New plain language guides on the comparison of insulin treatments for Type 2 diabetes are available
Research Activities, May 2009, No. 345
The Agency for Healthcare Research and Quality (AHRQ) released a pair of plain-language guides for consumers and clinicians comparing the efficacy, effectiveness, and side effects of newer premixed insulin analogues with conventional insulin (human insulin) and other preparations used to control Type 2 diabetes.
The consumer guide—Premixed Insulin for Type 2 Diabetes: A Guide for Adults—is a primer on diabetes, diabetes testing, and treatments. The guide explains the differences among insulin analogues that last all day, insulin used at meal time, and the newer premixed insulin analogues that are both effective all day and after meals, a time when blood sugar levels can suddenly rise. Finally, the guide offers a cost comparison chart for different types of treatments under generic and brand names.
The clinician guide—Premixed Insulin Analogues: A Comparison with Other Treatments for Type 2 Diabetes—covers the same information as the consumer guide, but also includes a level of confidence scale for the information included in the guide, based on the systematic review of literature and assists clinicians in choosing the appropriate type of insulin based on patients' physiologic needs. The new guides on treatments for type 2 diabetes show that:
- When newer premixed insulin analogues were compared with long-acting insulin analogues (insulin lasting all day), the premixed insulin analogues were better at lowering A1c levels and at lowering blood sugar after meals. The long-acting insulin analogues were found to be better at lowering fasting blood sugar levels, and showed fewer incidents of hypoglycemia and less weight gain.
- When conventional insulin (premixed human insulin) was compared with newer premixed insulin analogues, the latter was better at lowering blood sugar after meals, but both kinds of insulin were equally as effective at lowering A1c and lowering fasting blood sugar levels. They showed similar incidence of hypoglycemia and weight gain.
Premixed Insulin for Type 2 Diabetes: A Guide for Adults and Premixed Insulin Analogues: A Comparison with Other Treatments for Type 2 Diabetes are the newest in a series of comparative effectiveness guides from AHRQ's Effective Health Care program. Other AHRQ guides compare treatments for prostate cancer, osteoarthritis, pills for hypertension, pills for type 2 diabetes, depression, and other conditions. These guides and more information about the Effective Health Care program can be found at http://www.effectivehealthcare.ahrq.gov.