- Insulin degludec and insulin glargine provide similar glycaemic control, but insulin degludec has an overall beneficial effect on type 2 diabetes mellitus (T2DM) management, mainly manifesting in the lower risks for severe and nocturnal hypoglycaemia.
Why this matters
- Findings suggest that insulin degludec may be an alternative treatment for patients with T2DM who are prone to hypoglycaemia with insulin glargine.
- Meta-analysis of 15 studies included 9619 patients in the insulin degludec group and 7075 patients in the insulin glargine group.
- Main outcomes: glycaemic control, hypoglycaemic event, weight gain and serious adverse events (SAEs).
- Funding: Natural Science Foundation of China and others.
- Mean overall reduction in fasting plasma glucose was in favour of insulin degludec (weighted mean difference [WMD], −5.20 mg/dL; 95% CI, −7.34 to −3.07; P<.00001>
- Compared with insulin glargine, insulin degludec was associated with a lower ratio of patients experiencing:
- ≥1 severe hypoglycaemic event (relative risk [RR], 0.68; 95% CI, 0.50-0.93; P=.01) and
- nocturnal hypoglycaemia (RR, 0.81; 95% CI, 0.75-0.88; P<.0001>
- Insulin glargine was associated with a higher ratio of patients with HbA1c ≤7.0% vs insulin degludec (RR, 0.92; 95% CI, 0.86-0.98; P=.01).
- No significant difference observed between the two groups for:
- HbA1c reduction (WMD, 0.03; 95% CI, −0.00 to 0.07; P=.08),
- body weight gain (WMD, 0.12; 95% CI, −0.19 to 0.43; P=.46) and
- proportion of participants with SAEs (RR, 0.97; 95% CI, 0.92-1.02; P=.20).
- Potential risks of bias.
- Heterogeneity among included studies.