Are New Ultra-Rapid-Acting Insulins Associated with Improved Glycemic Control and Reduced Hypoglycemia in Comparison to Conventional Rapid-Acting Insulins for Individuals with Type 1 and Type 2 Diabetes? A Systematic Review and Meta-Analysis
Authors' conclusion
Mealtime URAI improves 1 and 2 h postprandial glycemic control compared to RAI without increasing hypoglycemia or weight gain.
Study context
- Population
- Individuals with T1D or T2D in RCTs lasting at least 12 weeks; 3 TI studies excluded for high heterogeneity12 studies
- Comparison
- Ultra-rapid-acting insulin analogs vs rapid-acting insulin analogs
- Outcome
- Early 1 h postprandial glycemia (mealtime URAI)
Pooled result
As reported in the abstract
URAI vs RAIDifference, mg/dL (95% CI)P value
T1D; I2 = 33.42%
−20.230(−24.040 to −16.421)
P < 0.001T2D; I2 = 0%
−9.138(−12.612 to −5.663)
P < 0.001Further pooled results
| Outcome | Difference (mg/dL) (95% CI) | P value | |
|---|---|---|---|
| 2 h postprandial glucose (mealtime URAI)T1D; I2 = 65.88% | −17.620 (−26.047 to −9.193) | P < 0.001 | |
| −40−20020Difference, mg/dL (linear scale) |
| Outcome | Difference (%) (95% CI) | P value | |
|---|---|---|---|
| HbA1c (mealtime URAI) · 52 weeksI2 = 0% | −0.080 (−0.147 to −0.013) | P = 0.019 | |
| −0.2−0.100.1Difference, % (linear scale) |
2 h postprandial glucose (mealtime URAI)
- Significant reduction remained only in T1D
Postprandial glycemia with postmeal URAI
- Benefits lost when URAI was administered postmeal
HbA1c · 24-26 weeks
- No significant difference in HbA1c between groups
Weight
- No difference in weight
Safety
| Outcome | Estimate | P value |
|---|---|---|
| Early 1-h hypoglycemiaT1D only; small but significant increase with URAI; I2 = 0% | 1.468 (95% CI 1.235–1.747) | P < 0.001 |
Severe or confirmed hypoglycemia
- No difference in the rate of severe or confirmed hypoglycemia
Original publication
Are New Ultra-Rapid-Acting Insulins Associated with Improved Glycemic Control and Reduced Hypoglycemia in Comparison to Conventional Rapid-Acting Insulins for Individuals with Type 1 and Type 2 Diabetes? A Systematic Review and Meta-Analysis. Diabetes Technol Ther. Published 15 April 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →