PMID- 24471814
OWN - NLM
STAT- MEDLINE
DCOM- 20151026
LR  - 20221207
IS  - 1742-1241 (Electronic)
IS  - 1368-5031 (Linking)
VI  - 68
IP  - 3
DP  - 2014 Mar
TI  - A comparison of biphasic insulin aspart and insulin glargine administered with 
      oral antidiabetic drugs in type 2 diabetes mellitus--a systematic review and 
      meta-analysis.
PG  - 304-13
LID - 10.1111/ijcp.12337 [doi]
AB  - OBJECTIVE: It is uncertain whether the addition of biphasic insulin analogues to 
      oral antidiabetic drugs (OADs) is as effective and safe as basal insulin in 
      patients with type 2 diabetes mellitus (T2DM). We performed a systematic review 
      to compare glycaemic control and selected clinical outcomes in T2DM patients 
      inadequately controlled with OADs whose treatment was intensified by adding 
      biphasic insulin aspart (BIAsp 30) or insulin glargine (IGlar). METHODS: The 
      analysis included randomised controlled trials (RCTs) identified by a systematic 
      literature search in medical databases (MEDLINE, EMBASE, The Cochrane Library and 
      other sources) up to March 2013. Studies met the inclusion criteria if they 
      compared BIAsp 30 vs. IGlar added to at least one OAD in T2DM patients. Trials 
      applying different OADs in both treatment arms were also included. Results were 
      presented as weighted mean difference (WMD) or odds ratio (OR) with a 95% 
      confidence interval (CI). RESULTS: Five trials, including a total number of 1758 
      patients followed up from 24 to 28 weeks, were identified. Quantitative synthesis 
      demonstrated that BIAsp 30 reduced HbA1c level more efficiently than IGlar [5 
      RCTs; WMD (95% CI): -0.21% (-0.35%, -0.08%)]. Differences were observed in favour 
      of BIAsp for lower mean prandial glucose increment [3 RCTs; WMD (95% CI): 
      -14.70 mg/dl (-20.09, -9.31)]; no difference was observed for fasting plasma 
      glucose [3 RCTs; WMD (95% CI): 7.09 mg/dl (-15.76, 29.94)]. We found no evidence 
      for higher risk of overall [2 RCTs; 63% vs. 51%; OR = 1.77 (0.91; 3.44)] and 
      severe hypoglycaemic episodes [4 RCTs; 0.98% vs. 1.12%; OR (95% CI) = 0.88 (0.31, 
      2.53)] in the BIAsp 30 group as compared with IGlar group. Twice-daily 
      administration of BIAsp 30 resulted in larger weight gain [2 RCTs; WMD (95% 
      CI) = 1.78 kg (1.04; 2.52)]. CONCLUSIONS: BIAsp 30 added to OAD therapy results 
      in a better glycaemic control as compared with IGlar in T2DM patients. BIAsp 30 
      use is associated with slightly larger weight gain but no rise in risk of severe 
      hypoglycaemic episodes.
CI  - (c) 2014 John Wiley & Sons Ltd.
FAU - Rys, P
AU  - Rys P
AD  - HTA Consulting, Krakow, Poland.
FAU - Wojciechowski, P
AU  - Wojciechowski P
FAU - Siejka, S
AU  - Siejka S
FAU - Malecki, P
AU  - Malecki P
FAU - Hak, L
AU  - Hak L
FAU - Malecki, M T
AU  - Malecki MT
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20140128
PL  - India
TA  - Int J Clin Pract
JT  - International journal of clinical practice
JID - 9712381
RN  - 0 (Biphasic Insulins)
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin, Long-Acting)
RN  - 0 (insulin aspart, insulin aspart protamine drug combination 30:70)
RN  - 2ZM8CX04RZ (Insulin Glargine)
RN  - 53027-39-7 (Insulin, Isophane)
RN  - D933668QVX (Insulin Aspart)
SB  - IM
MH  - Administration, Oral
MH  - Biphasic Insulins/*administration & dosage/adverse effects
MH  - Blood Glucose/metabolism
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Drug Therapy, Combination
MH  - Fasting/blood
MH  - Female
MH  - Glycated Hemoglobin/drug effects/metabolism
MH  - Humans
MH  - Hypoglycemia/chemically induced
MH  - Hypoglycemic Agents/*administration & dosage/adverse effects
MH  - Insulin Aspart/*administration & dosage/adverse effects
MH  - Insulin Glargine
MH  - Insulin, Isophane/*administration & dosage/adverse effects
MH  - Insulin, Long-Acting/*administration & dosage/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Postprandial Period
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
MH  - Weight Gain/drug effects
EDAT- 2014/01/30 06:00
MHDA- 2015/10/27 06:00
CRDT- 2014/01/30 06:00
PHST- 2014/01/30 06:00 [entrez]
PHST- 2014/01/30 06:00 [pubmed]
PHST- 2015/10/27 06:00 [medline]
AID - 10.1111/ijcp.12337 [doi]
PST - ppublish
SO  - Int J Clin Pract. 2014 Mar;68(3):304-13. doi: 10.1111/ijcp.12337. Epub 2014 Jan 
      28.