Effects of Basal Insulin on Lipid Profile Compared to Other Classes of Antihyperglycemic Agents in Type 2 Diabetic Patients

• Published in: The journal of clinical endocrinology and metabolism 2020-07, Vol.105 (7), p.1-2474
• Main Authors: Rigato, Mauro, Avogaro, Angelo, Vigili de Kreutzenberg, Saula, Fadini, Gian Paolo
• Format: Article
• Language: English
• Subjects: Blood lipids; Cardiovascular diseases; Cholesterol; Clinical trials; Comparative analysis; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Dipeptidyl-peptidase IV; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; Drug therapy; GLP-1 receptor agonists; Glucagon; Glucagon-like peptide 1; Health aspects; High density lipoprotein; Humans; Hypoglycemic agents; Hypoglycemic Agents - therapeutic use; Insulin; Insulin - blood; Insulin - therapeutic use; Lipids; Lipids - blood; Low density lipoprotein; Metformin; Peptidase; Randomized Controlled Trials as Topic; Statistics; Sulfonylurea; Sulfonylurea Compounds - therapeutic use; Thiazolidinediones; Triglycerides; Type 2 diabetes
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgaa178

The lipid profile represents a driver of cardiovascular risk in type 2 diabetes. The effect of chronic insulin therapy on cholesterol levels is unclear. We aim to evaluate the effect of basal insulin on lipid profile compared to other classes of antihyperglycemic agents in type 2 diabetic patients. We performed a meta-analysis of randomized controlled trials reporting changes of lipid parameters in type 2 diabetic patients randomly assigned to basal insulin or other classes of anti-hyperglycemic agents. The levels of total (TC) and low-density lipoprotein cholesterol (LDL-C) appeared to be significantly reduced by therapies with glucagon-like peptide-1 receptor agonists (GLP-1RA) in comparison to basal insulin (mean difference [MD] -3.80; 95% CI [-6.30 to -1.30] mg/dL, P