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Littérature scientifique sur le sujet « Insulin analogue »

Auteur : Grafiati
Publié le 9 mars 2023
Mis à jour le 10 mars 2023

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Articles de revues sur le sujet "Insulin analogue"

1

Balos, Ljiljana, Silvija Sajic et Vera Zdravkovic. « Elements of metabolic control in children with type 1 diabetes before and after introduction to insulin analogues ». Srpski arhiv za celokupno lekarstvo 139, no 9-10 (2011) : 605–9. http://dx.doi.org/10.2298/sarh1110605b.

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Introduction. Diabetes mellitus type 1 (T1DM) in children is characterized by unstable course. A significant number of studies shows that introduction to insulin analogues treatment aims towards better control of the disease. Objective. The assessment of metabolic control in children with T1DM that were introduced to insulin analogue treatment after many years of treatment with classic (human) insulin. Methods. The study included 59 patients 2-19 years old (12.9?3.8) with T1DM, transferred from treatment with human insulin to insulin analogues treatment. Data were obtained directly from patients and their parents, as well as from medical records. Results. The introduction to insulin analogues treatment, leads to a decrease in the value of glycolized haemoglobin (HbA1c) after 6 months (9.27?1.68% vs 8.63?1:26%, p=0.06). Average daily dose of insulin expressed per IU/kg of classic and insulin analogue (1.04?0.38 vs 1.03?0.30; p>0.05), remained almost the same. In 39 examinees (66.1%), 6 months before the introduction to insulin analogue treatment, severe hypoglicemia was registered and 6 months after the introduction to insulin analogue treatment it appeared in only two examinees (3.4%) (p<0.001). Ketoacidosis, 6 months before introduction to insulin analogues treatment, appeared in 16 examinees (27.1%), while 6 months after it was not registered (p<0.001). Conclusion. The use of insulin analogue treatment in childhood provides adequate metabolic control and substantially reduces the risk of acute complications (severe hypoglicemia, ketoacidosis).
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Girsh, Ya V., et Z. A. Akhmedova. « Hypersensitivity Reaction to Insulin Detemir in a Paediatric Patient Taking Basal-Bolus Therapy ». Doctor.Ru 19, no 10 (2020) : 69–73. http://dx.doi.org/10.31550/1727-2378-2020-19-10-69-73.

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Objective: To present a case study demonstrating an atypic side effect of insulin — hepersensitivity reaction to insulin detemir, a long-term human insulin analogues. Key Points. At the inpatient paediatric unit, we had an 11-year old girl with symptoms and clinical signs of diabetes mellitus (DM). Following physical examination, the patient was diagnosed with type 1 diabetes (manifestation). She was prescribed intensified basal-bolus therapy with insulin analogues: insulin detemir and insulin aspart. On day 5, the patient developed a hypersensitivity reaction in the site of insulin detemir injections. Replacement of insulin detemir with insulin degludec resolved the allergic reaction. Conclusion. We described a case of a hypersensitivity reaction to intensified insulin therapy with basal insulin analogue detemir. Hypersensitivity reactions to insulin analogues are rare; however they can be life-threatening. The primary management is the use of another insulin analogue. Keywords: diabetes mellitus, allergy, insulin detemir, insulin degludec.
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Ewen, Margaret, Huibert-Jan Joosse, David Beran et Richard Laing. « Insulin prices, availability and affordability in 13 low-income and middle-income countries ». BMJ Global Health 4, no 3 (juin 2019) : e001410. http://dx.doi.org/10.1136/bmjgh-2019-001410.

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IntroductionGlobally, one in two people needing insulin lack access. High prices and poor availability are thought to be key contributors to poor insulin access. However, few studies have assessed the availability, price and affordability of different insulin types in low-income and middle-income countries in a systematic way.MethodsIn 2016, 15 insulin price and availability surveys were undertaken (using an adaptation of the WHO/Health Action International medicine price and availability measurement methodology) in Brazil, China (Hubei and Shaanxi Provinces), Ethiopia, Ghana, India (Haryana and Madhya Pradesh States), Indonesia, Jordan, Kenya, Kyrgyzstan, Mali, Pakistan, Russia (Kazan Province) and Uganda. Data were collected in three sectors (public, private pharmacies and private hospitals/clinics) in three regions per survey. Insulin prices were standardised to 10 mL 100 IU/mL in US dollars ($). Data were also collected for four comparator medicines.ResultsMean availability was higher for human (55%–80%) versus analogue insulins (55%–63%), but only short-acting human insulin reached 80% availability (public sector). Median government procurement prices were $5 (human insulins) and $33 (long-acting analogues). In all three sectors, median patient prices were $9 for human insulins. Median patient prices for analogues varied between the public sector ($34) and the two private sectors ($44). Vials were cheaper than pens and cartridges. Biosimilars, when available, were mostly cheaper than originators. A low-income person had to work 4 and 7 days to buy 10 mL human and analogue insulin, respectively. For isophane human insulin, only three countries meet the WHO target of 80% availability of affordable essential medicines for non-communicable diseases in any sector.ConclusionImproving insulin availability and affordability needs to be addressed through national and global actions, including prioritising the supply of more affordable human insulin, increasing competition through the use of lower priced quality-assured biosimilars, negotiating lower prices from manufacturers and improving distribution systems.
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Romantsova, Tatiana Ivanovna, T. Sh Dzhavakhishvili et O. V. Roik. « Effects of metformin on body weight in patients with type 2 diabetes mellitus,receiving insulin analogue treatment ». Diabetes mellitus 16, no 1 (15 mars 2013) : 48–51. http://dx.doi.org/10.14341/2072-0351-3596.

