Zusammenfassung
Die molekularbiologischen Vorgänge der Absorption von Insulin in die Blutbahn nach der subkutanen Injektion der Hormonlösung sind bis heute nicht endgültig geklärt. Die Erweiterung der Kenntnisse über die Kinetik des Absorptionsvorganges hat jedoch für die klinische Praxis eine zunehmende Bedeutung gewonnen. Heute wird der Absorptionsprozeß zumeist mittels des Schemas der Abb. 11 beschrieben. Dabei geht man davon aus, daß ein erheblicher (und modifizierbarer) Anteil der Verzögerung des Absorptionsvorganges nach der subkutanen Insulininjektion durch die Dissoziation der in handelsüblichen Lösung vorliegenden Insulin-Hexa- mere bedingt ist.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Berger M, Cüppers HJ, Hegner H, Jörgens V, Berchtold P (1982) Absorption kinetics and biological effects of subcutaneously injected insulin preparations. Diabetes Care 5:77–91
Heinemann L, Berger M (2000) Insulintherapie. In: Berger M (Hrsg.) Diabetes mellitus, 2. Auflage. Urban & Fischer, München, Jena, pp. 125–149
Starke AAR, Heinemann L, Hohmann A, Berger M (1989) The action profiles of human insulin preparations. Diabetic Medicine 6:239–244
Berger M, Cüppers HJ, Hegner H, Jörgens V, Berchtold P (1982) Absorption kinetics and biological effects of subcutaneously injected insulin preparations. Diabetes Care 5:77–91
Kemmer FW, Berchtold P, Berger M et al (1980) Exercise-induced fall of blood glucose in insulin-treated diabetics unrelated to alteration of insulin mobilisation. Diabetes 28:1131–1137
Thow JC, Johnson AB, Antsiferov M, Home PO (1989) Exercise augments the absorption of isophane (NPH) insulin. Diabetic Medicine 6:342–345
Frid A, Linden B (1986) Where do lean diabetics inject their insulin? A study using computed tomography. Br Med J 292:1638
Spraul M, Chantelau E, Koumoulidou J, Berger M (1988) Subcutaneous or nonsubcutaneous injection of insulin. Diabetes Care 11:733–736
Vaag A, Handberg A, Lauritzen M (1990) Variation in absorption of NPH insulin due to intramuscular injection. Diabetes Care 13:74–76
Berger M (1987) Human insulin — much ado about hypoglycemia (un)awareness. Diabetologia 30:829–833
Chantelau EA, Lee DM, Hemmann D et al (1991) What makes insulin injections painful? Brit Med J 303:26–27
Colagiuri S, Miller JJ, Petocz P (1992) Double-blind crossover comparison of human and porcine insulins in patients reporting lack of hypoglycaemia awareness. Lancet 339:1432–1435
Mühlhauser I, Todt G, Sawicki PT, Berger M (1991) Hypoglycemic symptoms and frequency of severe hypoglycemia in patients treated with human and animal insulin preparations. Diabetes Care 14:745–749
Sonnenberg GE, Berger M (1983) Human insulin — much ado about one amino acid? Diabetologia 25:457–459
Overmann H, Heinemann I (1999) Injection-time interval: recommendations of diabetologists and how patients handle it. Diab Res Clin Pract 43:137–142
Scheen AJ, Letiexhe MR, Scheen, Lefèbvre PJ (1999) Minimal influence of the time interval between injection of regular insulin and food intake on blood glucose control of Type 1 diabetic patients on a basal-bolus insulin scheme. Diabetes & Metabolism. 25:157–162
Berger M, Heinemann L (1997) Are presently available insulin analogues clinically beneficial? Diabetologia 40(suppl 2):91-S96
Bolli GB, Di Marchi RD, Park GD, Pramming S, Koivisto VA (1999) Insulin analogues and their potential in the management of diabetes mellitus. Diabetologia 42:1151–1167
Brunelle RL, Llewelyn J, Anderson H jr et al (1998) Meta-analysis of the effect of insulin lispro on severe hypoglycemia in patients with Type 1 diabetes. Diabetes Care 21: 1726–1731
Brunner GA, Hirschberger S, Sendlhofer G, Wutte A, Ellmerer M, Balent B, Schaupp L, Krejs GJ, Pieber TR (2000) Post-prandial administration of the insulin analogue aspartat in patients with type 1 diabetes mellitus. Diabetic Medicine 17:371–375
Buse J (2000) Insulin glargine. First responsibilities: understanding the data and ensuring safety. Diabetes Care 23:576–578
Davey P, Grainger D, MacMillan J et al (1997) Clinical outcome with insulin lispro compared with human regular insulin: a meta-analysis. Clin Ther 19:656–674
