qab zib hom 1 feem ntau yog txhaj ob zaug tshuaj NPH insulin rau ib hnub. Thiab cov neeg mob uas muaj ntshav qab zib hom 2 tuaj yeem txhaj ib hnub ib zaug. Txhua yam nws yog nyob ntawm theem ntawm cov piam thaj hauv cov ntshav thiab tus kws kho mob cov lus pom zoo.

Cov tshuaj insulin, cov tshuaj lom neeg hauv cov tshuaj uas tau hloov pauv kom lawv maj mam nqus thiab cuam tshuam ntawm cov tshuaj, yog suav tias yog hluavtaws analogue ntawm tib neeg cov tshuaj insulin.

Lantus, Abasaglar, Tujeo thiab Tresiba muaj cov yeeb yam zoo sib xws - lub sijhawm ua haujlwm ntev dua thiab tsis tshua pom lub ncov ntawm kev ua dua NPH. Hauv qhov no, lawv qhov kev nkag tsawg txo kev pheej hmoo ntawm hypoglycemia thiab lub cev qhov hnyav. Txawm li cas los xij, tus nqi ntawm analogues yog siab dua.

Abasaglar, Lantus, thiab Tresiba cov tshuaj insulin yog ib zaug ib hnub. Qee tus neeg mob tseem siv tshuaj Levemir ib hnub ib zaug. Qhov no tsis siv rau cov neeg muaj ntshav qab zib hom 1 rau cov neeg uas ua yeeb tshuaj tsawg dua 24 teev.

Tresiba yog qhov tshiab tshaj plaws thiab tam sim no kim tshaj plaws ntawm daim ntawv insulin muaj nyob rau ntawm kev ua lag luam. Txawm li cas los xij, nws muaj qhov tseem ceeb tseem ceeb - txoj kev pheej hmoo ntawm ntshav qog ntshav, tshwj xeeb tshaj yog thaum tsaus ntuj, yog qhov qis tshaj.

Lub luag haujlwm ntawm cov tshuaj insulin ntev yog sawv cev rau lub zais qhov tseem ceeb ntawm cov kua dej los ntawm cov kua txiav ntshav. Yog li, qib sib luag ntawm cov tshuaj no hauv cov ntshav tau paub meej hauv nws cov haujlwm. Qhov no tso cai rau peb lub cev siv cov piam thaj hauv cov ntshav hauv 24 teev.

Txhua qhov kev tawm tsam ntev ntev yog txhaj rau hauv qab daim tawv nqaij mus rau qhov chaw uas muaj cov rog ua rog. Lub cev tom qab ntawm tus ncej puab yog qhov zoo tshaj plaws rau cov laj thawj no. Qhov chaw no tso cai rau kom qeeb qeeb, kev nqus ntawm cov dej ntawm cov tshuaj. Nyob ntawm qhov teem caij mus los ntawm tus kws kho mob endocrinologist, koj yuav tsum tau txhaj ib lossis ob zaug ib hnub.

Qhov zoo thiab qhov tsis zoo ntawm kev ua haujlwm ntev ntawm insulin

Hom insulin koj xaiv nyob ntawm ntau yam, nrog rau koj li kev kho mob yav dhau los, kev pheej hmoo ntawm lub qog ntshav qab zib, thiab qhov kev tswj hwm ntawm koj cov tshuaj insulin txhua hnub.

Yog tias koj lub hom phiaj xav kom muaj cov tshuaj insulin tsawg li tsawg tau, siv Abasaglar, Lantus, Toujeo, lossis Tresiba analogues. Ib qho kev txhaj tshuaj (sawv ntxov lossis yav tsaus ntuj, tab sis nco ntsoov nyob rau tib lub sijhawm ntawm nruab hnub) tuaj yeem muab cov tshuaj pleev xim txawv ib ncig ntawm lub moos.

Koj yuav tsum tau txhaj ob zaug nyob rau ib hnub txhawm rau tswj cov qib ntshav ntshav zoo thaum xaiv NPH. Qhov no, txawm li cas los xij, tso cai rau koj los kho lub koob tshuaj nyob ntawm lub sijhawm ntawm hnub thiab kev ua si - siab dua thaum nruab hnub thiab tsawg dua thaum mus pw.

Kev cuam tshuam nrog lwm yam tshuaj

Cov ntaub ntawv ntawm nplooj ntawv tau txheeb xyuas qhov tseeb los ntawm kws kho mob Vasilieva E.I.

Yuav ua li cas xaiv txoj cai piv rau
Hauv khw muag tshuaj, tshuaj feem ntau muab faib ua cov lus ua kom sib piv thiab cov duab analogues. Cov txheej txheem ntawm cov lus txhais suav nrog ib los yog ntau qhov kev dhia tshuaj qub uas muaj kev kho lub cev. Los ntawm cov qauv piv txwv yog cov tshuaj uas muaj cov tshuaj sib txawv, tab sis npaj rau kev kho mob ntawm tib cov kab mob.

Qhov sib txawv ntawm cov kis thiab kab mob
Cov kab mob kis tau yog tshwm sim los ntawm cov kab mob, kab mob, hu ua fungi thiab protozoa. Cov chav kawm ntawm kab mob tshwm sim los ntawm cov kab mob thiab cov kab mob feem ntau zoo sib xws. Txawm li cas los xij, kom paub qhov txawv ntawm qhov ua rau tus mob txhais tau tias xaiv qhov kev kho mob uas yuav pab tau sai sai nrog qhov malaise thiab yuav tsis ua mob rau tus menyuam.

Kev ua xua yog qhov ua rau mob khaub thuas
Qee tus neeg tau paub txog qhov xwm txheej uas tus menyuam yaus nyob ntev thiab ntau lub sijhawm muaj tus mob khaub thuas. Cov niam txiv coj nws mus rau cov kws kho mob, ua cov kev xeem, siv tshuaj, thiab vim li ntawd, tus me nyuam twb sau npe nrog kws kho mob raws li feem ntau mob. Qhov tseeb uas ua rau mob ntsws ua pa heev tsis txheeb xyuas.

Txoj hlab zis: kho mob chlamydial urethritis
Chlamydial urethritis feem ntau pom muaj nyob ntawm txoj kev siv ntawm urologist. Nws tshwm sim los ntawm tus kab mob intracellular parasite Chlamidia trachomatis, uas muaj cov khoom ntawm ob hom kab mob thiab kab mob, uas feem ntau xav tau cov tshuaj tua kab mob ntev mus rau kev siv tshuaj tua kab mob. Nws muaj peev xwm ua rau tsis muaj qhov mob tshwj xeeb ntawm txoj hlab zis rau txiv neej thiab poj niam.

Rp.: Insulini degludecumi 100 PIECES / 3 ml - Tsis muaj
D.S. Subcutaneously 1 lub sijhawm nyob rau ib hnub.

Kev tua ntshav. Cov nyhuv pharmacological ntawm insulin degludec tau pom zoo ib yam li cov nyhuv ntawm tib neeg insulin los ntawm kev khi tshwj xeeb thiab kev cuam tshuam nrog kev txais ntawm tib neeg cov tshuaj insulin. Cov nyhuv ntawm hypoglycemic ntawm degludec insulin yog vim muaj kev siv ntau dua ntawm cov suab thaj los ntawm cov ntaub so ntswg tom qab khi rau cov leeg thiab cov roj ntsha ua kom lub zog thiab ib qho kev txo qis hauv cov ntshav qabzib ntau lawm los ntawm lub siab.

Subcutaneously 1 lub sijhawm nyob rau ib hnub, nyiam dua tib lub sijhawm. Qhov tshuaj tau raug muab xam ib leeg zuj zus raws li cov ntsiab lus qabzib nyob hauv cov ntshav ntshav. Cov neeg mob uas muaj ntshav qab zib hom I xav tau ntxiv ntxiv rau kev npaj tshuaj insulin kom sai sai kom ntseeg tau tias muaj kev tiv thaiv insulin (ua ntej noj mov) insulin.

