Hernando Vargas-Uricoechea, Pablo Frias Juan
Director of the Metabolic Diseases Study Group, Associate Professor of the Department of Internal Medicine, Universidad Del Cauca, Carrera 5 # 13N-36, Popayán, Cauca, Colombia.
National Research Institute, 2010 Wilshire Blvd # 302, Los Angeles, CA, USA.
Diabetes Metab Syndr. 2019 May-Jun;13(3):2126-2141. doi: 10.1016/j.dsx.2019.05.001. Epub 2019 May 12.
Type 2 diabetes mellitus is a progressive disease, which requires insulin treatment when other management is no longer effective. Although, insulin plays a vital role in the treatment of diabetes, conventional basal insulins have certain limitations, which have led to the development of more stable and peak less analogues.
To analyze the efficacy and safety of second generation vs. first generation basal insulins, and the efficacy and safety of second generation vs. second generation basal insulins, in patients with type 2 diabetes mellitus, from the evidence provided by head-to-head randomized controlled trials.
The following electronic databases were searched: PubMed and MEDLINE, Scopus, BIOSIS, Embase, ClinicalTrials.gov, Google Scholar, and Springer Online Archives Collection, from January 1966 to October 2018. Articles resulting from these searches and relevant references cited in those articles were examined.
The efficacy among insulins evaluated was similar, however, second generation insulins cause a lower risk of hypoglycemia compared to first generation insulins. A single study showed similar metabolic control with subtle differences in the risk of hypoglycemia among second generation insulins.
The second-generation basal insulins result in metabolic control similar to first generation insulins, with lower risk of hypoglycemia. Second-generation insulins have comparable efficacy, with some differences in the risk of hypoglycemia.
2型糖尿病是一种进行性疾病，当其他治疗方法不再有效时需要胰岛素治疗。尽管胰岛素在糖尿病治疗中起着至关重要的作用，但传统的基础胰岛素有一定局限性，这促使了更稳定、峰效应更低的类似物的研发。
根据头对头随机对照试验提供的证据，分析第二代与第一代基础胰岛素在2型糖尿病患者中的疗效和安全性，以及第二代与第二代基础胰岛素之间的疗效和安全性。
检索了以下电子数据库：1966年1月至2018年10月期间的PubMed和MEDLINE、Scopus、BIOSIS、Embase、ClinicalTrials.gov、谷歌学术和施普林格在线档案库。对这些检索结果以及这些文章中引用的相关参考文献进行了审查。
所评估的胰岛素之间疗效相似，然而，与第一代胰岛素相比，第二代胰岛素导致低血糖的风险更低。一项研究显示，第二代胰岛素在代谢控制方面相似，但在低血糖风险方面存在细微差异。
第二代基础胰岛素导致的代谢控制与第一代胰岛素相似，但低血糖风险更低。第二代胰岛素具有相当的疗效，在低血糖风险方面存在一些差异。
