Efficacy and safety of ultra-rapid insulin analogues in insulin pumps in patients with Type 1 Diabetes Mellitus: A systematic review and meta-analysis.
FIAsp
Insulin pumps
Meta-analysis
Systematic review
Type 1 diabetes mellitus
URLi
Journal
Diabetes research and clinical practice
ISSN: 1872-8227
Titre abrégé: Diabetes Res Clin Pract
Pays: Ireland
ID NLM: 8508335
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
05
10
2022
accepted:
31
10
2022
pubmed:
10
11
2022
medline:
26
11
2022
entrez:
9
11
2022
Statut:
ppublish
Résumé
To assess the efficacy and safety of ultra-rapid insulin analogues used with continuous subcutaneous insulin infusion systems (CSII) in adults with type 1 diabetes (T1DM). We searched MEDLINE and Cochrane Library up to May 2022 for randomized controlled trials comparing ultra-rapid with rapid-acting insulin analogues (RAIAs) used with CSII. We performed random effects meta-analyses for % of 24-h time in range of 70-180 mg/dl (TIR), time in hypoglycaemia (<70 mg/dl) and hyperglycaemia (>180 mg/dl), 1- and 2-hour post-prandial glucose [PPG] increment after a meal test, HbA1c and average insulin dose at endpoint, unplanned infusion set changes and severe hypoglycaemia. Nine studies (1,156 participants) were included. Ultra-rapid insulins were superior to RAIAs on TIR (mean difference [MD] 1.1 %, 95 % CI 0.11-2.11), time spent in hypoglycaemia (MD -0.47 %, 95 % CI -0.63 to -30), and 1- and 2-hour PPG (MD -12.20 mg/dl, 95 % CI -19.85 to -4.54 and MD -17.61 mg/dl, 95 % CI -28.55 to -6.66, respectively). Ultra-rapid insulins increased odds of unplanned infusion set changes (odds ratio 1.60, 95 % CI 1.26-2.03). Ultra-rapid acting insulins provided better PPG control compared to RAIAs but their use might result in more infusion set changes.
Identifiants
pubmed: 36351486
pii: S0168-8227(22)00958-5
doi: 10.1016/j.diabres.2022.110144
pii:
doi:
Substances chimiques
Insulin
0
Hypoglycemic Agents
0
Insulin, Regular, Human
0
Insulin, Short-Acting
0
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
110144Informations de copyright
Copyright © 2022 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: A.T. has served on an advisory board for Novo Nordisk and Boehringer Ingelheim, and his university has received funding for educational and research support from Boehringer Ingelheim, Eli Lilly and Novo Nordisk, all outside this work. A.S., T.K. and A.C. declare that they have no relevant or material financial interests that relate to the research described in this paper.