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Diabetes aktuell 2019; 17(02): 67-71
DOI: 10.1055/a-0836-1951
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Insulintherapie beim Typ-2-Diabetes

Therapievorteil durch neue analoge Insuline?
Stephan Kress
1   Medizinische Klinik I Vinzentius-Krankenhaus Landau
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Publication Date:
10 April 2019 (online)

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ZUSAMMENFASSUNG

Um einer physiologischen Insulinwirkung bei der Mahlzeit näher zu kommen, wurden kurzwirksame analoge Insuline entwickelt, die schneller, kürzer und mit einem höheren Wirkspiegel wirksam sind. Dadurch haben kurzwirksame analoge Insuline eine höhere Effektivität, Effizienz und weniger Hypoglykämien gegenüber Normalinsulinen. Der Patient schätzt die Vorteile eines geringeren Therapieaufwandes. Bei den langwirksamen analogen Insulinen war das Ziel der Weiterentwicklung, möglichst gleichmäßige 24 Stunden wirksame, flache Wirkprofile zu entwickeln. Dadurch konnte die Hypoglykämiegefahr gegenüber NPH-Insulinen, insbesondere nachts, verringert werden. Durch 24-Stunden-Wirkung kann der Betazellstress minimiert und die residuale Insulinsekretionsleistung wieder gesteigert werden. Das Erreichen glykämischer Ziele gelingt daher besser gegenüber NPH-Insulinen. Für die Wahl des Spritzzeitpunktes haben 24 Stunden wirksame analoge Insuline eine maximale Freiheit. Das oft fehlerhafte Schwenken von NPH-Insulinen und der daraus entstehende Dosisfehler ist bei langwirksamen Analoginsulinen nicht mehr notwendig.

 

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