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Systematic Review and Meta-analysis of Short-Acting Insulin Analogues in Patients With Diabetes Mellitus.

Authors :
Plank, Johannes
Siebenhofer, Andrea
Berghold, Andrea
Jeitler, Klaus
Horvath, Karl
Mrak, Peter
Pieber, Thomas R.
Source :
Archives of Internal Medicine; 6/27/2005, Vol. 165 Issue 12, p1337-1344, 8p
Publication Year :
2005

Abstract

Background This article compares the effect of treatment with short-acting insulin (SAI) analogues vs regular insulin on glycemic control, hypoglycemic episodes, quality of life, and diabetes-specific complications. Methods Electronic searches (Cochrane Library, MEDLINE, and EMBASE) and additional searching (pharmaceutical companies, experts, approval agencies, abstracts of diabetology meetings) were performed. Two reviewers independently screened randomized controlled trials to determine inclusion. Results Forty-two randomized controlled trials that assessed the effect of SAI analogues vs regular insulin in 7933 patients with type 1 diabetes mellitus, type 2 diabetes mellitus, and gestational diabetes mellitus were identified. The weighted mean difference between hemoglobin A<subscript>1c</subscript> values obtained using SAI analogues and regular insulin was -0.12% (95% confidence interval [CI], -0.17% to -0.07%) for adult patients with type 1 diabetes mellitus and -0.02% (95% CI, -0.10% to 0.07%) for patients with type 2 diabetes mellitus. The standardized mean difference for overall hypoglycemia (episodes per patient per month) was -0.05 (95% CI, -0.22 to 0.11) and -0.04 (95% CI, -0.12 to 0.04) comparing SAI analogues with regular insulin in adult patients with type 1 and type 2 diabetes mellitus, respectively. No differences between treatments were observed in children with type 1 diabetes, pregnant women with type 1 diabetes mellitus, and women with gestational diabetes. Concerning quality of life, improvement was observed only in open-label studies in patients with type 1 diabetes mellitus. No differences were seen in a double-blinded study of patients with type 1 or in the studies of patients with type 2 diabetes mellitus. Conclusion Our analysis suggests only a minor benefit to hemoglobin A<subscript>1c</subscript> values in adult patients with type 1 diabetes mellitus but no benefit in the remaining population with type 2 or gestational diabetes from SAI analogue treatment. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00039926
Volume :
165
Issue :
12
Database :
Complementary Index
Journal :
Archives of Internal Medicine
Publication Type :
Academic Journal
Accession number :
17457026
Full Text :
https://doi.org/10.1001/archinte.165.12.1337