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Open Access 01-08-2015 | Original Article

Systematic review and meta-analysis of randomized clinical trials comparing efficacy and safety outcomes of insulin glargine with NPH insulin, premixed insulin preparations or with insulin detemir in type 2 diabetes mellitus

Authors: Przemyslaw Rys, Piotr Wojciechowski, Agnieszka Rogoz-Sitek, Grzegorz Niesyczyński, Joanna Lis, Albert Syta, Maciej T. Malecki

Published in: Acta Diabetologica | Issue 4/2015

Abstract

Aims

A variety of basal insulin preparations are used to treat patients with type 2 diabetes mellitus (T2DM). We aimed to summarize scientific evidence on relative efficacy and safety of insulin glargine (IGlar) and other insulins in T2DM.

Methods

A systematic review was carried out in major medical databases up to December 2012. Relevant studies compared efficacy and safety of IGlar, added to oral drugs (OAD) or/and in combination with bolus insulin, with protamine insulin (NPH) or premixed insulin (MIX) in the same regimen, as well as with insulin detemir (IDet), in T2DM. Target HbA1c level without hypoglycemic events was considered the primary endpoint.

Results

Twenty eight RCTs involving 12,669 T2DM patients followed for 12–52 weeks were included in quantitative analysis. IGlar + OAD use was associated with higher probability of reaching target HbA1c level without hypoglycemia as compared to NPH + OAD (RR = 1.32 [1.09, 1.59]) or MIX without OAD (RR = 1.61 [1.22, 2.13]) and similar effect as IDet + OAD (RR = 1.07 [0.87, 1.33]) and MIX + OAD (RR = 1.09 [0.86, 1.38]). IGlar + OAD demonstrated significantly lower risk of symptomatic hypoglycemia as compared to NPH + OAD (RR = 0.89 [0.83, 0.96]), MIX + OAD (RR = 0.75 [0.68, 0.83]) and MIX without OAD(RR = 0.75 [0.68, 0.83]), but not with IDet + OAD (RR = 0.99 [0.90, 1.08]). In basal-bolus regimens, IGlar demonstrated similar proportion of T2DM patients achieving target HbA1c as compared to NPH (RR = 1.14 [0.91, 1.44]) but higher than MIX (RR = 1.26 [1.12, 1.42) or IDet (RR = 1.38 [1.11, 1.72]). The risk of severe hypoglycemia was lower in IGlar than in NPH (RR = 0.77 [0.63, 0.94]), with no differences in comparison with MIX (RR = 0.74 [0.46, 1.20]) and IDet (RR = 1.10 [0.54, 2.25]). IGlar + OAD has comparable safety profile to NPH, with less frequent adverse events leading to treatment discontinuation than MIX + OAD (RR = 0.41 [0.22, 0.76]) and IDet + OAD (RR = 0.40 [0.24, 0.69]). Also severe adverse reactions were less common for IGlar + OAD when compared to MIX + OAD (RR = 0.71 [0.52; 0.98]).

Conclusion

For the majority of examined efficacy and safety outcomes, IGlar use in T2DM patients was superior or non-inferior to the alternative insulin treatment options.

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Inzucchi SE, Bergenstal RM, Buse JB et al (2012) Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 55:1577–1596PubMedCrossRef

Handelsman Y, Mechanick JI, Blonde L et al (2011) American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan. Endocr Pract 17:1–53PubMedCrossRef

U.K. Prospective Diabetes Study Group (1995) U.K. prospective diabetes study 16. Overview of 6 years’ therapy of type II diabetes: a progressive disease. Diabetes 44:1249–1258CrossRef

Control Group, Turnbull FM, Abraira C et al (2009) Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia 52:2288–2298. doi:10.1007/s00125-009-1470-0 CrossRef

Zoungas S, Patel A, Chalmers J et al (2010) Severe hypoglycemia and risks of vascular events and death. N Engl J Med 363:1410–1418. doi:10.1056/NEJMoa1003795 PubMedCrossRef

Hsu P-F, Sung S-H, Cheng H-M et al (2013) Association of clinical symptomatic hypoglycemia with cardiovascular events and total mortality in type 2 diabetes: a nationwide population-based study. Diabetes Care 36:894–900. doi:10.2337/dc12-0916 PubMedCentralPubMedCrossRef