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Aims. To study the dynamics of body weight, waist circumference, blood lipid and insulin demand in patients with type 2 diabetes mellitus (T2DM) during first year of combined treatment with metformin and insulin analogues, compared with insulin analogue monotherapy. Materials and Methods. We examined 78 patients with T2DM on newly initiated insulin therapy, including 54 females and 24 males. Median age was 56 [51.0; 64.0] years, median disease duration ? 9 [6.8;14.0] years. Participants were subdivided in two groups. First group was comprised of 48 subjects (33 females and 15 males), who received monotherapy with insulin analogues (glargine, de- temir, biphasic Aspart 30 and Humalog Mix 25 or rapid-acting lispro and aspart). Second group included 30 patients (18 females and12 males), who were treated with combined therapy (insulin analogues plus metformin). We measured HbA1c, plasma lipid composition, BMI, waist circumference and insulin demand initially and after one year of follow-up. Results. We showed that combined therapy vs. insulin monotherapy allows better glycemic compensation while reducing insulin demand and lowering risks for weight gain. Conclusions. Combined insulin analogue plus metformin treatment delivers better metabolic control in patients with T2DM and is as- sociated with lower risks for body weight gain and increase in insulin demand against monotherapy with insulin analogues.
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Mbanya, Jean Claude, Juergen Sandow, Wolfgang Landgraf et David R. Owens. « Recombinant Human Insulin in Global Diabetes Management – Focus on Clinical Efficacy ». European Endocrinology 13, no 01 (2017) : 21. http://dx.doi.org/10.17925/ee.2017.13.01.21.

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Biosynthetic human insulin and insulin analogues are the mainstay of insulin therapy for both type 1 and type 2 diabetes although access to human insulin at affordable prices remains a global issue. The world is experiencing an exponential rise in the prevalence of diabetes presenting an urgent need to establish effective diabetes therapy in countries burdened by inadequate health care budgets, malnutrition and infectious diseases. Recombinant human insulin has replaced animal insulins and animal-based semisynthetic human insulin thereby available in sufficient quantities and at affordable prices able to provide global access to insulin therapy. In many patients, analog insulins can offer additional clinical benefit, although at a considerably higher price thus severely restricting availability in low income countries. The approval process for recombinant human insulins (i.e. biosimilars) and analogue insulins is highly variable in the developing countries in contrast to Europe and in North America, where it is well established within a strict regulatory framework. This review aims to discuss the future access to human insulin therapy in a global context with an ever increasing burden of diabetes and significant economic implications.
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Noor Wafaa Hashim, Kadhim Ali Kadhim et Abbas Mahdi Rahmah. « Effect of human insulin and insulin analogue on some inflammatory markers and total antioxidant capacity in a sample of Iraqi type 1 diabetic children and adolescents ». Al Mustansiriyah Journal of Pharmaceutical Sciences 21, no 2 (19 avril 2022) : 9–14. http://dx.doi.org/10.32947/ajps.v21i2.804.

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Background: Both human insulin and insulin analogue used in the treatment of type 1 diabetes mellitus. The modification in amino acids sequences of human insulin lead to produce analogue form which have a pharmacokinetic and pharmacodynamics effect near to normal human endogenous insulin release. Aim of study: This study designed to compare between the effect of each type of insulin on high sensitive C-reactive protein and interleukin-6 and total antioxidant capacity in a sample of Iraqi type 1 diabetic children and adolescents. Study design: The study was enrolled on fifty-one Iraqi type 1 diabetic children and adolecence age range (6-18) year. The patients allocated into two groups, Group (1) includes 20 patients assigned to receive conventional human insulin (regular and NPH), and Group (2) includes 20 patients assigned to receive insulin analogue (insulin aspart and glargine) for three months. The inflammatory and antioxidant markers measured at baseline and after three months of intervention. Results: After three months of treatment, both insulin groups did not affect high sensetive C_reactive protein (hs-CRP) significantly from baseline to 3 months. Only insulin analogue reduced Interleukin-6 (IL-6) significantly, while human insulin reduced level of IL-6 but it was not statistically significant. Both therapies reduced total antioxidant capacity (TAOC) significantly; however, insulin analogue had higher reduction percentage (15.1% vs. 5.7%) compared to the conventional insulin. Conclusion: Only insulin analogue reduced IL-6 significantly. Both types of insulins did not effect on hs-CRP. Both therapies reduce TAOC significantly.
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Plavsic, Ljiljana, Katarina Mitrovic, Sladjana Todorovic, Rade Vukovic, Tatjana Milenkovic et Dragan Zdravkovic. « Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues ». Vojnosanitetski pregled 71, no 9 (2014) : 817–20. http://dx.doi.org/10.2298/vsp130422039p.

