Basal Insulin Analogues Similar for Glucose Lowering

Slight differences in risk for nocturnal hypoglycemia or weight gain exist.
Slight differences in risk for nocturnal hypoglycemia or weight gain exist.

HealthDay News — Basal insulin analogues for type 2 diabetes mellitus (T2DM) do not substantially differ in their glucose-lowering effect, according to a review published online July 10 in the Annals of Internal Medicine.

Anastasia-Vasiliki Madenidou, MD, from the Aristotle University of Thessaloniki in Greece, and colleagues conducted a systematic literature review to assess the comparative efficacy and safety of basal insulin analogues for adults with T2DM. 

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The researchers identified a total of 39 eligible trials (26,195 patients). Thrice-weekly degludec (Deg-3TW) was inferior to most other regimens for reducing glycated hemoglobin levels, according to low- to very-low-quality evidence. Detemir had a favorable weight profile versus all comparators based on high- to moderate-quality evidence. Glar-300 was associated with less weight gain than glargine, 100U/mL (Glar-100); Deg-100; degludec, 200U/mL (Deg-200); Deg-3TW; and LY2963016. Deg-100, Deg-200, and Glar-300 were associated with lower incidence of nocturnal hypoglycemia than detemir, Glar-100, LY2963016, and neutral protamine lispro (NPL), but the evidence was low- and very-low quality. Only NPL was associated with increased incidence of severe hypoglycemia versus Deg-100, detemir, Glar-100, and Glar-300.

"Low-quality evidence suggests that basal insulin analogues for T2DM do not substantially differ in their glucose-lowering effect," the authors write.

One author disclosed receiving personal fees from pharmaceutical companies.

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