Current and Future Strategies in Insulin Development and Treatment.

IF 2.6 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Jantje Weiskorn, Banshi Saboo, Thomas Danne
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引用次数: 0

Abstract

Background: Recent advances in insulin research open new avenues for treatment, both, for type 1 and type 2 diabetes. In developed countries, standardized "ultra-rapid-acting insulins" are now also used in addition to rapid-acting insulins. First- and second-generation basal analogs are available. Third-generation basal analogs, which only need to be applied once a week, are in the pipeline.

Summary: Second-generation "ultra-rapid-acting insulins" insulins with faster onset and offset of action may be particularly useful for multiple daily injections and automated insulin delivery systems. An improved time-action profile of bolus insulin would be able to cover the rapid increase in glucose after meals with a rapid fall thereafter to avoid postprandial hypoglycemia. The third-generation basal insulins allowing once-weekly dosing made major steps toward becoming a clinical reality. However, issues with insulin affordability and availability remain problematic even in more affluent countries. Biosimilar insulins products can provide people with additional safe, high-quality, and potentially cost-effective options for treating diabetes. Particularly in low-middle income countries insulin therapy is facing issues not only of access but also storage, lack of diabetes education, and stigma.

Key message: With the new bolus insulins, the physiological insulin secretion pattern can be mimicked better and better and hypoglycemia can be avoided. With the ever longer pharmacokinetic action profiles of the basal analogs, the injection frequency is reduced, which leads to better adherence and quality of life, but these insulins are not available for everyone who needs it worldwide.

胰岛素开发和治疗的当前和未来战略。
背景:胰岛素研究的最新进展为治疗 1 型和 2 型糖尿病开辟了新途径。在发达国家,除了速效胰岛素外,现在还使用标准化的 "超速效胰岛素"。目前有第一代和第二代基础类似物。小结:第二代 "超速效胰岛素 "起效和停效更快,特别适用于每日多次注射和胰岛素自动给药系统。改进后的药栓胰岛素的时间-作用曲线将能够覆盖餐后血糖的快速上升和随后的快速下降,从而避免餐后低血糖。第三代基础胰岛素允许每周给药一次,这为实现临床目标迈出了重要一步。然而,即使在较为富裕的国家,胰岛素的可负担性和可获得性问题依然存在。生物仿制胰岛素产品可为人们提供更多安全、优质和具有潜在成本效益的糖尿病治疗选择。特别是在中低收入国家,胰岛素治疗面临的问题不仅是获取问题,还有储存问题、缺乏糖尿病教育和耻辱感。关键按摩:新型栓剂胰岛素可以更好地模拟胰岛素的生理分泌模式,避免低血糖的发生。随着基础类似物的药代动力学作用曲线越来越长,注射次数也会减少,从而提高依从性和生活质量。在这种情况下,与目前的标准疗法相比,每周一次的胰岛素疗法是否有可能防止过早死亡,应在试点研究中进行评估。胰岛素给药模式的不断变化加强了国际社会与不同利益相关方共同努力的必要性,以确保全世界需要这种救命药物的每个人都能获得适当的产品。
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来源期刊
Hormone Research in Paediatrics
Hormone Research in Paediatrics ENDOCRINOLOGY & METABOLISM-PEDIATRICS
CiteScore
4.90
自引率
6.20%
发文量
88
审稿时长
4-8 weeks
期刊介绍: The mission of ''Hormone Research in Paediatrics'' is to improve the care of children with endocrine disorders by promoting basic and clinical knowledge. The journal facilitates the dissemination of information through original papers, mini reviews, clinical guidelines and papers on novel insights from clinical practice. Periodic editorials from outstanding paediatric endocrinologists address the main published novelties by critically reviewing the major strengths and weaknesses of the studies.
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