Gitt AK, Bramlage P, Binz C et al (2012) Hypoglycaemia is more frequent in type 2 diabetic patients with co-morbid vascular disease: an analysis of the DiaRegis registry. Eur J Prev Cardiol 19:765–772. doi:10.1177/1741826711411104 PubMedCrossRef

Nathan DM, Buse JB, Davidson MB et al (2009) Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 32:193–203. doi:10.2337/dc08-9025 PubMedCentralPubMedCrossRef

National Collaborating Centre for Chronic Conditions (2008) Type 2 diabetes: national clinical guideline for management in primary and secondary care (update). Royal College of Physicians, London. http://www.nice.org.uk/guidance/cg66

10.

Scottish Intercollegiate Guidelines Network (2010) Management of diabetes. A national clinical guideline. Scottish Intercollegiate Guidelines Network (SIGN), Edinburgh, Scotland. http://www.sign.ac.uk/pdf/sign116.pdf

11.

IDF, ISPAD (2011) Global IDF/ISPAD guideline for diabetes in childhood and adolescence

12.

Lepore M, Pampanelli S, Fanelli C et al (2000) Pharmacokinetics and pharmacodynamics of subcutaneous injection of long-acting human insulin analog glargine, NPH insulin, and ultralente human insulin and continuous subcutaneous infusion of insulin lispro. Diabetes 49:2142–2148PubMedCrossRef

13.

Gerich J, Becker RHA, Zhu R, Bolli GB (2006) Fluctuation of serum basal insulin levels following single and multiple dosing of insulin glargine. Diabetes Technol Ther 8:237–243. doi:10.1089/dia.2006.8.237 PubMedCrossRef

14.

Rotenstein LS, Ran N, Shivers JP et al (2012) Opportunities and challenges for biosimilars: What’s on the horizon in the global insulin market? Clin Diabetes 30:138–150. doi:10.2337/diaclin.30.4.138 CrossRef

15.

Pistrosch F, Köhler C, Schaper F et al (2013) Effects of insulin glargine versus metformin on glycemic variability, microvascular and beta-cell function in early type 2 diabetes. Acta Diabetol 50:587–595. doi:10.1007/s00592-012-0451-9 PubMedCentralPubMedCrossRef

16.

Esposito K, Chiodini P, Capuano A et al (2012) Basal supplementation of insulin lispro protamine suspension versus insulin glargine and detemir for type 2 diabetes: meta-analysis of randomized controlled trials. Diabetes Care 35:2698–2705. doi:10.2337/dc12-0698 PubMedCentralPubMedCrossRef

17.

Fakhoury W, Lockhart I, Kotchie RW et al (2008) Indirect comparison of once daily insulin detemir and glargine in reducing weight gain and hypoglycaemic episodes when administered in addition to conventional oral anti-diabetic therapy in patients with type-2 diabetes. Pharmacology 82:156–163. doi:10.1159/000149569 PubMedCrossRef

18.

Mullins P, Sharplin P, Yki-Jarvinen H et al (2007) Negative binomial meta-regression analysis of combined glycosylated hemoglobin and hypoglycemia outcomes across eleven Phase III and IV studies of insulin glargine compared with neutral protamine Hagedorn insulin in type 1 and type 2 diabetes mellitus. Clin Ther 29:1607–1619. doi:10.1016/j.clinthera.2007.08.020 PubMedCrossRef

19.

Rosenstock J, Dailey G, Massi-Benedetti M et al (2005) Reduced hypoglycemia risk with insulin glargine: a meta-analysis comparing insulin glargine with human NPH insulin in type 2 diabetes. Diabetes Care 28:950–955PubMedCrossRef

20.

Bazzano LA, Lee LJ, Shi L et al (2008) Safety and efficacy of glargine compared with NPH insulin for the treatment of Type 2 diabetes: a meta-analysis of randomized controlled trials. Diabet Med 25:924–932. doi:10.1111/j.1464-5491.2008.02517.x PubMedCrossRef

21.

Clissold R, Clissold S (2007) Insulin glargine in the management of diabetes mellitus: an evidence-based assessment of its clinical efficacy and economic value. Core Evid 2:89–110PubMedCentralPubMed

22.

