Safety and Efficacy of Long-Acting Insulins Degludec and Glargine Among Asian Patients With Type 2 Diabetes Mellitus: A Meta-Analysis

Background Global variation in susceptibility to diabetes, insulin sensitivity, and regimen intensity poses a challenge for clinicians regarding the optimal choice of insulin therapy. The current study was carried out to see the relative safety and efficacy of currently available long-acting insulins among the type 2 diabetic Asian population. Methods A systematic literature search was done using various search engines (PubMed, Cochrane, Google Scholar, Scopus, and Embase) and included published randomized controlled trials (RCTs) in English before December 2019. Further, a manual search was performed by screening the reference list of the identified articles. Results We included four RCTs with 534 participants (349 in the insulin degludec group and 185 in the insulin glargine group) with type 2 diabetes mellitus (T2DM). Results show that both insulin glargine and degludec are equally efficacious in reducing fasting blood glucose (mean difference is -4.45, confidence interval -13.32- 4.43, I(2)=67%) and HbA1c (glycosylated hemoglobin) (mean difference is 0.12, confidence interval -0.12-0.35, I(2)=0%). However, insulin glargine was associated with lower risks of hypoglycemia (risk ratio = 0.9684, confidence interval- 0.8003- 1.1717, I(2)=30%). Conclusion Insulin glargine and degludec are comparable in achieving glycemic control with fewer hypoglycemic episodes in the insulin glargine-treated group.