100 Jahre Insulin: Wie hat sich die Insulintherapie bei Erwachsenen zwischen 2000 und 2021 verändert?

Zusammenfassung

100 Jahre nach Einführung der Insulintherapie haben sich durch pharmakologische Weiterentwicklung der Insuline mit vielfältigen Wirkdauern, aber auch Veränderungen der Applikations- und Messmöglichkeiten, die angewendeten Insulintherapien insbesondere in den letzten 20 Jahren stark verändert, hin zu einer häufigeren Anwendung von Insulinanaloga, insbesondere bei Patienten mit T1DM [1]. Bei Typ-2-DM ergibt sich mit unterschiedlichen Strategien der Insulintherapie auch in Kombination mit oralen Antidiabetika für die Patienten ein breites Spektrum an Formen der Insulintherapie. Durch die verschiedenen Applikationsformen und Insuline zeigt sich eine kleine, aber signifikante Verbesserung der Blutzuckereinstellung, aber vor allem eine Individualisierung der Diabetestherapie.

Abstract

100 years after using insulin therapy for the very first time, pharmacological advances in medicine – especially in terms of insulin preparations with different kinetics, but also different methods of application and glucose self measurement – have brought about quite drastic changes, particularly within the last 20 years. Today, the use of insulin analogues has become far more common, in particular for patients with T1DM. For patients with T2DM there now is a broad spectrum of different forms of insulin therapy: BOT, BOTplus, SIT, various pre-mixtures of insulin, conventional or intensive conventional insulin therapy, or even the use of insulin pumps for few patients. The numerous different insulins and methods of application have led to a small but quite significant improvement in the blood-sugar levels of patients and have further advanced the individuality in patient care.

Schlüsselwörter

Insulin - Diabetes - Typ 1 Diabetes - Typ 2 Diabetes - insulin therapy - T1DM - T2DM

