Comparison of daily insulin dose and other anti-diabetic medications usage for type 2 diabetes patients treated with an analog basal insulin Systematic review and Single arm Meta-Analysis.

Abstract

Background: Type 2 diabetes (T2D) is a chronic developing illness that accounts for over 90% of all people with diabetes.
Aim: To evaluate the daily insulin dosage and the utilization of additional anti-diabetic drugs in cases with type 2 diabetes receiving analog basal insulin therapy.
Patients and methods: This systematic review and single-arm meta-analysis aimed to evaluate the use of analog basal insulin in cases with T2D. The study included data from four primary research articles, conducted in various geographic locations such as Denmark, the USA, and multicenter sites spanning 80 countries. The study design adhered to the PRISMA guidelines for systematic reviews, ensuring a rigorous and transparent approach.
Results: No variation has been observed in the continuing of any non-insulin anti-diabetic medicines among cases receiving insulin detemir (DET) and those receiving insulin glargine (GLAR). Most cases utilizing metformin, sulfonylureas, thiazolidinediones, or exenatide prior to the start of insulin detemir or insulin glargine maintained the same class of medicine following the introduction of insulin. With RR and 95% CI; 0.57[0.51, 0.64] for metformin, 0.078[0.047, 0.1] for DPP-4 inhibitors, 0.1[0.02, 0.34] for sulfonylureas and 0.11[0.008, 0.2] for TZD. From figure 3 to figure 6 represents Forest plots for this outcome.
Conclusion: The study found no difference in non-insulin anti-diabetic agent continuation among DET and GLAR cases, with metformin being the most common concomitant medication.