Efficacy and Safety of Once-Weekly Insulin Regimes on Glycemic Control for Type 2 Diabetes: A Systematic Review and Network Meta-analysis
Abstract Background Randomized controlled trials have found that once-weekly insulin resulted in greater glycemic control compared to once-daily insulin in patients with type 2 diabetes. However, no direct comparisons have been made between different types of once-weekly insulin thus far. This syste...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Diabetology & Metabolic Syndrome |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13098-023-01240-5 |
| _version_ | 1827388244543668224 |
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| author | Peng Wang Yu Zhang Wenhao Xu Jialing He Liyuan Peng Yuning Feng Ping Xu Weelic Chong Yang Hai Lu Jia Fang Fang |
| author_facet | Peng Wang Yu Zhang Wenhao Xu Jialing He Liyuan Peng Yuning Feng Ping Xu Weelic Chong Yang Hai Lu Jia Fang Fang |
| author_sort | Peng Wang |
| collection | DOAJ |
| description | Abstract Background Randomized controlled trials have found that once-weekly insulin resulted in greater glycemic control compared to once-daily insulin in patients with type 2 diabetes. However, no direct comparisons have been made between different types of once-weekly insulin thus far. This systematic review and network meta-analysis aimed to evaluate the effect of the two most advanced once-weekly insulin analogues, namely insulin icodec and insulin Fc, in patients with type 2 diabetes. Methods We conducted a thorough search in the databases PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The search included articles published from the beginning to October 10, 2023, with no language limitations. Our aim was to conduct a systematic review of randomized controlled trials that investigated the effectiveness and safety of once-weekly insulin in individuals with type 2 diabetes. Our primary outcome was to evaluate excellent glycemic control, defined as patients achieving glycated hemoglobin levels below 7%. Results We identified a total of 7 trials involving 2829 patients. The results showed that once-weekly insulin icodec is more effective than once-weekly insulin Fc (RR 1.59 [95% CI 1.08–2.38]), once-daily degludec (RR 1.43 [95% CI 1.14–1.83]), and once-daily glargine (RR 1.15 [95% CI 1.00-1.41]). Moreover, the incidence of severe hypoglycemia was lower with once-weekly insulin icodec compared to once-daily degludec (RR 0.00016 [95% CI 0 to 0.41]). However, no significant difference in the incidence of severe hypoglycemia was observed between once-weekly insulin icodec and once-daily glargine (RR 0.39 [95% CI 0.03 to 4.83]). Conclusions In patients with type 2 diabetes, once-weekly insulin icodec achieved superior glycemic control compared to once-weekly insulin Fc, with no significant difference in the occurrence of hypoglycemia. The ranking probability results have shown that one weekly icodec seems to be the preferred option in patients with type 2 diabetes. Trial registration PROSPERO Identifier: CRD42023470894. |
| first_indexed | 2024-03-08T16:14:54Z |
| format | Article |
| id | doaj.art-0102ef856fa148b18f45b00606c5249c |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-03-08T16:14:54Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-0102ef856fa148b18f45b00606c5249c2024-01-07T12:37:22ZengBMCDiabetology & Metabolic Syndrome1758-59962024-01-011611910.1186/s13098-023-01240-5Efficacy and Safety of Once-Weekly Insulin Regimes on Glycemic Control for Type 2 Diabetes: A Systematic Review and Network Meta-analysisPeng Wang0Yu Zhang1Wenhao Xu2Jialing He3Liyuan Peng4Yuning Feng5Ping Xu6Weelic Chong7Yang Hai8Lu Jia9Fang Fang10West China Hospital, Sichuan UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversityWest China Hospital, Sichuan UniversityDepartment of critical care medicine, Affiliated Hospital of Chengdu UniversityCenter for Evidence-based Medicine, Affiliated Hospital of Chengdu UniversitySichuan University LibraryDepartment of Medical Oncology, Thomas Jefferson UniversitySidney Kimmel Medical College, Thomas Jefferson UniversityDepartment of Surgical Intensive care medicine, Shanxi Provincial People’s HospitalWest China Hospital, Sichuan UniversityAbstract Background Randomized controlled trials have found that once-weekly insulin resulted in greater glycemic control compared to once-daily insulin in patients with type 2 diabetes. However, no direct comparisons have been made between different types of once-weekly insulin thus far. This systematic review and network meta-analysis aimed to evaluate the effect of the two most advanced once-weekly insulin analogues, namely insulin icodec and insulin Fc, in patients with type 2 diabetes. Methods We conducted a thorough search in the databases PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The search included articles published from the beginning to October 10, 2023, with no language limitations. Our aim was to conduct a systematic review of randomized controlled trials that investigated the effectiveness and safety of once-weekly insulin in individuals with type 2 diabetes. Our primary outcome was to evaluate excellent glycemic control, defined as patients achieving glycated hemoglobin levels below 7%. Results We identified a total of 7 trials involving 2829 patients. The results showed that once-weekly insulin icodec is more effective than once-weekly insulin Fc (RR 1.59 [95% CI 1.08–2.38]), once-daily degludec (RR 1.43 [95% CI 1.14–1.83]), and once-daily glargine (RR 1.15 [95% CI 1.00-1.41]). Moreover, the incidence of severe hypoglycemia was lower with once-weekly insulin icodec compared to once-daily degludec (RR 0.00016 [95% CI 0 to 0.41]). However, no significant difference in the incidence of severe hypoglycemia was observed between once-weekly insulin icodec and once-daily glargine (RR 0.39 [95% CI 0.03 to 4.83]). Conclusions In patients with type 2 diabetes, once-weekly insulin icodec achieved superior glycemic control compared to once-weekly insulin Fc, with no significant difference in the occurrence of hypoglycemia. The ranking probability results have shown that one weekly icodec seems to be the preferred option in patients with type 2 diabetes. Trial registration PROSPERO Identifier: CRD42023470894.https://doi.org/10.1186/s13098-023-01240-5InsulinType 2 DiabetesIcodecMeta-analysis |
| spellingShingle | Peng Wang Yu Zhang Wenhao Xu Jialing He Liyuan Peng Yuning Feng Ping Xu Weelic Chong Yang Hai Lu Jia Fang Fang Efficacy and Safety of Once-Weekly Insulin Regimes on Glycemic Control for Type 2 Diabetes: A Systematic Review and Network Meta-analysis Diabetology & Metabolic Syndrome Insulin Type 2 Diabetes Icodec Meta-analysis |
| title | Efficacy and Safety of Once-Weekly Insulin Regimes on Glycemic Control for Type 2 Diabetes: A Systematic Review and Network Meta-analysis |
| title_full | Efficacy and Safety of Once-Weekly Insulin Regimes on Glycemic Control for Type 2 Diabetes: A Systematic Review and Network Meta-analysis |
| title_fullStr | Efficacy and Safety of Once-Weekly Insulin Regimes on Glycemic Control for Type 2 Diabetes: A Systematic Review and Network Meta-analysis |
| title_full_unstemmed | Efficacy and Safety of Once-Weekly Insulin Regimes on Glycemic Control for Type 2 Diabetes: A Systematic Review and Network Meta-analysis |
| title_short | Efficacy and Safety of Once-Weekly Insulin Regimes on Glycemic Control for Type 2 Diabetes: A Systematic Review and Network Meta-analysis |
| title_sort | efficacy and safety of once weekly insulin regimes on glycemic control for type 2 diabetes a systematic review and network meta analysis |
| topic | Insulin Type 2 Diabetes Icodec Meta-analysis |
| url | https://doi.org/10.1186/s13098-023-01240-5 |
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