TY - JOUR
T1 - Effectiveness, safety, initial optimal dose, and optimal maintenance dose range of basal insulin regimens for type 2 diabetes
T2 - A systematic review with meta-analysis
AU - Luo, Yingying
AU - Xia, Jun
AU - Zhao, Zhan
AU - Chang, Yaping
AU - Bee, Yong Mong
AU - Nguyen, Khue Thy
AU - Lim, Soo
AU - Yabe, Daisuke
AU - McGill, Margaret
AU - Kong, Alice Pik Shan
AU - Chan, Siew Pheng
AU - Deodat, Marisa
AU - Deerochanawong, Chaicharn
AU - Suastika, Ketut
AU - Xu, Chenchen
AU - Chen, Liming
AU - Chen, Wei
AU - Li, Xiaoying
AU - Zhao, Weigang
AU - Yao, Xiaomei
AU - Ji, Linong
N1 - Publisher Copyright:
© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.
PY - 2023/5
Y1 - 2023/5
N2 - 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 < 7.0%) and lead to fewer hypoglycemic events than injecting it at bedtime. The optimal starting dose for the initiation of any basal insulins can be 0.10–0.20 U/kg/day. There is no eligible evidence to investigate the optimal maintenance dose for basal insulins. Conclusions: The five basal insulins are effective for the target population. Glargine U-300, degludec U-100, glargine U-100, and detemir lead to fewer hypoglycemic events than NPH without compromising glycemic control.
AB - 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 < 7.0%) and lead to fewer hypoglycemic events than injecting it at bedtime. The optimal starting dose for the initiation of any basal insulins can be 0.10–0.20 U/kg/day. There is no eligible evidence to investigate the optimal maintenance dose for basal insulins. Conclusions: The five basal insulins are effective for the target population. Glargine U-300, degludec U-100, glargine U-100, and detemir lead to fewer hypoglycemic events than NPH without compromising glycemic control.
KW - basal insulin
KW - effectiveness
KW - initiation and maintenance dose
KW - safety
KW - systematic review
KW - type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85152389490&partnerID=8YFLogxK
U2 - 10.1111/1753-0407.13381
DO - 10.1111/1753-0407.13381
M3 - Article
C2 - 37038616
AN - SCOPUS:85152389490
SN - 1753-0393
VL - 15
SP - 419
EP - 435
JO - Journal of Diabetes
JF - Journal of Diabetes
IS - 5
ER -