Document Detail


Rapid-acting insulin analogues in Basal-bolus regimens in type 1 diabetes mellitus.
MedLine Citation:
PMID:  20150026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare rapid-acting insulin analogues with regular human insulin in terms of hemoglobin A1c, hypoglycemia, and insulin dose when used in a basal-bolus regimen in patients with type 1 diabetes mellitus. METHODS: MEDLINE and congress proceedings were searched for randomized controlled trials comparing prandial insulins in a basal-bolus regimen in adults or children/adolescents with type 1 diabetes. Studies in pregnancy, observational studies, studies that compared premixed insulin or continuous subcutaneous insulin infusion/insulin pumps, and studies where the basal insulin was also changed were excluded. Only studies reporting baseline-endpoint change in insulin dose, or baseline and/or endpoint values, were included. RESULTS: Twenty-eight studies were identified (insulin glulisine, 4; insulin aspart, 7; insulin lispro, 17). Twenty-five studies compared a rapid-acting insulin analogue with regular human insulin, and 3 trials compared 2 rapid-acting insulin analogues. Overall, rapid-acting insulin analogues in a basal-bolus regimen provided similar or greater improvements in glycemic control than regular human insulin at similar insulin doses, as well as a lower incidence of hypoglycemia. CONCLUSIONS: Results of the studies identified in this literature review indicate that a basal-bolus regimen with prandial rapid-acting insulin analogue provides advantages over basal-bolus regimens using prandial regular human insulin, providing improvements in glycemic control comparable to those obtained with regular human insulin, as well as a lower incidence of hypoglycemia.
Authors:
Satish Garg; Francisco Javier Ampudia-Blasco; Martin Pfohl
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  16     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-06-16     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  486-505     Citation Subset:  IM    
Affiliation:
Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Aurora, Colorado 80045, USA. satish.garg@ucdenver.edu
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MeSH Terms
Descriptor/Qualifier:
Diabetes Mellitus, Type 1 / drug therapy*
Female
Humans
Hypoglycemic Agents / therapeutic use*
Insulin / analogs & derivatives*,  therapeutic use*
Pregnancy
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/basal insulin; 11061-68-0/Insulin; 133107-64-9/insulin LISPRO; 207748-29-6/insulin glulisine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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