Intensification of insulin therapy with basal-bolus or premixed insulin regimens in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.

摘要: The purpose of this study was to conduct a systematic review and meta-analysis randomized controlled trials (RCTs) comparing the effect intensified insulin regimens (basal-bolus versus premixed) on glycemic control in patients with type 2 diabetes. We conducted an electronic search until March 2015 many databases including online registries ongoing trials. All RCTs basal-bolus premixed regimens, duration >12 weeks >30 per arm, were included. Investigators extracted data characteristics, outcome measures, methodological quality. found thirteen lasting 16-60 involving 5255 assessed for primary endpoint (reduction HbA1c from baseline). Meta-analysis change level between resulted small non-significant difference 0.09% (95% CI -0.03 0.21), substantial heterogeneity studies (I(2) = 74.4%). There no statistically significant event rate overall hypoglycemia (0.16 episode/patient/year, 95%CI -2.07 2.3), weight (-0.21 kg, -0.164 0.185), daily dose (-0.54 U/day, -2.7 1.6). likelihood reaching <7% 8% higher (3-13%, I(2) 68.8%) as compared regimen. is clinically relevant efficacy decrease diabetic patients. These findings may be helpful adapt treatment individual patient needs.