TY - JOUR
T1 - Efficacy of insulin analogs in achieving the hemoglobin A 1c target of
AU - Giugliano, Dario
AU - Maiorino, Maria Ida
AU - Bellastella, Giuseppe
AU - Chiodini, Paolo
AU - Ceriello, Antonio
AU - Esposito, Katherine
PY - 2011/2
Y1 - 2011/2
N2 - 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.
AB - 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.
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U2 - 10.2337/dc10-1710
DO - 10.2337/dc10-1710
M3 - Article
C2 - 21216850
AN - SCOPUS:79951717317
VL - 34
SP - 510
EP - 517
JO - Diabetes Care
JF - Diabetes Care
SN - 1935-5548
IS - 2
ER -