Dailey G, Admane K, Mercier F, Owens D (2010) Relationship of insulin dose, A1c lowering, and weight in type 2 diabetes: comparing insulin glargine and insulin detemir. Diabetes Technol Ther 12:1019–1027. doi:10.1089/dia.2010.0063 PubMedCentralPubMedCrossRef

23.

Fonseca V, Davidson J, Home P et al (2010) Starting insulin therapy with basal insulin analog or premix insulin analog in T2DM: a pooled analysis of treat-to-target trials. Curr Med Res Opin 26:1621–1628. doi:10.1185/03007995.2010.485087 PubMedCrossRef

24.

Halimi S, Raskin P, Liebl A et al (2005) Efficacy of biphasic insulin aspart in patients with type 2 diabetes. Clin Ther 27:S57–S74PubMedCrossRef

25.

Horvath K, Jeitler K, Berghold A, Ebrahim SH, Gratzer TW, Plank J, Kaiser T, Pieber TR, Siebenhofer A (2007) Long-acting insulin analogues versus NPH insulin (human isophane insulin) for type 2 diabetes mellitus. Cochrane Database Syst Rev 2:CD005613. doi:10.1002/14651858.CD005613.pub3 PubMed

26.

Ilag LL, Kerr L, Malone JK, Tan MH (2007) Prandial premixed insulin analogue regimens versus basal insulin analogue regimens in the management of type 2 diabetes: an evidence-based comparison. Clin Ther 29:1254–1270CrossRef

27.

Jansen HJ, Vervoort G, van der Graaf M, Tack CJ (2010) Pronounced weight gain in insulin-treated patients with type 2 diabetes mellitus is associated with an unfavourable cardiometabolic risk profile. Neth J Med 68:359–366PubMed

28.

Levien TL, Baker DE, White JR Jr, Campbell RK (2002) Insulin glargine: a new basal insulin. Ann Pharmacother 36:1019–1027PubMedCrossRef

29.

Monami M, Marchionni N, Mannucci E (2008) Long-acting insulin analogues versus NPH human insulin in type 2 diabetes: a meta-analysis. Diabetes Res Clin Pract 81:184–189. doi:10.1016/j.diabres.2008.04.007 PubMedCrossRef

30.

Pollock RF, Erny-Albrecht KM, Kalsekar A, Bruhn D, Valentine WJ (2011) Long-acting insulin analogs: a review of “Real-World” effectiveness in patients with type 2 diabetes. Curr Diabetes Rev 7(1):61–74. doi:10.2174/157339911794273892 PubMedCrossRef

31.

Pontiroli AE, Miele L, Morabito A (2012) Metabolic control and risk of hypoglycaemia during the first year of intensive insulin treatment in type 2 diabetes: systematic review and meta-analysis. Diabetes Obes Metab 14:433–446PubMedCrossRef

32.

Rolla AR, Rakel RE (2005) Practical approaches to insulin therapy for type 2 diabetes mellitus with premixed insulin analogues. Clin Ther 27:1113–1125. doi:10.1016/j.clinthera.2005.07.003 PubMedCrossRef

33.

Qayyum R, Bolen S, Maruthur N et al (2008) Systematic review: comparative effectiveness and safety of premixed insulin analogues in type 2 diabetes. Ann Intern Med 149:549–559PubMedCrossRef

34.

Gough SCL (2007) A review of human and analogue insulin trials. Diabetes Res Clin Pract 77:1–15. doi:10.1016/j.diabres.2006.10.015 PubMedCrossRef

35.

Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. doi:10.1371/journal.pmed.1000097 PubMedCentralPubMedCrossRef

36.

Davidson J, Lacaya L, Jiang H et al (2010) Impact of race/ethnicity on the efficacy and safety of commonly used insulin regimens: a post hoc analysis of clinical trials in type 2 diabetes mellitus. Endocr Pract 16:818–828. doi:10.4158/EP09285.OR PubMedCrossRef

37.

Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12PubMedCrossRef

38.

Higgins JPT, Green S (eds) (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration. http://www.cochrane-handbook.org

39.

Hsia SH (2011) Insulin glargine compared to NPH among insulin-naïve, U.S. inner city, ethnic minority type 2 diabetic patients. Diabetes Res Clin Pract 91:293–299. doi:10.1016/j.diabres.2010.11.028 PubMedCentralPubMedCrossRef

40.