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Background/Aim. An ideal insulin regimen for children and adolescents with type 1 diabetes mellitus (T1DM) should be physiological, flexibile and predictable, protecting against hypoglycaemia. The aim of this study was to evaluate the influence of insulin analogues on glycaemic control and the occurrence of hypoglycaemic episodes in children and adolescents with T1DM. Methods. The study group consisted of 151 children and adolescents (90 boys, 61 girls) treated with human insulins for at least 12 months before introducing insulin analogues. All the patients were divided into two groups: the group I consisted of 72 (47.7%) patients treated with three injections of regular human insulin before meals and long-acting analogue (RHI/LA), and the group II of 79 (52.3%) patients treated with a combination of rapid-acting and long-acting analogue (RA/LA). The levels of glycated hemoglobin (HbA1c) and the number of hypoglycaemic episodes were assessed at the beginning of therapy with insulin analogues, and after 6 and 12 months. Results. The mean HbA1c was significantly lower in the group I (RHI/LA) after 6 months (9.15% vs 8.20%, p < 0.001) and after 12 months (9.15% vs 8.13%, p < 0.001) as well as in the group II (RA/LA) after 6 months (9.40% vs 8.24%, p < 0.001) and after 12 months of insulin analogues treatment (9.40% vs 8.38%, p < 0.001). The frequency of severe hypoglycaemia was significantly lower in both groups after 6 months (in the group I from 61.1% to 4.2% and in the group II from 54.4% to 1.3%, p < 0.001), and after 12 months (in the group I from 61.1% to 1.4% and in the group II from 54.4% to 1.3%, p < 0.001). Conclusion. Significantly better HbA1c values and lower risk of severe hypoglycaemia were established in children and adolescents with T1DM treated with insulin analogues.
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Greeff, Oppel B. W., Jacob John Van Tonder, Kershlin Naidu, Alicia McMaster, Alet Van Tonder et Rashem Mothilal. « A practical guide to the interpretation of PK/PD profiles of longer-acting analogue insulins. Part two : Insulin degludec vs. insulin glargine U300 ». South African Family Practice 60, no 4 (28 août 2018) : 7–12. http://dx.doi.org/10.4102/safp.v60i4.4903.

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Glucose clamp studies form an integral part of the early development of insulin therapies. Data generated in these studies are used to establish pharmacokinetic (PK) and pharmacodynamic (PD) profiles of the agents, but methodological differences confound comparison of results from different glucose clamp studies. The first part of this series on glucose clamp studies discussed practical tips for the interpretation of glucose clamp studies. The second part of the series compares the PK/PD profiles of longer-acting basal analogue insulins, insulin degludec (IDeg) and insulin glargine U300 (Gla-300). The patient populations for glucose clamp studies with these analogue insulins differ, and therefore direct comparison of the data is not always possible. The maximum duration of action of IDeg is reported as 42 h and that of Gla-300 as 36 h, translating to 24 h coverage. The plasma insulin concentration of IDeg is 56 times that of Gla-300. Results from phase III clinical trials for these analogue insulins confirm the predictability and low within-subject variability observed in glucose clamp studies. Insight into the PK/PD profiles of longer-acting basal analogue insulins allows the treating physician to utilise these characteristics to optimise the treatment of their patients with diabetes.
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Koivisto, Veikko A. « The human insulin analogue insulin lispro ». Annals of Medicine 30, no 3 (janvier 1998) : 260–66. http://dx.doi.org/10.3109/07853899809005853.

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Ametov, Alexander Sergeevich, et Natalya Al'bertovna Chernikova. « Individual stepwise intensification of insulin analogue therapy in type 2 diabetes mellitus ». Diabetes mellitus 15, no 4 (15 décembre 2012) : 89–94. http://dx.doi.org/10.14341/2072-0351-5544.

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Article reviews basic steps and regimens of insulin analogue therapy intensification in patients with type 2 diabetes mellitus (T2DM). Intensification of insulin therapy is commonly implemented by supplementation of basal insulin with prandial before breakfast, lunch and dinner. Updated EASD/ADA guidelines (August 2012) recommend individual stepwise intensification of T2DM insulin therapy. Application of insulin analogues simplifies diabetes training and patient self-monitoring.
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Thèses sur le sujet "Insulin analogue"

1

Elamin, Ahmed Abu Baker. « Studies on the short-acting insulin analogue lispro ». Thesis, University of Newcastle Upon Tyne, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310125.

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PEROTTI, MARIO. « EFFICACIA DEL PASSAGGIO A DEGLUDEC DA UN’ALTRA INSULINA BASALE (GLARGINE/ DETEMIR) IN UNA COORTE DI PAZIENTI CON DIABETE MELLITO TIPO 1 ( DMT1) IN CONDIZIONI DI REALE PRATICA CLINICA ». Doctoral thesis, Università degli Studi di Milano-Bicocca, 2019. http://hdl.handle.net/10281/241121.

