MEAL-TIME INTRANASAL INSULIN DELIVERY IN TYPE 2 DIABETES

被引：25

作者：

BRUCE, DG ^{[1
]}

CHISHOLM, DJ ^{[1
]}

STORLIEN, LH ^{[1
]}

BORKMAN, M ^{[1
]}

KRAEGEN, EW ^{[1
]}

机构：

[1] ST VINCENTS HOSP,GARVAN INST MED RES,DARLINGHURST,NSW 2010,AUSTRALIA

来源：

DIABETIC MEDICINE | 1991年 / 8卷 / 04期

关键词：

NASAL INSULIN; INSULIN THERAPY; TYPE-2; DIABETES;

D O I：

10.1111/j.1464-5491.1991.tb01611.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Correction of the deficiency of early meal-time insulin secretion, using intravenous insulin in patients with Type 2 diabetes causes substantial improvement in post-prandial hyperglycaemia. The present study was designed to determine whether similar benefit would result from physiological supplementation using intranasal insulin delivery. Six patients with Type 2 diabetes were studied twice during a standard mixed meal. At the start of the meal they received a single intranasal spray containing either 15 units of insulin in 1 % sodium glycocholate (adjuvant agent) or glycocholate alone (placebo) in a single-blind fashion. Intranasal insulin delivery resulted in rapid absorption of insulin with peak levels (92 +/- 8 (+/- SE) mU l-1) within 5-10 min. Peak insulin levels were at least equal to those in non-diabetic subjects, though occurring at an earlier time-point. However, no significant improvement in post-prandial hyperglycaemia was seen (peak blood glucose increment 4.9 +/- 0.6 vs 5.4 +/- 0.5 mmol l-1; total 3-h response 611 +/- 53 vs 668 +/- 41 mmol l-1 min). We conclude that an elevation of insulin levels, earlier and more transient than the normal physiological response, achieved by intranasal insulin delivery at the start of a meal, fails to significantly improve the blood glucose excursion in Type 2 diabetes.

引用

页码：366 / 370

页数：5

共 16 条

[1]

Yalow RS, Berson SA, Plasma insulin concentrations in nondiabetic and early diabetic subjects. Determinations by a new sensitive immuno‐assay technique, Diabetes, 9, pp. 254-260, (1960)

[2]

Perley M., Kipnis DM, Plasma insulin response to glucose and tolbutamide of normal weight and obese diabetic and nondiabetic subjects, Diabetes, 15, pp. 867-874, (1966)

[3]

Seltzer HS, Allen EW, Herron AL, Brennan MT, Insulin secretion in response to glycaemic stimulus: Relation of delayed initial release to carbohydrate intolerance in mild diabetes, J Clin Invest, 46, pp. 323-335, (1967)

[4]

DeFronzo RA, Ferrannini E., The pathogenesis of non‐insulin‐dependent diabetes: an update, Medicine, 61, pp. 125-140, (1982)

[5]

Colwell JA, Lein A., Diminished insulin response to hyperglycaemia in prediabetes and diabetes, Diabetes, 16, pp. 560-565, (1967)

[6]

Kosaka K., Hagura R., Kuzuya T., Insulin responses in equivocal and definite diabetes, with special reference to subjects who had mild glucose intolerance but later developed definite diabetes, Diabetes, 26, pp. 944-952, (1977)

[7]

Bruce DG, Chisholm DJ, Storlien LH, Kraegen EW, The physiological importance of the deficiency in early prandial insulin secretion in noninsulin dependent diabetes mellitus, Diabetes, 37, pp. 736-744, (1988)

[8]

Hirai S., Ikenaga T., Matsuzawa T., Nasal absorption of insulin in dogs, Diabetes, 27, pp. 296-299, (1978)

[9]

Moses AC, Gordon GS, Carey MC, Flier JS, Insulin administered intranasally as an insulin‐bile salt aerosol: Effectiveness and reproducibility in normal and diabetic subjects, Diabetes, 32, pp. 1040-1047, (1983)

[10]

Gordon GS, Moses AC, Silver RD, Flier JS, Carey MC, Nasal absorption of insulin: enhancement by hydrophobic bile salts, Proc Natl Acad Sci, 82, pp. 7419-7423, (1985)

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