Инсулинотерапия Сахарного Диабета Второго Типа

Gendeleka, G.F.; Gendeleka, A.N.

doi:10.22141/2224-0721.16.1.2020.199130

Cited by 3 publications

(7 citation statements)

References 18 publications

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“…Базальные инсулины являются препаратами выбора для инициации инсулинотерапии, поскольку режим их применения является наиболее простым с точки зрения степени вовлечения пациента в процесс лечения. Для проведения базальной инсулинотерапии на сегодняшний день существует достаточно широкая палитра пролонгированных препаратов -как человеческих, так и аналогов инсулина [7,8,11,14].…”

Section: áàçàëüíûå èíñóëèíû êàê îñíîâà òåðàïèè ñäunclassified

“…Инсулин НПХ -хорошо изученный препарат, который используется в терапии СД уже несколько десятков лет. Его значимым недостатком стал пик действия с опасностью развития эпизодов ночной гипогликемии, а также выраженные колебания при достижении целевых показателей натощак [11,14].…”

Section: áàçàëüíûå èíñóëèíû êàê îñíîâà òåðàïèè ñäunclassified

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Insulin therapy is a personalized approach to glycemic management in diabetes

Demidova

Titova

2020

Terapevticheskii arkhiv

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Type 2 diabetes is characterized by chronic hyperglycemia and varying degrees of insulin resistance and insulinopenia. Achieving targeted glycemic control in diabetic patients is important to reduce the risk of late complications, and many patients with type 2 diabetes ultimately require insulin therapy to maintain adequate glycemic control. Timely administration of insulin can prevent the progression of diabetes, reduce the development of complications, and have fewer side effects. Basal insulin is the preferred option in most cases when glycemic control is not achieved. However, there is considerable therapeutic inertia in clinical practice, both with respect to initiation of insulin therapy and titration of the basal insulin dose. The longer duration of action, reduced glucose variability and a lower risk of hypoglycemia seen with the latest generation of basal insulin analogs compared to the previous generation simplify titration and may increase patient compliance.

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Section: áàçàëüíûå èíñóëèíû êàê îñíîâà òåðàïèè ñäunclassified

Insulin therapy is a personalized approach to glycemic management in diabetes

Demidova

Titova

2020

Terapevticheskii arkhiv

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“…Своевременное назначение инсулина при сахарном диабете (СД) 2-го типа позволяет быстро нормализовать уровень глюкозы. Адекватная инсулинотерапия уменьшает липо-и глюкозотоксичность, защищает бета-клетки, сосуды, другие ткани и органы от повреждающего действия гипергликемии [1][2][3]. Имеются данные в пользу восстановления функции бета-клеток в условиях инсулинотерапии [4,5].…”

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“…Имеются данные в пользу восстановления функции бета-клеток в условиях инсулинотерапии [4,5]. Экзогенный инсулин замедляет прогрессирование СД 2-го типа [3,6], снижает риск осложнений, улучшает перфузию миокарда [2]. Сообщалось, что ранняя инсулинотерапия может привести к ремиссии СД, которая продолжается после отмены инсулина [3][4][5].…”

unclassified

“…Экзогенный инсулин замедляет прогрессирование СД 2-го типа [3,6], снижает риск осложнений, улучшает перфузию миокарда [2]. Сообщалось, что ранняя инсулинотерапия может привести к ремиссии СД, которая продолжается после отмены инсулина [3][4][5]. Медикаментозная стимуляция секреции инсулина может со временем привести к снижению функции бета-клеток.…”

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Раннє Призначення Інсуліну При Цукровому Діабеті 2-Го Типу: Плюси І Мінуси

Jargin¹

2021

Mìžnarodnij endokrinologìčnij žurnal

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The timely insulin administration can promptly normalize the blood glucose level. Indications for early insulin therapy include severe insulin deficiency, often in young patients with low body weight; elderly people with sarcopenia and chronic infections; early manifestation of microvascular complications; insufficient effectiveness of two- or three-component combinations of anti-diabetic drugs; severe symptoms associated with hyperglycemia. Adequate insulin therapy reduces lipo- and glucotoxicity, protects beta cells, other tissues and organs from damage. At the same time, there is an opinion that, in view of adverse effects of exogenous insulin and appearance of new anti-diabetic drugs, the insulin therapy should be started as late as possible. Adverse effects include the risk of hypoglycemia, weight gain and possibly also cardiovascular complications. Combinations of insulin with other hypoglycemic drugs are discussed. There is a tendency for the target glycemic levels to increase with age. Obviously, the approach must be individual, taking into account the age, clinical and laboratory data, comorbidities and preferences of patients. Hyperinsulinemia itself can contribute to dyslipidemia and atherosclerosis. Severe hyperglycemia and other adverse effects are more likely with inadequate insulin therapy. In particular, weight gain is possible with long-acting and short-acting insulin mixtures. Correlation of the glucose-lowering effect of exogenous insulin with an increase in body weight was noted. In turn, severe hypoglycemia is associated with major adverse cardiovascular events, arrhythmias, and other complications. Finally, insulin therapy comes with a number of inconveniences, especially for older patients.

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Evolution of insulin therapy in the light of innovative technologies of the 21<sup>st</sup> century

Demidova,

Titova

2024

Medicinskij sovet

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The advent of insulin biosimilars has ushered in a new era in the treatment of diabetes mellitus, promising increased accessibility and affordability of this life-saving medication. This comprehensive review explores the evolving landscape of insulin biosimilars, focusing on their therapeutic equivalence, regulatory considerations, and clinical implications. Biosimilars are biological drugs produced using innovative technologies that replicate the structure and action of the reference drug in a very close way and are not inferior in effectiveness and other characteristics to the original, but are more affordable in pricing. Assessing their therapeutic equivalence requires a multifaceted approach including physicochemical and biological characterization, preclinical studies, and performance testing. The introduction of biosimilar drugs into clinical practice is gradually gaining importance for global health, especially in the treatment of oncological, autoimmune, endocrine diseases and, in particular, diabetes. The process of their registration and introduction into patient treatment practice has already been standardized in developed countries, international documents necessary for implementation have been issued, and convincing and clear confirmation of the positive results obtained during preclinical and clinical studies proving the bioequivalence and interchangeability of the biosimilar and the reference drug is required. The clinical implications of insulin biosimilars are of paramount importance, impacting patient outcomes, healthcare costs, and overall diabetes management. This review synthesizes existing evidence on the efficacy, safety, and immunogenicity of insulin biosimilars, providing insights into their potential role in diabetes therapy. Insulin biosimilars represent a promising avenue for expanding access to insulin therapy while addressing the economic burden of diabetes care. This review underscores the importance of continued research, robust regulatory oversight, and informed clinical decision-making to maximize the benefits of insulin biosimilars for patients and healthcare systems worldwide.

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Инсулинотерапия Сахарного Диабета Второго Типа

Cited by 3 publications

References 18 publications

Insulin therapy is a personalized approach to glycemic management in diabetes

Insulin therapy is a personalized approach to glycemic management in diabetes

Раннє Призначення Інсуліну При Цукровому Діабеті 2-Го Типу: Плюси І Мінуси

Evolution of insulin therapy in the light of innovative technologies of the 21<sup>st</sup> century

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