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Provedor de dados:  BJPS
País:  Brazil
Título:  Insulin analogues versus human insulin in type 1 diabetes: direct and indirect meta-analyses of efficacy and safety
Autores:  Sanches,Andréia Cristina Conegero
Correr,Cassyano Januário
Venson,Rafael
Gonçalves,Patrícia Rodrigues
Garcia,Mariana Martins
Piantavini,Mário Sérgio
Pontarolo,Roberto
Data:  2013-09-01
Ano:  2013
Palavras-chave:  Insulins/meta-analysis
Diabetes mellitus/type 1
Insulin/treatment efficacy
Insulin/safety use
Resumo:  All patients with Diabetes Mellitus (DM) receive insulin therapy. In this study, we evaluated the efficacy, safety and tolerability of human insulin and insulin analogues. We performed a systematic review of the literature and a meta-analysis according to the Cochrane Collaboration methodology. In the absence of clinical studies comparing insulins, we performed a mixed treatment comparison to establish the differences between the active treatments. We included studies published from 1995 to 2010. HbA1c results, episodes of hypoglycemia and nocturnal hypoglycemia data were extracted and analyzed. Thirty-five randomized clinical trials were selected after examining the abstract and a full text review. These studies included 4,206 patients who received long-acting insulin analogues and 5,733 patients who received short-acting insulin analogues. Pooled data regarding efficacy indicated no significant differences in HbA1c values between glargine or detemir (once daily) and NPH insulin. However, a twice-daily dose of detemir produced differences in HbA1c values that favored detemir (-0.14% [95% CI: -0.21 to -0.08]; p<0.0001; I²=0%). Direct and indirect comparisons are consistent and show that there were no significant differences between human insulin and insulin analogues in efficacy or safety. Our results indicate that long- and short-acting insulin analogues offer few clinical advantages over conventional human insulin.
Tipo:  Info:eu-repo/semantics/article
Idioma:  Inglês
Identificador:  http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502013000300011
Editor:  Universidade de São Paulo, Faculdade de Ciências Farmacêuticas
Relação:  10.1590/S1984-82502013000300011
Formato:  text/html
Fonte:  Brazilian Journal of Pharmaceutical Sciences v.49 n.3 2013
Direitos:  info:eu-repo/semantics/openAccess
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