Efficacy of insulin analogs in achieving the hemoglobin A _1c target of

OBJECTIVE - Insulin analogs are increasingly used in patients with type 2 diabetes. We compared the effect of basal, biphasic, prandial, and basal-bolus insulin regimens with insulin analogs to reach the hemoglobin A _1c (HbA _1c) target of 1c target of 30. RESULTS - We found 16 RCTs,with 20 comparisons and 7,759 patients. A greater proportion of patients achieved the HbA1c goal of ,7% with both biphasic (odds ratio 1.88 [95% CI 1.38-2.55]) and prandial (2.07 [1.16-3.69]) insulin compared with basal insulin; this was associated for biphasic insulin with greater hypoglycemia (event/patient/30 days, mean difference, 0.34 [range 0-0.69]) and weight gain in kg (1.0 kg [0.28-1.73]). Compared with biphasic insulin, the basal-bolus regimen was associated with a greater chance to reach the HbA _1c goal (odds ratio 1.75 [95% CI 1.11-2.77]), with no greater hypoglycemia or weight gain. The effect of insulin analogs on long-term diabetes complications is still lacking. CONCLUSIONS - A greater proportion of type 2 diabetic patients can achieve the HbA _1c goal 1c goal.