- mob ntshav qab zib rau cov neeg laus.

- nce ib tug neeg rhiab rau degludec insulin
- cov me nyuam qis dua 18 xyoo
- lub sijhawm ntawm cev xeeb tub thiab pub niam mis (tsis muaj kev paub txog kev siv tshuaj nyob hauv menyuam yaus, pojniam thaum cev xeeb tub thiab pub niam mis).

Kev daws d / p / rau qhov kev taw qhia ntawm 100 PIECES / 1 ml: cartridges 3 ml 5 pcs.
Kev daws rau sc tswj hwm yog pob tshab, xim tsis muaj zog.
1 ml:
kev sib xyaw ntawm cov tshuaj insulin degludec thiab cov tshuaj insulin aspart hauv qhov sib piv ntawm 70/30
(sib npaug rau 2.56 mg ntawm cov tshuaj insulin degludec thiab 1.05 mg ntawm cov tshuaj insulin aspart) 100 IU *
Cov neeg siv: glycerol - 19 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinc 27.4 μg (raws li zinc acetate 92 μg), sodium chloride 0.58 mg, hydrochloric acid los yog sodium hydroxide (rau kev kho pH), dej d / thiab - txog li 1 ml.

3 ml (300 PIECES) - Penfill® iav daim cartridges (5) - Al / PVC cov hlwv (1) - pob cov duab los qhia.
pH ntawm kev daws 7.4.
* 1 PIECE muaj 0.0256 mg ntawm anhydrous saltless insulin degludec thiab 0.0105 mg ntawm anhydrous saltless insulin aspart, uas sib raug rau 1 IU ntawm tib neeg insulin, 1 chav tsev ntawm insulin detemir, insulin glargine lossis biphasic insulin aspart.

Cov ntaub ntawv ntawm nplooj ntawv koj tab tom saib yog tsim rau cov ntaub ntawv lub hom phiaj nkaus xwb thiab tsis txhawb nqa nws tus kheej kev noj tshuaj hauv ib txoj kev twg. Cov peev txheej yog npaj los ua kom paub cov kws kho mob paub ntxiv txog qee yam tshuaj, yog li nce lawv qib kev tshaj lij. Kev siv yeeb tshuaj “Insulin degludec” tsis muaj swb muab kev sab laj nrog tus kws tshaj lij, nrog rau nws cov lus pom zoo ntawm txoj kev siv thiab ntau npaum li cas ntawm koj cov tshuaj xaiv.

Ntshav qab zib mellitus, hom 1, hom 2, kev kuaj mob, kho mob, ntshav qab zib, ntshav qab zib hauv menyuam yaus

Zoo siab txais tos, Nyob zoo cov neeg tuaj saib lub site! Niaj hnub no hauv peb cov nplooj ntawv peb yuav tham txog lub ntsiab lus tseem ceeb heev rau txhua tus mob ntshav qab zib noj cov tshuaj insulin. Tsis ntev los no ntau tshaj (Lub Peb Hlis 2014), ib lub tuam txhab loj tshaj plaws ntawm cov khoom neeg tsim cov tshuaj lom neeg Novo Nordisk qhia txog qhov khoom noj tshiab ntawm superlong kev ua - deglyutek. Nws yog xov xwm kho mob ntshav qab zib siab tshaj ua ntej xyoo 2014.

Yuav pib nrog, qhov xav tau rau kev kho mob insulin tuaj yeem tshwm sim nrog txhua yam ntshav qab zib. Ntxiv mus, cov neeg mob T2DM feem ntau siv cov insulins "ntev". Txog thaum tsis ntev los no, glargin (Lantus) thiab detemir (Levemir) tau ua haujlwm ntev tshaj plaws. Lawv qhov kev ua tau zoo nyob ntev li ib hnub.

Deglutec yog ib qho txiaj ntsig super-ntev. Lub sij hawm ntawm nws kom nquag plias sijhawm ua haujlwm yog 36-42 teevCov. Txawm li cas los xij, nws tseem yog ib qho tshuaj tsis muaj txiaj ntsig, muaj qhov zoo tshaj tawm thiab muaj qhov pib ntawm kev ua. Tam sim no, txoj kev siv ntawm cov tshuaj tau kawm tsuas yog kho cov neeg laus cov neeg laus. Menyuam yaus thiab poj niam cev xeeb tub tsis koom nrog qhov kev sim siab!

Ntau cov kev tshawb fawb (Tebchaws USA, Nyiv, Canada, Is Nrias teb, EU) qhia tias kev them nyiaj ntawm tus kabmob tiv thaiv keeb kwm ntawm subcutaneous cov thawj coj ntawm lub tshiab tsis yog tsis tsuas yog qis dua rau cov chav kawm mob ntshav qab zib thaum kho nrog glargine, tab sis txawm tias me ntsis dhau ntawm cov neeg sib tw ntawm cov ntsuas. Lub ntsiab sib txawv yog qhov pheej hmoo tsawg kawg nkaus ntawm kev txo qis vim lub ntsej muag ncaj qha.

Nws ntseeg tias kev txaus siab tswj kev mob ntshav qab zib tuaj yeem ua tiav los ntawm kev siv cov tshuaj tshiab tsuas yog 3 zaug hauv ib lub lim tiam. Qhov kev koom tes no yuav txo qis qhov kev txhaj tshuaj txhua hnub, thiab cov neeg mob uas muaj ntshav qab zib hom 2 thiab qee lwm cov kab mob tsis tshua muaj txiaj ntsig yuav muaj peev xwm txhim kho lawv lub neej zoo, txo qis cov teebmeem ntawm kev kho mob ntshav qab zib.

Lub sijhawm tam sim no, kev siv cov tshuaj no raug tso cai hauv EU, Asmeskas, Canada thiab qee lub tebchaws. Kuj ceeb tias, kawg tau tso cai muag cov tshuaj los ntawm nws cov neeg tsim txiaj - cov Askiv. Lawv tau txiav txim siab tias tus nqi kho yog ntau dhau, yog li nws tsis pom zoo kom qhia qhov tshuaj hormones rau ntau tus neeg mob.

Ib lub pev txwv kuj yuav tshwm sim hauv tebchaws Russia nyob rau hauv lub npe kev lag luam Tresiba, cov tshuaj yuav raug nchuav ntawm ib lub hoobkas hauv nroog Kaluga. Yog lawm, nws cia siab tias, raws li cov ntawv qhia dawb, cov neeg mob ntshav qab zib hauv tsev yuav tau txais nws sai sai, txog tam sim no. Tab sis ntawm lawv tus kheej kev tawm tswv yim, hauv kev sib koom tes nrog tus kws kho mob koom nrog, nws yuav muaj peev xwm pib txoj kev kho kom zoo yav tom ntej.

Peb lub vev xaib yuav saib xyuas cov xov xwm tshiab tshaj plaws hauv kev kho mob ntshav qab zib thiab yuav qhia koj thaum nws paub tias theem 3 ntawm kev sim tshuaj tshiab tau ua tiav, i.e. nws yuav muaj rau txhua txhua tus neeg.

Ntxiv rau Tim 17, 2015: Yog li thawj qhov kev coj ua tawm Treshiba hauv chaw kho mob hauv tsev tau tshwm sim. Tam sim no, nyob rau hauv txoj kev sim, cov neeg mob ntshav qab zib uas yav dhau los tau txais Lantus tau hloov mus rau nws. Yog tias qhov xav tau, cov tshuaj yuav tau ntawm ntau lub tsev muag tshuaj ntawm tus nqi. Raws li tau hais los ntawm cov chaw tsim khoom, cov nyhuv kav txog li 36 teev, feem, kev txhaj tshuaj nyob rau hauv cov tshuaj uas ze rau qhov uas tau ntawm Lantus tau ua ib zaug txhua 1.5 hnub nrog kev hloov pauv ib teev lossis ob zaug ua ntej.

