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Basal insulin analogues have no different glucose-lowering effects in type 2 diabetes

According to new research in Annals of Internal Medicine, adults with type 2 diabetes do not experience substantially different glucose-lowering effects from basal insulin analogues.

Additionally, low- and very-low-quality evidence suggests that certain regimens could be associated with lower risk for nocturnal hypoglycemia or less weight gain.

Researchers conducted a systematic review and meta-analysis to compare safety and efficacy of basal insulin analogues among adults with type 2 diabetes. They included trials lasting at least 12 weeks that measured HbA1c, weight and hypoglycemia. The analysis included 39 trials, comprising 26,195 patients and studying 10 different basal insulin analogues.

They found that thrice-weekly degludac was inferior to degludac 100 U/mL and glargine 300 U/mL in terms of lowering HbA1c levels, based on low-to-very-low quality evidence. Looking at weight-lowering effects, the researchers found high-to-moderate-quality evidence that detemir was favorable vs. all other insulins, and that glargine 300 U/mL led to less weight gain compared with glargine.

In terms of nocturnal hypoglycemia, low-quality and very-low-quality evidence suggested that degludac 100 U/mL, degludac 300 U/mL and glargine 300 U/mL were associated with a lower incidence vs. other regimens. There was no difference in severe hypoglycemia among the regimens.

“Low-quality indirect evidence suggests that available basal insulin analogues for [type 2 diabetes] do not substantially differ in their glucose-lowering effects. Certain regimens may be associated with lower risk for nocturnal hypoglycemia or less weight gain,” the researchers wrote. “In addition to short-term efficacy and safety, effects on individual drugs on long-term cardiovascular outcomes and cost-effectiveness data should be considered for optimal therapeutic decision making.” – by Jake Scott

Disclosure s: Healio Internal Medicine was unable to determine any relevant financial disclosures at the time of publication.