Efficacy and safety of insulin degludec vs other long-acting basal insulin analogues in the treatment of type 1 diabetes

doi:10.19803/j.1672-8629.20210787

Abstract

Abstract: Objective To evaluate the efficacy and safety of insulin degludec(IDeg) vs other long-acting basal insulin analogues in the treatment of type 1 diabetes(T1DM), and provide evidence-based reference for clinical treatment. Methods PubMed, Cochrane Library, Clinical Trails.gov, CNKI, Wangfang Database, VIP and Chinadrugtrials.org.cn from the inception to March 31, 2021 were searched for articles related to randomized controlled trials about IDeg in the treatment of T1DM. Studies that met the inclusion criteria were analyzed using Rev Man 5.4.1. Results Totally, 5 RCTs were enrolled in meta-analysis, involving 2 256 patients. Results of Meta-analysis showed that for adult T1DM patients, there was no significant difference between IDeg and other long-acting basal insulin analogues in the ability to lower HbA₁c [MD=0.01, 95%CI (-0.05, 0.08), P=0.69] , and the former was more effective in reducing FPG[MD=-0.85, 95%CI (-1.15, -0.56),P<0.000 01]. Weight gain was greater with IDeg than with insulin detemir [MD=1.07, 95%CI (0.47, 1.67), P<0.000 01]. The overall confirmed hypoglycemia rates[RR=0.95, 95%CI (0.92, 0.97), P=0.000 3], severe hypoglycemia rates[RR=0.78, 95%CI (0.66, 0.93), P=0.005] and nocturnal hypoglycemia rates[RR=0.70, 95%CI（0.61,0.80）, P<0.000 01] were lower with IDeg. Literature review found that insulin IDeg was also suitable for children and teenagers with type 1 diabetes. The reduced blood glucose fluctuations and hypoglycemia made it more cost effective. Conclusion For adult T1DM patients, IDeg is not only as effective and safe as other long-acting basal insulin analogues, but also has advantages in reducing FPG and the incidence of hypoglycemia, especially nocturnal hypoglycemia. IDeg may be an option for T1DM patients with relatively high fasting glucose or at high risk of hypoglycemia.

Key words: insulin degludec, type 1 diabetes, long-acting basal insulin analogue, Meta-analysis, efficacy, safety

CLC Number:

R977.15

ZHANG Shuai, GENG Yue, WAN Liyan, JI Liwei. Efficacy and safety of insulin degludec vs other long-acting basal insulin analogues in the treatment of type 1 diabetes[J]. Chinese Journal of Pharmacovigilance, 2022, 19(12): 1358-1361.

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