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insulin (Oralgen, Generex / insulin, RapidMist / Oralgen)

✓ Approved

Eli Lilly · INSR · 多肽类

什么是 insulin？

insulin 是一种多肽类，由Eli Lilly研发。该药已获批，用于治疗相关适应症，给药途径：Oral (PO)、Sublingual (SL)/Oral Transmucosal。

药物档案

商品名Oralgen, Generex, insulin, RapidMist, Oralgen
公司Eli Lilly
药物类别多肽类
分子靶点INSR
给药途径Oral (PO), Sublingual (SL)/Oral Transmucosal
状态Approved
来源： ClinicalTrials.gov, Eli Lilly

作用机制

分子靶点

insulin 作用于 1 个分子靶点：

INSRinsulin receptor (CD220, HHF5)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

insulin 针对 3 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Metabolism and nutrition disordersType 1 diabetes mellitus✓ Approved
Metabolism and nutrition disordersType 2 diabetes mellitus✓ Approved
Metabolism and nutrition disordersGlucose tolerance impairedPhase II

相关研究文献

PubMedDentistry journal2026-07-27

Management of the Post-Extraction Socket with Buccal Dehiscence in the Esthetic Zone Associated with Immediate Implant Placement Using L-PRF and CTG for Periosteal Inhibition: A Case Report.

Balice Giuseppe G, Serroni Matteo M, Frisone Alessio A, Di Gregorio Stefania S et al.

Background: Management of post-extraction sockets with buccal dehiscence in the esthetic zone remains clinically challenging, particularly when immediate implant placement is indicated. Conventional approaches often rely on guided bone regeneration (GBR) with biomaterials, which may increase surgical complexity and morbidity. This case report evaluates the clinical and radiographic outcomes of a fully autologous approach combining leukocyte- and platelet-rich fibrin (L-PRF) and connective tissue graft (CTG) in conjunction with immediate implant placement. Methods: A 50-year-old healthy patient presenting with a fractured maxillary lateral incisor and buccal bone dehiscence underwent atraumatic extraction, immediate implant placement, and simultaneous site management using L-PRF membranes and CTG. Clinical and radiographic evaluations were performed at baseline (T0) and after 12 months (T1). Cone-beam computed tomography (CBCT) was used to assess horizontal bone thickness (HBT) at multiple apico-coronal levels and vertical evaluation parameters, including nasal floor-crest distance (NF-AC). Clinical outcomes included probing pocket depth (PPD), keratinized tissue width (KT), gingival thickness (GT) and patient-reported outcome measures (PROMs). Results: Radiographic analysis demonstrated increased HBT at all levels (+1.4 mm at 9 mm, +3.1 mm at 12 mm, +3.2 mm at 15 mm, and +2.6 mm at 18 mm). NF-AC showed a marked increase (+2.7 mm) and substantial reduction in the buccal dehiscence defect. Clinically, KT increased by +2.0 mm and GT by +1.8 mm. Healing was uneventful, with minimal postoperative discomfort and high patient satisfaction. Conclusions: Within the limitations of a single case report, the combined use of L-PRF and CTG with immediate implant placement was associated with favorable clinical and radiographic outcomes. These preliminary findings suggest that a fully autologous, biologically driven approach may represent a potential alveolar ridge preservation strategy and a biomaterial-sparing alternative to conventional GBR in carefully selected cases. Further controlled studies are required to confirm these observations and define the indications and limitations of this approach.

PMID 42505753
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PubMedMetabolites2026-07-27

Insulin Clearance Along the Liver-Kidney Axis: Implications for Insulin Action.

Perdomo Germán G, Cózar-Castellano Irene I, Najjar Sonia M SM

The pleiotropic actions of insulin are mediated by cascades of signaling pathways and are regulated by circulating insulin levels. Under physiologic conditions, insulin levels reflect the balance between pancreatic beta-cell secretion and insulin clearance, which occurs primarily in liver hepatocytes and, to a lesser extent, in kidney proximal tubule cells. Therefore, coordination between insulin secretion and clearance is essential for systemic insulin sensitivity. Whereas insulin secretion is widely investigated, exploring the role of insulin clearance in regulating insulin sensitivity remains limited. This review summarizes the main mechanisms underlying insulin clearance along the liver-kidney axis and discusses how they contribute to metabolic regulation in health and disease.

