,

, MSc, PhD,
/ ,









* :

1923:

Frederck Grant Banting (1891-1941)

John James Richard Macleod (1876-1935)

(15/12/1922)

(15/2/1923)

,
(ctrapid, Regular)

(NPH)
(Lente)

H ,

*
Lispro
Aspart
Glulisine

15-30
<20
10 15

0,5-2,5
1-3
0,5-2,5

<5
3-5
<3

30-60 2-3

3-6

Lente

2-4
3-4

4-10
4-12

10-16
12-18

Ultralente
Clargine (Lantus)**

6-10
2-4

10-16

18-20
20-24

* .
** 24.

140

120

(mg/dl)
100

80
-40 -20

20

40

60

80 100 120 140 160 180 200 220 240

(min)

100

80

(mU/L)

60
40
20
Dimitriadis G. and Gerich J.
Diabetes Care
6: 374-377, 1983

0
-40 -20

20

40

60

80 100 120 140 160 180 200 220 240

(min)

24-

Rossetti P et al. Diabetes Care 2008; 31(Suppl 2): S113-S120

,
,
.

.

1
2.

,





: : 80-120 mg/dl

24

Glargine
(Lantus)

2-4 h

24h

Detemir
(Levemir)

1-2 h

18-24 h

(mg/kg/min)

Glargine Levemir
24
,
Glargine Levemir(n=20)

6
5
4
3
2
1
0

30
10
20

()
=

SC, subcutaneous.

Adapted from Lantus (insulin glargine) EMEA Summary of Product Characteristics. 2002.

.


(-)

 ()

: Actrapid, Regular

: 1-3
: 6 - 8

: Lispro (Humalog)
Aspart(NovoRapid), Glulisin
(Apidra)
: 10 20

: 1 - 3

: 3 - 5


( NPH)

: NPH, Protaphane

: 1
: 4 - 12
: ~20

 ME

Aspart/
Lispro/
Glulisine

08:00

Aspart/
Lispro/
Glulisine

14:00

Aspart/
Lispro/
Glulisine

24:00

20:00

Glargine
Detemir

SOS , stress,

:
80-120mg/dl

:

( > > > )
( > )

: 4 (, ,
)
2 : 2 (
)
2- : 2
( )