Table 3: Evidence of analogue insulin used in the treatment of T2DM.
Study | Intervention | Outcomes | Statistical significance |
Swinnen, et al. [32] (24 week randomised trial) | Once daily glargine versus twice daily detemir | 27.5% glargine and 25.6% detemir achieved HbA1c < 7% | P = 0.254 |
Greater proportion detemir patients < 6.5%
Weight gain higher for glargine |
P = 0.017 | ||
Lower doses of glargine for equivalent glycaemic control | P < 0.001 | ||
Hypoglycaemia similar | P < 0.001 | ||
Meneghini, et al. [33] (26 week randomised trial) | Detemir versus glargine | 38% detemir and 53% glargine achieved HbA1c < 7%
Weight loss with detemir (- 0.49 kg) versus weight gain with glargine (+ 1.0) |
P = 0.026 |
Lower doses of glargine for equivalent glycaemic control | P = 0.0208 | ||
Reduced incidence of hypoglycaemia for detemir | P = 0.034 | ||
Waugh, et al. [34]. Systematic review of long-acting insulin analogues | Glargine versus NPH | Similar improvements to HbA1c
Hypoglycaemia, symptomatic, nocturnal and severe |
Not Significant (NS) Mixed results
some significant reduction for glargine, some NS |
Weight gain for both glargine and NPH | NS
Mixed results |
||
Detemir versus NPH | Similar improvements in HbA1c | P < 0.05 | |
Symptomatic and severe hypoglycaemia | P < 0.00001 [34] | ||
Less nocturnal hypoglycaemia for detemir
Less weight gain for detemir than NPH |
P < 0.05 | ||
Zinman, et al. [35] (1 year trial) | Degludec versus glargine | Reduction in HbA1c similar in both groups
Insulin doses similar Confirmed hypoglycaemia similar |
P = 0.40 |
Confirmed nocturnal hypoglycaemia less for degludec | P = 0.106 | ||
Less severe hypoglycaemia for degludec | P = 0.004 | ||
Similar weight gain in both groups | P = 1.017 | ||
Marso SP, et al. [10] (DEVOTE, 3 Year trial) | Degludec versus Glargine (Cardiovascular safety) | Primary outcome
Severe hypoglycaemia incidence |
Hazard ratio 0.91, 95% CI 0.78-1.06
P < 0.001 for non-inferiority Rate ratio 0.6, P < 0.001 for superiority Odds ratio 0.73, P < 0.001 for superiority |