Efficacy and safety comparison of rapid-acting insulin aspart and regular human insulin in the treatment of type 1 and type 2 diabetes mellitus: a systematic review.


BACKGROUND:Insulin aspart (IAsp) is one of the three rapid-acting insulin analogues (RAAs) registered for the treatment of diabetes. However, there is an ongoing debate concerning the efficacy and safety of RAAs. For this reason, a systematic review-based study was performed to compare clinical outcomes of treatment with IAsp and regular human insulin (RHI) as well as biphasic insulin aspart and premixed human insulin in type 1 and type 2 diabetes (T1DM, T2DM) patients. METHODS:Relevant articles were identified by a systematic search through the electronic medical databases (MEDLINE, EMBASE, CENTRAL) up to July 2009. RESULTS:A total of 28 trials fulfilled the inclusion criteria, including 17 studies of T1DM, 10 of T2DM and one study of both. For T1DM, pooled data for HbA(1c) (13 studies) demonstrated lower levels with IAsp than with RHI (WMD=-0.11%; 95% CI: -0.16 to -0.06). In addition, meta-analysis revealed statistically significant differences in favour of IAsp for postprandial glucose (PPG) after breakfast, lunch and dinner, but not for fasting glucose (FG). The Diabetes Treatment Satisfaction Questionnaire evaluating treatment flexibility showed IAsp benefits compared with RHI (WMD=0.31; 95% CI: 0.15 to 0.47). Safety analyses (three studies) showed a significant reduction in nocturnal hypoglycaemia risk with IAsp (RR=0.67; 95% CI: 0.54 to 0.83), and no difference in severe hypoglycaemias and a slight increase in any hypoglycaemic episodes with RAAs (RR=1.06; 95% CI: 1.01 to 1.10). For T2DM, a meta-analysis of nine studies revealed no significant differences between IAsp and RHI in HbA(1c) (WMD=-0.04%; 95% CI: -0.10 to 0.03), whereas PPG was significantly lower in the IAsp group (WMD=-1.18 mmol/L; 95% CI: -1.88 to -0.47). No studies of treatment satisfaction or quality of life were identified. CONCLUSION:Analyses based on a systematic review showed that treatment with IAsp in T1DM patients resulted in moderately better metabolic control and treatment satisfaction than RHI. In T2DM patients, meta-analysis showed improvement in PPG, but not in any other outcomes.


Diabetes Metab


Diabetes & metabolism


Rys P,Pankiewicz O,Łach K,Kwaskowski A,Skrzekowska-Baran I,Malecki MT




Has Abstract


2011-06-01 00:00:00














  • Epidemiological data on postprandial glycaemia.

    abstract::There are few studies on the effects of postprandial hyperglycaemia, and usually it is assumed that its effects are the same as those of post-glucose-load hyperglycaemia, following a standard 75 g oral glucose tolerance test. There is some evidence from a study with blood drawn following ingestion of a standardised "d...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Balkau B,Eschwège E

    更新日期:2006-09-01 00:00:00

  • Practical implementation of automated closed-loop insulin delivery: A French position statement.

    abstract::Automated closed-loop (CL) insulin therapy has come of age. This major technological advance is expected to significantly improve the quality of care for adults, adolescents and children with type 1 diabetes. To improve access to this innovation for both patients and healthcare professionals (HCPs), and to promote adh...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Tubiana-Rufi N,Schaepelynck P,Franc S,Chaillous L,Joubert M,Renard E,Reznik Y,Abettan C,Bismuth E,Beltrand J,Bonnemaison E,Borot S,Charpentier G,Delemer B,Desserprix A,Durain D,Farret A,Filhol N,Guerci B,Guilhem I,

    更新日期:2020-11-02 00:00:00

  • IL-33 receptor ST2 deficiency attenuates renal ischaemia-reperfusion injury in euglycaemic, but not streptozotocin-induced hyperglycaemic mice.

