Short-acting insulin analogues versus regular human insulin for adults with type 1 diabetes mellitus

Abstract

Our analysis suggests only a minor benefit of short-acting insulin analogues on blood glucose control in people with type 1 diabetes. To make conclusions about the effect of short acting insulin analogues on long-term patient-relevant outcomes, long-term efficacy and safety data are needed.

Por que as pessoas recorrem ao Judiciário para obter o acesso aos medicamentos? O caso das insulinas análogas na Bahia

“…Even in the face of a lack of scientific evidence concerning the superiority of the insulin analogues over human insulin 9,10 , the doctors prescribed them including for patients who were not in a good financial position to purchase them outright. In the prescriptions or doctors' reports that would reinforce the lawsuits, they alleged the necessity of the patient in using the insulin analogues even though there was no proof to justify their choice.…”

“…Firstly, the position of the doctors goes against what the clinical studies 9,10 have shown which indicates that insulin analogues do not present any relevant advantages over human insulin. Secondly, the SUS managers have differing positions.…”

“…Also, the Cochrane Collaboration reviews did not provide results that indicate that insulin analogues present relevant advantages in comparison with human insulin. They showed that the scientific debate on the use of insulin analogues in relation to human insulin, is still controversial 9,10 . Even with the lack of evidence on the therapeutic advantages of the insulin analogues in relation to human insulin and despite the fact they are not included in Rename, doctors continue prescribing them to their patients and they have been appealing to the courts so that the state provides these medications.…”

Update on newer antidiabetic drugs in clinical practice

“…Education regarding matching prandial insulin doses to carbohydrate intake, pre-meal glucose levels, and anticipated activity should be considered when planning insulin regimens for those with type 1 diabetes mellitus. The glycaemic control achieved is comparable between regular (soluble) insulin and the newer rapid acting analogues [3,26] and between NPH insulin and the newer long acting analogues [11,12].…”

“…The recommendation that most individuals with type 1 diabetes mellitus should use rapid-acting insulin analogs to reduce hypoglycemia risk [22], should be weighed against the cost and the lack of a significant difference in terms of glycaemic control [3,26] when compared with regular (soluble) insulin, which is cheaper.…”