Abstract

BackgroundGlobal variation in susceptibility to diabetes, insulin sensitivity, and regimen intensity poses a challenge for clinicians regarding the optimal choice of insulin therapy. The current study was carried out to see the relative safety and efficacy of currently available long-acting insulins among the type 2 diabetic Asian population.MethodsA systematic literature search was done using various search engines (PubMed, Cochrane, Google Scholar, Scopus, and Embase) and included published randomized controlled trials (RCTs) in English before December 2019. Further, a manual search was performed by screening the reference list of the identified articles.ResultsWe included four RCTs with 534 participants (349 in the insulin degludec group and 185 in the insulin glargine group) with type 2 diabetes mellitus (T2DM). Results show that both insulin glargine and degludec are equally efficacious in reducing fasting blood glucose (mean difference is -4.45, confidence interval -13.32- 4.43, I2=67%) and HbA1c (glycosylated hemoglobin) (mean difference is 0.12, confidence interval -0.12-0.35, I2=0%). However, insulin glargine was associated with lower risks of hypoglycemia (risk ratio = 0.9684, confidence interval- 0.8003- 1.1717, I2=30%).ConclusionInsulin glargine and degludec are comparable in achieving glycemic control with fewer hypoglycemic episodes in the insulin glargine-treated group.

Highlights

  • Type 2 diabetes mellitus (T2DM) is a chronic non-communicable disease characterized by progressive B- cell dysfunction [1]

  • Insulin glargine was associated with lower risks of hypoglycemia

  • Race and ethnic differences variate the susceptibility to diabetes, insulin sensitivity, and regimen intensity which poses a challenge regarding the optimal choice of second-line therapy for clinicians [4,5,6]

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Summary

Introduction

Type 2 diabetes mellitus (T2DM) is a chronic non-communicable disease characterized by progressive B- cell dysfunction [1]. According to International Diabetes Federation's IDF Diabetes Atlas 2019, globally, 463 million people live with diabetes mellitus, and out of that, 88 million are from the South East Asia region (SEAR) only. Race and ethnic differences variate the susceptibility to diabetes, insulin sensitivity, and regimen intensity which poses a challenge regarding the optimal choice of second-line therapy for clinicians [4,5,6]. In the South-East Asian diabetic population, 90% of the population has T2DM, which is preventable [10]. Global variation in susceptibility to diabetes, insulin sensitivity, and regimen intensity poses a challenge for clinicians regarding the optimal choice of insulin therapy. The current study was carried out to see the relative safety and efficacy of currently available long-acting insulins among the type 2 diabetic Asian population

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