Abstracts
Résumé
Plusieurs études réalisées à grande échelle ont démontré la nécessité d’un contrôle strict de la glycémie chez les patients diabétiques. Des injections quotidiennes d’insuline humaine par voie sous-cutanée sont classiquement utilisées pour tenter de contrôler la glycémie. Si cette méthode permet d’obtenir une amélioration dans la régulation de la glycémie, elle ne permet pas de reproduire parfaitement le profil normal des concentrations d’insuline endogène au cours de la journée. Des avancées dans les techniques d’ingénierie des protéines ont toutefois abouti à la mise au point d’analogues de l’insuline ayant de meilleures capacités d’absorption à partir du dépôt sous-cutané, permettant une amélioration des profils insuliniques chez les patients. Dans le même temps, de nouvelles stratégies d’administration de l’insuline en sous-cutané, mais aussi par d’autres voies d’administration, ont été développées.
Summary
The importance of the intensive control of blood glucose in patients with diabetes has been well documented in several large scale studies. Attempts to attain strict glucose control when managing diabetes have traditionally utilized daily subcutaneous injections of human insulin. This strategy has offered improvements in glycaemic control but is unable to replicate fully the normal diurnal plasma profile of endogenous human insulin. Advances in protein engineering techniques have, however, resulted in the formulation of a number of insulin analogues that offer more desirable properties of absorption from the subcutaneous depot and hence improved insulin profiles in patients with diabetes. Concurrent to the development of insulin analogues, devices to deliver insulin either subcutaneously or by other routes have also advanced. These novel delivery strategies are also likely to contribute to improved glycaemic control for patients with diabetes in the future.
Appendices
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