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諾和諾德是一家致力于人類健康、以先進(jìn)的生物技術(shù)造福患者、醫(yī)生和社會(huì)的世界領(lǐng)先生物制藥公司。
諾和諾德公司的歷史最早可追溯至1923年,80多年來一直是世界糖尿病研究和藥物開發(fā)領(lǐng)域的主導(dǎo)。諾和諾德總部位于丹麥?zhǔn)锥几绫竟F(xiàn)在全球79個(gè)國家設(shè)有分支機(jī)構(gòu),6個(gè)國家設(shè)有生產(chǎn)廠,截至08年底,員工超過 27,000名,銷售遍及180個(gè)國家。
諾和諾德憑借自身的研發(fā)實(shí)力成為世界糖尿病治療領(lǐng)域先導(dǎo),在行業(yè)內(nèi)擁有最為廣泛的糖尿病治療產(chǎn)品,其中包括最先進(jìn)的胰島素給藥系統(tǒng)產(chǎn)品。
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Robert Ligthelm教授:國際指南與強(qiáng)化治療的選擇
發(fā)布日期:2009-12-09 17:23 文章來源:丁香園
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關(guān)鍵詞: 諾和銳
諾和諾德
novonordisk
Robert
Ligthelm
指南
規(guī)范
點(diǎn)擊次數(shù):
Intensification options and guidelines
Dr. Robert Ligthelm
Medical Director, EHM-Hoofddorp
Rotterdam, The Netherlands
對(duì)已接受胰島素治療的患者,隨著其病情的進(jìn)展,仍會(huì)出現(xiàn)血糖控制不佳,這時(shí)需要強(qiáng)化胰島素治療。Ligthelm教授指出,對(duì)于強(qiáng)化胰島素治療策略的選擇,需要考慮患者意愿和低血糖風(fēng)險(xiǎn)等多重因素。當(dāng)使用預(yù)混或基礎(chǔ)胰島素控糖效果不佳時(shí),使用預(yù)混胰島素類似物(如門冬胰島素30)是簡單、有效的方法,而且可每日3次使用。
目前,關(guān)于預(yù)混胰島素強(qiáng)化治療方案和劑量的相關(guān)推薦有限,近期發(fā)表于《國際臨床實(shí)踐雜志》(Int J Clin Pract)的共識(shí)提供了較簡單的門冬胰島素30強(qiáng)化治療方案,包括從每日1次或2次門冬胰島素30治療轉(zhuǎn)至每日2次或3次門冬胰島素30治療,即從初始到強(qiáng)化均為門冬胰島素30的簡單轉(zhuǎn)換,以及從每日1次或2次基礎(chǔ)胰島素治療轉(zhuǎn)至每日2次門冬胰島素30治療,具有較好的臨床參考價(jià)值。
而且,Ligthelm教授指出,使用門冬胰島素30作為強(qiáng)化治療有以下優(yōu)勢(shì)。首先,與人胰島素30相比,門冬胰島素30降糖更符合生理特點(diǎn);其次,門冬胰島素30劑量調(diào)整方便,每日使用2次可有效降糖,且可增至每日3次使用,同時(shí)餐時(shí)注射方便;最后,門冬胰島素30可同時(shí)降低FPG和PPG,每日1次使用與基礎(chǔ)胰島素類似物相比,可更好地控制HbA1c和PPG。
After successfully initiating and optimising insulin, modification of treatment by adding or changing therapy to achieve glycaemic targets is often required. However, this must be carefully moderated by patient’s willingness and the risk associated with hypoglycaemia.
Basal and premix insulins are commonly prescribed as first-line therapies for patients failing to maintain glycaemic control on oral therapy. However, when control with these insulins begins to fail, a premix analogue such as NovoMix? 30 is a simple and effective tool for intensification as being the only premix analogue which has been approved to be injected up to three-times daily. Currently, international recommendations for intensification of insulin therapy using premix analogues are limited and specific guidance on dosing is not available for many circumstances. As such, Dr Ligthelm will review the recently published consensus statement in the International Journal of Clinical Practice (2009) which provides simplified algorithms for intensifying insulin therapy with NovoMix? 30.??
Robert Ligthelm教授:指南與強(qiáng)化治療的選擇
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