Forst T, Larbig M, Hohberg C et al (2010) Adding insulin glargine vs. NPH insulin to metformin results in a more efficient postprandial beta-cell protection in individuals with type 2 diabetes. Diabetes Obes Metab 12:437–441. doi:10.1111/j.1463-1326.2010.01209.x PubMedCentralPubMedCrossRef

41.

Eliaschewitz FG, Calvo C, Valbuena H et al (2006) Therapy in type 2 diabetes: insulin glargine vs. NPH insulin both in combination with glimepiride. Arch Med Res 37:495–501PubMedCrossRef

42.

Fritsche A, Schweitzer MA, Häring H-U (2003) Glimepiride combined with morning insulin glargine, bedtime neutral protamine hagedorn insulin, or bedtime insulin glargine in patients with type 2 diabetes. A randomized, controlled trial. Ann Intern Med 138:952–959PubMedCrossRef

43.

Yki-Järvinen H, Kauppinen-Mäkelin R, Tiikkainen M et al (2006) Insulin glargine or NPH combined with metformin in type 2 diabetes: the LANMET study. Diabetologia 49:442–451. doi:10.1007/s00125-005-0132-0 PubMedCrossRef

44.

Riddle MC, Rosenstock J, Gerich J (2003) The treat-to-target trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients. Diabetes Care 26:3080–3086PubMedCrossRef

45.

Massi Benedetti M, Humburg E, Dressler A, Ziemen M (2003) A one-year, randomised, multicentre trial comparing insulin glargine with NPH insulin in combination with oral agents in patients with type 2 diabetes. Horm Metab Res 35:189–196. doi:10.1055/s-2003-39080 PubMedCrossRef

46.

Koivisto V, Cleall S, Pontiroli AE, Giugliano D (2011) Comparison of insulin lispro protamine suspension versus insulin glargine once daily in basal-bolus therapies with insulin lispro in type 2 diabetes patients: a prospective randomized open-label trial. Diabetes Obes Metab 13:1149–1157PubMedCrossRef

47.

Rosenstock J, Schwartz SL, Clark CM Jr et al (2001) Basal insulin therapy in type 2 diabetes: 28-week comparison of insulin glargine (HOE 901) and NPH insulin. Diabetes Care 24:631–636PubMedCrossRef

48.

Esposito K, Ciotola M, Maiorino MI et al (2008) Addition of neutral protamine lispro insulin or insulin glargine to oral type 2 diabetes regimens for patients with suboptimal glycemic control: a randomized trial. Ann Intern Med 149:531–539PubMedCrossRef

49.

Strojek K, Shi C, Carey MA, Jacober SJ (2010) Addition of insulin lispro protamine suspension or insulin glargine to oral type 2 diabetes regimens: a randomized trial. Diabetes Obes Metab 12:916–922PubMedCrossRef

50.

Roach P, Woodworth JR (2002) Clinical pharmacokinetics and pharmacodynamics of insulin lispro mixtures. Clin Pharmacokinet 41:1043–1057PubMedCrossRef

51.

Rosenstock J, Fonseca V, McGill JB et al (2009) Similar progression of diabetic retinopathy with insulin glargine and neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes: a long-term, randomised, open-label study. Diabetologia 52:1778–1788. doi:10.1007/s00125-009-1415-7 PubMedCentralPubMedCrossRef

52.

Al-Shaikh AR (2006) Comparison of basal insulin added to oral agents versus twice-daily premixed insulin as initial insulin therapy for type 2 diabetes. Pak J Med Sci 22:14–17

53.

Janka HU, Plewe G, Riddle MC et al (2005) Comparison of basal insulin added to oral agents versus twice-daily premixed insulin as initial insulin therapy for type 2 diabetes. Diabetes Care 28:254–259PubMedCrossRef

54.

Schiel R, Muller UA (2007) Efficacy and treatment satisfaction of once-daily insulin glargine plus one or two oral antidiabetic agents versus continuing premixed human insulin in patients with type 2 diabetes previously on long-term conventional insulin therapy: the Switch pilot study. Exp Clin Endocrinol Diabetes 115:627–633PubMedCrossRef

55.

