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Long-acting insulin analogues in type 2 diabetes: advantage over human insulin not proven
Date:4/3/2009

studies within the framework of intensified insulin therapy. One study investigated various treatment schemes. This study on insulin glargine lasted 5 years; all the other studies lasted a maximum of 12 months.

It is notable that in 7 of the 9 studies comparing insulin glargine and human insulin, the drugs were not used as normally used in Germany. The study participants only injected the drugs once daily, even though in daily practice they are often injected more frequently. The relevance of these studies is therefore limited.

Conclusions about late complications of diabetes are hardly possible

It is not possible to draw reliable conclusions about the long-term advantages and disadvantages of the drugs investigated, solely due to the short duration of most studies. Even the 5-year study on insulin glargine, the results of which were not available at the time of the preparation of the preliminary report, only allows limited conclusions about late complications of diabetes. Regarding heart disease, the comparison with NPH insulin does not provide indications of a difference between treatment options. Similarly, the data do not provide indications that insulin glargine is associated with a higher risk of damage to the ocular fundus. This suspicion had prompted the US regulatory authority FDA (Food and Drug Administration) to request a long-term study from the manufacturer (Sanofi-Aventis). This study has now been completed and is assessed in the IQWiG report.

Data provide an indication of less frequent severe hypoglycaemia in patients using insulin glargine

The data do not prove short-term advantages of LAIAs, either. However, the data do provide some indications: in certain treatment schemes, non-severe hypoglycaemia seems to occur less frequently with insulin detemir, in consideration of the individual lowering of HbA1c levels. However, this only applies to the use as basal insulin (once or twice daily) i
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Contact: Dr. Anna-Sabine Ernst
info@iqwig.de
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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