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La terapia del diabete tipo 1 può oggi essere più flessibile e personalizzata grazie alla disponibilità di numerosi tipi di insulina che differiscono tra loro per la farmacocinetica (inizio, picco e durata di azione). Il miglior controllo glicometabolico può essere ottenuto attraverso una terapia multiniettiva secondo uno schema basal-bolus, il quale prevede 3 somministrazioni preprandiali di un analogo rapido, che esprime meglio la fisiologica secrezione insulinica determinata dai pasti e da 1 iniezione di insulina ad azione lenta, necessaria per rispondere al fabbisogno insulinico nei periodi di digiuno (interprandiale e notturno). Il raggiungimento di un controllo glicemico ottimale mediante trattamento insulinico intensivo determina un riduzione del rischio di complicanze micro e macrovascolari, ma conduce inevitabilmente a un incremento dell’incidenza di ipoglicemie, con conseguenze potenzialmente negative per il sistema cardiovascolare e neurologico. Ottimizzare la terapia farmacologica mediante l’utilizzo di nuovi analoghi dell’insulina ad azione lenta in grado di offrire un minore rischio di ipoglicemia rappresenta un punto di fondamentale importanza. Insulina degludec presenta molte delle caratteristiche che definiscono il profilo ideale di un’insulina basale. Dopo la somministrazione nel sottocute, grazie alla particolare ingegneria chimica, degludec viene assorbita in modo continuo e uniforme con un effetto ipoglicemizzante stabile e una durata di azione che supera le 42 ore. Dopo circa tre giorni di terapia è possibile raggiungere lo steady state condizione farmacocinetica in cui i livelli circolanti di insulina si mantengano stabili riducendo così la variabilità day-to day L'utilizzo di degludec è stato ampiamente analizzato nel corso di studi clinici randomizzati ( RCT) sia in pazienti con diabete mellito tipo I sia in pazienti con diabete mellito tipo II. I risultati mostrano una non inferiorità di degludec rispetto a glargine in termine di target glicemici, ma una superiorità di degludec rispetto a glargine in termini di riduzione degli episodi di ipoglicemia soprattutto notturni. Tuttavia il contesto clinico di uno studio randomizzato può non essere completamente riproducibile nella pratica clinica quotidiana. Obiettivo di questo studio retrospettivo è la valutazione dell’efficacia clinica di degludec in una coorte di pazienti affetti da diabete mellito tipo 1 precedentemente trattati con diverso analogo lento ( glargine o detemir) nella pratica clinica quotidiana di real-life. I risultati di questo studio mostrano un impatto positivo di degludec nella gestione terapeutica di pazienti con diabete mellito tipo 1 in linea con precedenti studi clinici randomizzati . Il passaggio a degludec da un altro analogo basale ( glargine o detemir) è in grado di migliorare il controllo glicemico, con una riduzione media dei valori di HbA1c di 0,20 % [-0,24;-0.17] a 6 mesi rispetto al basale (p <0.001). Inoltre i dati descritti in questo lavoro hanno evidenziato una riduzione del rischio di ipoglicemia sia totale ( rate ratio 0,79 [0,69: 0,89]), sia notturna (rate ratio 0,54 [0,42; 0,69]) sia grave (rate ratio 0,15 [0,09; 0,24]) a 6 mesi dalla modifica di terapia (p <0.001). Tale significatività rimane per tutto il periodo di follow-up di 12 mesi. Infine dopo 6 mesi di terapia con degludec, la dose totale di insulina giornaliera è diminuita del 11% rispetto al basale (p <0,001). Sulla base di questi dati, possiamo affermare che la terapia insulinica con degludec rappresenta un valido strumento terapeutico nella pratica clinica quotidiana, in grado di migliorare il compenso glicemico e la qualità di vita dei pazienti, favorendo così il raggiungimento di obiettivi glicemici più ambiziosi.
Type 1 diabetes (DMT1) leads to absolute insulin deficiency due to immunologic destruction of the islet cells. Therefore affected patients need lifelong insulin treatment. Newer therapies for type 1 diabetes are aimed at developing insulin delivery systems that mimick normal physiology, identifying newer insulins that mimick endogenous insulin. To reproduce physiologic insulin secretion, both long- and short-acting insulins are used. Long-acting insulin, given at bedtime, suppresses glucose output from the liver overnight and provides basal insulin between meals; bolus doses of short-acting insulin modulate glucose excursions associated with carbohydrate consumption. Optimal glycemic control is necessary to reduce the risk for diabetes complications. However, tight glucose control carries a risk for hypoglycemia. Hypoglycemia may accelerate the vascular complications of diabetes by increasing platelet aggregation, leading to higher cardiovascular risk and all-cause mortality. Even brief hypoglycemia can cause profound dysfunction of the brain. Insulin administration by subcutaneous route has intrinsic limitations that, together with the pharmacokinetic (PK) profile of insulin formulations, do not reproduce the physiological patterns of insulin secretion. Insulin degludec (IDeg) is an ultra-long insulin analog that has unique pharmacokinetic and pharmacodynamic properties with a half-life of more than 24 h and a duration of action of more than 42 h. Compared to insulin glargine , the insulin degludec glucose-lowering action at steady state shows four time lower day-to day variability. Randomized clinical studies of degludec have shown a reduction in nocturnal hypoglycemia compared to insulin glargine. Given this background, IDeg is an ultra-long insulin analog that exhibits low intra-individual variability and whose efficacy is comparable to IGlar, but which presents as advantages flexibility in dose timing and lower risk of hypoglycemia, benefits that may impact quality of life and adherence to therapy. In Europe data on the use or effect of degludec in the general diabetes population not exist yet. Thus collection of data under routine clinical practice is highly warranted in order to access the effectiveness of degludec in real-life clinical setting. Aim of this retrospective non interventional study is to evaluate the clinical effectiveness of switching to IDeg in insulin treated patients with DMT1 under condition of routine clinical care. In all patients (n: 900), basal insulin was switched to IDeg at least 6 months before the start of data collection. Baseline was defined as the most recent recording during the 3-month period before first prescription of IDeg. Values are presented as mean [95%CI]. HbA1c decreased by -0.20 % [-0.24; -0.17%] at 6 months vs baseline (P < .001). Rate ratio of overall (0.79 [0.69; 0.89]), non-severe nocturnal (0.54 [0.42; 0.69]) and severe (0.15 [0.09; 0.24]) hypoglycaemia was significantly lower in the 6-month post-switch period vs the pre-switch period (P < .001 for all). Total daily insulin dose decreased by -4.88 [-5.52; -4.24] U (-11%) at 6 months vs baseline (P < .001). This study demonstrates that switching patients to IDeg from other basal insulins improves glycaemic control and significantly reduces the risk of hypoglycaemia in routine clinical practice.
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Louafi, Fethi. « Role of retinoic acid or vitamin D analogue in models of human keratinocyte apoptosis : interactions with the IGF system ». Thesis, University of Warwick, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269235.

