基于黎明现象与延伸黎明现象寻找合适的胰岛素治疗方案
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摘要
黎明现象和延伸黎明现象主要表现为空腹血糖异常升高与早餐后持续性血糖异常升高。黎明现象是在胰岛β细胞功能减退的基础上,清晨时内源性产糖量增加和持续性胰岛素抵抗共同作用的结果。黎明现象与延伸黎明现象是糖尿病病程进展和恶化的标志,影响整体血糖控制。基础胰岛素是首选治疗方案,无口服降糖药能有效控制黎明现象。地特胰岛素作为长效胰岛素类似物,一天一次注射,作用时间长达24h,能有效改善空腹血糖、且变异性小,是改善黎明现象,实现糖尿病患者全天整体血糖平稳控制的合适方案。
The dawn phenomenon and extended dawn phenomenon are the terms used to describe the abnormal increase in fasting blood glucose and the persistent abnormal hyperglycemia after breakfast. Dawn phenomenon is the result of the increase in endogenous glucose production and sustained insulin resistance in the early morning on the basis of dysfunction of pancreatic beta cells. The dawn phenomenon and extended dawn phenomenon are the symbols of the progress and deterioration of diabetes mellitus, which will affect the overall glycemic control. To control the dawn phenomenon, basal insulin therapy is the first choice, and no effective oral antidiabetes drugs. Insulin detemir, as a long-acting insulin analogues with up to 24-hour duration of action, is administered once daily. It can effectively improve fasting blood glucose and has low variability. Insulin detemir is an appropriate regimen for improving the dawn phenomenon and achieving stable daily glucose control in diabetes patients.
The dawn phenomenon and extended dawn phenomenon are the terms used to describe the abnormal increase in fasting blood glucose and the persistent abnormal hyperglycemia after breakfast. Dawn phenomenon is the result of the increase in endogenous glucose production and sustained insulin resistance in the early morning on the basis of dysfunction of pancreatic beta cells. The dawn phenomenon and extended dawn phenomenon are the symbols of the progress and deterioration of diabetes mellitus, which will affect the overall glycemic control. To control the dawn phenomenon, basal insulin therapy is the first choice, and no effective oral antidiabetes drugs. Insulin detemir, as a long-acting insulin analogues with up to 24-hour duration of action, is administered once daily. It can effectively improve fasting blood glucose and has low variability. Insulin detemir is an appropriate regimen for improving the dawn phenomenon and achieving stable daily glucose control in diabetes patients.
引文
[1]Wu W,Huang Y,Qiu J,et al.Self-Monitoring of Blood Glucose to Assess Dawn Phenomenon in Chinese People with Type 2 Diabetes Mellitus[J].Int J Endocrinol,2017,2017:7174958.
[2]Monnier L,Colette C,Dunseath GJ,et al.The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes[J].Diabetes Care,2007,30(2):263-269.
[3]Schmidt MI,Hadji-Georgopoulos A,Rendell M,etal.The dawn phenomenon,an early morning glucose rise:Implications for diabetic intraday blood glucose variation[J].Diabetes Care,1981,4(6):579-585.
[4]Bolli GB,Gerich JE.The"dawn phenomenon"-a common occurrence in both non insulin-dependentand insulin dependent diabetes mellitus[J].NEngl J Med,1984,310(12):746-750.
[5]Monnier L,Colette C,Rabasa-Lhoret R,et al.Morning hyperglycemic excursions:A constant failure in the metabolic control of non-insulin using patients with type 2 diabetes[J].Diabetes Care,2002,25(4):737-741.
[6]Monnier L,Colette C,Dejager S,et al.Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2diabetes:Is this of concern?[J].Diabetes Care,2013,36(12):4057-4062.
[7]Shih KC,Hsieh SH,Kwok CF,et al.Effect of growth hormone on dawnphenomenon in patients with type 2 diabetes[J].Growth Factors,2013,31(2):66-73.
[8]Fridlyand IE,Tamarina NA,Schally AV,et al.Growth hormone-releasing hormone in diabetes[J].Front Endocrinol(Lausanne),2016,7(9922):1-7.
[9]Yuen KC,Chong LE,Riddle MC.Influence of glucocorticoids and growth hormone on insulin sensitivity in humans[J].Diabet Med,2013,30(6):651-663.
[10]Boyle PJ,Avogaro A,Smith L,et al.Absence of the dawn phenomenon and abnormal lipolysis in type 1(insulin dependent)diabetic patients with chronic growth hormone deficiency[J].Diabetologia,1992,35(4):372-379.
[11]Mc Curdy CE,Klemm D J.Adipose tissue insulin sensitivity and macrophage recruitment:does P13K pick the pathway?[J].Adipocyte,2013,2(3):135-142.
[12]Prattali RR,Barreiro GC,Caliseo CT,et al.Aspirininhibits serine phosphorylation of insulin receptor sub-stratel in growth hormone treated animals[J].FEBS Lett,2005,579(14):3152-3158.
