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Short‐acting insulin analogues vs. regular human insulin in type 2 diabetes: a meta‐analysis
Author(s) -
Mannucci E.,
Monami M.,
Marchionni N.
Publication year - 2009
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2008.00934.x
Subject(s) - postprandial , medicine , insulin lispro , insulin aspart , insulin , odds ratio , confidence interval , type 2 diabetes , diabetes mellitus , endocrinology , randomized controlled trial , meta analysis
Aim: Short‐acting insulin analogues, in comparison with regular human insulin (HRI), provide a greater control of postprandial glucose, while their superiority on haemoglobin A1c (HbA1c) is controversial. Method: All randomized controlled trials (RCTs) with a duration >4 weeks comparing short‐acting insulin analogues (lispro, aspart or glulisine) with HRI in type 2 diabetic patients were retrieved; data on HbA1c and postprandial glucose et end‐point and incidence of severe hypoglycaemia were extracted and meta‐analysed. Results: A total of 13 RCTs (7, 4 and 2 with lispro, aspart and glulisine, respectively) were retrieved and included in the analysis. Short‐acting analogues reduced HbA1c by 0.4% (0.1–0.6%) (p = 0.027) in comparison with HRI. A significant improvement was observed also in self‐monitored 2 h postbreakfast and dinner blood glucose. The overall rate of severe hypoglycaemia was not significantly different with short‐acting analogues and HRI [Mantel–Haenszel odds ratio for 95% confidence interval 0.61 (0.25–1.45)]. Conclusion: In type 2 diabetic patients, short‐acting insulin analogues provide a better control of HbA1c and postprandial glucose than regular human insulin, without any significant reduction of the risk of severe hypoglycaemia.