PMID- 29649221
OWN - NLM
STAT- MEDLINE
DCOM- 20180723
LR  - 20221207
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 4
DP  - 2018
TI  - Long-acting insulin analogues for type 1 diabetes: An overview of systematic 
      reviews and meta-analysis of randomized controlled trials.
PG  - e0194801
LID - 10.1371/journal.pone.0194801 [doi]
LID - e0194801
AB  - BACKGROUND: The comparison between long acting insulin analogues (LAIA) and human 
      insulin (NPH) has been investigated for decades, with many randomized controlled 
      trials (RCTs) and systematic reviews giving mixed results. This overlapping and 
      contradictory evidence has increased uncertainty on coverage decisions at health 
      systems level. AIM: To conduct an overview of systematic reviews and update 
      existing reviews, preparing new meta-analysis to determine whether LAIA are 
      effective for T1D patients compared to NPH. METHODS: We identified systematic 
      reviews of RCTs that evaluated the efficacy of LAIA glargine or detemir, compared 
      to NPH insulin for T1D, assessing glycated hemoglobin (A1C) and hypoglycemia. 
      Data sources included Pubmed, Cochrane Library, EMBASE and hand-searching. The 
      methodological quality of studies was independently assessed by two reviewers, 
      using AMSTAR and Jadad scale. We found 11 eligible systematic reviews that 
      contained a total of 25 relevant clinical trials. Two reviewers independently 
      abstracted data. RESULTS: We found evidence that LAIA are efficacious compared to 
      NPH, with estimates showing a reduction in nocturnal hypoglycemia episodes (RR 
      0.66; 95% CI 0.57; 0.76) and A1C (95% CI 0.23; 0.12). No significance was found 
      related to severe hypoglycemia (RR 0.94; 95% CI 0.71; 1.24). CONCLUSION: This 
      study design has allowed us to carry out the most comprehensive assessment of 
      RCTs on this subject, filling a gap in diabetes research. Our paper addresses a 
      question that is important not only for decision makers but also for clinicians.
FAU - Laranjeira, Fernanda O
AU  - Laranjeira FO
AD  - Faculty of Health Sciences, University of Brasilia, Brasilia, Federal District, 
      Brazil.
FAU - de Andrade, Keitty R C
AU  - de Andrade KRC
AUID- ORCID: 0000-0002-8882-6856
AD  - Faculty of Medical Sciences, University of Brasilia, Brasilia, Federal District, 
      Brazil.
FAU - Figueiredo, Ana C M G
AU  - Figueiredo ACMG
AD  - Faculty of Health Sciences, University of Brasilia, Brasilia, Federal District, 
      Brazil.
FAU - Silva, Everton N
AU  - Silva EN
AD  - Faculty of Health Sciences, University of Brasilia, Brasilia, Federal District, 
      Brazil.
FAU - Pereira, Mauricio G
AU  - Pereira MG
AD  - Faculty of Medical Sciences, University of Brasilia, Brasilia, Federal District, 
      Brazil.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20180412
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin, Long-Acting)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 2ZM8CX04RZ (Insulin Glargine)
RN  - 4FT78T86XV (Insulin Detemir)
SB  - IM
MH  - Diabetes Mellitus, Type 1/*drug therapy
MH  - Glycated Hemoglobin/chemistry
MH  - Humans
MH  - Hypoglycemia/drug therapy
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin Detemir/therapeutic use
MH  - Insulin Glargine/therapeutic use
MH  - Insulin, Long-Acting/*therapeutic use
MH  - Models, Statistical
MH  - Randomized Controlled Trials as Topic
MH  - Regression Analysis
PMC - PMC5896894
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2018/04/13 06:00
MHDA- 2018/07/24 06:00
PMCR- 2018/04/12
CRDT- 2018/04/13 06:00
PHST- 2017/10/31 00:00 [received]
PHST- 2018/03/10 00:00 [accepted]
PHST- 2018/04/13 06:00 [entrez]
PHST- 2018/04/13 06:00 [pubmed]
PHST- 2018/07/24 06:00 [medline]
PHST- 2018/04/12 00:00 [pmc-release]
AID - PONE-D-17-38511 [pii]
AID - 10.1371/journal.pone.0194801 [doi]
PST - epublish
SO  - PLoS One. 2018 Apr 12;13(4):e0194801. doi: 10.1371/journal.pone.0194801. 
      eCollection 2018.