Premixed Insulin Analogues Compare Well with Other Meds

Premixed insulin analogues may offer better glycemic control than long-acting insulin analogues, non-insulin diabetes meds

TUESDAY, Sept. 16 (HealthDay News) -- Premixed insulin analogues may offer tighter glycemic control than long-acting insulin analogues or non-insulin agents in adults with type 2 diabetes, according to research published online Sept. 16 in the Annals of Internal Medicine.

Rehan Qayyum, M.D., of Johns Hopkins Hospital in Baltimore, and colleagues performed a systematic review of studies comparing premixed insulin analogues with other diabetes medications in adults with type 2 diabetes. The authors included 45 studies enrolling more than 14,000 patients. Data on clinical outcomes were limited, so the researchers evaluated intermediate outcomes such as hemoglobin A1c.

The investigators found that premixed insulin analogues were similar to premixed human insulin in lowering fasting glucose and hemoglobin A1c, but were more effective in lowering postprandial glucose. The premixed insulin analogues appeared to be superior to long-acting insulin analogues and non-insulin agents for lowering postprandial glucose and hemoglobin A1c. In addition, they appeared to be less effective than long-acting insulin analogues but more effective than oral agents for lowering fasting glucose.

"Premixed insulin analogues provide glycemic control similar to that of premixed human insulin and may provide better glycemic control than long-acting insulin analogues and non-insulin anti-diabetic agents, but data on clinical outcomes are very limited. Studies with longer follow-up are needed to determine whether the effects observed early in treatment are sustainable long-term. Moreover, given that improvement in intermediate clinical outcomes may not always result in improvement in clinical outcomes, studies specifically designed to evaluate clinical outcomes are needed," the authors conclude.

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