Tshuaj Insulin degludec - yuav siv li cas rau hom 1 thiab ntshav qab zib hom 2

Txhua qhov kev txhaj tshuaj insulin yog cais los ntawm lub sijhawm ua rau 2 pawg.

Cov tshuaj sib xyaw ua ke yog tau tsim kho, khiav lag luam hauv 2 theem.

Degludec yog cov tshuaj lom neeg muaj tshuaj lom neeg ntev, siv rau hom 1 thiab ntshav qab zib hom 2.

Nws yog tsim ua tsaug rau niaj hnub thev naus laus zis ntawm kev tsim kho tshuab.

Tresiba FlexTouch (lub npe lag luam rau cov tshuaj insulin) tam sim no yog cov tshuaj nkaus xwb nrog cov tshuaj nquag - insulin degludec.

Pom zoo siv rau kev mob ntshav qab zib hom 1 hauv cov neeg mob neeg laus.

Qee zaus cov kws kho mob yuam kom muab tshuaj rau hauv cov xwm txheej zoo li no:

• nrog rau qhov ua tsis tau zoo ntawm cov tshuaj ntawm qhov ncauj, tsis muaj peev xwm tswj tau cov ntshav qab zib kom tsawg,
• contraindications rau kev siv cov tshuaj hauv qhov ncauj,
• kuaj mob ntshav qab zib muaj ntshav qab zib ntau ntau thiab cov tsos mob uas cuam tshuam,
• myocardial infarction
• lub paj hlwb angiography,
• mob ntshav roj,
• mob sib kis tau yooj yim
• tom qab phais.

Kev kho mob ntshav qab zib hom 2 pib nrog kev noj haus thiab tshuaj ntsiav.

Cov ntawv sau los ntawm peb cov nyeem

Kuv tus niam pog tau mob ntshav qab zib tau ntev ntev (hom 2), tab sis tsis ntev los no cov teeb meem tau ploj mus ntawm nws ob txhais ceg thiab hauv nruab nrog cev.

Kuv txhob txwm nrhiav tau ib tsab xov xwm hauv Is Taws Nem uas khaws kuv lub neej. Nws yog qhov nyuaj rau kuv pom qhov tsim txom, thiab qhov tsis hnov ​​tsw phem hauv chav tsev tau ua rau kuv vwm.

Los ntawm cov chav kawm ntawm kev kho, lub granny txawm hloov nws lub siab. Nws tau hais tias nws ob txhais ceg tsis raug mob thiab qhov mob tsis huam vam li lawm; lwm lub lim tiam peb yuav mus tom kws kho mob. Tshaj tawm qhov txuas rau kab lus

Xav txog qhov zoo ntawm cov tshuaj:

• yooj yim zam los ntawm lub cev,
• theem zoo ntawm kev ntxuav tu
• hypoallergenicity.

Cov tshuaj tswj cov tshuaj glycemia 24-40 teev. Txoj kev pheej hmoo ntawm nce ua suab thaj nrog txoj kev noj tshuaj yog tsawg heev.

Yuav ua li cas kom qab zib kom zoo nyob rau hauv 2019

Nov yog ib qho tshuaj kim kim uas ua rau muaj kev phiv. Cov kev xav tsis zoo tshwm sim feem ntau tshwm sim tom qab ua txhaum txoj cai ntawm kev coj ua, kev hloov ntau npaum li cas, kev xaiv cov tshuaj kho tsis raug.

Qhov no yog qhov khoom neeg tsim cov tshuaj ntawm superlong kev ua. Nws yog txhaj rau hauv daim tawv nqaij 1 zaug hauv ib hnub, nws raug nquahu kom txhaj rau tib lub sijhawm, soj ntsuam cov kev tswj hwm. Hauv hom 2 pathology, nws yog siv los ua kev kho mob thiab hauv PHGP los yog nrog insulin bolus.

Yog tias muaj tus kabmob hom 1, nws yog siv nrog kev sib ntxiv ntawm cov tshuaj hormones ntawm luv thiab ultrashort kev ua haujlwm kom txaus siab rau qhov kev xav tau ntawm insulin tsis txaus siab. Qhov ntau npaum li cas ntawm cov tshuaj tau txiav txim siab los ntawm tus kws tshwj xeeb, suav txog qhov xav tau ntawm tus neeg mob. Txhawm rau qhov ib txwm muaj qib ntawm glycemia, koj tuaj yeem kho lub koob tshuaj ntawm cov tshuaj noj mus rau hauv tus account qib ntawm cov piam thaj ntawm lub plab khoob.

Cov koob tshuaj hloov pauv thaum tus neeg mob pib mob siab rau kev tawm dag zog, hloov khoom noj lossis nws muaj qhov tsis haum xeeb.

• Txog hom mob ntshav qab zib hom 2 - 10 units ib hnub, ua haujlwm dhau sijhawm, tus kws kho keeb endocrinologist hloov qhov tshuaj txhaj ib tus zuj zus.
• Rau cov ntshav qab zib hom 1 - siv ib zaug ib hnub nyob rau hauv sib xyaw nrog prandial insulin, uas tau txhaj nrog zaub mov. Tus kws kho mob saib xyuas lub cev kev teb rau tshuaj, xaiv ib qho tshuaj rau ib tug neeg.

Thaum hloov cov tshuaj insulin-raws li, cov piam thaj hauv qab zib yog tswj hwm hauv thawj ob peb lub lis piam tom qab siv cov tshuaj tshiab.

Txoj cai noj tshuaj hloov pauv tau raug siv raws li kev xav tau ntawm cov ntshav qab zib. Cov tshuaj tuaj yeem muab tshuaj nyob rau lub sijhawm sib txawv ntawm lub hnub nrog lub sijhawm tsawg kawg ntawm 8 teev. Cov neeg uas tsis nco qab txhaj cov tshuaj hormones uas tsis raug nyob rau lub sijhawm yuav tsum siv tshuaj kom sai li sai tau thaum lawv nco qab qhov no, tom qab ntawd rov kho lawv cov tshuaj yav dhau los.

Tsis muaj qhov sib txawv ntawm qhov chaw muag tshuaj ntawm Pharmacokinetic cov yam ntxwv ntawm Degludec insulin, nyob ntawm poj niam txiv neej. Cov neeg laus ntshav qab zib uas muaj cov kab mob ntawm cov khoom nruab nrog sab hauv yuav tsum siv cov tshuaj nrog ceev faj. Tsis muaj qhov sib txawv hauv qhov chaw kho mob hauv cov chaw muag tshuaj ntawm cov tshuaj insulin Degludek ntawm cov neeg laus thiab cov neeg mob ntshav qab zib.

Cov Insulin cuam tshuam rau lub cev ntawm cov menyuam yaus thiab cov hluas, raws li cov neeg laus. Nrog rau kev siv ntau npaum li cas ntawm cov tshuaj, hom 1 ntshav qab zib tau tuaj yeem txiav txim siab tias tag nrho cov txiaj ntsig ntawm cov tshuaj ntawm cov tshuaj hauv cov menyuam yaus muaj ntau dua li cov neeg laus.

Peb muab cov luv nqi rau cov nyeem ntawm peb lub xaib!

Tsis txhob siv nrog intolerance mus rau lub tshuaj, cov menyuam yaus tsis tshua muaj menyuam, niam cev xeeb tub thiab lactating leej niam. Tsis muaj qhov kev sim kho mob hauv kev siv cov tshuaj hauv cov menyuam yaus thiab poj niam nrog kev yoj tes thiab lactation. Cov kws kho mob tsis paub tias cov tshuaj no puas kis tau los ntawm niam mis.

