The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Edoardo Mannucci - One of the best experts on this subject based on the ideXlab platform.
-
long acting Insulin analogues vs nph Human Insulin in type 1 diabetes a meta analysis
Diabetes Obesity and Metabolism, 2009Co-Authors: Matteo Monami, Niccolo Marchionni, Edoardo MannucciAbstract:Aim: Basal Insulin in type 1 diabetes can be provided using either NPH (Neutral Protamine Hagedorn) Human Insulin or long-acting Insulin analogues, which are supposed to warrant a better metabolic control with reduced hypoglycaemic risk. Aim of this meta-analysis is the assessment of differences with respect to HbA1c (Glycated hemoglobin), incidence of hypoglycaemia, and weight gain, between NPH Human Insulin and each long-acting analogue. Methods: Of 285 randomized controlled trials with a duration > 12 weeks comparing long-acting Insulin analogues (detemir or glargine) with NPH Insulin in type 1 diabetic patients identified through Medline search and searches on www.clinicaltrials.gov, 20 met eligibility criteria (enrolling 3693 and 2485 in the long-acting analogues and NPH group respectively). Data on HbA1c and body mass index at endpoint, and incidence of any, nocturnal and severe hypoglycaemia, were extracted and meta-analysed. Results: Long-acting analogues had a small, but significant effect on HbA1c [-0.07 (−0.13; −0.01)%; p = 0.026], in comparison with NPH Human Insulin. When analysing the effect of long-acting analogues on body weight, detemir was associated with a significantly smaller weight gain than Human Insulin [by 0.26 (0.06;0.47) kg/m2; p = 0.012]. Long-acting analogues were associated with a reduced risk for nocturnal and severe hypoglycaemia [OR (Odd Ratio, 95% Confidence Intervals) 0.69 (0.55; 0.86), and OR 0.73 (0.60; 0.89) respectively; all p < 0.01]. Conclusions: The switch from NPH to long-acting analogues as basal Insulin replacement in type 1 diabetic patients had a small effect on HbA1c, and also reduced the risk of nocturnal and severe hypoglycaemia.
-
short acting Insulin analogues vs regular Human Insulin in type 2 diabetes a meta analysis
Diabetes Obesity and Metabolism, 2009Co-Authors: Edoardo Mannucci, Matteo Monami, Niccolo MarchionniAbstract:Aim: Short-acting Insulin analogues, in comparison with regular Human Insulin (HRI), provide a greater control of postprandial glucose, while their superiority on haemoglobin A1c (HbA1c) is controversial. Method: All randomized controlled trials (RCTs) with a duration >4 weeks comparing short-acting Insulin analogues (lispro, aspart or glulisine) with HRI in type 2 diabetic patients were retrieved; data on HbA1c and postprandial glucose et end-point and incidence of severe hypoglycaemia were extracted and meta-analysed. Results: A total of 13 RCTs (7, 4 and 2 with lispro, aspart and glulisine, respectively) were retrieved and included in the analysis. Short-acting analogues reduced HbA1c by 0.4% (0.1–0.6%) (p ¼ 0.027) in comparison with HRI. A significant improvement was observed also in self-monitored 2 h postbreakfast and dinner blood glucose. The overall rate of severe hypoglycaemia was not significantly different with short-acting analogues and HRI [Mantel–Haenszel odds ratio for 95% confidence interval 0.61 (0.25–1.45)]. Conclusion: In type 2 diabetic patients, short-acting Insulin analogues provide a better control of HbA1c and postprandial glucose than regular Human Insulin, without any significant reduction of the risk of severe hypoglycaemia.
