Early initiation of insulin glargine may have benefits in type 2 diabetes.

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What should be the next step when metformin alone is not enough to control type 2 diabetes?  Current practice usually augments metformin with sulphonylurea. This systematic review addresses the question of whether insulin should be added earlier than is currently the case. The reviewers pooled the data from 11 randomised trials looking at this issue.  [read the full story…]

Insulin glargine may be cost-effective compared with basal insulin.

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Insuline glargine has several clinical and quality of life benefits compared with human basal insulin (NPH).  However, it is also more costly.  Do these benefits justify the additional cost? A new economic evaluation addresses this question.  The authors searched the literature for published evaluations.  They found seven good quality studies that addressed the issue, though [read the full story…]

No difference between insulin detemir and glargine in control of type 2 diabetes

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This systematic review identified four studies that directly compared insulin detemir with glargine.  The reviewers found no clinically significant difference between detemir and glargine in terms of glyaemic control (HbA1c), nor in rates of hypoglycaemia. Insulin detemir was associated with less weight gain, but glargine patients used less insulin and had fewer adverse reactions to [read the full story…]