Heinemann L, Heise T, Wahl LC et al (1996) Prandial glycaemia after a carbohydrate-rich meal in Type 1 diabetic patients: using the rapid acting insulin analogue [Lys(B28), Pro(B29)] human insulin. Diabetic Medicine 13:625–629
Holleman F et al (1996) Comparison of Lys(B28), Pro(B29)-human insulin analog and regular human insulin in the correction of incidental hyperglycemia Diabetes Care 19:1426–1429
Jorgensen LN, Dideriksen LH, Drejer K (1992) Carcinogenic effect of human insulin analogue BlOAsp in female rats, (abst.) Diabetologia 35 (suppl. 1):A3
Kitzmiller JL, Main E, Ward B et al (1999) Insulin Lispro and the development of proliferative diabetic retinopathy during pregnancy (letter) Diabetes Care 22:874–876
Kotsanos JG, Vignati L, Huster W et al (1997) Health-related quality-of-life results from multinational clinical trials of insulin lispro Diabetes Care 20:948–958
Lalli C, Ciofetta M, Del Sindaco P et al (1999) Long-term intensive treatment of Type 1 diabetes with the short-acting insulin analog lispro in variable combination with NPH insulin at mealtime Diabetes Care 22:468–477
Mühlhauser I, Chantelau EA, Jansen M et al (1991) Are there common features of insulin substitution strategies among C-peptide negative diabetic patients who maintain normal glycosylated haemoglobin values? Diab Nutr Metab 4:17–22
Nielsen FS, Jørgensen LN, Ipsen M et al(1995) Long-term comparison of human insulin analogue BlOAsp and soluble human insulin in IDDM patients on an basal/bolus insulin regimen Diabetologia 38:592–598
Renner R, Pfützner A, Trautmann M et al(1999) Use of insulin lispro in continuous subcutaneous insulin infusion treatment Diabetes Care 22:784–788
Zinman B, Tildesley H, Chiasson JL, Tsui E, Strack T (1997) Insulin-lispro in CSII. Results of a double-blind cross-over study Diabetes 46:440–443
Berger M (2000) Safety of insulin glargine. Lancet 356:2013–2014
Home P (1999) Insulin glargine: the first clinically useful extended-acting insulin in half a century? Exp Opin Invest Drugs 8:307–314
Kurtzhals P, Schäffer L, Sorensen A, Kristensen C, Jonassen lb, Schmid C, Trüb T (2000) Correlations of receptor binding and metabolic and mitogenic potencies of insulin analogs designed for clinical use Diabetes 49:999–1005
Heinemann L, Breuer Z, Cebulla D et at (1996) Wirkungsprofile von Normalinsulin, NPH- Insulin sowie einer 25/75 Mischung hergestellt aus gentechnologischem bzw. semisynthetischem Humaninsulin. Diabetes Stoffw 5:157–163
Heinemann L, Linkeschova, R, Rave K, Hompesch B, Sedlak, M, Heise T (2000) TimeAction profile of long-acting insulin analog insulin glargine (Hoe 901) in comparison with those of insulin and placebo. Diabetes Care 23:644–649
Pieber TR, Eugene-Jolchine I, Derobert E, the European Study Group of HOE 901 in Type 1 Diabetes (2000) Efficacy and safety of HOE 901 versus NPH insulin in patients with type 1 diabetes. Diabetes Care 23:157–162
Ratner RE, Hirsch IB, Neifing JL, Garg SK, Mecca TE, Wilson CA, for the U.S. Study Group of Insulin Glargine in Type 1 Diabetes (2000) Less hypoglycemia with insulin glargine in intensive insulin therapy for type 1 diabetes. Diabetes Care 23:639–643
Yki-Järvinen H, Dressier A, Ziemen M et al (2000) Less nocturnal hypoglycemia and better post-dinner glucose control with bedtime insulin glargine compared with bedtime NPH insulin during insulin combination therapy in type 2 diabetes. Diabetes Care 23:1130–1136
Heinemann L, Berger M (2000) Insulintherapie. In: Berger M (Hrsg) Diabetes mellitus, 2. Aufl. Urban & Fischer, München Jena, pp 125–149
Davidson JK, Anderson JHJ, Chance RE (2000) Insulin therapy. In: Davidson JK (ed) Clinical diabetes mellitus. A problem-oriented approach, 3rd edn. Thieme-Stratton, New York, pp 329–404
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2001 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Berger, M., Jörgens, V. (2001). Pharmakokinetik subkutan injizierten Insulins. In: Praxis der Insulintherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-97548-6_5
Download citation
DOI: https://doi.org/10.1007/978-3-642-97548-6_5
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-57468-2
Online ISBN: 978-3-642-97548-6
eBook Packages: Springer Book Archive