A10基础胰岛素的理想选择(网络版).ppt

p0.001 for all comparisons of AUC This slide summarises nicely the improvements that have been made with Levemir?. The slide shows some glucose infusion rate (GIR) curves for individuals with type 1 diabetes, with the range illustrated based on four repeated measurements in a clamp study (Heise et al. 2004). The brown curves show the profiles for patients given four separate NPH injections, each preceding a 24-hour clamp. The pink curves show equivalent data for insulin glargine, and the green curves for Levemir?. Firstly, it is striking that the Levemir? curves are notably longer and flatter in comparison with the NPH curves showing a more prolonged absorption, with less of a peak effect. Secondly, it is striking that the Levemir? curves are much more closely spaced for each patients in comparison with those of NPH and glargine. This shows that, under clamp conditions at least, Levemir? produces a much more reproducible effect from one injection to the next in an individual patient helping to better control of glycaemia. The final panel shows the calculated values for the coefficient of variation (CV) for GIRAUC(0–24 h), which is a measure of the variability in the total glucose-lowering effect over 24 hours. Levemir? was significantly less variable in this parameter than either NPH or glargine (p0.001, both comparisons). This was also true for the CV of GIRmax (23 vs. 46 vs. 36%), which is a measure of variability in the maximal glucose-lowering effect. Thus, this study showed that as well as providing a better mean profile than older basal insulins (long duration of action with low peak effect). Levemir? provides greater reproducibility in these desired aspects of its profile than either NPH or glargine. Soluble at neutral pH: avoids variability problems associated with: Resuspension of pre-formed crystals (NPH) Precipitation redissolution of formulations designed for subcutaneous precipitation (both NPH: precipitate Glargine: micro-precipitate) * *