血糖变异性的意义及地特胰岛素对其的作用

Significance of the glycemic variability and the effect of insulin detemir on it

当前的糖尿病治疗指南强调控制"糖三角"(HbA1c、空腹及餐后血糖)的重要性。而越来越多的研究提示,血糖变异性也是糖尿病并发症的独立危险因素,在临床实践中需引起重视。地特胰岛素是一种长效胰岛素类似物,其长效作用来源于地特胰岛素的自联作用,以及能与白蛋白结合,这也带来了地特胰岛素血糖变异性更小,低血糖的发生率更低的临床优势。因而,地特胰岛素已成为基础胰岛素治疗时的一种理想选择。

The current guidelines for diabetes treatment emphasize the importance of the control of ＂glucose triad＂ （post--prandial glucose, fasting plasma glucose, and glycated haemoglobin）. However, more and more studies suggest that the glycemie variability is also an independent risk factor for diabetic complications, and it should also be paid attention to in clinical practice. Insulin detemir is an analog of human insulin with a long duration of basal insulin action which results in part from the increased self-- association of insulin detemir molecules and in part from reversible albumin binding. In consequence, it has less glycemic variability and less risk in hypoglycemia. Therefore insulin detemir becomes a valuable option when basal insulin is recommended.