Degludec yog ib qho hloov kho cov tshuaj hormone siv los kho cov neeg mob sib txawv ntawm cov ntshav qab zib. Nws yog tsim nyob rau hauv cov hauv paus ntawm niaj hnub thev naus laus zis ntawm kev tsim kho tshuab. Ua tsaug rau cov tshuaj no, cov piam thaj ib txwm muaj khaws cia, uas tuaj yeem txhim kho lub neej ntawm cov neeg mob. Kev tiv thaiv tau zoo tuaj yeem ua tiav thaum tswj kom muaj ntshav qab zib nyob rau hauv cov ntshav yam tsis muaj kev hloov pauv ntau.

Mob ntshav qab zib ib txwm ua rau neeg tuag taus. Muaj ntshav qab zib ntau dhau yog qhov txaus ntshai heev.

Alexander Myasnikov nyob rau lub Kaum Ob Hlis 2018 tau piav qhia txog kev kho mob ntshav qab zib. Nyeem tag nrho

1. 
   Onipko, V.D. Phau ntawv rau cov neeg mob ntshav qab zib mellitus / V.D. Onipko. - Moscow: Teeb, 2001 .-- 192 p.
2. 
   Radkevich V. Mob Ntshav Qab Zib mellitus: kev tiv thaiv, kuaj mob, kho mob. Moscow, 1997.
3. 
   Balabolkin M.I., Klebanova E.M., Kreminskaya V.M. Lub hauv paus thiab chaw kho mob cov thyroidology, Tshuaj - M., 2013. - 816 p.

Cia kuv qhia kuv tus kheej. Kuv lub npe yog Elena. Kuv tau ua haujlwm li endocrinologist rau ntau tshaj 10 xyoo. Kuv ntseeg hais tias tam sim no kuv yog tus kws tshaj lij hauv kuv daim teb thiab kuv xav pab txhua tus neeg tuaj xyuas lub vev xaib kom daws qhov nyuaj thiab tsis yog li cov haujlwm. Txhua cov ntaub ntawv rau lub xaib tau sau thiab ua tib zoo ua kom tiav thiaj li xa ntau li ntau tau cov ntaub ntawv tsim nyog. Ua ntej thov cov ntaub ntawv uas tau piav qhia hauv lub vev xaib, yuav tsum tau sab laj nrog tus kws kho mob tshwj xeeb.

Yam khoom muaj sia

Tshuaj Insulin degludec + Insulin aspart

subcutaneous tov

1 ml ntawm cov tshuaj muaj:

cov tshuaj nquag: 100 units ntawm insulin degludec / insulin aspart hauv qhov sib piv ntawm 70/30 (sib npaug ntawm 2.56 mg ntawm insulin degludec / 1.05 insulin aspart),

tus zam: glycerol 19.0 mg, phenol 1.5 mg, metacresol 1.72 mg, zinc 27.4 μg (raws li zinc acetate 92.0 μg), sodium chloride 0.58 mg, hydrochloric acid / sodium hydroxide (rau kev kho pH ), dej rau kev txhaj tshuaj txog li 1 ml.

pH ntawm kev daws yog 7.4.

Ib qho koob txhaj tshuaj ib muaj 3 ml ntawm ib qho tshuaj sib npaug rau 300 PIECES.

Ib chav tsev ntawm insulin Ryzodeg muaj 0.0256 mg ntawm anhydrous saltless insulin degludec thiab 0.0105 mg ntawm anhydrous tsis muaj ntsev rau insulin aspart.

Ib ntu ntawm insulin Ryzodeg (U) sib raug rau ib chav nyob thoob ntiaj teb (ME) ntawm tib neeg cov tshuaj insulin, ib chav ntawm insulin glargine, ib chav ntawm insulin detemir lossis ib chav ntawm ob-theem insulin aspart.

Pob tshab tsis muaj xim.

Kws tshuaj:

Kev npaj Ryzodeg FlexTouch yog kev npaj ua ke uas muaj kev sib xyaw ua ke ntawm kev sib xyaw ntawm tib neeg cov tshuaj insulin ntawm superlong kev ua haujlwm (insulin degludec) thiab kev ua haujlwm sai ntawm cov tib neeg insulin (insulin aspart), tsim los ntawm kev tso tawm DNA biotechnology siv Saccharomyces cerevisiae hom.

Cov tshuaj insulin degludec thiab cov tshuaj insulin aspart tshwj xeeb tshaj tawm rau cov receptor ntawm tib neeg endogenous insulin thiab, cuam tshuam nrog nws, paub lawv cov nyhuv pharmacological zoo ib yam li cov nyhuv ntawm tib neeg insulin. Qhov ua rau lub ntsej muag ntshav ntawm insulin yog vim muaj kev siv cov kua nplaum ntau ntxiv los ntawm cov ntaub so ntswg tom qab khi ntawm insulin rau cov leeg nqaij thiab cov cell rog, thiab tib lub sij hawm txo tus nqi ntawm cov piam thaj los ntawm lub siab.

Cov chaw muag tshuaj muaj txiaj ntsig ntawm cov tshuaj ntawm Ryzodeg FlexTouch muaj qhov sib txawv (daim duab 1) thiab qhov dav dav ntawm qhov kev sib cuam tshuam ntawm cov tshuaj muaj kev cuam tshuam cov profiles ntawm qhov kev txiav txim ntawm qee qhov kev sib xyaw: high-speed insulin aspart thiab insulin degludec ntawm superlong kev ua.

Qhov tseem ceeb ntawm cov tshuaj Ryzodeg FlexTouch, uas muaj qhov kev ua haujlwm ntev (insulin degludec), tom qab txhaj tshuaj subcutaneous ua rau cov tshuaj tiv thaiv kab mob siab rau hauv cov subcutaneous depot, los ntawm qhov muaj ib qho kev txuas qeeb qeeb ntawm insulin degludec rau hauv cov kev ncig, muab cov ntaub ntawv tiaj tus ntawm kev txiav txim thiab ruaj khov hypoglycemic cov tshuaj. Cov nyhuv no tau muab khaws cia ua ke nrog insulin aspart thiab tsis cuam tshuam rau tus nqi ntawm kev nqus ntawm monomers ntawm kev ua yeeb yam sai li sai tau insulin aspart.

Ryzodeg® FlexTouch® tshuaj pib ua haujlwm sai sai, muab qhov kev xav tau ntawm insulin sai sai tom qab kev txhaj tshuaj, thaum lub hauv paus cov khoom tiv thaiv muaj qhov tiaj tiaj, ruaj khov thiab ultra-ntev profile ntawm kev ua uas muab qhov kev xav tau rau basal insulin. Lub sijhawm caij nyoog ntawm ib qho kev ntsuas ntawm Ryzodeg FlexTouch yog ntau tshaj 24 teev.

Saib Daim Duab 1. Qhov nruab nrab ntawm cov ntshav qab zib feem ntau yog qhov sib npaug ntawm Ryzodeg tom qab kev tswj hwm ntawm ib koob ntawm 0.8 U / kg rau hom 1 mob ntshav qab zib mellitus (kawm 3539).

Kev sib txig sib luag ntawm qhov nce hauv koob tshuaj ntawm Ryzodeg FlexTouch thiab nws qhov dav dav thiab qhov siab tshaj plaws ntawm kev tiv thaiv hypoglycemic yog muaj pov thawj. Qhov sib luag ntawm cov tshuaj Ryzodeg FlexTouch tiav tom qab 2-3 hnub ntawm kev tswj hwm tshuaj.