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Moolman, Lukas Johannes. « The effect of snacking on continuously monitored glucose concentrations in analogue insulin basal bolus treatment regimens ». Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/40694.

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Gagnon-Auger, Maude. « Améliorer la pharmacocinétique de l’insuline analogue ultrarapide chez des sujets obèses et diabétiques de type 2 ». Thèse, Université de Sherbrooke, 2015. http://hdl.handle.net/11143/11616.

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Résumé: Comparées aux classiques insulines humaines régulières (IHR), les insulines analogues ultrarapides (IAUR) ont été conçues pour mieux synchroniser le pic insulinémique avec l’absorption du repas. Le progrès a été démontré chez les patients diabétiques de type 1, mais le contrôle glycémique s’est peu ou pas amélioré chez les patients diabétiques de type 2 (DT2), qu’ils soient sous IAUR ou IHR. Or ces patients constituent 75 % des utilisateurs d’insuline. L’utilité des IAUR est donc toujours débattue. La dose (donc le volume) injectée et le flot sanguin dans le tissu adipeux sous-cutané (FSTA) sont les facteurs majeurs de l’absorption de l’insuline. Les patients DT2, résistants à l’insuline, s’injectent des doses importantes et leur FSTA est de 50 à 70 % plus faible que celui des sujets sains de poids normal (PN). Nous avons montré que l’absorption sous-cutanée des IAUR est diminuée chez les sujets obèses et DT2 (ODT2) par rapport aux sujets PN, que le volume injecté avait un effet délétère additionnel et que le FSTA peut être augmenté de façon pharmacologique avec un agent vasoactif (AV) chez des sujets résistants à l’insuline. Nous suggérons que l’ajout d’un AV à une IAUR va augmenter le FSTA au site d’injection et donc améliorer sa pharmacocinétique (PK) et sa pharmacodynamie (PD). Pour vérifier cette hypothèse, nous avons 1) évalué la réponse du FSTA à 4 AV chez des sujets PN, obèses non-diabétiques et ODT2; 2) évalué la PK/PD et la biodisponibilité de l’IAUR lispro ± AV chez des sujets ODT2; et 3) caractérisé l’expression des cibles des AV dans le tissu adipeux sous-cutané chez les sujets énumérés en 1). Les 4 AV ont augmenté le FSTA des sujets ODT2, mais moins que celui des autres sujets. L’occurrence de la raréfaction et/ou dysfonction microvasculaire chez les sujets ODT2 pourrait expliquer l’hyporéactivité vasculaire aux AV testés. Le plus actif des AV chez les sujets ODT2 a été ajouté à l’IAUR lispro pour améliorer sont absorption sc. Les PK/PD ont été améliorées seulement chez les sujets ODT2 avec une hémoglobine glycosylée A1c ≥ 8 %; c’est-à-dire 4 sujets sur 8. Chez ces derniers, l’absorption de 30 U + AV a été plus rapide de 14 et 71 min à 20 et 80 % de l’aire sous la courbe totale de la lispro plasmatique, respectivement. Chez les 4 autres sujets ODT2, l’absorption de la lispro semble s’être détériorée avec l’AV. Une interaction chimique a peut-être eu lieu entre l’AV et la lispro, ce qui aurait perturbé son absorption. Selon nos résultats, le niveau de contrôle du diabète, le volume d’injection et les caractéristiques chimiques de l’AV seraient des modulateurs de l’efficacité du concept IAUR + AV. Il nous faut maintenant déterminer l’impact de ces facteurs sur la capacité d’un AV à améliorer l’absorption sc de l’IAUR chez les sujets ODT2.
Abstract: Compared to classic regular human insulin (RHI), short-acting insulin analogues were designed to better synchronize plasma insulin increase to food absorption. Although improvements were noted in subjects with type 1 diabetes, slight to no improvement in glycemic control were observed in subjects with type 2 diabetes (T2D) using SAIA instead of RHI. Nevertheless, they represent 75 % of all insulin users. Consequently, the relative useful-ness of SAIA in T2D patients is currently hotly debated. Injected volume and subcutaneous (sc) adipose tissue blood flow (ATBF) are two main factors involved in insulin absorption. In fact, T2D patients use large doses of insulin because of their resistance to insulin and have an ATBF 50 to 70 % lower than lean healthy subjects. We already showed that SAIA absorption is decreased in obese T2D (OT2D) subjects compared to normal weight healthy subjects and that volume has additional detrimental effects. We also showed that ATBF can be increased pharmacologically with vasoactive agents (VA) in healthy and insulin-resistant subjects. Then we suggest that in OT2D subjects, addition of VA to SAIA preparations will locally increase ATBF, improve insulin sc absorption (Pharmacokinetic - PK) and bioavailability, thus insulin hypoglycemic effect (Pharmacodynamic - PD). To test this hypothesis, we 1) assessed ATBF response of 4 selected VA within three experimental groups (normal weight, obese non-diabetic and OT2D subjects); 2) evaluated insulin PK/PD and bioavailability improvement in OT2D subjects after the addition of the best VA to SAIA lispro and 3) characterized expression of selected VA targets in sc adipose tissue biopsies, within equivalent experimental groups, and compared results with ATBF responses. All 4 VA were able to increase ATBF of OT2D subjects but in a less extend than other subjects. The occurrence of microvascular rarefaction and/or dysfunction in OT2D subjects can explain the hyporeactivity to tested VA. Nevertheless, one VA among others was shown more effective to increase ATBF in OT2D subjects and was then tested (mixed) with SAIA lispro. With the AV, PK/PD were improved only in OT2D subjects with A1c glycated hemoglobin ≥ 8 %; 4 subjects on 8. The sc absorption of 30 U + VA was faster by 14 and 71 min for respectively 20 and 80 % of the total area under the lispro plasmatic curve. But the sc absorption with VA appeared blunted with the other subjects. Maybe detrimental chemical interactions occurred between the VA and lispro, which could impede absorption. Our results suggest that diabetes control state, injection volume, and VA chemical characteristics influence the efficacy of our SAIA + VA concept. Further tests are needed to seize the impact of these factors on VA effectiveness in sc absorption improvement of SAIA in OT2D subjects.
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LEPERRE, ARMELLE. « Etude des effets de l'insulin-like growth factor i (igf-i, facteur analogue a l'insuline i) sur les fibroblastes en cultures monocouches et tridimensionnelles ». Reims, 1992. http://www.theses.fr/1992REIMM037.