Buse JB, Wolffenbuttel BH, Herman WH et al (2009) DURAbility of basal versus lispro mix 75/25 insulin efficacy (DURABLE) trial 24-week results: safety and efficacy of insulin lispro mix 75/25 versus insulin glargine added to oral antihyperglycemic drugs in patients with type 2 diabetes. Diabetes Care 32:1007–1013PubMedCentralPubMedCrossRef

56.

Kann PH, Wascher T, Zackova V et al (2006) Starting insulin therapy in type 2 diabetes: twice-daily biphasic insulin Aspart 30 plus metformin versus once-daily insulin glargine plus glimepiride. Exp Clin Endocrinol Diabetes 114:527–532. doi:10.1055/s-2006-949655 PubMedCrossRef

57.

Raskin P, Allen E, Hollander P et al (2005) Initiating insulin therapy in type 2 Diabetes: a comparison of biphasic and basal insulin analogs. Diabetes Care 28:260–265PubMedCrossRef

58.

Robbins DC, Beisswenger PJ, Ceriello A et al (2007) Mealtime 50/50 basal + prandial insulin analogue mixture with a basal insulin analogue, both plus metformin, in the achievement of target HbA1c and pre- and postprandial blood glucose levels in patients with type 2 diabetes: a multinational, 24-week, randomized, open-label, parallel-group comparison. Clin Ther 29:2349–2364PubMedCrossRef

59.

Strojek K, Bebakar W, Khutsoane D et al (2009) Once-daily initiation with biphasic insulin aspart 30 versus insulin glargine in patients with type 2 diabetes inadequately controlled with oral drugs: an open-label, multinational RCT. Curr Med Res Opin 28:2887–2894CrossRef

60.

Bowering K, Reed VA, Felicio J et al (2012) A study comparing insulin lispro mix 25 with glargine plus lispro therapy in patients with Type 2 diabetes who have inadequate glycaemic control on oral anti-hyperglycaemic medication: results of the PARADIGM study. Diabet Med 29:e263–e272PubMedCrossRef

61.

Miser WF, Arakaki R, Jiang H et al (2010) Randomized, open-label, parallel-group evaluations of basal-bolus therapy versus insulin lispro premixed therapy in patients with type 2 diabetes mellitus failing to achieve control with starter insulin treatment and continuing oral antihyperglycemic drugs: a noninferiority intensification substudy of the DURABLE trial. Clin Ther 32:896–908PubMedCrossRef

62.

Fritsche A, Larbig M, Owens D, Haring HU (2010) Comparison between a basal-bolus and a premixed insulin regimen in individuals with type 2 diabetes-results of the GINGER study. Diabetes Obes Metab 12:115–123PubMedCrossRef

63.

Jain SM, Mao X, Escalante-Pulido M et al (2010) Prandial-basal insulin regimens plus oral antihyperglycaemic agents to improve mealtime glycaemia: initiate and progressively advance insulin therapy in type 2 diabetes. Diabetes Obes Metab 12:967–975PubMedCentralPubMedCrossRef

64.

Rosenstock J, Ahmann AJ, Colon G et al (2008) Advancing insulin therapy in type 2 diabetes previously treated with glargine plus oral agents: prandial premixed (insulin lispro protamine suspension/lispro) versus basal/bolus (glargine/lispro) therapy. Diabetes Care 31:20–25PubMedCrossRef

65.

Rosenstock J, Davies M, Home PD et al (2008) A randomised, 52-week, treat-to-target trial comparing insulin detemir with insulin glargine when administered as add-on to glucose-lowering drugs in insulin-naive people with type 2 diabetes. Diabetologia 51:408–416. doi:10.1007/s00125-007-0911-x PubMedCentralPubMedCrossRef

66.

Swinnen SG, Dain M-P, Aronson R et al (2010) A 24-week, randomized, treat-to-target trial comparing initiation of insulin glargine once-daily with insulin detemir twice-daily in patients with type 2 diabetes inadequately controlled on oral glucose-lowering drugs. Diabetes Care 33:1176–1178. doi:10.2337/dc09-2294 PubMedCentralPubMedCrossRef

67.