-
long acting Insulin analogues versus nph Human Insulin in type 2 diabetes a meta analysis
Diabetes Research and Clinical Practice, 2008Co-Authors: Matteo Monami, Niccolo Marchionni, Edoardo MannucciAbstract:Abstract Background Long-acting Insulin analogues, in comparison with NPH Insulin, should warrant a greater reproducibility of absorption after subcutaneous injection, providing better metabolic control with reduced hypoglycaemic risk. Aim of the present meta-analysis is the assessment of differences with respect to HbA1c, incidence of hypoglycaemia, weight gain, between NPH Human Insulin and each long-acting analogue. Methods All randomized controlled trials (RCTs) with a duration >12 weeks comparing long-acting Insulin analogues (detemir or glargine) with NPH Insulin in type 2 diabetic patients were retrieved; data on HbA1c and BMI at endpoint, and incidence of any, symptomatic, nocturnal, and severe hypoglycaemia, were extracted and meta-analysed. Results A total of 14 RCTs was retrieved and included in the analysis. Long-acting analogues did not produce any significant improvement of HbA1c, in comparison with NPH Human Insulin. When trials with different analogues were analysed separately, NPH showed a significant superiority (by 0.1%) over detemir, but not over glargine. When analysing the effect of long-acting analogues on body weight, detemir, but not glargine, was associated with a significantly smaller weight gain than Human Insulin Both analogues were associated with a reduced risk for nocturnal and symptomatic hypoglycaemia (OR: 0.46[0.38–0.55] and 0.69[0.60–0.80]; all p Conclusions Long-acting Insulin analogues in type 2 diabetic patients does not seem to provide a better glycemic control in comparison with NPH Insulin, whereas it reduces the risk of nocturnal and symptomatic hypoglycemia. Detemir, but not glargine, could be associated with smaller weight gain than NPH Insulin.
M A Gall - One of the best experts on this subject based on the ideXlab platform.
-
Insulin analogues Insulin detemir and Insulin aspart versus traditional Human Insulins nph Insulin and regular Human Insulin in basal bolus therapy for patients with type 1 diabetes
Diabetologia, 2004Co-Authors: Kjeld Hermansen, P Fontaine, Karmen Kukolja, V Peterkova, G Leth, M A GallAbstract:The aim of the trial was to compare the efficacy and tolerability of two types of basal-bolus therapy, using either the soluble long-acting basal Insulin analogue, Insulin detemir, in combination with the rapid-acting analogue, Insulin aspart, or NPH Insulin in combination with mealtime regular Human Insulin. In this 18-week, 1:1 randomised, open-labelled, parallel trial, 595 patients with Type 1 diabetes mellitus received Insulin detemir or NPH Insulin in the morning and at bedtime in combination with mealtime Insulin aspart or regular Human Insulin respectively. Glycaemic control with Insulin detemir/Insulin aspart was improved in comparison with NPH Insulin/regular Human Insulin (HbA1c: 7.88% vs 8.11%; mean difference: −0.22% point [95% CI: −0.34 to −0.10]; p<0.001). Self-measured 8-point plasma glucose profiles differed between the groups (p<0.001), with lower postprandial plasma glucose levels in the Insulin detemir/Insulin aspart group. Within-person day-to-day variation in plasma glucose was lower with Insulin detemir/Insulin aspart than with NPH Insulin/regular Human Insulin (SD: 2.88 vs 3.12 mmol/l; p<0.001). Risk of overall and nocturnal hypoglycaemia (23.00–06.00 hours) was, respectively, 21% (p=0.036) and 55% (p<0.001) lower in the Insulin detemir/Insulin aspart group than in the NPH Insulin/regular Human Insulin group. Body weight (adjusted for baseline and change in HbA1c) was 1 kg lower with Insulin detemir/Insulin aspart than with NPH Insulin/regular Human Insulin (p<0.001). Basal-bolus therapy using Insulin detemir/Insulin aspart offers a better balance of control and tolerability than with NPH Insulin/regular Human Insulin. The low variability and more physiological action profiles generated with these Insulin analogues resulted in improved glycaemic control with lower risk of hypoglycaemia and no concomitant body weight increase.
