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Evidence summaries

Lispro Insulin Compared with Human Regular Insulin

Insulin lispro appears to yield a better postprandial glycaemic control, but there is no evidence of improved overall glycaemic control or reduction of hypoglycaemic episodes. Level of evidence: "B"

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.

    References

    • Davey P, Grainger D, MacMillan J, Rajan N, Aristides M, Gliksman M. Clinical outcomes with insulin lispro compared with human regular insulin: a meta-analysis. Clin Ther 1997 Jul-Aug;19(4):656-74. [PubMed][DARE]

Primary/Secondary Keywords