Cochrane · systematic review · CD005613
(Ultra‐)long‐acting insulin analogues versus NPH insulin (human isophane insulin) for adults with type 2 diabetes mellitus
Semlitsch, T, Engler, J, Siebenhofer, A, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Metabolic and Endocrine DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
12
No studies
2
Included studies
NR
No studies 2 · 14.3%Ungraded 0 · 0%Very low 6 · 42.9%Low 4 · 28.6%Moderate 2 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Insulin glargine versus NPH insulin for type 2 diabetes mellitus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Diabetes‐related complications (1) Fatal MI (2) Fatal stroke (3) Progression in retinopathy (4) Amputations (5) ESRD Insulin glargine vs NPH insulin | RR 1.03 [0.6, 1.77] | 1 study · 4 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Hypoglycaemic episodes(1) Severe hypoglycaemia (2) Serious hypoglycaemia (3) Confirmed hypoglycaemia (BG < 75 mg/dL) (4) Confirmed hypoglycaemia (BG < 55 mg/dL) (5) Confirmed nocturnal hypoglycaemia (BG < 75 mg/dL) (6) Confirmed nocturnal hypoglyc... Insulin glargine vs NPH insulin | RR 0.68 [0.46, 1.01] | 1 study · 14 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
HRQoL Insulin glargine vs NPH insulin | no estimate extracted | 3 studies · 1228 participants | Very low Downgraded: risk of bias, imprecision |
All‐cause mortality Insulin glargine vs NPH insulin | Peto OR 1.06 [0.62, 1.82] | 14 studies · 6173 participants | Low Downgraded: risk of bias, imprecision |
AEs other than hypoglycaemia (1) SAE (2) Overall AE (3) AE leading to discontinuation Insulin glargine vs NPH insulin | RR 0.98 [0.87, 1.1] | 1 study · 13 participants | Moderate Downgraded: imprecision |
Socioeconomic effects Insulin glargine vs NPH insulin | no estimate extracted | NR | No studies |
HbA1c Insulin glargine vs NPH insulin | no estimate extracted | 16 studies · 5809 participants | Low Downgraded: imprecision, inconsistency |
Insulin detemir versus NPH insulin for type 2 diabetes mellitus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Diabetes‐related complications (1) Fatal MI (2) Fatal stroke (3) Progression in retinopathy (4) Amputations (5) ESRD Insulin detemir vs NPH insulin | RR 1.5 [0.68, 3.32] | 1 study · 2 participants | Very low Downgraded: risk of bias, imprecision |
Hypoglycaemic episodes (1) Severe hypoglycaemia (2) Serious hypoglycaemia (3) Confirmed hypoglycaemia (BG < 75 mg/dL) (4) Confirmed hypoglycaemia (BG < 55 mg/dL) (5) Confirmed nocturnal hypoglycaemia (BG < 75 mg/dL) (6) Confirmed nocturnal hypogly... Insulin detemir vs NPH insulin | RR 0.45 [0.17, 1.2] | 1 study · 5 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Health‐related quality of life Insulin detemir vs NPH insulin | no estimate extracted | 3 studies · 873 participants | Very low Downgraded: risk of bias, imprecision |
All‐cause mortality Insulin detemir vs NPH insulin | Peto OR 0.74 [0.2, 2.65] | 8 studies · 2328 participants | Low Downgraded: imprecision |
AEs other than hypoglycaemia (1) SAE (2) Overall AE (3) AE leading to discontinuation Insulin detemir vs NPH insulin | RR 0.88 [0.64, 1.2] | 1 study · 8 participants | Moderate Downgraded: imprecision |
Socioeconomic effects Insulin detemir vs NPH insulin | no estimate extracted | NR | No studies |
HbA1c Insulin detemir vs NPH insulin | no estimate extracted | 7 studies · 2233 participants | Low Downgraded: imprecision, inconsistency |