-
Insulin analogues Insulin detemir and Insulin aspart versus traditional Human Insulins nph Insulin and regular Human Insulin in basal bolus therapy for patients with type 1 diabetes
Diabetologia, 2004Co-Authors: Kjeld Hermansen, P Fontaine, Karmen Kukolja, V Peterkova, G Leth, M A GallAbstract:Aims/hypothesis The aim of the trial was to compare the efficacy and tolerability of two types of basal-bolus therapy, using either the soluble long-acting basal Insulin analogue, Insulin detemir, in combination with the rapid-acting analogue, Insulin aspart, or NPH Insulin in combination with mealtime regular Human Insulin.
Niccolo Marchionni - One of the best experts on this subject based on the ideXlab platform.
-
long acting Insulin analogues vs nph Human Insulin in type 1 diabetes a meta analysis
Diabetes Obesity and Metabolism, 2009Co-Authors: Matteo Monami, Niccolo Marchionni, Edoardo MannucciAbstract:Aim: Basal Insulin in type 1 diabetes can be provided using either NPH (Neutral Protamine Hagedorn) Human Insulin or long-acting Insulin analogues, which are supposed to warrant a better metabolic control with reduced hypoglycaemic risk. Aim of this meta-analysis is the assessment of differences with respect to HbA1c (Glycated hemoglobin), incidence of hypoglycaemia, and weight gain, between NPH Human Insulin and each long-acting analogue. Methods: Of 285 randomized controlled trials with a duration > 12 weeks comparing long-acting Insulin analogues (detemir or glargine) with NPH Insulin in type 1 diabetic patients identified through Medline search and searches on www.clinicaltrials.gov, 20 met eligibility criteria (enrolling 3693 and 2485 in the long-acting analogues and NPH group respectively). Data on HbA1c and body mass index at endpoint, and incidence of any, nocturnal and severe hypoglycaemia, were extracted and meta-analysed. Results: Long-acting analogues had a small, but significant effect on HbA1c [-0.07 (−0.13; −0.01)%; p = 0.026], in comparison with NPH Human Insulin. When analysing the effect of long-acting analogues on body weight, detemir was associated with a significantly smaller weight gain than Human Insulin [by 0.26 (0.06;0.47) kg/m2; p = 0.012]. Long-acting analogues were associated with a reduced risk for nocturnal and severe hypoglycaemia [OR (Odd Ratio, 95% Confidence Intervals) 0.69 (0.55; 0.86), and OR 0.73 (0.60; 0.89) respectively; all p < 0.01]. Conclusions: The switch from NPH to long-acting analogues as basal Insulin replacement in type 1 diabetic patients had a small effect on HbA1c, and also reduced the risk of nocturnal and severe hypoglycaemia.
-
short acting Insulin analogues vs regular Human Insulin in type 2 diabetes a meta analysis
Diabetes Obesity and Metabolism, 2009Co-Authors: Edoardo Mannucci, Matteo Monami, Niccolo MarchionniAbstract:Aim: Short-acting Insulin analogues, in comparison with regular Human Insulin (HRI), provide a greater control of postprandial glucose, while their superiority on haemoglobin A1c (HbA1c) is controversial. Method: All randomized controlled trials (RCTs) with a duration >4 weeks comparing short-acting Insulin analogues (lispro, aspart or glulisine) with HRI in type 2 diabetic patients were retrieved; data on HbA1c and postprandial glucose et end-point and incidence of severe hypoglycaemia were extracted and meta-analysed. Results: A total of 13 RCTs (7, 4 and 2 with lispro, aspart and glulisine, respectively) were retrieved and included in the analysis. Short-acting analogues reduced HbA1c by 0.4% (0.1–0.6%) (p ¼ 0.027) in comparison with HRI. A significant improvement was observed also in self-monitored 2 h postbreakfast and dinner blood glucose. The overall rate of severe hypoglycaemia was not significantly different with short-acting analogues and HRI [Mantel–Haenszel odds ratio for 95% confidence interval 0.61 (0.25–1.45)]. Conclusion: In type 2 diabetic patients, short-acting Insulin analogues provide a better control of HbA1c and postprandial glucose than regular Human Insulin, without any significant reduction of the risk of severe hypoglycaemia.