Publikationsverlauf

Eingereicht: 15. Dezember 2022

Angenommen nach Revision: 14. Februar 2023

Artikel online veröffentlicht:
21. April 2023

• Literatur

• 1 Dittrich HM, Hahn von Dorsche H. The anatomical and histological investigation of the pancreas in the 19th century and till the discovery of insulin (1921). 1. The anatomical pancreas research from the beginning till the discovery of islets of pancreas (1869) (author’s transl). Anat Anz 1978; 143: 221-230 (PMID: 356672)
• 2 Weinstock RS, Schutz-Fuhrmann I, Connor CG. et al. Type 1 diabetes in older adults: Comparing treatments and chronic complications in the United States T1D Exchange and the German/Austrian DPV registries. Diabetes Res Clin Pract 2016; 122: 28-37 DOI: 10.1016/j.diabres.2016.09.024. (PMID: 27764721)
• 3 Bramlage P, Tittel SR, Müther S. et al. A comparison of the rapid-acting insulin analogue glulisine with lispro and aspart for the pump treatment of patients with type-1 diabetes. Acta Diabetologica 2022; 59: 1453-1460
• 4 Schöttler H, Auzanneau M, Best F. et al. Insulinpumpe, kontinuierliche und kapilläre Glukosemessung bei Kindern, Jugendlichen und Erwachsenen mit Diabetes mellitus: Daten des DPV-Registers zwischen 1995 -2019. Diabetologie und Stoffwechsel 2020; 15: 477-486
• 5 Grammes J, Kustner E, Dapp A. et al. Comparative characteristics of older people with type 1 diabetes treated with continuous subcutaneous insulin infusion or insulin injection therapy: data from the German/Austrian DPV registry. Diabet Med 2020; 37: 856-862 DOI: 10.1111/dme.14218. (PMID: 31853984)
• 6 Vliebergh J, Lefever E, Mathieu C. Advances in newer basal and bolus insulins: impact on type 1 diabetes. Curr Opin Endocrinol Diabetes Obes 2021; 28: 1-7 DOI: 10.1097/MED.0000000000000599. (PMID: 33315628)
• 7 Xu J, Yao D, Xia J. Efficacy and safety of dulaglutide compared with glargine in patients with type 2 diabetes: A systematic review and meta-analysis. J Clin Pharm Ther 2021; 46: 1245-1253 DOI: 10.1111/jcpt.13398.
• 8 Mark Gv, Lanzinger S, Sziegoleit S. et al. Characteristics of patients with type 1 or type 2 diabetes receiving insulin glargine U300 – an analysis of 7,268 patients based on the DPV and DIVE registries. Advances in Therapy 2019; 36: 1628-1641
• 9 Melmer A, Zurrer I, Kopp F. et al. Differences in insulin dosing in women with type 1 diabetes before and after the menopause. Swiss Med Wkly 2021; 151: w30025 DOI: 10.4414/smw.2021.w30025.
• 10 Benioudakis E, Karlafti E, Kalaitzaki A. et al. Technological Developments and Quality of Life in Type 1 Diabetes Mellitus Patients: A Review of the Modern Insulin Analogues, Continuous Glucose Monitoring and Insulin Pump Therapy. Curr Diabetes Rev 2022; 18: e031121197657 DOI: 10.2174/1573399818666211103163208. (PMID: 34732118)
• 11 Bain S, Feher M, Fisher M. et al. A review of the NG17 recommendations for the use of basal insulin in type 1 diabetes. Diabet Med 2020; 37: 219-228 DOI: 10.1111/dme.14180. (PMID: 31729775)
• 12 Mannucci E, Caiulo C, Naletto L. et al. Efficacy and safety of different basal and prandial insulin analogues for the treatment of type 2 diabetes: a network meta-analysis of randomized controlled trials. Endocrine 2021; 74: 508-517 DOI: 10.1007/s12020-021-02889-6. (PMID: 34599695)
• 13 Prinz N, Schwandt A, Borgert B. et al. Not All Type-2-Diabetes Patients Increase Body Mass Index After Initiating Insulin: Results of Latent Class Analysis from the DPV Registry. Diabetes Technol Ther 2021; 23: 799-806 DOI: 10.1089/dia.2021.0144.
• 14 van Mark G, Tittel SR, Welp R. et al. DIVE/DPV registries: benefits and risks of analog insulin use in individuals 75 years and older with type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2021; 9 DOI: 10.1136/bmjdrc-2021-002215.
• 15 Bohn B, Bramlage P, Wagner C. et al. Welche Patienten aus der Routinebetreuung verwenden das neue Insulin-Analogon Glargin U300 im Vergleich zu Patienten mit Glargin U100? Eine multizentrische Analyse von 14.123 Patienten mit Insulin Glargin aus den Diabetesregistern DPV und DIVE. Wiener Medizinische Wochenschrift 2018; 168: 415-422
• 16 Farmer AJ, Oke J, Stevens R. et al. Differences in insulin treatment satisfaction following randomized addition of biphasic, prandial or basal insulin to oral therapy in type 2 diabetes. Diabetes Obes Metab 2011; 13: 1136-1141 DOI: 10.1111/j.1463-1326.2011.01475.x. (PMID: 21767341)
• 17 Persano M, Nollino L, Sambataro M. et al. Real-world study on the effectiveness and safety of basal insulin IDegLira in type 2 diabetic patients previously treated with multi-injective insulin therapy. Eur Rev Med Pharmacol Sci 2021; 25: 923-931 DOI: 10.26355/eurrev_202101_24661.
• 18 Pfohl M, Siegmund T, Pscherer S. et al. Effectiveness and tolerability of treatment intensification to basal-bolus therapy in patients with type 2 diabetes on previous basal insulin-supported oral therapy with insulin glargine or supplementary insulin therapy with insulin glulisine: the PARTNER observational study. Vasc Health Risk Manag 2015; 11: 569-578 DOI: 10.2147/VHRM.S82720. (PMID: 26604774)