Tsis muaj qhov sib txawv ntawm cov chaw muag tshuaj ntawm Ryzodeg FlexTouch kev npaj hauv cov neeg laus thiab cov neeg laus.

Cov chaw kuaj mob tau zoo thiab Kev Nyab Xeeb

Tsib thoob ntiaj teb kev tswj hwm, tswj, qhib, kev sim kev sim ntawm Ryzodeg hauv "Kev Kho Mob rau Lub Hom Phiaj" ua rau 26 lossis 52 lub lis piam nrog 1360 cov neeg mob ntshav qab zib mellitus (362 cov neeg mob ntshav qab zib hom 1 thiab 998 cov neeg mob ntshav qab zib hom 2).

Ob txoj kev tshawb nrhiav ntawm kev tswj hwm ib zaug ntawm Ryzodeg hauv kev sib xyaw nrog cov tshuaj tiv thaiv ntshav qab zib hauv qhov ncauj (PHGP) thiab kev tswj hwm ib leeg ntawm insulin glargine nrog PHGP hauv cov neeg mob uas muaj ntshav qab zib hom 2 tau sim ua.

Kev tswj hwm ntawm Ryzodeg ob zaug ib hnub hauv kev sib xyaw nrog PHGP tau muab piv nrog kev tswj hwm ntawm biphasic insulin aspart 30 ob zaug hauv ib hnub ua ke nrog PHGP hauv ob txoj kev tshawb nrhiav hauv cov neeg mob ntshav qab zib hom 2.

Kev tswj hwm ntawm Ryzodeg ib hnub ib zaug nyob rau hauv kev sib xyaw nrog insulin aspart kuj tseem piv nrog kev tswj hwm ntawm insulin detemir ib zaug lossis ob zaug ib hnub nyob rau hauv kev sib xyaw nrog insulin aspart hauv cov neeg mob uas muaj hom 1 ntshav qab zib mellitus.

Qhov tsis muaj qhov zoo tshaj ntawm cov tshuaj sib piv ntawm cov tshuaj Ryzodeg muaj feem rau qhov txo qis hauv HbA1C qhov ntsuas txhua qhov kev tshawb fawb hauv kev kho cov neeg mob mus rau lub hom phiaj tau ua pov thawj.

Hauv cov neeg mob uas muaj ntshav qab zib hom 2 uas tsis tau txais kev kho mob insulin, thiab cov neeg mob uas tau txais kev kho mob insulin yav dhau los, Ryzodeg nrog PHGP muab kev tswj zoo glycemic piv rau insulin glargine.

Ryzodeg® muab zoo dua ntawm kev tswj hwm glycemic piv rau insulin glargine nrog tsawg zaus ntawm nocturnal hypoglycemia (txhais tau raws li kev mob tshwm sim ntawm hypoglycemia uas tau tshwm sim nruab nrab ntawm 0 teev thiab 6 teev thaum sawv ntxov, paub tseeb los ntawm cov txiaj ntsig ntawm ntsuas ntshav ntshav muaj zog tsawg dua 3.1 mmol / l lossis cov pov thawj ntawm qhov no tias tus neeg mob xav tau kev pab ntawm peb tog).

Kev tswj hwm ntawm Ryzodeg ob zaug ib hnub muab cov tshuaj zoo sib xws glycemic tswj (HbA1c) piv nrog biphasic insulin aspart 30, uas tseem tau tswj hwm ob zaug ib hnub.

Cov tshuaj Ryzodeg muab qhov ua tau zoo tshaj plaws hauv kev txo qis qhov muaj cov ntshav qabzib hauv plasma ntawm ib qho khoob.

Nrog rau kev siv ntawm Ryzodeg npaj, lub hom phiaj plasma glucose muaj nuj nqis ntawm 5 mmol / L tau tiav nrawm dua rau cov neeg mob piv nrog cov neeg mob kho nrog biphasic aspart 30 insulin. Cov tshuaj Ryzodeg ua rau muaj ntshav qab zib tsawg dua (suav nrog thaum tsaus ntuj).

Hauv cov neeg mob uas muaj mob ntshav qab zib hom 1, kev kho mob nrog Ryzodeg ib hnub ib zaug ua ke nrog insulin aspart ua ntej lwm yam zaub mov tau qhia zoo sib xws glycemic tswj (HbA1c thiab yoo plasma ntshav qab zib) nrog tsawg tus mob nocturnal hypoglycemia piv nrog lub hauv paus bolus regimen ntawm insulin detemir. thiab insulin aspart nrog txhua pluas noj.

Raws li kev paub txog kev soj xyuas ob ntawm 26-lub limtiam qhib kev sim ua raws li "kho rau lub hom phiaj" txoj hauv paus ntsiab lus uas cuam tshuam nrog cov neeg mob ntshav qab zib hom 2, Ryzodeg tshuaj, muab ob zaug ib hnub, pom tias muaj tsawg dua qhov tshwm sim ntawm kev paub txog ntshav qab zib hauv feem ntau ( Daim duab 2) thiab ntu ntu ntawm paub tseeb tias tsis muaj ntshav qabzib (daim duab 3) piv nrog biphasic aspart 30 insulin Cov txiaj ntsig pom tau hais tias Ryzodeg txo qis ntshav plasma cov ntsiab lus tsawg nrog txo kev pheej hmoo ntawm hypoglycemia emy nyob rau hauv tus txheej txheem ntawm kev tshawb fawb thiab nyob rau hauv lub txij nkawm koob tshuaj los ntawm 16 lub lim piam (Rooj 1).

Saib Daim Duab 2 ntawm qhov ntim. Cov ntsiab lus pom tseeb tias yog ntshav qog ntshav, kev npaj Ryzodeg (2 zaug hauv ib hnub) piv nrog biphasic insulin aspart 30 (2 zaug hauv ib hnub), hais txog qhov kev ua kom zoo rau ob lub sijhawm 26-lis piam, qhib kev sim uas tsim raws li "kho rau lub hom phiaj" hauv paus ntsiab lus hauv cov neeg mob nrog ntshav qab zib hom 2

Saib daim duab 3ntawm ntim. Txheeb xyuas tias hmo ntuj cov ntshav qog ua kom qis, Ryzodeg (2 zaug hauv ib hnub) hauv kev sib piv nrog biphasic insulin aspart 30 (2 zaug hauv ib hnub), nyob rau hauv cov lus hais txog kev ua kom zoo rau ob lub sijhawm 26-lis piam, qhib kev sim uas tsim raws li "kho rau lub hom phiaj" hauv paus ntsiab lus hauv cov neeg mob muaj ntshav qab zib hom 2.

Tsis muaj ib qho tseem ceeb ntawm cov tshuaj tiv thaiv kab mob rau cov tshuaj insulin tom qab kho nrog Ryzodeg ntev heev.

Cov Tshuaj Pharmacokinetics:

Kev Tsis Txaus Siab

Tom qab txhaj tshuaj subcutaneous, qhov tsim muaj cov kua dej tsis ruaj khov ntawm cov kua roj av insulin multihexamers tshwm sim, uas tsim cov kua dej rau hauv cov nqaij subcutaneous, thiab tsis txhob cuam tshuam nrog kev tso tawm sai ntawm insulin aspart monomers mus rau hauv cov hlab ntshav.

Multihexamers maj mam sib cais, tso tawm degludec insulin monomers, uas ua rau lub qeeb txuas ntxiv ntawm cov tshuaj mus rau hauv cov ntshav.

Qhov sib xyaw ua ke ntawm ib qho kev sib xyaw ntawm superlong kev ua (insulin degludec) hauv cov ntshav ntshav tau tiav 2-3 hnub tom qab tswj hwm ntawm Ryzodeg tshuaj.