-
long acting Insulin analogues versus nph Human Insulin in type 2 diabetes a meta analysis
Diabetes Research and Clinical Practice, 2008Co-Authors: Matteo Monami, Niccolo Marchionni, Edoardo MannucciAbstract:Abstract Background Long-acting Insulin analogues, in comparison with NPH Insulin, should warrant a greater reproducibility of absorption after subcutaneous injection, providing better metabolic control with reduced hypoglycaemic risk. Aim of the present meta-analysis is the assessment of differences with respect to HbA1c, incidence of hypoglycaemia, weight gain, between NPH Human Insulin and each long-acting analogue. Methods All randomized controlled trials (RCTs) with a duration >12 weeks comparing long-acting Insulin analogues (detemir or glargine) with NPH Insulin in type 2 diabetic patients were retrieved; data on HbA1c and BMI at endpoint, and incidence of any, symptomatic, nocturnal, and severe hypoglycaemia, were extracted and meta-analysed. Results A total of 14 RCTs was retrieved and included in the analysis. Long-acting analogues did not produce any significant improvement of HbA1c, in comparison with NPH Human Insulin. When trials with different analogues were analysed separately, NPH showed a significant superiority (by 0.1%) over detemir, but not over glargine. When analysing the effect of long-acting analogues on body weight, detemir, but not glargine, was associated with a significantly smaller weight gain than Human Insulin Both analogues were associated with a reduced risk for nocturnal and symptomatic hypoglycaemia (OR: 0.46[0.38–0.55] and 0.69[0.60–0.80]; all p Conclusions Long-acting Insulin analogues in type 2 diabetic patients does not seem to provide a better glycemic control in comparison with NPH Insulin, whereas it reduces the risk of nocturnal and symptomatic hypoglycemia. Detemir, but not glargine, could be associated with smaller weight gain than NPH Insulin.
Matteo Monami - One of the best experts on this subject based on the ideXlab platform.
-
long acting Insulin analogues vs nph Human Insulin in type 1 diabetes a meta analysis
Diabetes Obesity and Metabolism, 2009Co-Authors: Matteo Monami, Niccolo Marchionni, Edoardo MannucciAbstract:Aim: Basal Insulin in type 1 diabetes can be provided using either NPH (Neutral Protamine Hagedorn) Human Insulin or long-acting Insulin analogues, which are supposed to warrant a better metabolic control with reduced hypoglycaemic risk. Aim of this meta-analysis is the assessment of differences with respect to HbA1c (Glycated hemoglobin), incidence of hypoglycaemia, and weight gain, between NPH Human Insulin and each long-acting analogue. Methods: Of 285 randomized controlled trials with a duration > 12 weeks comparing long-acting Insulin analogues (detemir or glargine) with NPH Insulin in type 1 diabetic patients identified through Medline search and searches on www.clinicaltrials.gov, 20 met eligibility criteria (enrolling 3693 and 2485 in the long-acting analogues and NPH group respectively). Data on HbA1c and body mass index at endpoint, and incidence of any, nocturnal and severe hypoglycaemia, were extracted and meta-analysed. Results: Long-acting analogues had a small, but significant effect on HbA1c [-0.07 (−0.13; −0.01)%; p = 0.026], in comparison with NPH Human Insulin. When analysing the effect of long-acting analogues on body weight, detemir was associated with a significantly smaller weight gain than Human Insulin [by 0.26 (0.06;0.47) kg/m2; p = 0.012]. Long-acting analogues were associated with a reduced risk for nocturnal and severe hypoglycaemia [OR (Odd Ratio, 95% Confidence Intervals) 0.69 (0.55; 0.86), and OR 0.73 (0.60; 0.89) respectively; all p < 0.01]. Conclusions: The switch from NPH to long-acting analogues as basal Insulin replacement in type 1 diabetic patients had a small effect on HbA1c, and also reduced the risk of nocturnal and severe hypoglycaemia.
-
short acting Insulin analogues vs regular Human Insulin in type 2 diabetes a meta analysis
Diabetes Obesity and Metabolism, 2009Co-Authors: Edoardo Mannucci, Matteo Monami, Niccolo MarchionniAbstract:Aim: Short-acting Insulin analogues, in comparison with regular Human Insulin (HRI), provide a greater control of postprandial glucose, while their superiority on haemoglobin A1c (HbA1c) is controversial. Method: All randomized controlled trials (RCTs) with a duration >4 weeks comparing short-acting Insulin analogues (lispro, aspart or glulisine) with HRI in type 2 diabetic patients were retrieved; data on HbA1c and postprandial glucose et end-point and incidence of severe hypoglycaemia were extracted and meta-analysed. Results: A total of 13 RCTs (7, 4 and 2 with lispro, aspart and glulisine, respectively) were retrieved and included in the analysis. Short-acting analogues reduced HbA1c by 0.4% (0.1–0.6%) (p ¼ 0.027) in comparison with HRI. A significant improvement was observed also in self-monitored 2 h postbreakfast and dinner blood glucose. The overall rate of severe hypoglycaemia was not significantly different with short-acting analogues and HRI [Mantel–Haenszel odds ratio for 95% confidence interval 0.61 (0.25–1.45)]. Conclusion: In type 2 diabetic patients, short-acting Insulin analogues provide a better control of HbA1c and postprandial glucose than regular Human Insulin, without any significant reduction of the risk of severe hypoglycaemia.
-
long acting Insulin analogues versus nph Human Insulin in type 2 diabetes a meta analysis
Diabetes Research and Clinical Practice, 2008Co-Authors: Matteo Monami, Niccolo Marchionni, Edoardo MannucciAbstract:Abstract Background Long-acting Insulin analogues, in comparison with NPH Insulin, should warrant a greater reproducibility of absorption after subcutaneous injection, providing better metabolic control with reduced hypoglycaemic risk. Aim of the present meta-analysis is the assessment of differences with respect to HbA1c, incidence of hypoglycaemia, weight gain, between NPH Human Insulin and each long-acting analogue. Methods All randomized controlled trials (RCTs) with a duration >12 weeks comparing long-acting Insulin analogues (detemir or glargine) with NPH Insulin in type 2 diabetic patients were retrieved; data on HbA1c and BMI at endpoint, and incidence of any, symptomatic, nocturnal, and severe hypoglycaemia, were extracted and meta-analysed. Results A total of 14 RCTs was retrieved and included in the analysis. Long-acting analogues did not produce any significant improvement of HbA1c, in comparison with NPH Human Insulin. When trials with different analogues were analysed separately, NPH showed a significant superiority (by 0.1%) over detemir, but not over glargine. When analysing the effect of long-acting analogues on body weight, detemir, but not glargine, was associated with a significantly smaller weight gain than Human Insulin Both analogues were associated with a reduced risk for nocturnal and symptomatic hypoglycaemia (OR: 0.46[0.38–0.55] and 0.69[0.60–0.80]; all p Conclusions Long-acting Insulin analogues in type 2 diabetic patients does not seem to provide a better glycemic control in comparison with NPH Insulin, whereas it reduces the risk of nocturnal and symptomatic hypoglycemia. Detemir, but not glargine, could be associated with smaller weight gain than NPH Insulin.
Thomas R. Pieber - One of the best experts on this subject based on the ideXlab platform.
-
short acting Insulin analogues versus regular Human Insulin in patients with diabetes mellitus
Cochrane Database of Systematic Reviews, 2006Co-Authors: Andrea Siebenhofer, Johannes Plank, Klaus Jeitler, Karl Horvath, Markus Narath, Robert Gfrerer, Andrea Berghold, Thomas R. PieberAbstract:Short acting Insulin analogue use for diabetic patients is still controversial, as reflected in many scientific debates. The objective of this review is to assess the effects of short acting Insulin analogues versus regular Human Insulin.