[13]苏杭,周健,贾伟平.糖尿病黎明现象及延伸黎明现象的研究进展[J].中华内分泌代谢杂志,2015,31(8):739-742.
[14]Yagasaki H,Kobayashi K,Saitou T,et al.Nocturnal blood glucose and IGFBP-1 changes in type 1 diabetes:Differences in the dawn phenomenon between insulin regimens[J].Exp Clin Endocrinol Diabetes,2010,118(3):195-199.
[15]Yu H,Xia F,Lam KS,et al.Circadian rhythm of circulating fibroblast growth factor 21 is related to diurnal changes in fatty acids in humans[J].Clin Chem,2011,57(5):691-700.
[16]Chen W,Hoo RL,Konishi M,et al.Growth hormone induces hepatic production of fibroblast growth factor 21 through a mechanism dependent on lipolysis in adipocytes[J].J Biol Chem,2011,286(40):34559-34566.
[17]Rybicka M,Krysiak R,Okopien B.The dawn phenomenon and the Somogyi effect-two phenomena of morning hyperglycaemia[J].Endokrynol Pol,2011,62(3):276-284.
[18]Radziuk J,Pye S.Diurnal rhythm in endogenous glucose production is a major contributor to fasting hyperglycaemia in type 2 diabetes.Suprachiasmatic deficit or limit cycle behaviour?[J].Diabetologia,2006,49(7):1619-1628.
[19]窦京涛.对“黎明现象”的思考[J].中华糖尿病杂志,2016,8(1):60-62.
[20]Monnier L,Colette C,Dunseath GJ,et al.The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes[J].Diabetes Care,2007,30(2):263-269.
[21]杨少华,许杰,王靖宇,等.“黎明现象”不同诊断标准比较及其对血糖波动的影响[J].中华内分泌代谢杂志,2016,32(2):117-120.
[22]Perriello G,De Feo P,Torlone E,et al.The dawn phenomenonin type1(insulin-dependent)diabetes mellitus:magnitude,frequency,variability,and dependency on glucosecounterregulation and insulin sensitivity[J].Diabetologia,1991,34(1):21-28.
[23]任惠珠,陈莉明,郑妙艳,等.2型糖尿病患者黎明现象与胰岛α和β细胞功能的关系[J].中华糖尿病杂志,2015,7(6):367-371.
[24]郭振红,许杰,王靖宇,等.2型糖尿病患者肥胖与黎明现象的相关性研究[J].中华内科杂志,2016,55(1):16-20.
[25]Porcellati F,Lucidi P,Bolli GB,et al.Thirty years of research on the dawn phenomenon:Lessons to optimize blood glucose control in diabetes[J].Diabetes Care,2013,36(12):3860-3862.
[26]Miller KM,Foster NC,Beck RW,et al.Current state of type 1 diabetes treatment in the U.S.:updated data from the T1D Exchange clinic registry[J].Diabetes Care,2015,38(6):971-978.
[27]Meneghini L,Liebl A,Abrahamson MJ.Insulin detemir:A historical perspective on a modern basal insulin analogue[J].Prim Care Diabetes,2010,4(Suppl 1):S31-42.
[28]Heise T,Nosek L,Ronn BB,et al.Lower within subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1diabete[J].Diabetes,2004,53(6):1614-1620.
[29]Nelson SE.Detemir as a once-daily basal insulin in type 2 diabetes[J].Clin Pharmacol,2011,3:27-37.
[30]Home P,Kurtzhals P.Insulin detemir:from concept to clinical experience[J].Expert Opin Pharmacother,2006,7(3):325-343.
[31]Blonde L,Merilainen M,Karwe V,et al.Patient-directed titration for achieving glycaemic goals using a once-daily basal insulin analogue:an assessment of two different fasting plasma glucose targets-the TITRATEstudy[J].Diabetes Obes Metab,2009,11(6):623-631.
[2]Monnier L,Colette C,Dunseath GJ,et al.The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes[J].Diabetes Care,2007,30(2):263-269.
[3]Schmidt MI,Hadji-Georgopoulos A,Rendell M,etal.The dawn phenomenon,an early morning glucose rise:Implications for diabetic intraday blood glucose variation[J].Diabetes Care,1981,4(6):579-585.
[4]Bolli GB,Gerich JE.The"dawn phenomenon"-a common occurrence in both non insulin-dependentand insulin dependent diabetes mellitus[J].NEngl J Med,1984,310(12):746-750.
[5]Monnier L,Colette C,Rabasa-Lhoret R,et al.Morning hyperglycemic excursions:A constant failure in the metabolic control of non-insulin using patients with type 2 diabetes[J].Diabetes Care,2002,25(4):737-741.
[6]Monnier L,Colette C,Dejager S,et al.Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2diabetes:Is this of concern?[J].Diabetes Care,2013,36(12):4057-4062.
[7]Shih KC,Hsieh SH,Kwok CF,et al.Effect of growth hormone on dawnphenomenon in patients with type 2 diabetes[J].Growth Factors,2013,31(2):66-73.