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Watson, Christopher John. « Insulin analogues for insulin receptor studies and medical applications ». Thesis, University of York, 2012. http://etheses.whiterose.ac.uk/3797/.

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The structure of insulin molecule was determined by Dorothy Hodgkin in 1969. Subsequently, it has been established that insulin must rearrange upon binding to its receptor (Insulin Receptor – IR). However, all known structures of the hormone depict its storage or inactive form. It has been shown that some residues, key for IR binding, are buried inside the insulin molecule and must be exposed for an efficient insulin-IR complex formation. It has been postulated that the C-terminal region of the B-chain (~B20-B30) is dynamic in this process, and that the detachment of the B20-B30 β-strand leads to the activation of insulin. However, the understanding of the molecular basis of the insulin regulatory role is hindered by the lack of the structure of the insulin-IR complex; only 3-D description of the apo-form of the IR ectodomain is known. The very complex molecular biology behind expression and production of IR fragments also hampers progress in this field. In order to facilitate progress towards determination of the insulin-IR complex crystal structure this work delivered: (i) structural characterisation of highly-active insulin analogues for stable hormone-IR complexes, (ii) development of various attempts for an alternative production of L1 domain of human IR, (iii) structural characterisation of the role of residues B24 and B26 for insulin function, (iv) clarification of individual contributions of hydrogen bonds stabilising the insulin dimer, (v) understanding of the structural basis of different functionality of click-chemistry based novel insulin analogues. This work established that: (i) the structural signature of the highly active insulin analogues is new -turn at the Cterminus of the B-chain (the B26 turn) achieved by trans-to-cis isomerisation of the PheB25- TyrB26 peptide bond. This conformational change exposes residues responsible for IR binding, (ii) the production of the L1 domain in E. coli, instead of the usual mammalian expression system, is not feasible, (iii) the structural invariance of the PheB24 is fundamental to the formation of the insulin-IR complex. It acts as an anchoring and side-chain pivot for the B26 turn, (iv) removal of the NHB25-COA19 dimer interface hydrogen bond is sufficient for a complete disruption of the dimer, whilst the other four hydrogen bonds had a less marked effect in this process, (v) the formation of the B26 turn can be efficiently mimicked by click-chemistry based intra-B-chain crosslinks. These results provide a wealth of information about the active form of insulin, they provide important tools towards the first insulin-IR complex, and deliver novel insulin analogues.
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Shojaee-Moradie, Fariba. « Hepatic and peripheral effects of four insulin analogues ». Thesis, King's College London (University of London), 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338643.

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Bagley, Christopher James. « Analogues of Insulin-Like Growth Factor-1 / Christopher James Bagley ». Title page, table of contents and summary only, 1989. http://web4.library.adelaide.edu.au/theses/09PH/09phb146.pdf.

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Milner, Steven John. « The oxidative folding of insulin-like growth factor-I analogues / ». Title page, table of contents and summary only, 1996. http://web4.library.adelaide.edu.au/theses/09PH/09phm65945.pdf.

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Livres sur le sujet "Insulin analogue"

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E, Warren, et National Co-ordinating Centre for HTA (Great Britain), dir. Systematic review and economic evaluation of a long-acting insulin analogue, insulin glargine. Tunbridge Wells : Gray Publishing on behalf of NCCHTA, 2004.

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Shukla, Vijay. Insulin lispro : A critical evaluation. Ottawa, Ont : Canadian Coordinating Office for Health Technology Assessment, 1999.

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Liu, Hui-Kang. Modification of the function of insulin-secreting cells by beta-cell toxins, differentiation drugs, insulin mimetics, steriods, and incretin hormones and their stable analogues. [S.l : The Author], 2003.

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Wilshire, Carolyn E. Conduction Aphasia : Impaired Phonological Processing. Sous la direction de Anastasia M. Raymer et Leslie J. Gonzalez Rothi. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199772391.013.8.