Hollander P, Cooper J, Bregnhøj J, Pedersen CB (2008) A 52-week, multinational, open-label, parallel-group, noninferiority, treat-to-target trial comparing insulin detemir with insulin glargine in a basal-bolus regimen with mealtime insulin aspart in patients with type 2 diabetes. Clin Ther 30:1976–1987. doi:10.1016/j.clinthera.2008.11.001 PubMedCrossRef

68.

Raskin P, Gylvin T, Weng W, Chaykin L (2009) Comparison of insulin detemir and insulin glargine using a basal-bolus regimen in a randomized, controlled clinical study in patients with type 2 diabetes. Diabetes Metab Res Rev 25:542–548. doi:10.1002/dmrr.989 PubMedCrossRef

69.

Saisho Y, Kou K, Tanaka K et al (2013) Postprandial serum C-peptide to plasma glucose ratio predicts future insulin therapy in Japanese patients with type 2 diabetes. Acta Diabetol 50:987–988. doi:10.1007/s00592-012-0441-y PubMedCrossRef

70.

Swinnen SG, Simon AC, Holleman F et al (2011) Insulin detemir versus insulin glargine for type 2 diabetes mellitus. Cochrane Database Syst Rev. doi:10.1002/14651858.CD006383.pub2 PubMed

71.

Piatti PM, Marone E, Mantero M et al (2013) Effect of normalization of fasting glucose by intensified insulin therapy and influence of eNOS polymorphisms on the incidence of restenosis after peripheral angioplasty in patients with type 2 diabetes: a randomized, open-label clinical trial. Acta Diabetol 50:373–382. doi:10.1007/s00592-012-0426-x PubMedCrossRef

72.

American Diabetes Association (2013) Standards of medical care in diabetes-2014. Diabetes Care 37:S14–S80. doi:10.2337/dc14-S014 CrossRef

73.

Authors/Task Force Members, Rydén L, Grant PJ et al (2013) ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 34:3035–3087. doi:10.1093/eurheartj/eht108 CrossRef

74.

International Diabetes Federation (2012) Clinical Guidelines Task Force. Global guideline for type 2 diabetes. http://www.idf.org/global-guideline-type-2-diabetes-2012

75.

Nicolucci A (2010) Epidemiological aspects of neoplasms in diabetes. Acta Diabetol 47:87–95. doi:10.1007/s00592-010-0187-3 PubMedCrossRef

76.

Janghorbani M, Dehghani M, Salehi-Marzijarani M (2012) Systematic review and meta-analysis of insulin therapy and risk of cancer. Horm Cancer 3:137–146. doi:10.1007/s12672-012-0112-z PubMedCrossRef

77.

Colmers IN, Bowker SL, Tjosvold LA, Johnson JA (2012) Insulin use and cancer risk in patients with type 2 diabetes: a systematic review and meta-analysis of observational studies. Diabetes Metab 38:485–505. doi:10.1016/j.diabet.2012.08.011 PubMedCrossRef

78.

Chen Y, Chen Q, Wang Z, Zhou J (2013) Insulin therapy and risk of prostate cancer: a systematic review and meta-analysis of observational studies. PLoS ONE 8:e81594. doi:10.1371/journal.pone.0081594 PubMedCentralPubMedCrossRef

79.

Karlstad O, Starup-Linde J, Vestergaard P et al (2013) Use of insulin and insulin analogs and risk of cancer—systematic review and meta-analysis of observational studies. Curr Drug Saf 8:333–348PubMedCrossRef

80.

Tseng C-H (2013) Diabetes, insulin use, smoking, and pancreatic cancer mortality in Taiwan. Acta Diabetol 50:879–886. doi:10.1007/s00592-013-0471-0 PubMedCrossRef

81.

Gerstein HC, Bosch J, Dagenais GR et al (2012) Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med 367:319–328. doi:10.1056/NEJMoa1203858 PubMedCrossRef

Title: Systematic review and meta-analysis of randomized clinical trials comparing efficacy and safety outcomes of insulin glargine with NPH insulin, premixed insulin preparations or with insulin detemir in type 2 diabetes mellitus
Authors: Przemyslaw Rys
Piotr Wojciechowski
Agnieszka Rogoz-Sitek
Grzegorz Niesyczyński
Joanna Lis
Albert Syta
Maciej T. Malecki
Publication date: 01-08-2015
Publisher: Springer Milan
Published in: Acta Diabetologica / Issue 4/2015
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-014-0698-4

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