{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:17:25Z","timestamp":1761743845595},"reference-count":45,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Braz. J. Pharm. Sci."],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:p>All patients with Diabetes Mellitus (DM) receive insulin therapy. In this study, we evaluated the efficacy, safety and tolerability of human insulin and insulin analogues. We performed a systematic review of the literature and a meta-analysis according to the Cochrane Collaboration methodology. In the absence of clinical studies comparing insulins, we performed a mixed treatment comparison to establish the differences between the active treatments. We included studies published from 1995 to 2010. HbA1c results, episodes of hypoglycemia and nocturnal hypoglycemia data were extracted and analyzed. Thirty-five randomized clinical trials were selected after examining the abstract and a full text review. These studies included 4,206 patients who received long-acting insulin analogues and 5,733 patients who received short-acting insulin analogues. Pooled data regarding efficacy indicated no significant differences in HbA1c values between glargine or detemir (once daily) and NPH insulin. However, a twice-daily dose of detemir produced differences in HbA1c values that favored detemir (-0.14% [95% CI: -0.21 to -0.08]; p&lt;0.0001; I\u00b2=0%). Direct and indirect comparisons are consistent and show that there were no significant differences between human insulin and insulin analogues in efficacy or safety. Our results indicate that long- and short-acting insulin analogues offer few clinical advantages over conventional human insulin.<\/jats:p>","DOI":"10.1590\/s1984-82502013000300011","type":"journal-article","created":{"date-parts":[[2013,11,2]],"date-time":"2013-11-02T10:12:16Z","timestamp":1383387136000},"page":"501-509","source":"Crossref","is-referenced-by-count":9,"title":["Insulin analogues versus human insulin in type 1 diabetes: direct and indirect meta-analyses of efficacy and safety"],"prefix":"10.1590","volume":"49","author":[{"given":"Andr\u00e9ia Cristina Conegero","family":"Sanches","sequence":"first","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}]},{"given":"Cassyano Janu\u00e1rio","family":"Correr","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}]},{"given":"Rafael","family":"Venson","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}]},{"given":"Patr\u00edcia Rodrigues","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}]},{"given":"Mariana Martins","family":"Garcia","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}]},{"given":"M\u00e1rio S\u00e9rgio","family":"Piantavini","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}]},{"given":"Roberto","family":"Pontarolo","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1,  Brazil"}]}],"member":"530","reference":[{"issue":"1","key":"ref1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0149-2918(97)80073-2","article-title":"Improved mealtime treatment of diabetes mellitus using an insulin analogue: Multicenter Insulin Lispro Study Group","volume":"19","author":"ANDERSON JR. J.H.","year":"1997","journal-title":"Clin. 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Metab."},{"issue":"5","key":"ref27","doi-asserted-by":"crossref","first-page":"625","DOI":"10.2337\/diacare.18.5.625","article-title":"Evaluation of a structured outpatient group education program for intensive insulin therapy","volume":"18","author":"PIEBER T.R.","year":"1995","journal-title":"Diabetes Care","ISSN":"http:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"issue":"7","key":"ref28","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1111\/j.1464-5491.2005.01545.x","article-title":"Comparison of three multiple injection regimens for type 1 diabetes: morning plus dinner or bedtime administration of insulin detemir vs. morning plus bedtime NPH insulin","volume":"22","author":"PIEBER T.R.","year":"2005","journal-title":"Diabetic Med","ISSN":"http:\/\/id.crossref.org\/issn\/0742-3071","issn-type":"print"},{"issue":"6","key":"ref29","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/j.1464-5491.2007.02113.x","article-title":"Comparison of insulin detemir and insulin glargine in subjects with Type 1 diabetes using intensive insulin therapy","volume":"24","author":"PIEBER T.R.","year":"2007","journal-title":"Diabetic Med","ISSN":"http:\/\/id.crossref.org\/issn\/0742-3071","issn-type":"print"},{"issue":"12","key":"ref30","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1001\/archinte.165.12.1337","article-title":"Systematic review and meta-analysis of short-acting insulin analogues in patients with diabetes mellitus","volume":"165","author":"PLANK J.","year":"2005","journal-title":"Arch. Intern. Med.","ISSN":"http:\/\/id.crossref.org\/issn\/0003-9926","issn-type":"print"},{"issue":"11","key":"ref31","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1111\/j.1464-5491.2004.01323.x","article-title":"Better long-term glycaemic control with the basal insulin glargine as compared with NPH in patients with type 1 diabetes mellitus given meal-time lispro insulin","volume":"21","author":"PORCELLATI F.","year":"2004","journal-title":"Diabetic Med","ISSN":"http:\/\/id.crossref.org\/issn\/0742-3071","issn-type":"print"},{"issue":"5","key":"ref32","doi-asserted-by":"crossref","first-page":"583","DOI":"10.2337\/diacare.23.5.583","article-title":"Use