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Conduction aphasia is a syndrome characterized by impaired repetition in the context of relatively preserved auditory comprehension and fluent speech. The classical conceptualization of conduction aphasia as a disconnection syndrome has been undermined in recent years. Nevertheless, this diagnosis delineates a small subset of individuals with aphasia who have many common cognitive and anatomical characteristics. Conduction aphasia is associated with damage to a relatively narrow and well-defined group of left hemisphere brain structures, which may include the posterior superior temporal lobe, the inferior parietal lobe, and the insula. According to current cognitive neuropsychological frameworks, an impairment in phonological planning for speech production is the common underlying cognitive dysfunction in the majority of cases, which may sometimes be accompanied by an analogous impairment in receptive phonology. Other common features, such as sentence repetition problems and reduced short-term memory span, may be a secondary consequence of the primary phonological impairment. Current approaches to the treatment of conduction aphasia target the underlying impairment in phonological planning. It is argued that the diagnosis of conduction aphasia can be a useful first step toward understanding a person’s language difficulties and planning effective treatment interventions.
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Chapitres de livres sur le sujet "Insulin analogue"

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Videnov, G., K. Büttner, M. Casaretto, J. Föhles, H. G. Gattner, S. Stoev, K. C. Goyal et D. Brandenburg. « Towards the synthesis of an A7-B7-dicarba insulin analogue ». Dans Peptides 1990, 232–33. Dordrecht : Springer Netherlands, 1991. http://dx.doi.org/10.1007/978-94-011-3034-9_97.

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Jie, Xin-feng, Ming-hua Xu, Wei Lin et Ching-I. Niu. « Insulin analogue with substitutions at the C-terminus of the A-chain ». Dans Peptides, 3–6. Dordrecht : Springer Netherlands, 1993. http://dx.doi.org/10.1007/978-94-010-9066-7_1.

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Shoelson, Steven E., Claire S. Lynch, Swati Chatterjee, Manas Chaudhuri et You-Ming Feng. « Bpa-insulins : Photoactivatable analogs for identifying site-site interactions between insulin and the insulin receptor ». Dans Peptides, 57–59. Dordrecht : Springer Netherlands, 1992. http://dx.doi.org/10.1007/978-94-011-2264-1_16.

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Hermansen, Kjeld. « Insulin and New Insulin Analogues, Insulin Pumps and Inhaled Insulin in Type 1 Diabetes ». Dans Pharmacotherapy of Diabetes : New Developments, 41–51. Boston, MA : Springer US, 2007. http://dx.doi.org/10.1007/978-0-387-69737-6_6.

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Madsbad, Sten. « Insulin and New Insulin Analogues with Focus on Type 2 Diabetes ». Dans Pharmacotherapy of Diabetes : New Developments, 53–65. Boston, MA : Springer US, 2007. http://dx.doi.org/10.1007/978-0-387-69737-6_7.

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Hansen, F. B., I. G. Clausen, B. Dath, E. B. Jensen, B. R. Johansen, I. Jonassen, F. Junker et al. « Insulin Analogues — Potentials for Improving Diabetes Treatment ». Dans Bayer AG Centenary Symposium, 155–63. Berlin, Heidelberg : Springer Berlin Heidelberg, 1989. http://dx.doi.org/10.1007/978-3-642-74255-2_13.

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Müller, Günter. « Insulin Analogs : Assessment of Insulin Mitogenicity and IGF-I Activity ». Dans Drug Discovery and Evaluation : Pharmacological Assays, 3119–66. Cham : Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-05392-9_71.

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Müller, Günter. « Insulin Analogs : Assessment of Insulin Mitogenicity and IGF-I Activity ». Dans Drug Discovery and Evaluation : Pharmacological Assays, 1–54. Berlin, Heidelberg : Springer Berlin Heidelberg, 2015. http://dx.doi.org/10.1007/978-3-642-27728-3_71-1.

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Vora, J. P., et D. R. Owens. « Future trends in insulin therapy : clinical implications of novel insulin analogues and nasal administration of insulin ». Dans Pharmacology of Diabetes, sous la direction de C. E. Mogensen et E. Standl, 39–56. Berlin, Boston : De Gruyter, 1990. http://dx.doi.org/10.1515/9783110850321-006.

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Svoboda, I., V. Kašička, M. Machová, J. Jiráček, Z. Prusík et T. Barth. « Separation of semisynthetic insulin analogues by capillary electrophoresis ». Dans Peptides 1992, 471–72. Dordrecht : Springer Netherlands, 1993. http://dx.doi.org/10.1007/978-94-011-1470-7_208.

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Actes de conférences sur le sujet "Insulin analogue"

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Pagkalos, Ilias, Pau Herrero et Pantelis Georgiou. « An analogue implementation of the beta cell insulin release model ». Dans 2013 IEEE International Symposium on Circuits and Systems (ISCAS). IEEE, 2013. http://dx.doi.org/10.1109/iscas.2013.6572384.

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Zedelmair, Michael M., et Abhijit Mukherjee. « Numerical Simulation of Insulin Depot Formation in Subcutaneous Tissue ». Dans ASME 2016 Fluids Engineering Division Summer Meeting collocated with the ASME 2016 Heat Transfer Summer Conference and the ASME 2016 14th International Conference on Nanochannels, Microchannels, and Minichannels. American Society of Mechanical Engineers, 2016. http://dx.doi.org/10.1115/fedsm2016-7719.

