Efficacy and safety of the second generation basal insulin analogs in type 2 diabetes mellitus: A critical appraisal

• Published in: Diabetes & metabolic syndrome clinical research & reviews 2019-05, Vol.13 (3), p.2126-2141
• Main Authors: Hernando, Vargas-Uricoechea, Pablo, Frias Juan
• Format: Article
• Language: English
• Subjects: Diabetes Mellitus, Type 2 - drug therapy; Humans; Hypoglycemia - prevention & control; Hypoglycemic Agents - therapeutic use; Insulin - analogs & derivatives; Prognosis
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2019.05.001

Type 2 diabetes mellitus is a progressive disease, which requires insulin treatment when other management is no longer effective. Although, insulin plays a vital role in the treatment of diabetes, conventional basal insulins have certain limitations, which have led to the development of more stable and peak less analogues. To analyze the efficacy and safety of second generation vs. first generation basal insulins, and the efficacy and safety of second generation vs. second generation basal insulins, in patients with type 2 diabetes mellitus, from the evidence provided by head-to-head randomized controlled trials. The following electronic databases were searched: PubMed and MEDLINE, Scopus, BIOSIS, Embase, ClinicalTrials.gov, Google Scholar, and Springer Online Archives Collection, from January 1966 to October 2018. Articles resulting from these searches and relevant references cited in those articles were examined. The efficacy among insulins evaluated was similar, however, second generation insulins cause a lower risk of hypoglycemia compared to first generation insulins. A single study showed similar metabolic control with subtle differences in the risk of hypoglycemia among second generation insulins. The second-generation basal insulins result in metabolic control similar to first generation insulins, with lower risk of hypoglycemia. Second-generation insulins have comparable efficacy, with some differences in the risk of hypoglycemia.