Zoo-ntsuas qhov ntsuas ntawm kev nqus sai ntawm cov tshuaj insulin aspart tau muab cia rau hauv cov tshuaj Risedeg. Cov kws kho mob cov ntaub ntawv ntawm cov tshuaj insulin aspart tshwm 14 feeb tom qab txhaj tshuaj, qhov siab tshaj plaws tau tsom ntsoov pom tom qab 72 feeb.

Kev xa Khoom

Qhov sib koom ua ke ntawm degludec insulin rau cov ntshiab albumin sib raug rau lub peev xwm khi ntawm plasma protein> 99% hauv tib neeg cov ntshav ntshav. Hauv cov tshuaj insulin aspart, lub plasma protein qhov khi ruaj khov muaj peev xwm qis dua (

Tresiba flex kov cov tshuaj r / c 100me / ml 3ml n5 koob txhaj

Pob tshab tsis muaj xim. Cov khoom siv TSIS muaj cov koob txhaj tshuaj. Koob muag nyias.

FlexTouch syringe cwjmem tau siv ua ke nrog NovoFine - Novofine 30G 8 mm No. 100 lossis Novofine 31G 6 hli No. 100 koob. Nws yog tsis yooj yim sua kom siv cov phwj syringe tsis muaj koob.

1 ml ntawm cov tshuaj muaj: cov tshuaj nquag: insulin degludec 100 IU (3.66 mg), cov neeg tsis muaj zog: glycerol 19.6 mg, phenol 1.5 mg, metacresol 1.72 mg, zinc 32.

7 μg (hauv daim ntawv ntawm zinc acetate 109.7 μg), hydrochloric acid / sodium hydroxide (rau pH kho), dej rau kev txhaj tshuaj txog li 1 ml, pH ntawm kev daws yog 7.6. Ib qho xaum xaum ib qho muaj 3 ml ntawm cov tshuaj, sib npaug rau 300 daim PIECES.

Cov xaum xaum tso cai rau koj kom nkag mus txog 80 chav nyob rau ib qhov kev txhaj tshuaj ntxiv hauv 1 chav tsev.

Cov ncauj lus dav dav thiab cov cim qhia

Xws li cov tshuaj insulin ntshiab yog tsim los ntawm lub tuam txhab tshuaj Novo Nordisk, thiab nws tau sau npe nyob rau hauv lub lag luam npe Tresiba. Cov tshuaj muaj nyob rau hauv 2 ntau npaum:

• daws hauv cov xaum uas siv tshuaj pov tseg (insulin lub npe "Tresiba Flextach"),
• daws hauv cov roj cartridges rau cov tib neeg rov siv tau cov tshuaj insulin (Tresiba Penfill).

Feem ntau cov tshuaj feem ntau siv rau cov neeg mob uas muaj ib hom mob ntshav qab zib insulin.

Tom qab tau nkag hauv qab daim tawv nqaij, ib qho kev txhim kho hloov cov roj ntsha insulin molecule ua cov txheej txheem ruaj khov, uas yog ib hom ntawm cov khoom ntawm no.

Xws li cov sib txuas tau tawg cia maj mam, vim tias cov insulin tas li nkag mus rau hauv cov ntshav ntawm qhov yuav tsum tau noj. Cov tshuaj feem ntau yog siv 1 zaug nyob rau ib hnub, vim tias nws cov nyhuv tseem nyob ntev li 24 teev.

Nws yog ib qho tseem ceeb tias lub sijhawm ntawm cov tshuaj tsis nyob ntawm lub hnub nyoog, poj niam txiv neej thiab pawg neeg ntawm tus neeg mob. Txawm hais tias nyob rau hauv cov neeg mob uas muaj lub siab thiab lub raum tsis ua haujlwm, xws li cov insulin kav ntev thiab muaj kev kho mob zoo.

Cov tshuaj no kuj tseem siv qee zaum nrog rau kev kho mob sib xyaw rau hauv cov neeg mob ntshav qab zib hom 2. Yog hais tias tus txiav ua kom tiav los yog nws lub zog tsis zoo, ntxiv rau cov ntsiav tshuaj uas muaj suab thaj, tus neeg mob yuav xav tau tshuaj insulin.

Muaj ntau lub npe lag luam tawm rau cov tshuaj hormones uas tuaj yeem siv rau lub hom phiaj no, thiab Treshiba yog ib qho ntawm lawv. Kev siv cov tshuaj pab ua rau cov ntshav khov nyob rau hauv lub cev, txhim kho lub cev ua haujlwm tag nrho thiab txhim kho lub neej kom zoo.

Kev siv cov tshuaj nyob rau theem pib ntawm kev txhim kho ntawm kev mob ntawm tus kabmob ntshav qab zib hom 2 tso cai rau koj tau los ntawm kev noj tshuaj tsawg kawg thiab lub sijhawm txhaj tshuaj luv.

Cov tshuaj Insulin Degludec: cov nyhuv ua haujlwm ruaj khov thiab txo kev pheej hmoo ntawm lub qog ntshav qab zib

Ntxiv ua yeeb yam ntev ntev rau kev npaj insulin tus dev (degludec) Novo Nordisk kuj tseem tuaj yeem tswj tau ntshav qab zib ntawm ntshav qab zibraws li kev sib tw tshuaj Lantus (Lantus) lub tuam txhab Sanofi (Sanofi), nrog cov tshuaj ntau dua. Raws li European Lub Koom Haum rau Kev Kawm ntawm mob ntshav qab zib mellitus (Cov Koom Haum European rau Kev Kawm txog Ntshav Qab Zib, EASD), insulin degludec (degludec) tau ua tiav kev txo cov ntshav qab zib ntau hauv cov neeg mob nrog ntshav qab zib hom 2, txawm tias siv ib zaug tshuaj rau plaub caug teev. Novo Nordisk tshaj tawm tias insulin degludec yuav yooj yim dua rau cov neeg mob, vim tias nws tuaj yeem noj lub sijhawm twg los tau ib hnub, tsis zoo li cov tshuaj Lantus nrog insulin glargine, uas yuav tsum tau noj ib lub sijhawm.

Txoj kev tshawb fawb tshiab tau qhia tias theem ntawm hemoglobin A1c, qhov taw qhia txog kev tswj ntshav qab zib tau raug txo los ntawm 1.28% mus rau 7.2% dhau 26 lub lis piam nrog kev pab ntawm insulin degludecs, uas tau piv nrog Lantus, qhov tshuaj zoo tshaj plaws hauv ntiaj teb.

Hauv cov neeg mob noj lub tuam txhab tshuaj Novo Nordisk, ntshav ntau dhau ntawm lub ntsej muag tseem poob qis, thiab hauv cov neeg mob noj cov tshuaj Lantus, nws poob qis tsuas yog thaum kawg ntawm txoj kev tshawb no.

Ob qho tshuaj no tau noj ib zaug ib hnub, tab sis Novo Nordisk kuj tseem tshawb nrhiav hauv kev soj ntsuam cov hauj lwm zoo li ntawm peb-hnub tshuaj txhua hnub ntawm insulin dewlydek.

Raws li Stephen Atkin, tus kws tshawb fawb tshawb fawb ntawm Tsev Kawm Ntawv Kho Mob York Hull, UK, txoj kev tshawb fawb no qhia tau tias kev tswj glycemic tuaj yeem tsim nrog kev txiav txim siab insulin, txawm hais tias tib neeg tsis tuaj yeem ncua sijhawm. kev txais tos tshuaj insulin, lossis coj nws mus rau lwm lub sijhawm hnub ntawd.