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In this study a numerical model of the insulin depot formation and absorption in the subcutaneous adipose tissue is developed using the commercial Computational Fluid Dynamics (CFD) software ANSYS Fluent. A better understanding of these mechanisms can be helpful in the development of new devices and cannula geometries as well as predicting the concentration of insulin in the blood. The injection method considered in this simulation is by the use of an insulin pump using a rapid acting U100 insulin analogue. The insulin is injected into the subcutaneous tissue in the abdominal region. The main composition of the subcutaneous tissue is blood vessels and adipose cells surrounded by interstitial fluid. The numerical simulation is conducted in a 2D-axisymmetric domain where the tissue is modeled as a fluid saturated porous media. Due to the presence of channel formation in lateral direction in the tissue, an anisotropic approach to define the permeability is studied having an impact on the viscous resistance to the flow. This configuration is resulting in a rather disk shaped depot following recent experimental findings. The depot formation is analyzed running Bolus injections ranging from 5–15 Units of insulin corresponding to 50–150μl. The depot formation model has been extended implementing the process of absorption of insulin from the depot to be able to run the simulation over longer timeframes where absorption starts playing an important role.
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King, A., C. Arnaud, G. Vial, E. Billoir, B. Ozcan, E. Belaidi, C. O'Donnell et S. Ryan. « The effect of the GLP-1 analogue Liraglutide on intermittent hypoxia-induced systemic insulin resistance in vivo ». Dans ERS International Congress 2022 abstracts. European Respiratory Society, 2022. http://dx.doi.org/10.1183/13993003.congress-2022.2182.

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Zedelmair, Michael M., et Abhijit Mukherjee. « Numerical Simulation of Insulin Depot Formation in Subcutaneous Tissue Comparing Different Cannula Geometries ». Dans ASME 2016 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2016. http://dx.doi.org/10.1115/imece2016-67473.

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In this study, the impact of the cannula geometry on the formation of the depot in subcutaneous tissue is investigated when injecting insulin using an insulin pump. The simulations have been conducted using the Computational Fluid Dynamics (CFD) software ANSYS Fluent. The study is focusing on rapid acting insulin analogues typically used in insulin pump therapy, which enter the bloodstream very shortly after administration. A previously developed 2-dimensional simulation has been transferred into a 3-dimensional case in order to simulate cases with non-axisymmetric geometries. The tissue has been modeled as a homogeneous anisotropic porous media by the use of different porosity values in the parallel and perpendicular direction with respect to the skin surface. The process of absorption is implemented into the model by the use of a locally variable species sink term. The basic case, simulated with a solid cannula, has been compared to other cannula geometries in order to evaluate if the delivery of insulin in the tissue can be improved. The geometries under consideration are the addition of circumferential holes in the wall of the cannula as well as using an array of cannulas instead of a single cannula. The depot formation is analyzed simulating a standard bolus injection of 0.05ml of insulin using an injection time of 25 seconds. It is observed that the addition of multiple holes in the wall of the cannula or using an array of cannulas can alter the shape of the depot quite significantly. The impact of the depot shape on the diffusion of insulin in the tissue has been evaluated by measuring the total volume of the depot after injection.
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Teupe, B. « Late revenge of analogue insulins among T1D-patients ? » Dans Diabetes Kongress 2018 – 53. Jahrestagung der DDG. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1641851.

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Selvan, Veera, et Namas Chandra. « Relationship Between Blast Overpressure and Shell Thickness on the Fluid Pressure on a Cylinder Under Blast Loading ». Dans ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14720.

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The mechanics of blast wave-head interaction determines the magnitude of mechanical insult to the human head during a field explosion and subsequent brain injury. In this work, blast overpressure and shell thickness are related to fluid pressure based on experimental and computational methods. A fluid-filled cylinder is idealized as a two-dimensional analog of a skull-brain complex and is subjected to a Friedlander blast wave. Strain and pressure on the surface of the cylinder and pressure in the fluid (analogue of Intracranial pressure) are experimentally measured and compared with numerical simulation results. The validated numerical model shows that fluid pressure increases linearly with increase in reflected overpressures (ROP) for a given shell thickness. When the ROP is kept constant, fluid pressure increases linearly with the decrease in shell thickness. An equation is developed for predicting the fluid pressure for a given ROP and shell thickness.
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Ellmerer, Martin, Richard N. Bergman, Manfred Bodenlenz et Thomas R. Pieber. « Long-acting insulin analogues : What we learn from integrated physiology ». Dans VIIIth Conference Biologically Active Peptides. Prague : Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, 2003. http://dx.doi.org/10.1135/css200306015.

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Dimitriu, Gabriel, Vasile Lucian Boiculese et Mihaela Moscalu. « Numerical simulations for modeling the insulin analogues using reduced order techniques ». Dans 2013 E-Health and Bioengineering Conference (EHB). IEEE, 2013. http://dx.doi.org/10.1109/ehb.2013.6707343.

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Klimontov, V. V., E. A. Koroleva et O. N. Fazullina. « Switching to insulin glargine 300 U/mL from other basal insulin analogues provides less 24-hour glucose variability in hospitalized patients with type 1 diabetes ». Dans 2018 11th International Multiconference Bioinformatics of Genome Regulation and Structure\Systems Biology (BGRS\SB). IEEE, 2018. http://dx.doi.org/10.1109/csgb.2018.8544728.

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Kobylska, Ewa, Marcin Drozd, Małgorzata Żmieńko et Michał Chudy. « Studies on Recombinant Insulin Analogs Interactions with Partner Cell Membrane Receptors Using the SPR Technique ». Dans I3S2022Warsaw. Basel Switzerland : MDPI, 2022. http://dx.doi.org/10.3390/engproc2022021022.

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