Intranasal aerosolized insulin. Mixed-meal studies and long-term use in type I diabetes.
Intranasal aerosolized insulin. Mixed-meal studies and long-term use in type I diabetes.
复制标题
鼻内雾化胰岛素。
DOI：
10.1056/nejm198504253121702
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Armstrong,J
中科院分区：
文献类型：
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作者：
Salzman,R;Manson,JE;Griffing,GT;Kimmerle,R;Ruderman,N;McCall,A;Stoltz,EI;Mullin,C;Small,D;Armstrong,J
我们通过8名患者的禁食研究、15名混合餐研究和8名长期在家使用的患者，评估了含有月桂-9的胰岛素喷雾剂作为I型糖尿病患者的表面活性物质的有效性。鼻内胰岛素(1%月桂-9中每公斤体重1U)被迅速吸收(在15分钟内)；在禁食的正常对照组中，它在45分钟内将血糖水平降低50%，而在空腹糖尿病患者中，它在120分钟内降低50%。降糖效果与胰岛素剂量和表面活性物质浓度有关。鼻腔刺激性与表面活性物质浓度成正比，不同受试者之间差异很大。在餐前滴入胰岛素(1U/公斤，1%月桂-9)后，I型糖尿病患者餐后两小时的血糖水平比餐前水平每分升增加38毫克，而在鼻内注射安慰剂后，每分升增加191毫克(P<；0.05)。一项门诊可行性研究检查了三个月的餐前鼻腔喷雾胰岛素作为Ultraalente胰岛素的补充，结果显示该气雾剂耐受性良好，血糖控制(通过糖化血红蛋白百分比、家庭血糖测量和低血糖反应表明)与随后三个月的常规皮下胰岛素治疗期间相当。结果提示，鼻腔胰岛素有可能作为皮下胰岛素的辅助药物用于治疗I型糖尿病。《英国医学杂志》1985；312：1078-84。
We assessed the efficacy of intranasal aerosolized insulin containing laureth-9 as a surfactant in patients with Type I diabetes by fasting studies in 8 patients, mixed-meal studies in 15, and long-term home use in 8. The intranasal insulin (1 U per kilogram of body weight in 1 per cent laureth-9) was rapidly absorbed (in 15 minutes); it lowered the plasma glucose level by 50 per cent in 45 minutes in fasting normal controls and by 50 per cent in 120 minutes in fasting diabetics. The glucose-lowering potency depended on the insulin dose and surfactant concentration. Nasal irritation was proportional to surfactant concentration, with great variability among subjects. After intranasal insulin used before meals (1 U per kilogram in 1 per cent laureth-9), the two-hour postprandial glucose level increased above before-meal levels by 38 mg per deciliter, as compared with 191 mg per deciliter after intranasal placebo in patients with Type I diabetes (P<0.05). An outpatient feasibility study examining three months of use of intranasal aerosolized insulin before meals as a supplement to Ultralente insulin revealed that the aerosol was well tolerated, with glycemic control (as indicated by the percentage of glycohemoglobin, home glucose measurements, and hypoglycemic reactions) comparable to that during a subsequent three-month period of conventional subcutaneous insulin treatment. The results suggest that intranasal insulin has potential as an adjunct to subcutaneous insulin in the therapy of Type I diabetes. (N Engl J Med 1985; 312:1078–84.)