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Drug efficacy

Long-acting insulin ‘probably superior’ to intermediate-acting insulin

Long-acting insulin is superior to intermediate-acting versions due to a greater reduction of haemoglobin A1c, new study finds


Choice of insulin should be tailored according to preference, cost and accessibility, say researchers

Several insulin formulations are available to treat hyperglycaemia in patients with type 1 diabetes. Andrea Tricco from St Michael’s Hospital, Toronto, and colleagues compared the relative effectiveness, safety and cost-effectiveness of long-acting insulin analogues (such as insulin glargine and insulin detemir) and intermediate-acting insulins (such as NPH insulin and insulin lente).

The meta-analysis of 39 studies suggests that long-acting insulin is “probably superior” owing to the greater reduction in haemoglobin A1c, less weight gain and lower incidence of severe hypoglycaemia compared with intermediate-acting insulin. Some, but not all, studies also found that long-acting insulin was more cost-effective than intermediate-acting insulin.

The choice of insulin should be tailored according to “preference, cost and accessibility”, say the researchers, writing in The BMJ (online, 1 October 2014)[1].

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20066717

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