of insulin aspart, a fast-acting insulin analog, as the mealtime insulin in the management of patients with type 1 diabetes","volume":"23","author":"RASKIN P.","year":"2000","journal-title":"Diabetes Care","ISSN":"http:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"issue":"11","key":"ref33","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.2337\/diacare.23.11.1666","article-title":"A 16-week comparison of the novel insulin analog insulin glargine (HOE 901) and NPH human insulin used with insulin lispro in patients with type 1 diabetes","volume":"23","author":"RASKIN P.","year":"2000","journal-title":"Diabetes Care","ISSN":"http:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"issue":"5","key":"ref34","doi-asserted-by":"crossref","first-page":"639","DOI":"10.2337\/diacare.23.5.639","article-title":"Less hypoglycemia with insulin glargine in intensive insulin therapy for type 1 diabetes","volume":"23","author":"RATNER R.E.","year":"2000","journal-title":"Diabetes Care","ISSN":"http:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"issue":"4","key":"ref35","doi-asserted-by":"crossref","first-page":"950","DOI":"10.2337\/diacare.28.4.950","article-title":"Reduced hypoglycemia risk with insulin glargine: a meta-analysis comparing insulin glargine with human NPH insulin in type 2 diabetes","volume":"28","author":"ROSENSTOCK J.","year":"2005","journal-title":"Diabetes Care","ISSN":"http:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"issue":"8","key":"ref36","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.2337\/diacare.23.8.1137","article-title":"Basal insulin glargine (HOE 901) versus NPH insulin in patients with type 1 diabetes on multiple daily insulin regimens","volume":"23","author":"ROSENSTOCK J.","year":"2000","journal-title":"Diabetes Care","ISSN":"http:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"issue":"5","key":"ref37","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/S0149-2918(04)90072-0","article-title":"Effects of QD insulin detemir or neutral protamine hagedorn on blood glucose control in patients with type I diabetes mellitus using a basal-bolus regimen","volume":"26","author":"RUSSELL-JONES D.","year":"2004","journal-title":"Clin. Ther."},{"issue":"2","key":"ref38","article-title":"Short acting insulin analogues versus regular human insulin in patients with diabetes mellitus","author":"SIEBENHOFER A.","year":"2004","journal-title":"Cochrane Database Syst. Rev."},{"issue":"11","key":"ref39","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1007\/s00125-004-1545-x","article-title":"Meta-analysis of short-acting insulin analogues in adult patients with type 1 diabetes: continuous subcutaneous insulin infusion versus injection therapy","volume":"47","author":"SIEBENHOFER A.","year":"2004","journal-title":"Diabetologia","ISSN":"http:\/\/id.crossref.org\/issn\/0012-186X","issn-type":"print"},{"issue":"4","key":"ref40","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1503\/cmaj.081041","article-title":"Efficacy and safety of insulin analogues for the manegement of diabetes mellitus: a meta-analysis","volume":"180","author":"SINGH S.R.","year":"2009","journal-title":"Can. Med. Assoc. J."},{"issue":"2","key":"ref41","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0168-8227(01)00262-5","article-title":"Glycaemic control in type 1 diabetic patients using optimised insulin aspart or human insulin in a randomised multinational study","volume":"54","author":"TAMAS G.","year":"2001","journal-title":"Diabetes Res. Clin. Pr."},{"issue":"9139","key":"ref42","first-page":"837","article-title":"UK prospective diabetes study (UKPDS) group: Intensive blood-glucose control with sulphonylureas and insulin compared with conventional treatment and risk complications in patients with type 2 diabetes (UKDPS33)","volume":"352","year":"1998","journal-title":"Lancet","ISSN":"http:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"issue":"3","key":"ref43","doi-asserted-by":"crossref","first-page":"590","DOI":"10.2337\/diacare.26.3.590","article-title":"Insulin detemir is associated with more predictable glycemic control and reduced risk of hypoglycemia than NPH insulin in patients with type 1 diabetes on a basal-bolus regimen with premeal insulin aspart","volume":"26","author":"VAGUE P.","year":"2003","journal-title":"Diabetes Care","ISSN":"http:\/\/id.crossref.org\/issn\/0149-5992","issn-type":"print"},{"issue":"45","key":"ref44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta8450","article-title":"Systematic review and economic evaluation of a long-acting insulin analogue, insulin glargine","volume":"8","author":"WARREN E.","year":"2004","journal-title":"Health Technol. Assess."},{"key":"ref45","series-title":"Indirect evidence: indirect treatment comparisons in meta-analysis","author":"WELLS G.A.S.S.A.","year":"2009"}],"container-title":["Brazilian Journal of Pharmaceutical Sciences"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/bjps\/v49n3\/v49n3a11.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T12:41:51Z","timestamp":1495888911000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1984-82502013000300011&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["S1984-82502013000300011"],"URL":"https:\/\/doi.org\/10.1590\/s1984-82502013000300011","relation":{},"ISSN":["1984-8250"],"issn-type":[{"value":"1984-8250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9]]}}}