Ntawm 71 lub rooj sib tham ib xyoos ib zaug ntawm American Diabetes Association, tau muaj nyob rau lub Rau Hli 2011 hauv San Diego, California, cov ntsiab lus ntawm ob txoj kev tshawb fawb ntawm insulin tshiab tau raug sib tham. Raws li cov txiaj ntsig, insulin deglyudec hauv cov neeg mob uas muaj hom 1 thiab ntshav qab zib hom 2 txhim kho glycemic tswj thaum txo qis kev pheej hmoo ntawm nocturnal hypoglycemia piv rau Glargin insulin.

Insulin Degludek - insulin basaluas, tom qab tswj hwm subcutaneous, ua cov ntawv soluble multi-hexamers, uas ua rau muaj kev ua haujlwm ntev-ntev. Cov txiaj ntsig ntawm kev kawm qib II, twb tau luam tawm hauv Lancet xyoo 2011, tau nthuav tawm.

Degludek hauv kev kho mob ntawm hom 2 mob ntshav qab zib

Ib txoj kev tshawb fawb suav nrog cov neeg mob ntshav qab zib hom 2 (tus thawj coj ntawm pawg neeg tshawb fawb yog Prof. Alan J. Garber, los ntawm Lub Chaw Haujlwm Saib Xyuas Mob Ntshav Qab Zib, Endocrinology thiab Metabolism ntawm Baylor College of Medicine, Houston, Texas).

Nws piv qhov ua tau zoo thiab kev nyab xeeb ntawm kev siv degludec piv rau Glargin cov tshuaj insulin.

Ob qho tshuaj insulin tau sau ib hnub ib zaug, ua ke nrog insulin aspart ua ntej noj mov, los yog sib xyaw nrog metformin lossis pioglitazone.

Qhov kev sim tshuaj sim tau qhib, kav ntev txog 1 xyoos, thiab suav nrog 992 tus neeg mob nruab nrab glycated hemoglobin theem ntawm 8.3% uas tswj kom HbA1C theem ntawm 7 txog 10% tsawg kawg yog 3 lub hlis ntawm kev siv tshuaj insulin hauv kev sib xyaw nrog tshuaj noj qhov ncauj lossis tsis muaj lawv.

Cov neeg mob tau nyob ntawm 3: 1 piv rau cov pab pawg uas tau txais los ntawm Degludec insulin lossis Glargin insulin. Qhov tshuaj ntawm cov kab mob basal insulin tau hloov kho raws li theem nrawm plasma glucose mus txog rau qib tau mus txog (tsawg dua 5 mmol).

Txoj kev tshawb no tau ua tiav los ntawm ntau dua 80% ntawm cov neeg mob los ntawm ob pawg neeg. Tom qab 12 lub hlis, qib ntawm glycated hemoglobin poob qis dua nruab nrab los ntawm 1.2% hauv degludec pawg thiab los ntawm 1.

3% hauv pawg glargine (qhov sib txawv tsis yog qhov muaj txiaj ntsig zoo heev), ib nrab ntawm cov neeg mob tau mus txog qib hom HbA1C (tsawg dua 7%).

Qhov kev txo qis ntawm cov ntshav khov nyob hauv ntshav ntawm ob pawg tsis txawv (qhov nruab nrab, los ntawm 2.4 mmol nyob rau hauv degludec pawg thiab los ntawm 2.1 mmol hauv pawg glargine).

Tsuas yog ib qho tseem ceeb sib txawv pom ntawm cov pawg: kev siv cov degludec ua rau txo qis tseem ceeb ntawm qhov kev pheej hmoo nocturnal hypoglycemia (ntshav qabzib tsawg dua 3.1 mmol lossis mob ntshav qab zib tsawg, raws li lub ntsiab lus txhais ntawm ADA).

Pawg degludec qhia pom 25% txo qis hauv cov zaus ntawm cov xwm txheej no piv rau pawg glargine (1.4 tiv tiag 1.8 ntu ntu rau ib tus neeg mob ib xyoos, p = 0.0399).

Tsis tas li ntawd, qhov ntau zaus ntawm tag nrho cov pov thawj hypoglycemic tsawg dua nyob rau hauv degludec pawg piv nrog pawg glargine (11.1 piv rau 13.6 ntu ntu / neeg mob-xyoo, p = 0.0359).

Tom qab ib xyoos, qhov nruab nrab cov tshuaj txhua hnub yog 1.46 IU / kg rau cov tshuaj insulin txo thiab 1.42 IU / kg rau insulin glargine, nrog rau faib ntawm qhov chaw qis thiab bolus insulin ntawm kwv yees li 50:50 hauv ob pawg. Qhov ntau zaus ntawm kev phiv yog tib yam.

Insulin degludec hauv kev kho mob ntawm hom 1 mob ntshav qab zib

Qhov kev tshawb nrhiav thib ob tau tshawb fawb hauv Sheffield University, UK, los ntawm Professor Simon Heller. Txoj kev tsim qauv ntawm txoj kev tshawb no zoo sib xws, tab sis nws suav nrog cov neeg mob nrog ntshav qab zib hom 1Cov. Ob qho tshuaj deglyudec thiab glargine tau muab tshuaj subcutaneously ib hnub ib zaug, insulin aspart ua ntej noj mov.

629 cov neeg nrog ntshav qab zib hom 1 nrog tus lej HbA1C nruab nrab ntawm 7.7%, tau txais cov tshuaj insulin hauv cov theem pib bolus tsawg kawg ib xyoos, raug xaiv nyob rau ntawm 3: 1 piv hauv cov pawg degludec thiab glargine.

Tom qab ib xyoos, theem ntawm HbA1C poob qis dua 0.4% hauv ob pawg neeg. Li ntawm 40% ntawm cov neeg mob tau ua tiav theem hom HbA1C (tsawg dua 7%), qhov nruab nrab ntawm cov ntshav plasma qis dua qhov qis qis qis los ntawm 1.3 mmol / L hauv cov pab pawg degludec, thiab los ntawm 1.4 mmol / L hauv pawg glargine.

Hauv pab pawg neeg degludec, cov neeg mob tau siv sijhawm tsawg dua mus cuag lub hom phiaj yoo ntshav plasma glucose ntau dua (tsawg dua 5 mmol / L), qhov nruab nrab hauv cov pawg degludec yog 5 lub lis piam, thaum nyob hauv pawg glargine nws yog 10 lub lis piam (p = 0.002).

Qhov zaus ntawm paub tseeb nocturnal hypoglycemia tsawg dua nyob rau hauv degludec pawg piv nrog glargine pawg (4.4 piv rau 5.9 ntu lossis neeg mob-xyoo, p = 0.021), txawm li cas los xij, tsis muaj qhov sib txawv ntawm qhov tsawg zaus ntawm hypoglycemia ntawm cov pawg (42.5 piv rau 40.2 ntu kev sib txawv / tus neeg mob xyoo) Cov.

Ib xyoos tom qab pib ntawm txoj kev tshawb no, nruab nrab cov tshuaj insulin txhua hnub yog 0.75 U / kg hauv cov pab pawg degludec, thiab 0.82 U / kg hauv cov pab pawg glargine, nrog rau qhov chaw pib / bolus insulin faib kwv yees li 50:50 hauv ob pawg. Qhov tshwm sim ntawm cov kev mob tshwm sim zoo sib xws.

Dr. Heller, tus thawj coj ntawm pawg kws tshawb fawb, ntseeg hais tias cov txiaj ntsig ntawm kev sim tshuaj tau lees paub tias qhov kev qhia tshiab ntawm cov tshuaj insulin txuas ntxiv tuaj yeem txo qhov kev pheej hmoo ntawm kev mob ntshav qab zib, tshwj xeeb tshaj yog thaum tsaus ntuj, uas yog qhov tseem ceeb heev rau ntau tus neeg mob thiab lawv tsev neeg. Kev siv cov degludec tuaj yeem txhim kho lub neej zoo ntawm cov neeg mob ntawd.

