Researchers looked at once daily and twice daily doses of both long- and intermediate-acting insulin and ranked their effectiveness, safety and cost-effectiveness.


"In patients with type 1 diabetes, we found that long-acting insulin is superior to intermediate-acting insulin when it came to controlling blood sugar, preventing weight gain and treating severe hypoglycemia," said Andrea Tricco, lead author and assistant professor at the University of Toronto's Dalla Lana School of Public Health in Canada.

For their study, Tricco and her colleagues used data from 39 studies and compared two long-acting forms of insulin - glargine and detemir - against intermediate-acting forms, like Neutral Protamine Hagedorn (NPH).

They found that long-acting insulin takes about one hour after ingesting to begin lowering blood sugar and lasts up to 26 hours whereas intermediate-acting insulin takes between one and three hours to begin lowering blood sugar and can last up to 16 hours.

"Also those taking intermediate-acting insulin were more likely to gain weight - an average of four to six pounds more than the participants who took long-acting insulin doses," explained Tricco.

The researchers also found that people with type 1 diabetes were 38 percent less likely to experience severe hypoglycemia or extremely low blood sugar.

"With this information, patients and their doctors should tailor their choice of insulin according to preference, cost and accessibility," concluded Tricco.

The study appeared in the journal BMJ.

 

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