Meta-analysis of insulin aspart versus regular human insulin in diabetes treatment in China / 中国糖尿病杂志

ABSTRACT

Objective To compare the efficacy and safety of insulin aspart (IAsp) versus regular human insulin (RHI) used in basal bolus (BB) or continuous subcutaneous insulin infusion (CSII) regimen in patients with diabetes mellitus in Chinese population.Methods We searched MEDLINE (via OVID),the Cochrane Library,Embase,PubMed,CBM,China National Knowledge Infrastructure (CNKI),and Wanfang databases from the beginning of the databases to November,2015.The randomized controlled trials comparing IAsp and RHI in DM were searched.The meta-analysis in newly diagnosed DM and treated DM was performed by RevMan 5.3.Results A total of 40 trials were included in this study,with 1087 newly diagnosed and 2395 treated DM patients.In both groups,IAsp was better in lowering 2 hours postprandial plasma glucose (2 hPG) after breakfast,lunch and dinner (For newly diagnosed population MD=-1.22,-1.70,-1.44;95%CI-1.79~-0.64,-2.77~-0.63,-2.12~-0.75;for treated population MD=-1.19,-1.14,-1.03;95%CI-1.39~-0.98,-1.27~-1.02,-1.25~-0.81) and fasting plasma glucose (For newly diagnosed population MD=-0.55,95%CI-0.97~-0.12;for treated population MD=-0.24,95%CI-0.44~-0.03) when compared with RHI.IAsp could shorten the time to achieve blood glucose target(For newly diagnosed population MD=-1.58,95%CI-1.74~-1.42;for treated population MD=-1.73,95%CI-2.10~-1.36) and reduce the risk of hypoglycaemia compared with RHI (For newly diagnosed population RR=0.33,95%CI0.19~0.56;for treated population RR=0.44,95%CI0.32~0.61) (P<0.05).Moreover,the total daily insulin dose was lower in IAsp therapy than in RHI therapy when using CSII regimen.Conclusion In Chinese DM patients,IAsp shows advantages in controlling 2 hPG,shortening the time to achieve blood glucose target and lowering the risk of hypoglycaemia when compared with RHI.