Possibilities of using insulin degludec in the treatment of diabetes mellitus in patients with previous ineffective insulin therapy: analysis of clinical cases
- Авторлар: Elsukova O.S.1,2
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Мекемелер:
- Kirov State Medical University
- Yurlova Kirov Clinical Hospital No. 7
- Шығарылым: Том 31, № 8 (2024)
- Беттер: 114-123
- Бөлім: Clinical case
- URL: https://journals.eco-vector.com/2073-4034/article/view/680287
- DOI: https://doi.org/10.18565/pharmateca.2024.8.114-123
- ID: 680287
Дәйексөз келтіру
Аннотация
Achieving and maintaining target values of glycemic control remains an urgent task in the treatment of patients with both type 1 diabetes mellitus (DM1) and type 2 diabetes mellitus (DM2). At the present stage, in addition to the glycated hemoglobin level, new indicators of glucose control have appeared associated with the introduction of the method of continuous glucose monitoring in patients. Particular attention is paid to the indicators of glycemic variability (GV). In DM1 patients, therapy with intermediate-acting insulins and their peak-acting analogues does not fully mimic endogenous insulin secretion, increases the risk of hypoglycemia and may be associated with an increased incidence of GV. DM2 patients more often require higher doses of insulin, the use of which is also associated with high GV. GV can be considered as a risk factor for hypoglycemia and vascular complications. The emergence of new-generation insulins with a long action that do not have an absorption peak can reduce GV. Insulin degludec (Tresiba®) is a long-acting basal insulin analogue (with an action duration of more than 42 hours), which was specially developed for low variability of action. This article considers a series of clinical cases of DM1 and DM2 patients being switched to insulin degludec therapy due to ineffective previous treatment with insulin detemir.
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Авторлар туралы
O. Elsukova
Kirov State Medical University; Yurlova Kirov Clinical Hospital No. 7
Хат алмасуға жауапты Автор.
Email: oselsukova@mail.ru
ORCID iD: 0000-0002-2341-9491
Cand. Sci. (Med.), Associate Professor at the Department of Hospital Therapy; Head of the Endocrinology Department of the Regional Endocrinology Center
Ресей, Kirov; KirovӘдебиет тізімі
- Дедов И.И., Шестакова М.В., Викулова О.К. и др. Сахарный диабет в Российской Федерации: динамика эпидемиологических показателей по данным Федерального регистра сахарного диабета за период 2010–2022 гг. Сахарный диабет. 2023;26(2):104–23. [Dedov I.I., Shestakova M.V., Vikulova O.K., et al. Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal Register of Diabetes Mellitus for the period 2010–2022. Diabetes Mellitus. 2023;26(2):104-23. (In Russ.)]. doi: 10.14341/DM13035.
- Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. 10-й выпуск, доп. Сахарный диабет. 2019;22(1 Suppl. 1):1–144. [Algorithms of specialized medical care for patients with diabetes mellitus. Edited by I. I. Dedov, M. V. Shestakova, A. Yu. 10th issue, suppl. Diabetes Mellitus. 2019;22(1 Suppl. 1):1–144. (In Russ.)].
- American Diabetes Association Professional Practice Committee. 1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes – 2022. Diab Care. 2022;45(Suppl. 1):S8–16.
- Iga R., Uchino H., Kanazawa K., et al. Glycemic Variability in Type 1 Diabetes Compared with Degludec and Glargine on the Morning Injection: An Open-label Randomized Controlled Trial. Diab Ther. 2017;8(4):783–92. doi: 10.1007/s13300-017-0269-0.
- Nicolucci A., Ceriello A., Di Bartolo P., et al. Rapid-Acting Insulin Analogues Versus Regular Human Insulin: A Meta-Analysis of Effects on Glycemic Control in Patients with Diabetes. Diab Ther. 2020;11(3):573–84. doi: 10.1007/s13300-019-00732-w.
- Pal R., Banerjee M., Bhadada S.K. Glycaemic efficacy and safety of mealtime faster-acting insulin aspart administered by injection as compared to insulin aspart in people with diabetes mellitus: A meta-analysis of randomized controlled trials. Diab Med. 2021;38(3):e14515. doi: 10.1111/dme.14515.
- Monnier L., Colette C., Owens D. Glucose variability and diabetes complications: Risk factor or biomarker? Can we disentangle the “Gordian Knot”? Diab Metab. 2021;47(3):101225. doi: 10.1016/j.diabet.2021.101225.
- Sun B., Luo Z., Zhou J. Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications. Cardiovasc Diab. 2021;20(1):9. doi: 10.1186/s12933-020-01200-7.
- Wilmot E.G., Choudhary P., Leelarathna L., Baxter M. Glycaemic variability: The under-recognized therapeutic target in type 1 diabetes care. Diab Obes Metab. 2019;21(12):2599–608. doi: 10.1111/dom.13842.
- Danne T., Nimri R., Battelino T., et al. International Consensus On Use Of Continuous Glucose Monitoring. Diab Care. 2017;40(12):1631–40. doi: 10.2337/Dc17-1600.
- Гариева М.А., Кондратьева Л.В., Черникова Н.А. Вариабельность гликемии у пациентов с сахарным диабетом типа 2, работающих в ночные смены. Эндокринология: Новости. Мнения. Обучение. 2019;8(2):16–24. [Garievа M.A., Kondratieva L.V., Chernikova N.A. Glycemic variability in patients with type 2 diabetes working on night shifts. Endocrinology: News, Opinions, Training. 2019;8(2):16–24. (In Russ.)]. Doi:.24411/2304-9529-2019-12002.
- Wysham C., Bhargava A., Chaykin L., et al. Effect of insulin degludec vs insulin glargine U100 on hypoglycemia in patients with type 2 diabetes. JAMA. 2017;318(1):45. doi: 10.1001/jama.2017.7117.
- Liu W., Yang X., Huang J. Efficacy and safety of insulin degludec versus insulin glargine: A systematic review and meta-analysis of fifteen clinical trials. Int J Endocrinol. 2018;2018(2):1–10. doi: 10.1155/2018/8726046.
- Ratner R.E., Gough S.C.L., Mathieu C., et al. Hypoglycaemia risk with insulin degludec compared with insulin glargine in type 2 and type 1 diabetes: a pre-planned meta-analysis of phase 3 trials. Diab Obes Metab. 2013;15(2):175–84. doi: 10.1111/dom.12032.
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