Proportion of type 2 diabetics achieving good glycemic control by insulin regimen

Picture of a syringe

This review collated data from over 80 studies of different insulin regimens to determine what proportion of people with type 2 diabetes patients achieve a glycosylated haemoglobin target of HbA1c of 7% or lower:

  • Basal insulin:  37.2% (31.5-43.1%)
  • Biphasic insulin: 35.3% (28.9-42.1%)
  • Prandial insulin: 37.5% (27.7-47.9%)
  • Basal-bolus insulin: 51.2% (41.4-61.1%)

Note that there may be many other factors at play here, such as a patient being assigned to a particular therapy because of poor control.  The wide confidence intervals are also notable.

Appraisal hints

Users of this research are advised to consider:

  • Possible sources of bias in the individual studies.
  • The amount of uncertainty around the overall percentages quoted above.
  • There were a lot of differences between the studies in terms of patients, interventions and outcomes.
  • Whether the validity of the meta-analysis compromised by this heterogeneity.

You may be better to look for a good quality individual study that is more relevant to your circumstances.

Reference

Esposito K, Maiorino MI, Bellastella G, Chiodini P, Giugliano D.  Insulin analogs and glycosylated hemoglobin target of less than 7% in type 2 diabetes: a systematic review of randomized trials.  Metab Syndr Relat Disord. 2011 Jun;9(3):167-76. Epub 2011 Mar 16.
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Badenoch

Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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