糖尿病治疗新进展.ppt

研究2：

荟萃分析：甘精胰岛素并不升高肿瘤发生风险目的：评估接受甘精胰岛素治疗中癌症的发生风险采用随机效应模型进行荟萃分析：5项观察性研究：自国家数据库(德国、瑞典、苏格兰、英格兰和中国台湾)收集的报告了接受甘精胰岛素治疗的患者中癌症风险的观察性研究1项甘精胰岛素的随机试验的荟萃分析1项主要评估视网膜进展的甘精胰岛素的随机对照试验1项小型的在意大利进行的病例对照研究甘精胰岛素并不升高肿瘤发生危险

（荟萃分析）必威体育精装版发布的临床研究（Accord研究5年数据分析及荟萃分析）进一步证实甘精胰岛素并不增加肿瘤发生风险体外研究的进展如何？甘精胰岛素在1型及2型糖尿病患者中的主要代谢产物甘精胰岛素、人胰岛素与AspB10代谢途径的差异PlasmaConcentrationsofInsulinGlargineandItsMetabolitesafterS.C.InjectionofGlargineinSubjectswithType1DiabetesViewPresentation?PresentedDuringSession:?PharmacologicTreatmentofDiabetes—InsulinTherapySaturday,June25,2011:2:15PM?-2:30PM?AbstractNo:0071-OR?AbstractType:Oral?Author(s):GEREMIAB.BOLLI,ANNKEFRICK,RONALDSCHMIDT,TANJAEISENBLAETTER,REINHARDBECKERLocation(s):Perugia,Italy,Frankfurt,GermanyAbstractBody:Invitro,glargine(GLA)exhibitshigheraffinityforIGF-1receptors(IGF1R)thanhumaninsulin(HI),incontrasttoitsM1andM2metabolitesthatexhibitloweraffinity.Afters.cinjectioninvivo,GLAisenzymaticallytransformedintoM1andM2withlossofthetwoargininesatB30a-30bbutretentionoftheglycineforasparaginesubstitutionatA21.DuetotechnicalconstraintsfewdataexistonplasmaconcentrationsofGLA,M1andM2afters.c.injectionofGLAinhumans.GLA,M1andM2plasmaconcentrationsweredeterminedfromsamplestakeninasingle-center,randomized,euglycemicglucoseclamptrialwhere12malesubjectswithtype1diabetes(BMI25kg/m2;A1C8.0%)pergroupreceivedsingles.c.dosesof0.3,0.6,or1.2U/kgGLAandwerestudiedfor24h.GLA,M1andM2wereextractedusingimmunoaffinitycolumnsandquantifiedbyaspecificLC-MS/MSassay,withoutcross-reactivitytoendogenousHIorotherinsulins.LLOQwas200pg/ml.TheareasundertheGLA,M1andM2curves(PK-AUC0-24h)weredetermined.Thepharmacodynamic(PD)effectwasdeterminedfromtheAUCundertheglucoseinfusionratecurve(PD-AUC0-24h).GLAandM2weredetectableinonlyonethird