Effectiveness, safety, initial optimal dose, and optimal maintenance dose range of basal insulin regimens for type 2 diabetes: A systematic review with meta-analysis

Luo Y 1 , Xia J 2 , Zhao Z 3 , Chang Y 4 , Bee YM 5 , Nguyen KT 6 Show all authors , Lim S 7 , Yabe D 8 , McGill M 9 , Kong APS 10 , Chan SP 11 , Deodat M 12 , Deerochanawong C 13 , Suastika K 14 , Xu C 3 , Chen L 15 , Chen W 16 , Li X 17 , Zhao W 18 , Yao X 19 , Ji L 1

Affiliations 

  • 1 Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, 100044, China
  • 2 Nottingham Ningbo GRADE Centre, University of Nottingham Ningbo China, Ningbo, Zhejiang, 315100, China
  • 3 Tianjin Tiantian Biotechnology Co., Ltd., Tianjin, 300000, China
  • 4 OrthoEvidence Inc., Burlington, Ontario, L7N 3H8, Canada
  • 5 Department of Endocrinology, Singapore General Hospital, 169608, Singapore, Singapore
  • 6 Ho Chi Minh University of Medicine and Pharmacy Medic Medical Center, Ho Chi Minh City, 700000, Vietnam
  • 7 Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, 13620, South Korea
  • 8 Departments of Diabetes, Endocrinology and Metabolism/Rheumatology and Clinical Immunology, Gifu University Graduate School of Medicine, Gifu, 501-1194, Japan
  • 9 Diabetes Centre, Royal Prince Alfred Hospital, Faculty of Medicine and Health University of Sydney, Sydney, New South Wales, 2050, Australia
  • 10 Division of Endocrinology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, 999077, China
  • 11 Subang Jaya Medical Centre, Department of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, 59100, Malaysia
  • 12 Michael G. DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, Ontario, L8V 5C2, Canada
  • 13 College of Medicine, Rangsit University, Bangkok, 10400, Thailand
  • 14 Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Prof. IGNG Ngoerah Hospital, Denpasar, Bali, 80114, Indonesia
  • 15 Chu Hsien-I Memorial (Metabolic Diseases) Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
  • 16 Department of Clinical Nutrition, Department of Health Medicine, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, 100730, China
  • 17 Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
  • 18 Department of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China
  • 19 Center for Clinical Practice Guideline Conduction and Evaluation, Children's Hospital of Fudan University, Shanghai, 201100, China
J Diabetes, 2023 Apr 10.
PMID: 37038616 DOI: 10.1111/1753-0407.13381

Abstract

AIMS: To investigate the effectiveness, safety, optimal starting dose, optimal maintenance dose range, and target fasting plasma glucose of five basal insulins in insulin-naïve patients with type 2 diabetes mellitus.

METHODS: MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched from January 2000 to February 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was adopted. The registration ID is CRD42022319078 in PROSPERO.

RESULTS: Among 11 163 citations retrieved, 35 publications met the planned criteria. From meta-analyses and network meta-analyses, we found that when injecting basal insulin regimens at bedtime, the optimal choice in order of most to least effective might be glargine U-300 or degludec U-100, glargine U-100 or detemir, followed by neutral protamine hagedorn (NPH). Injecting glargine U-100 in the morning may be more effective (ie, more patients archiving glycated hemoglobin 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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