Degludec thiab saj zawg zog noj kom haum

Pab neeg ntawm Dr. Luigi Meneghini los ntawm University of Miami, Florida, nthuav tawm cov ntaub ntawv ntawm kev hloov pauv tau ntawm cov tshuaj insulin dewlydes.

Cov kws tshawb nrhiav tau pom tias kev txhaj tshuaj ib zaug ntawm degludec ib hnub tuaj yeem sau rau ntau lub sijhawm ntau - los ntawm 8 txog 40 teev tom qab cov koob tshuaj dhau los yam tsis muaj kev tswj hwm glycemic, hauv kev sib piv rau glargine, uas yuav tsum tau tswj hwm nyob rau tib lub sijhawm txhua hnub. Tom qab 26 lub lim tiam ntawm txoj kev tshawb no, qib ntawm HbA1C poob qis los ntawm 1.2% hauv ob pawg, qhov ntau zaus ntawm qhov dav dav thiab nocturnal lub sijhawm ntawm hypoglycemia tau zoo sib xws hauv ob pawg tshuaj noj.

Qhov no yog qhov tshwj xeeb tshaj yog rau cov neeg uas yuav tsum tau hloov lub sijhawm txhaj tshuaj rau tus kheej (pw tsaug zog, rov qab los tsev, thiab lwm yam) thiab cov kws tshaj lij (haujlwm ua haujlwm, hmo ntuj, thiab lwm yam).

Lub sijhawm sib txawv ntawm lub sijhawm txhaj tshuaj dua tuaj yeem txhim kho tus neeg mob kom ua raws li txoj haujlwm thiab lub sijhawm ua haujlwm tau ntev. glycemic tswjTxawm li cas los xij, qhov kev xav tau no xav tau kev pom zoo hauv kev tshawb fawb ntxiv.

American Diabetes Association (ADA) 71st Cov Kev Tshawb Fawb Txog Kev Tshawb Fawb: Tawm Tshab 0074-LOSSIS, nthuav tawm Lub Rau Hli 25, 2011, Abstract 0070-LOSSIS, nthuav tawm Lub Rau Hli 25, 2011, Abstract 0035-LB, nthuav tawm Lub Rau Hli 24, 2011.

Cov lus qhia rau kev teem caij Tresiba

Cov tshuaj yog siv ua ke nrog cov insulins ceev rau kev hloov pauv hormone rau kev kho mob ntshav qab zib ob hom. Nrog hom 2 mob, tsuas ntev insulin tuaj yeem kho nyob hauv thawj theem.

Thaum pib, cov lus qhia hauv Lavxias rau kev siv tau tso cai siv Treshiba tshwj xeeb rau cov neeg mob laus.

Tom qab kev tshawb fawb paub tseeb txog nws txoj kev nyab xeeb rau kev muaj kab mob loj hlob, kev hloov pauv tau ua raws li cov lus qhia, thiab tam sim no nws tso cai siv cov tshuaj no rau menyuam yaus txij thaum 1 xyoos.

Cawv ntawm degludec txog kev xeeb tub thiab kev loj hlob ntawm cov menyuam yaus txog ib xyoos tseem tsis tau kawm, yog li ntawd, cov tshuaj Tresib insulin tsis tau sau tseg rau cov mob no. Yog hais tias tus mob ntshav qab zib tau sau tseg yav dhau los ua rau muaj kev tsis haum tshuaj rau qhov chaw degludec lossis lwm yam ntawm cov tshuaj, nws tseem raug nquahu kom tsis txhob kho nrog Tresiba.

Cov lus qhia rau kev siv

Yog tias tsis paub txog cov kev cai rau kev tswj hwm insulin, kev them nyiaj zoo rau ntshav qab zib yog tsis tau. Ua tsis tau raws li cov lus qhia tuaj yeem ua rau mob hnyav: ketoacidosis thiab mob ntshav qab zib siab heev.

Yuav ua li cas yuav ua rau kev kho mob nyab xeeb:

• muaj ntshav qab zib hom 1, cov tshuaj xav tau yuav tsum tau xaiv hauv cov tsev kho mob. Yog tias tus neeg mob tau txais insulin ntev ntev, thaum hloov mus rau Tresiba, cov koob tshuaj yog thawj zaug tsis hloov, tom qab ntawd nws raug kho raws cov ntaub ntawv glycemic. Cov tshuaj puv tawm nws cov nyhuv tsis pub dhau 3 hnub, yog li thawj zaug tshuaj kho tsuas yog tso cai nkaus xwb tom qab lub sijhawm no tau dhau mus,
• nrog hom 2 tus kab mob, qhov pib kis yog 10 units, nrog qhov nyhav nyhav - txog 0.2 ib pawg. ib kg Tom qab ntawd nws tau maj mam hloov mus txog thaum glycemia yog li qub. Raws li txoj cai, cov neeg mob rog rog, txo qis kev ua haujlwm, muaj zog tiv thaiv insulin, thiab ntev mus ntev decompensated ntshav qab zib mellitus yuav tsum tau txhaj ntau dua ntawm Treshiba. Thaum kho lawv, lawv maj mam txo qis,
• txawm hais tias qhov tseeb tias Tresiba insulin ua haujlwm rau ntau dua 24 teev, nws yog txhaj ib hnub ib zaug ntawm lub sijhawm ua ntej. Qhov kev txiav txim ntawm koob tshuaj txuas ntxiv yuav tsum yog sib tshooj nrog qhov dhau los,
• cov tshuaj tuaj yeem tau muab tsuas yog subcutaneously. Txoj kev txhaj tshuaj Intramuscular yog qhov tsis txaus siab, vim tias nws tuaj yeem ua rau poob qab zib, mob ntshav yog muaj kev phom sij rau lub neej,
• qhov chaw txhaj tshuaj tsis yog qhov tseem ceeb, tab sis feem ntau cov ncej puab yog siv rau cov insulins ntev, vim tias qhov tshuaj tiv thaiv luv luv tau txhaj rau hauv lub plab - yuav ua li cas thiab qhov twg txhaj tshuaj insulin,
• rab koob xaum hluav taws xob yog qhov khoom siv yooj yim, tab sis nws zoo dua yog tias tus kws kho mob paub koj txog cov cai rau kev coj ua. Tsuas yog nyob rau hauv rooj plaub, cov cai no tau theej tawm hauv cov lus qhia uas txuas nrog rau txhua pob,
• Ua ntej txhua qhov kev qhia, koj yuav tsum xyuas kom meej tias cov tsos ntawm qhov kev daws tsis tau hloov pauv, daim cartridge yuav tsis txav, thiab lub koob tau dhau los. Txhawm rau tshuaj xyuas txoj kev noj qab haus huv ntawm cov kab ke, ib koob tshuaj ntawm 2 pawg tau teeb tsa rau ntawm xaum xaum npuav. thiab thawb lub piston. Lub pob tshab yuav tsum tshwm ntawm lub qhov koob. Rau Treshiba FlexTouch thawj koob NovoTvist, NovoFayn thiab lawv cov analogues los ntawm lwm cov tuam ntxhab tsim nyog,
• tom qab qhia cov tshuaj, hno tsis tau tawm ntawm daim tawv nqaij rau ob peb feeb kom qhov tshuaj insulin tsis pib xau. Qhov chaw txhaj tshuaj yuav tsum tsis txhob muab rhaub lossis zaws.

Treshiba tuaj yeem siv nrog txhua yam tshuaj ua kom ntshav qab zib, suav nrog tib neeg thiab tshuaj insulin, nrog rau cov ntsiav tshuaj noj rau ntshav qab zib hom 2.

Sab sij huam

Muaj peev xwm tshwm sim tsis zoo ntawm Tresiba kev kho mob ntshav qab zib mellitus thiab kev txheeb xyuas qhov pheej hmoo: