Meta-analysis of short-acting insulin analogues in adult patients with type 1 diabetes: continuous subcutaneous insulin infusion versus injection therapy

Diabetologia
Andrea SiebenhoferT R Pieber

Abstract

This study aimed to compare the effect of treatment with short-acting insulin (SAI) analogues versus structurally unchanged short-acting insulin (regular insulin) on glycaemic control and on the risk of hypoglycaemic episodes in type 1 diabetic patients using different insulin treatment strategies. We performed a meta-analysis of 27 randomised controlled trials that compared the effect of SAI analogues with regular insulin in patients with type 1 diabetes mellitus. The treatments were administered either via continuous subcutaneous insulin infusion (CSII) or by conventional intensified insulin therapy (IIT) with short-acting insulin injections before meals and basal insulin administered once or twice daily in most cases. HbA(1)c levels were reported for 20 studies. For studies using CSII, the weighted mean difference between values obtained using SAI analogues and regular insulin was -0.19% (95% CI: -0.27 to -0.12), whereas the corresponding value for injection studies was -0.08% (95% CI: -0.15 to -0.02). For the analysis of overall hypoglycaemia, we used the results from nine studies that reported the mean frequency of hypoglycaemic episodes per patient per month. For studies using CSII, the standardised mean difference betwee...Continue Reading

References

Feb 1, 1989·Journal of Pharmacokinetics and Biopharmaceutics·E MosekildeB Thorsteinsson
Aug 10, 1989·The New England Journal of Medicine·B Zinman
Feb 1, 1995·JAMA : the Journal of the American Medical Association·K F SchulzD G Altman
Feb 18, 1995·BMJ : British Medical Journal·J Windeler, S Lange
Sep 30, 1993·The New England Journal of Medicine·UNKNOWN Diabetes Control and Complications Trial Research GroupC Siebert
Feb 1, 1996·Controlled Clinical Trials·A R JadadH J McQuay
Jan 1, 1996·Diabetic Medicine : a Journal of the British Diabetic Association·S K GargH P Chase
Jan 1, 1996·Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association·A PfütznerJ Beyer
Apr 17, 1998·Diabetic Medicine : a Journal of the British Diabetic Association·S SchmaussR Landgraf
Sep 10, 1999·Diabetes Care·L JovanovicE J Bastyr
Dec 29, 2000·Diabetic Medicine : a Journal of the British Diabetic Association·P D HomeUNKNOWN European Insulin Aspart Study Group
Sep 12, 2001·Lancet·D R OwensG B Bolli
Sep 13, 2001·Diabetic Medicine : a Journal of the British Diabetic Association·S TupolaI Sipilä
Mar 27, 2002·International Journal of Epidemiology·Diana R ElbourneAndy Vail
May 23, 2002·Clinical Therapeutics·John H HolcombeUNKNOWN Lispro in Adolescents Study Group
May 25, 2002·Diabetic Medicine : a Journal of the British Diabetic Association·B O BoehmA Lindholm
Sep 5, 2002·Statistics in Medicine·François CurtinDiana Elbourne
Sep 6, 2002·Diabetes Research and Clinical Practice·B PerssonL-O Hansson

❮ Previous
Next ❯

Citations

Jul 20, 2007·Diabetologia·F Holleman, E A M Gale
Jan 10, 2013·Current Atherosclerosis Reports·Linde M MorsinkMichaela Diamant
Oct 30, 2012·Endocrine·Luigi F Meneghini
Feb 16, 2008·Diabetes Technology & Therapeutics·Steven D WittlinUNKNOWN CONTROL Study Group
Nov 13, 2009·Diabetes Technology & Therapeutics·Chidambarann SudhakaranViswanathan Mohan
Jan 1, 2010·Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy·Anna LihJohn N Carter
Jan 25, 2014·Paediatric Drugs·Faisal S Malik, Craig E Taplin
Sep 10, 2013·Irish Journal of Medical Science·N L ZaharanK Bennett
Aug 7, 2009·Wiener klinische Wochenschrift·Bernhard LudvikUNKNOWN Expertengruppe der Osterreichischen Diabetesgesellschaft
May 18, 2011·Wiener medizinische Wochenschrift·Monika Lechleitner, Friedrich Hoppichler
Oct 4, 2006·Expert Opinion on Drug Metabolism & Toxicology·David Owens, Jiten Vora
May 10, 2008·Archives of Physiology and Biochemistry·Paolo RossettiGeremia B Bolli
Aug 7, 2013·Endocrinología y nutrición : órgano de la Sociedad Española de Endocrinología y Nutrición·Pedro Mezquita-RayaUNKNOWN Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN)
May 16, 2014·Canadian Journal of Diabetes·UNKNOWN Canadian Diabetes Association Clinical Practice Guidelines Expert CommitteeJohn Dornan
Mar 8, 2011·Medicina clínica·María García-DomínguezLuis Felipe Pallardo
Aug 21, 2010·Endocrinology and Metabolism Clinics of North America·Sanjeev N Mehta, Joseph I Wolfsdorf
Nov 23, 2005·Pediatric Clinics of North America·Marianna RachmielDenis Daneman
Nov 23, 2006·Diabetes Research and Clinical Practice·Stephen C L Gough
Oct 22, 2005·Diabetes/metabolism Research and Reviews
Jan 31, 2008·Diabetes/metabolism Research and Reviews·Patrick J Boyle, John Zrebiec
Jan 17, 2015·Diabetic Medicine : a Journal of the British Diabetic Association·C WangI Idris
Jun 7, 2005·Expert Opinion on Pharmacotherapy·Claudio GonzálezJorge Alvariñas
May 24, 2014·Diabetes Care·George Grunberger
Mar 15, 2006·Lancet·Denis Daneman
Feb 6, 2017·The Cochrane Database of Systematic Reviews·Sinéad M O'NeillPatricia M Kearney
Jan 22, 2010·The Cochrane Database of Systematic Reviews·Marie L MissoJonathan Shaw
Jun 9, 2016·The Cochrane Database of Systematic Reviews·Diane FarrarHelen M West
Feb 12, 2008·Revista clínica española·J Sáez de la FuenteA Herreros de Tejada López-Coterilla
Feb 22, 2017·Nutrition, Metabolism, and Cardiovascular Diseases : NMCD·T WohlandA Holstein

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.