Efficacy and Safety of Insulin Glargine versus Premixed Insulin in Treatment of Type 2 Diabetes:A Meta-analysis
- 药学院－已发表论文 
目的:系统评价甘精胰岛素对比预混胰岛素治疗2型糖尿病的疗效与安全性,以为临床提供循证参考。方法:计算机检索Pub Med、中国期刊全文数据库、万方数据库和中文科技期刊数据库,收集甘精胰岛素(试验组)对比预混胰岛素(对照组)治疗2型糖尿病疗效与安全性的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取,并采用改良后的Jadad量表进行质量评价,采用Rev Man 5.0统计软件进行Meta分析。结果:共纳入10项RCT,合计1 655例患者。Meta分析结果显示,甘精胰岛素在降低糖化血红蛋白水平[MD=-0.41,95%CI(-0.64,-0.18),P<0.001]、空腹血糖水平[MD=-0.51,95%CI(-0.99,-0.02),P=0.04]方面均优于预混胰岛素,两组比较差异均有统计学意义,而在降低餐后2 h血糖水平[MD=-0.56,95%CI(-1.21,0.09),P=0.09]、体质量指数[MD=-0.52,95%CI(-1.52,0.48),P=0.31]方面,差异均无统计学意义;甘精胰岛素组患者的低血糖发生率[RR=0.65,95%CI(0.46,0.90),P=0.01]低于预混胰岛素组,差异有统计学意义。结论:甘精胰岛素治疗2型糖尿病的疗效与安全性优于预混胰岛素。OBJECTIVE:To systematically review the efficacy and safety of insulin glargine versus premixed insulin in treatment of type 2 diabetes,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Pub Med,CJFD,Wanfang Database and VIP Database,the randomized controlled trials(RCT)about the efficacy and safety of premixed insulin versus insulin glargine in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.0 statistics software after extracting data and evaluating quality by modified Jadad. RESULTS:A total of 10 RCTs were enrolled,involving 1 655 patients. Results of Meta-analysis showed that insulin glargine was better than premixed insulin on reducing glycated hemoglobin[M=-0.41,95% CI(-0.64,-0.18),P<0.001] and fasting blood glucose [MD=-0.51,95% CI(-0.99,-0.02),P=0.04],there were significantly differences between 2 groups,and there were no significantly differences in reducing 2 h postprandial blood glucose [MD=-0.56,95% CI(-1.21,0.09),P=0.09] and body mass index [MD=-0.52,95% CI(-1.52,0.48),P=0.31];the incidence of hypoglycemia in insulin glargine group was significantly lower than premixed insulin,there were significantly differences between 2 groups [RR=0.65,95%CI(0.46,0.90),P=0.01]. CONCLUSIONS:The efficacy and safety of insulin glargine are better than premixed insulin in the treatment of type 2 diabetes.