Basal Insulin Regimens for Adults with Type 1 Diabetes Mellitus: A Systematic Review and Network Meta-Analysis

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Dalia DawoudStephanie A Amiel

Abstract

To assess the relative efficacy and safety of basal insulin regimens in adults with type 1 diabetes mellitus (T1DM). A systematic review and Bayesian network meta-analysis (NMA) of randomized controlled trials comparing two or more basal insulin regimens were conducted. The following basal insulin regimens were included: Neutral Protamine Hagedorn (iNPH) (once [od], twice [bid], and four times daily [qid]), insulin detemir (iDet) (od and bid), insulin glargine 100 IU (iGlarg) (od), and insulin degludec (iDegl) (od). We searched the following databases: MEDLINE via OVID, Embase via OVID, and the Cochrane Library (Wiley). Study quality was appraised using Cochrane risk-of-bias checklist for randomized controlled trials. Two outcomes (change in hemoglobin A1c [HbA1c] and rate of severe/major hypoglycemia [SH]) were analyzed. Network inconsistency was assessed using Bucher and chi-square tests. Thirty studies met the eligibility criteria. Twenty-five were included in the HbA1c network and 16 in the SH network. All studies were of moderate quality. No network inconsistency was evident in the HbA1c network. Of the seven regimens of interest, iDet (bid) had the highest probability of being best (mean change in HbA1c -0.48; 95% credibl...Continue Reading

Citations

Aug 10, 2019·Journal of Managed Care & Specialty Pharmacy·Cheryl N McMahill-WalravenCatherine M Lockhart
Nov 16, 2019·Diabetic Medicine : a Journal of the British Diabetic Association·S BainM Baxter
Jul 11, 2018·Annals of Internal Medicine·Anastasia-Vasiliki MadenidouApostolos Tsapas
Jan 7, 2020·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Andrej JanežLea Smircic-Duvnjak

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