How pharmacokinetic and pharmacodynamic (PK/PD) principles pave the way for optimal basal insulin therapy in type 2 diabetes

Sabine Arnolds (1) , Bernd Kuglin (2) , Christoph Kapitza (2) , Tim Heise (2)

1 PROFIL Institut für Stoffwechselforschung GmbH
2 PROFIL Institut für Stoffwechselforschung GmbH

This pedagogical review illustrates the differences between pharmacokinetic (PK) and pharmacodynamic (PD) measures, using insulin therapy as the primary example. The main conclusion is that PD parameters are of greater clinical significance for insulin therapy than PK parameters. The glucose-clamp technique, the optimal method for determining insulin PD, is explained so that the reader can understand important studies in the literature. Key glucose-clamp studies that compare two basal insulin analogues—insulin glargine and insulin detemir—to NPH insulin and to each other are then presented. The review further explains how PD parameters have been translated into useful clinical concepts and simple titration algorithms for everyday clinical practice. Finally, the necessity of overcoming patient and/or physician barriers to insulin therapy and providing continuing education and training is emphasized.

Mots clés: Medicine

Sabine Arnolds, Bernd Kuglin, Christoph Kapitza, Tim Heise. How pharmacokinetic and pharmacodynamic (PK/PD) principles pave the way for optimal basal insulin therapy in type 2 diabetes. International Journal of Clinical Practice, 2010, 64 (10), pp.1415. ⟨10.1111/j.1742-1241.2010.02470.x⟩. ⟨hal-00552669⟩