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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Budapest, Korányi S. u. 2/A, 1083
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Absztrakt

Az inzulinkezelés a cukorbetegség leghatékonyabb kezelési módja. A microvascularis szövődmények kockázatának egyértelmű csökkentése és az esetleges hosszú távú cardiovascularis előnyök elérésének azonban ára van: a (súlyos) hypoglykaemia kockázata 2–3-szorosára nő, továbbá az inzulinkezelt betegek testsúlya gyorsabban növekszik, mint az egyéb kezelésben részesülőké. Egy vizsgálatban ráadásul az intenzív glykaemiás kezelés mellett (ami gyakrabban igényelt inzulint) növekedett az összmortalitás is. Jól ismert ezeken kívül az inzulin növekedési faktorszerű hatása, ami fokozott mitogenitást eredményezhet. Ezen potenciális mellékhatások mind a beteg, mind az orvos részéről gátat szabhatnak az inzulinterápia elkezdésének. A közleményben a szerzők bemutatják, hogy a cukorbetegség diagnózisakor alkalmazott átmeneti intenzív inzulinkezelés hosszú távú remissziót eredményezhet. Tárgyalják továbbá az inzulinkezelés elkezdésének optimális módját (napi egyszeri bázisinzulin), illetve az intenzifikálás lehetőségeit is. Kitérnek az analóg inzulinok farmakokinetikai előnyeire, és bemutatják, hogy az új bázisanalógok mellett hasonló hatékonyság érhető el, mint a humán inzulinnal, miközben a hypoglykaemia kockázata körülbelül 20–30%-kal csökken. Orv. Hetil., 2015, 156(36), 1443–1450.

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