PDF(Pubmed)
Abstract：
Background: Diabetes mellitus has become increasingly prevalent and a considerable health risk in the United States. Early introduction of insulin can improve overall health outcomes of patients with diabetes. With the development of long-acting insulin analogs, such as insulin glargine, limitations such as variable absorption and hypoglycemia were reduced. Majority of reported adverse drug effects secondary to insulin glargine include injection site reaction and hypoglycemia. There is limited data on gastrointestinal adverse effects, including nausea, of insulin glargine. Case Presentation: A 51-year-old female with a past medical history of type 2 diabetes was referred to the collaborative drug therapy management pharmacist for diabetes education and management. The patient was initiated on insulin glargine (Lantus®) and began to experience episodes of nausea and emesis over a 9 week period. Once the patient was switched from insulin glargine (Lantus®) to insulin detemir, symptoms subsided. Upon re-trial of insulin glargine (Lantus®), nausea and emesis-like symptoms resumed. A probable relationship between insulin glargine (Lantus®) and the reaction was estimated using the Naranjo Adverse Drug Reaction Probability Scale. Conclusion: Potential mechanisms behind the relationship of insulin glargine (Lantus®) and nausea are hypothesized, however there is limited literature supporting this claim and further investigation is warranted.
摘要：
背景：在美国，糖尿病已变得越来越普遍，并且具有相当大的健康风险。早期引入胰岛素可以改善糖尿病患者的整体健康结果。随着长效胰岛素类似物的发展,比如甘精胰岛素，限制因素如可变吸收和低血糖减少.据报道，甘精胰岛素继发的药物不良反应主要包括注射部位反应和低血糖。关于胃肠道不良反应的数据有限，包括恶心,甘精胰岛素。病例介绍：一名有2型糖尿病既往病史的51岁女性患者被转诊至合作药物治疗管理药剂师进行糖尿病教育和管理。患者开始服用甘精胰岛素（Lantus®），并在9周内开始出现恶心和呕吐的发作。一旦患者从甘精胰岛素（Lantus®）转换为地特胰岛素，症状消退。在甘精胰岛素(Lantus®)的重新试验中，恶心和呕吐样症状恢复。使用Naranjo药物不良反应概率量表估计甘精胰岛素(Lantus®)与反应之间的可能关系。结论：甘精胰岛素（Lantus®）与恶心关系背后的潜在机制被假设，然而，支持这一说法的文献有限，需要进一步调查。
