OBJECTIVES:

Most of Type 2 diabetes mellitus(T2DM) receive insulin therapy(analogues or human insulin).The aim of this study was to evaluate safety and effectiveness of Insulin analogues versus human insulin inT2DM.

METHODS:

A systematic review of the literature (The Cochrane Library,Scopus,Web of Science,Pubmed, Embase)and a meta-analysis were performed. We evaluated randomized clinical trials published until 2016. Studies of different insulin types including short-actings (Lispro, Aspart ,long-actings (glargine,detemir) and intermediate-acting(neutral protamine Hagedorn (NPH)) for adults T2DM were encompassed into the study.Two reviewers screened the selected studies independently and differences were resolved by discussion.Quality and risk of bias was appraised by using Jadad scale. Level of HbA1c, episodes of hypoglycemia and nocturnal hypoglycemia were considered as safety and effectiveness criteria.

RESULTS:

Ten randomized clinical trials were included after screening of 2712 titles/abstracts and 36 full text articles. Pooled data regarding effectiveness indicated no significant differences in HbA1c values between glargine,detemir,aspart and NPH insulin.However,Lispro produced differences in HbA1c values that favored lispro(-0.14%[95% CI: 0.18to0. 7];p<0.0001; I2=0%).Also in almost all studies, just one, the episodes of hypoglycemia of human insulin were lower than analogues one; though not significant.

CONCLUSIONS:

The most of analogues insulin appears to have no advantages over human insulin in reducing HbA1C in T2DM population.Only Lispro provided better results for lowering the level of HbA1C for diabetes patients.Nonetheless insulin analogues cause slightly fewer episodes of hypoglycemia in T2DM patients comparing to human insulin.