short-acting analogues - insulin aspart and insulin lispro
short-acting analogues, insulin lispro and insulin aspart, in comparison to conventional human insulins, result in a small decrease in haemoglobin A1c levels in patients with type 1, but not type 2, diabetes mellitus (1)
the short-acting insulin analogues also appear to reduce the incidence of severe hypoglycaemia but not the overall likelihood of hypoglycaemia (1)
longer-acting analogues - insulin glargine and insulin detemir
both longer-acting insulin analogues seem to produce glycaemic control that is at least comparable to that with isophane insulin
insulin detemir seems to reduce nocturnal hypoglycaemia and result in less weight gain than does isophane insulin in patients with type 1 diabetes
insulin glargine appears to reduce nocturnal hypoglycaemia in patients with type 1 or type 2 diabetes
a review (1) concluded that there is no convincing evidence to justify switching patients from existing conventional therapy to analogues if they have appropriate glycaemic control without troublesome hypoglycaemia
long acting insulin analogues do not reduce HbA1c concentrations more than coventional human insulin but do reduce nocturnal hypoglycaemia (2)
Reference:
(1) Drug and Therapeutics Bulletin (2004); 42(10):77-80.
(2) Banerjee S et al. Long-acting insulin analogues for diabetes mellitus: meta-analysis of clinical outcomes and assessment of cost-effectiveness. Technology Report 92.Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH); 2007.
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