PMID 42506393
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PubMedDiabetes research and clinical practice2026-07-27

U-500 regular insulin in automated insulin delivery systems for severe insulin resistance: A single-center retrospective cohort.

Lee David D, Pham Angela Q AQ, Abreu Marconi M

U-500 regular insulin use in automated insulin delivery systems (AIDs) is off-label and minimally studied. In this four-individual cohort, HbA1c remained stable, time below range stayed low, and no diabetic ketoacidosis or severe hypoglycemia occurred, despite lower TIR. These findings provide early clinical experience to inform cautious, individualized off-label use.

PMID 42503314
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PubMedDiabetes, obesity & metabolism2026-07-27

Efficacy and Safety of Once-Weekly Semaglutide 2.0 mg as an Add-On to Dose-Reduced Insulin Glargine versus Dose-Titrated Insulin Glargine in People With Type 2 Diabetes and Overweight (SUSTAIN OPTIMIZE).

Rodbard Helena W HW, Irace Concetta C, Lobo Jevitha J, Makrilakis Konstantinos K et al.

Type 2 diabetes (T2D) management with basal insulin can lead to hypoglycaemia and weight gain. SUSTAIN OPTIMIZE compared once-weekly semaglutide 2.0 mg as add-on to dose-reduced insulin glargine (Sema+IGlarreduced) versus dose-titrated IGlar (IGlartitrated) on glycated haemoglobin (HbA1c), body weight (BW), daily insulin dose, and participant satisfaction. SUSTAIN OPTIMIZE was a 40-week, phase 3b, open-label, randomised study. Adults with T2D, overweight (body mass index ≥ 25 kg/m2), and treatment with basal insulin ≤ 40 units/day were randomised 1:1 into Sema+IGlarreduced or IGlartitrated. The primary endpoint was change in HbA1c using a non-inferiority approach. Secondary endpoints assessed superiority of Sema+IGlarreduced versus IGlartitrated in reducing HbA1c, BW, daily insulin dose, and improving Diabetes Treatment Satisfaction Questionnaire change version (DTSQc) scores. Overall, 573 participants were randomised. Sema+IGlarreduced achieved both non-inferiority and superiority versus IGlartitrated in HbA1c reduction (estimated treatment difference [ETD]: -0.74%; 95% confidence interval [CI95]: -0.90, -0.59) and superiority in BW change (ETD: -8.5 kg; CI95: -9.5, -7.4), relative daily insulin dose change (ETD: -121.9%; CI95: -143.1, -100.6), and DTSQc scores (ETD: 2.6; CI95: 1.6, 3.5) (p < 0.0001 for all endpoints). No new safety concerns were identified. Severe hypoglycaemia was reduced (rate ratio: 0.45; CI95: 0.23, 0.87; p = 0.02), while gastrointestinal events were higher for Sema+IGlarreduced (310 vs. 32 events). Once-weekly subcutaneous semaglutide 2.0 mg as add-on to dose-reduced IGlar achieved superior reductions in HbA1c, BW, and daily insulin dose in people with T2D and overweight, while reducing their risk for severe hypoglycaemia compared to dose-titrated IGlar alone.

PMID 42504064
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PubMedAnnals of medicine2026-07-27

Hypertonic glucose vs insulin-dextrose to prevent hypoglycaemia following treatment for hyperkalaemia (HIGH-K): protocol for a double-blind randomized controlled trial.

Ford Samuel S, La Caze Adam A, Coombes Ian I, Hills Angela A et al.

