par Dorchy, Harry 
Référence Archives de pédiatrie, 13, 9, page (1275-1282)
Publication Publié, 2006-09
Référence Archives de pédiatrie, 13, 9, page (1275-1282)
Publication Publié, 2006-09
Article révisé par les pairs
| Résumé : | In the last decade, four fast- and long-acting insulin analogues have been created. Due to the pharmacokinetic characteristics of insulin analogues, they provide an insulin profile closer to normal physiology than can be achieved with human insulins. However, they do not necessarily improve glycated haemoglobin, but they allow better quality of life. In the two daily insulin injection regime, fast-acting analogues are very useful to rapidly correct hyperglycaemia, to allow sleeping in and eating something sweet. In the basal-bolus regime (≥ 4 insulin injections), long-acting analogues reduce nocturnal hypoglycaemias and improve fasting blood glucose. In the two insulin regime (2 or ≥ 4 injections), rapid-acting human insulin must not be systematically replaced by a fast-acting analogue. On the other hand, insulin dose alteration must be triple: • retrospective, according to numerous previous experiments, in order to enjoy more freedom for meals, sports, etc.; • prospective according to programmed changes in meals and sports; • with only a "touch" of compensatory adaptation according to actual glycaemia. © 2006 Elsevier SAS. All rights reserved. |
