A systematic review 1 including 3 studies on type I diabetes (n=1344) and 3 studies on type II diabetes (n=1017) was abstracted in DARE. The decrease in postprandial glucose levels below 8 mmol/L was significantly more frequent with insulin lispro (59.4% vs 49.3% of patients achieving at least one therapeutic success, OR 1.68, 95% CI 1.34 to 2.12). For the two other outcome variables (2-hour postprandial blood glucose level within 20% of the pre-meal level or at least a 50% decrease from baseline in 2-hour postprandial glucose excursion) no significant difference was found. For continuous variables, one hour postprandial blood glucose, 2-hour postprandial blood glucose, and 1-hour and 2-hour glucose excursion) showed statistically significant differences in favour of insulin lispro, but there was no difference in the weighted mean long-term glycaemic control, fasting blood glucose, and hypoglycaemic rate per 30 days.
Comment: The quality of evidence is downgraded by limitations in review methodology. The validity of the studies was not assessed.
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