Hyperkalaemia is a life-threatening electrolyte abnormality commonly managed with intravenous insulin-dextrose therapy (IDT). Although effective, IDT frequently causes hypoglycaemia, particularly in patients without diabetes. Glucose-only therapy, which leverages endogenous insulin production, may offer comparable potassium-lowering effects with reduced hypoglycaemia risk. However, evidence remains limited. The HIGH-K Trial is a single-centre, double-blind, randomised controlled trial in adult, non-diabetic patients presenting to an Australian Emergency Department with hyperkalaemia (>5.5 mmol/L [99 mg/dL]). Ninety-five participants are randomised 1:1 to receive either glucose-only therapy (100 mL 50% dextrose bolus followed by 250 mL 10% dextrose infusion over 2 h) or standard IDT (10 units IV insulin with 25 g dextrose followed by 250 mL saline infusion). The primary safety outcome is the incidence of hypoglycaemia (<3.9 mmol/L [70 mg/dL]) within six hours. The primary non-inferiority outcome is the mean change in serum potassium from baseline to two hours, using a non-inferiority margin of -0.5 mmol/L (-9 mg/dL). Secondary outcomes include severity of hypoglycaemia, rescue insulin requirements, and serum insulin/C-peptide levels. This is the first double-blind, randomised controlled trial to directly compare the safety and biochemical non-inferiority of glucose-only therapy versus standard insulin-dextrose therapy in the emergency department. By utilising a continuous glucose infusion following a bolus, the protocol aims to sustain endogenous insulin release and optimise intracellular potassium shift while preventing hypoglycaemia. If non-inferiority is demonstrated, this approach could provide a safer alternative in high-acuity or resource-limited clinical settings. Results will be disseminated in peer-reviewed journals and at national and international conferences. Findings may inform future research and clinical practice guidelines regarding glucose-only therapy for hyperkalaemia.

PMID 42504062
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PubMedEuropean journal of pediatrics2026-07-27

The spatial heterogeneity of intra-pancreatic fat deposition in children and adolescents with obesity.

Xiao Hanfang H, Zhang Huanhuan H, Yang Hong H, Li Tingting T et al.

Childhood obesity is associated with an increased risk of metabolic associated fatty liver disease (MAFLD) and intra-pancreatic fat deposition (IPFD). Recent studies in adults suggest that pancreatic fat distribution is heterogeneous and that fat deposition in different regions may have distinct metabolic implications. However, data on regional IPFD patterns and their association with insulin resistance in children with obesity remain limited. This study aimed to investigate the regional distribution of pancreatic fat and its association with insulin resistance in children and adolescents with obesity. This retrospective study included 231 children and adolescents with obesity (156 boys, 75 girls; age range 8-18 years). All participants underwent magnetic resonance imaging (MRI) using the qDixon technique to quantify fat fractions in the pancreatic head, body, and tail, as well as in the liver. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). Statistical analyses included Spearman correlations, logistic regression, and receiver operating characteristic (ROC) curve analysis. The prevalence of high IPFD was higher in the pancreatic head than in the body and tail across all cutoff values (> 10%, > 15%, and > 20%) in both sexes (p < 0.01). Pancreatic head fat, but not body or tail fat, was significantly correlated with insulin levels and HOMA-IR (p < 0.01). In logistic regression models adjusted for confounders, pancreatic head fat (as a continuous variable and with a > 20% cutoff) was independently associated with high insulin (odds ratio (OR) = 1.02, 95% confidence interval (CI):1.002-1.043, and OR = 2.10, 95%CI: 1.00-4.47) and insulin resistance (OR = 1.02, 95% CI: 1.002-1.044; and OR = 2.31, 95% CI: 1.13-4.78, respectively). ROC analysis showed that pancreatic head fat had a significantly higher area under the curve (AUC = 0.65) for predicting insulin resistance than body, tail and liver fat (AUC = 0.60)(p = 0.02). In children and adolescents with obesity, the deposition of pancreatic fat is heterogeneous, with the greatest accumulation observed in the pancreatic head. Fat in the pancreatic head is independently associated with high insulin resistance, whereas fat in the body and tail is not. What is Known? • Obesity is associated with an increased risk of intra-pancreatic fat deposition (IPFD). • IPFD may be associated with metabolic risk. What is New? • This is the first study reporting the spatial heterogeneity of IPFD in children and adolescents with obesity. • Fat accumulation in the pancreatic head, but no in body and tail is associated with high level of insulin resistance.

PMID 42507042
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