Hypoglycaemia induced by exogenous insulin--'human' and animal insulin compared.

摘要: Summary Aims  A systematic review of the literature was carried out to examine whether published evidence suggests a difference in frequency and awareness hypoglycaemia induced by ‘human’ animal insulin. Methods  The identified randomized controlled trials studies other designs including observational comparisons, case series reports which use insulin compared people with diabetes. These were from bibliographic databases hand-searches key journals. The main outcome measures frequency, severity, symptoms hypoglycaemia. Results  Fifty-two trials, 37 double-blind design, included one or more relevant measures. Of these, 21 specifically investigated hypoglycaemic as primary outcomes (six previously reported reduced awareness). remainder secondary incidental during comparative investigations efficacy immunogenicity. Seven differences symptoms, although none selected subjects on basis impaired demonstrated significant between species. Four unblinded hypoglycaemia. This reached statistical significance two studies. A further 56 considered. In addition 10 describing individuals awareness, nine incidence manifestation treatment. Notably, four population time trend found any relationship increasing hospital admission for unexplained death among those largest could find no support hypothesis that an influence treatment had contributed 50 deaths investigated. When all types considered are ranked order rigour (according accepted ‘hierarchy evidence’), it is least rigorous lend most notion has effect severity hypoglycaemia. Conclusions  Evidence does not contention per se affects However, number studies, mainly less describe when transferred insulin. It possible state how common this phenomenon specific resulting stricter glycaemic control (perhaps compounded, some cases, neurological complications long-standing diabetes). remaining uncertainty makes essential sources continues be available so clinicians patients may retain choice