A comparison of insulin lispro and buffered regular human insulin administered via continuous subcutaneous insulin infusion pump

Raskin, Philip; Holcombe, John H.; Tamborlane, William V.; Malone, John I.; Strowig, Suzanne M.; Ahern, Jo Ann; Lavent, Francine

doi:10.1016/s1056-8727(01)00168-4

Cited by 65 publications

(63 citation statements)

References 21 publications

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“…We ultimately identified 27 randomised controlled trials that compared SAI analogues with regular insulin using either CSII or IIT as injection regimens. Of these, 22 studies were performed with type 1 diabetic patients [5,6,7,10,11,12,14,15,16,38,39,40,41,42,43,44,45,46,47,48,49,50] and five studies had a combined study population of type 1 and type 2 diabetic patients [8,51,52,53,54]. Table 1 summarises the characteristics of the trials included in our analysis.…”

Section: Resultsmentioning

confidence: 99%

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Meta-analysis of short-acting insulin analogues in adult patients with type 1 diabetes: continuous subcutaneous insulin infusion versus injection therapy

Siebenhofer¹,

Plank²,

Berghold

et al. 2004

Diabetologia

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Aims/hypothesis. This study aimed to compare the effect of treatment with short-acting insulin (SAI) analogues versus structurally unchanged short-acting insulin (regular insulin) on glycaemic control and on the risk of hypoglycaemic episodes in type 1 diabetic patients using different insulin treatment strategies. Methods. We performed a meta-analysis of 27 randomised controlled trials that compared the effect of SAI analogues with regular insulin in patients with type 1 diabetes mellitus. The treatments were administered either via continuous subcutaneous insulin infusion (CSII) or by conventional intensified insulin therapy (IIT) with short-acting insulin injections before meals and basal insulin administered once or twice daily in most cases. Results. HbA 1 c levels were reported for 20 studies. For studies using CSII, the weighted mean difference between values obtained using SAI analogues and regular insulin was −0.19% (95% CI: −0.27 to − 0.12), whereas the corresponding value for injection studies was −0.08% (95% CI: −0.15 to −0.02). For the analysis of overall hypoglycaemia, we used the results from nine studies that reported the mean frequency of hypoglycaemic episodes per patient per month. For studies using CSII, the standardised mean difference between SAI analogues and regular insulin was −0.07 (95% CI: −0.43 to 0.28), whereas for IIT studies the corresponding value was −0.04 (95% CI: −0.24 to 0.16). Conclusions/interpretation. Taking into consideration the low quality of the trials included, we can conclude that use of a short-acting insulin analogue in CSII therapy provides a small, but statistically significant improvement in glycaemic control compared with regular insulin. An even smaller effect was obtained with the use of ITT. The rate of overall hypoglycaemic episodes was not significantly reduced with short-acting insulin analogues in either injection regimen.

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Section: Resultsmentioning

confidence: 99%

“…Despite the theoretical superiority of SAI analogues over regular insulin, the efficacy of SAI analogues in the treatment of diabetic patients is still unclear. Some studies have reported improved metabolic control and reduced hypoglycaemic episodes [5,6,7,8,9,10,11,12,13], whereas others failed to show a positive effect [14,15,16].…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of short-acting insulin analogues in adult patients with type 1 diabetes: continuous subcutaneous insulin infusion versus injection therapy

Siebenhofer¹,

Plank²,

Berghold

et al. 2004

Diabetologia

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“…Six studies (one parallel RCT 113 and five randomised crossover studies [114][115][116][117][118] ) comparing rapid-acting analogues with soluble insulin in CSII were included in the review and are reported in Tables 18-23 and Appendices 9 and 13. Bode and colleagues 113 compared two analogue insulins, lispro and aspart, whereas the other studies included insulin lispro.…”

Section: Analogue Versus Soluble Insulin In Csii Quantity and Qualitymentioning

confidence: 99%

“…Bode and colleagues 113 compared two analogue insulins, lispro and aspart, whereas the other studies included insulin lispro. Randomisation and allocation concealment were adequate in the parallel RCT, 113 but the method of randomisation was not reported in the five crossover studies [114][115][116][117][118] ( Table 18). The similarity of the groups at baseline was reported in two studies, 113,117 and all studies reported eligibility criteria.…”

Section: Analogue Versus Soluble Insulin In Csii Quantity and Qualitymentioning

confidence: 99%

“…Randomisation and allocation concealment were adequate in the parallel RCT, 113 but the method of randomisation was not reported in the five crossover studies [114][115][116][117][118] ( Table 18). The similarity of the groups at baseline was reported in two studies, 113,117 and all studies reported eligibility criteria. Five studies 113,114,[116][117][118] reported point estimates and measures of variability for the primary outcome measure; however, Schmauss and colleagues 115 reported the mean and standard error of glycated haemoglobin for each treatment at crossover and end of study, but did not combine the two periods.…”

Section: Analogue Versus Soluble Insulin In Csii Quantity and Qualitymentioning

confidence: 99%

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Clinical and cost-effectiveness of continuous subcutaneous insulin infusion for diabetes

Colquitt¹,

Green²,

Sidhu³

et al. 2004

Health Technol Assess

106

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Systematic Review and Meta-analysis of Short-Acting Insulin Analogues in Patients With Diabetes Mellitus

Plank

Siebenhofer²,

Berghold³

et al. 2005

Arch Intern Med

130

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A comparison of insulin lispro and buffered regular human insulin administered via continuous subcutaneous insulin infusion pump

Cited by 65 publications

References 21 publications

Meta-analysis of short-acting insulin analogues in adult patients with type 1 diabetes: continuous subcutaneous insulin infusion versus injection therapy

Meta-analysis of short-acting insulin analogues in adult patients with type 1 diabetes: continuous subcutaneous insulin infusion versus injection therapy

Clinical and cost-effectiveness of continuous subcutaneous insulin infusion for diabetes

Systematic Review and Meta-analysis of Short-Acting Insulin Analogues in Patients With Diabetes Mellitus

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