[8]Fridlyand IE,Tamarina NA,Schally AV,et al.Growth hormone-releasing hormone in diabetes[J].Front Endocrinol(Lausanne),2016,7(9922):1-7.
[9]Yuen KC,Chong LE,Riddle MC.Influence of glucocorticoids and growth hormone on insulin sensitivity in humans[J].Diabet Med,2013,30(6):651-663.
[10]Boyle PJ,Avogaro A,Smith L,et al.Absence of the dawn phenomenon and abnormal lipolysis in type 1(insulin dependent)diabetic patients with chronic growth hormone deficiency[J].Diabetologia,1992,35(4):372-379.
[11]Mc Curdy CE,Klemm D J.Adipose tissue insulin sensitivity and macrophage recruitment:does P13K pick the pathway?[J].Adipocyte,2013,2(3):135-142.
[12]Prattali RR,Barreiro GC,Caliseo CT,et al.Aspirininhibits serine phosphorylation of insulin receptor sub-stratel in growth hormone treated animals[J].FEBS Lett,2005,579(14):3152-3158.
[13]苏杭,周健,贾伟平.糖尿病黎明现象及延伸黎明现象的研究进展[J].中华内分泌代谢杂志,2015,31(8):739-742.
[14]Yagasaki H,Kobayashi K,Saitou T,et al.Nocturnal blood glucose and IGFBP-1 changes in type 1 diabetes:Differences in the dawn phenomenon between insulin regimens[J].Exp Clin Endocrinol Diabetes,2010,118(3):195-199.
[15]Yu H,Xia F,Lam KS,et al.Circadian rhythm of circulating fibroblast growth factor 21 is related to diurnal changes in fatty acids in humans[J].Clin Chem,2011,57(5):691-700.
[16]Chen W,Hoo RL,Konishi M,et al.Growth hormone induces hepatic production of fibroblast growth factor 21 through a mechanism dependent on lipolysis in adipocytes[J].J Biol Chem,2011,286(40):34559-34566.
[17]Rybicka M,Krysiak R,Okopien B.The dawn phenomenon and the Somogyi effect-two phenomena of morning hyperglycaemia[J].Endokrynol Pol,2011,62(3):276-284.
[18]Radziuk J,Pye S.Diurnal rhythm in endogenous glucose production is a major contributor to fasting hyperglycaemia in type 2 diabetes.Suprachiasmatic deficit or limit cycle behaviour?[J].Diabetologia,2006,49(7):1619-1628.
[19]窦京涛.对“黎明现象”的思考[J].中华糖尿病杂志,2016,8(1):60-62.
[20]Monnier L,Colette C,Dunseath GJ,et al.The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes[J].Diabetes Care,2007,30(2):263-269.
[21]杨少华,许杰,王靖宇,等.“黎明现象”不同诊断标准比较及其对血糖波动的影响[J].中华内分泌代谢杂志,2016,32(2):117-120.
[22]Perriello G,De Feo P,Torlone E,et al.The dawn phenomenonin type1(insulin-dependent)diabetes mellitus:magnitude,frequency,variability,and dependency on glucosecounterregulation and insulin sensitivity[J].Diabetologia,1991,34(1):21-28.
[23]任惠珠,陈莉明,郑妙艳,等.2型糖尿病患者黎明现象与胰岛α和β细胞功能的关系[J].中华糖尿病杂志,2015,7(6):367-371.
[24]郭振红,许杰,王靖宇,等.2型糖尿病患者肥胖与黎明现象的相关性研究[J].中华内科杂志,2016,55(1):16-20.
[25]Porcellati F,Lucidi P,Bolli GB,et al.Thirty years of research on the dawn phenomenon:Lessons to optimize blood glucose control in diabetes[J].Diabetes Care,2013,36(12):3860-3862.
[26]Miller KM,Foster NC,Beck RW,et al.Current state of type 1 diabetes treatment in the U.S.:updated data from the T1D Exchange clinic registry[J].Diabetes Care,2015,38(6):971-978.
[27]Meneghini L,Liebl A,Abrahamson MJ.Insulin detemir:A historical perspective on a modern basal insulin analogue[J].Prim Care Diabetes,2010,4(Suppl 1):S31-42.
[28]Heise T,Nosek L,Ronn BB,et al.Lower within subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1diabete[J].Diabetes,2004,53(6):1614-1620.
[29]Nelson SE.Detemir as a once-daily basal insulin in type 2 diabetes[J].Clin Pharmacol,2011,3:27-37.
[30]Home P,Kurtzhals P.Insulin detemir:from concept to clinical experience[J].Expert Opin Pharmacother,2006,7(3):325-343.
[31]Blonde L,Merilainen M,Karwe V,et al.Patient-directed titration for achieving glycaemic goals using a once-daily basal insulin analogue:an assessment of two different fasting plasma glucose targets-the TITRATEstudy[J].Diabetes Obes Metab,2009,11(6):623-631.