An analysis of early insulin glargine added to metformin with or without sulfonylurea: impact on glycaemic control and hypoglycaemia
2011

Early Insulin Glargine Addition to Metformin for Better Diabetes Control

Sample size: 2171 publication Evidence: high

Author Information

Author(s): Fonseca V, Gill J, Zhou R, Leahy J

Primary Institution: Tulane University Medical Center

Hypothesis

Does initiating insulin glargine earlier in treatment improve glycaemic control and reduce hypoglycaemia in patients with type 2 diabetes?

Conclusion

Adding insulin glargine to metformin monotherapy early in treatment may provide better efficacy and safety compared to regimens including sulfonylurea.

Supporting Evidence

  • Patients on 0/1 OAD had the largest reductions in HbA1c after adding insulin glargine.
  • 68.1% of patients on MET alone achieved HbA1c ≤ 7.0%.
  • Patients on MET alone had less hypoglycaemia than those on SU or MET + SU.

Takeaway

Starting insulin earlier can help people with diabetes control their blood sugar better and have fewer low blood sugar episodes.

Methodology

Pooled analysis of 11 randomized clinical trials with 2171 adults with uncontrolled type 2 diabetes initiating insulin glargine.

Potential Biases

Potential biases related to the selection of studies and the focus on insulin glargine only.

Limitations

Only studies of insulin glargine were evaluated; applicability to other insulin formulations is unknown.

Participant Demographics

Mean age 58.6 years, 55.6% male, 88.3% White.

Statistical Information

P-Value

p = 0.0006

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1111/j.1463-1326.2011.01412.x

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