What do systematic reviews say?

Summary of findings: insulin detemir vs NPH insulin

• (Ultra‐)long‐acting insulin analogues for people with type 1 diabetes mellitus 2021 · Cochrane Headline outcomes only
  4.97 [0.79, 31.38]
  9 studies · 3334 participants
  Moderate
• (Ultra‐)long‐acting insulin analogues versus NPH insulin (human isophane insulin) for adults with type 2 diabetes… 2020 · Cochrane Headline outcomes only
  Peto OR 0.74 [0.2, 2.65]
  8 studies · 2328 participants
  Low

Insulin glargine vs NPH insulin

• (Ultra‐)long‐acting insulin analogues for people with type 1 diabetes mellitus 2021 · Cochrane Headline outcomes only
  0.14 [0, 6.98]
  8 studies · 2175 participants
  Moderate
• (Ultra‐)long‐acting insulin analogues versus NPH insulin (human isophane insulin) for adults with type 2 diabetes… 2020 · Cochrane Headline outcomes only
  Peto OR 1.06 [0.62, 1.82]
  14 studies · 6173 participants
  Low

Sliding scale insulin vs basal‐bolus insulin

Sliding scale insulin showed no clear difference in all‐cause mortality (N) compared with basal‐bolus insulin (low certainty).

• Sliding scale insulin for non‐critically ill hospitalised adults with diabetes mellitus 2018 · Cochrane Headline outcomes only
  Peto OR 0.5 [0.05, 4.85]
  4 studies · 602 participants
  Low

Short‐acting insulin analogues vs regular human insulin

Short‐acting insulin analogues showed no clear difference in all‐cause mortality (N) compared with regular human insulin (moderate certainty).

• Short‐acting insulin analogues versus regular human insulin for adult, non‐pregnant persons with type 2 diabetes… 2018 · Cochrane Headline outcomes only
  Peto OR 1.66 [0.41, 6.64]
  6 studies · 2519 participants
  Moderate
• Short‐acting insulin analogues versus regular human insulin for adults with type 1 diabetes mellitus 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings: insulin detemir vs insulin glargine

• (Ultra‐)long‐acting insulin analogues for people with type 1 diabetes mellitus 2021 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 763 participants
  Low

Summary of findings: insulin degludec vs insulin detemir

• (Ultra‐)long‐acting insulin analogues for people with type 1 diabetes mellitus 2021 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 802 participants
  Low

Summary of findings: insulin degludec vs insulin glargine

It is very uncertain whether summary of findings: insulin degludec changes all‐cause mortality compared with insulin glargine (very low certainty).

• (Ultra‐)long‐acting insulin analogues for people with type 1 diabetes mellitus 2021 · Cochrane Headline outcomes only
  Peto OR 1.34 [0.15, 11.93]
  3 studies · 973 participants
  Very low

Insulin analogues vs biphasic insulin

It is very uncertain whether insulin analogues changes all‐cause mortality compared with biphasic insulin (very low certainty).

• Interventions for people with type 2 diabetes mellitus fasting during Ramadan 2023 · Cochrane Headline outcomes only
  RR 3.02 [0.12, 73.53]
  1 study · 263 participants
  Very low

Subcutaneous insulin lispro vs intravenous regular insulin

• Subcutaneous rapid‐acting insulin analogues for diabetic ketoacidosis 2016 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 156 participants
  Moderate

Subcutaneous insulin aspart vs intravenous regular insulin

• Subcutaneous rapid‐acting insulin analogues for diabetic ketoacidosis 2016 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 45 participants
  Low

Intervention not reported

The intervention showed no clear difference in all‐cause mortality a. Intervention vs placebo [30 weeks to 4.75… (low certainty).

• Sulphonylurea monotherapy for patients with type 2 diabetes mellitus 2013 · Cochrane Headline outcomes only
  RR 1.46 [0.87, 2.45]
  2 studies · 553 participants
  Low

Intervention not reported

The intervention showed no clear difference in all‐cause mortality a. Intervention vs metformin [a. 24 weeks to 4… (low certainty).

• Sulphonylurea monotherapy for patients with type 2 diabetes mellitus 2013 · Cochrane Headline outcomes only
  RR 0.98 [0.61, 1.58]
  6 studies · 3528 participants
  Low

Intervention not reported

The review found no eligible studies for this question.

• Zinc supplementation for the prevention of type 2 diabetes mellitus in adults with insulin resistance 2015 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Metformin vs insulin

The review found no eligible studies for this question.

• Metformin monotherapy for adults with type 2 diabetes mellitus 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention not reported

The review found no eligible studies for this question.

• Insulin monotherapy compared with the addition of oral glucose‐lowering agents to insulin for people with type 2… 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention not reported

The review found no eligible studies for this question.

• Insulin monotherapy compared with the addition of oral glucose‐lowering agents to insulin for people with type 2… 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention not reported

The review found no eligible studies for this question.

• Insulin monotherapy compared with the addition of oral glucose‐lowering agents to insulin for people with type 2… 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention not reported

The review found no eligible studies for this question.

• Insulin monotherapy compared with the addition of oral glucose‐lowering agents to insulin for people with type 2… 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention not reported

The review found no eligible studies for this question.

• Insulin monotherapy compared with the addition of oral glucose‐lowering agents to insulin for people with type 2… 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention not reported

• Insulin secretagogues for prevention or delay of type 2 diabetes mellitus and its associated complications in persons… 2016 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 274 participants
  Very low