    abstract:AIM:Kidney hypoxia can predispose to the development of acute and chronic renal failure in diabetes. Ischaemia-reperfusion injury (IRI) causes inflammation, and diabetes is known to exacerbate this inflammatory response in the kidney, whereas alarmin IL-33 could act as an innate immune mediator during kidney IRI. Thus,...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Sehnine M,Ferhat M,Sena S,Gombert JM,Goujon JM,Thierry A,Touchard G,Hauet T,Herbelin A,Hadjadj S

    更新日期:2018-02-01 00:00:00

  • Effectiveness of patient education on glycemic control in insulin treated patients in general practice.

    abstract:OBJECTIVE:To assess the effectiveness of a patient education program on diabetes control. METHODS:A pre-test post-test pre experimental study was performed with 87 insulin treated diabetic patients followed in the chronic disease unit of Kelibia district (Nabeul, Tunisia). Subjects received education in 6 monthly sess...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Jenhani M,Gaha K,Nabouli R,Ghedira A,Ben Abdelaziz A

    更新日期:2005-09-01 00:00:00

  • Role of metalloproteases and inhibitors in the occurrence and progression of diabetic renal lesions.

    abstract::Renal remodelling in hyperinsulinic/insulinopenic states is mediated by glucotoxicity, endothelial dysfunction and vascular and nephron collagen turnover. Hypertensive and renal links are renewed by renoprotective interventions of renin-angiotensin. Vasoactive peptide processing and vascular collagen deposition are un...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Zaoui P,Cantin JF,Alimardani-Bessette M,Monier F,Halimi S,Morel F,Cordonnier D

    更新日期:2000-07-01 00:00:00

  • OPHDIAT: a telemedical network screening system for diabetic retinopathy in the Ile-de-France.

    abstract:OBJECTIVE:International and national guidelines recommend an annual funduscopic examination for all diabetic patients, but such annual fundus examinations are not sufficiently performed in France. Non-mydriatic fundus photography is a valid method of evaluation for diabetic retinopathy (DR) and a viable alternative to ...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Massin P,Chabouis A,Erginay A,Viens-Bitker C,Lecleire-Collet A,Meas T,Guillausseau PJ,Choupot G,André B,Denormandie P

    更新日期:2008-06-01 00:00:00

  • Methods for the screening and diagnosis of gestational diabetes mellitus between 24 and 28 weeks of pregnancy.

    abstract::The aim of this review is to provide answers to the question “How does one screen for and diagnose gestational diabetes mellitus (GDM) between 24 and 28 weeks gestation?” Two methods are currently widely used: a one-step approach (the 75g-Oral Glucose Tolerance Test, OGTT) and a two-step approach (the 50g Glucose Chal...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Virally M,Laloi-Michelin M

    更新日期:2010-12-01 00:00:00

  • Role of fatty liver in the association between obesity and reduced hepatic insulin clearance.

    abstract:AIM:Hepatic insulin clearance (HIC) is important in regulating plasma insulin levels. Diminished HIC causes inappropriate hyperinsulinaemia, and both obesity and fatty liver (FL), which are known to decrease HIC, can be found either together in the same patient or on their own. The mechanism by which obesity reduces HI...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Matsubayashi Y,Yoshida A,Suganami H,Ishiguro H,Yamamoto M,Fujihara K,Kodama S,Tanaka S,Kaku K,Sone H

    更新日期:2018-03-01 00:00:00

  • Interest of pronostic score for optimal clinical management of obese patients.

    abstract:OBJECTIVE:The aim of this retrospective study was to identify key factors favoring weight regain. METHODS:Therefore, prognostic factors for weight loss and regain have been retrieved and identified among 186 obese patients (40 +/- 2 y and 34 +/- 0.3 kg/m(2)) through the use of a simple questionnaire which considered p...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Ybarra J,de Stefano M,Kammer A,de Tonnac N,Lehmann T,Golay A

    更新日期:2003-09-01 00:00:00

  • Early-stage atherosclerosis in newly diagnosed, untreated type 2 diabetes mellitus and impaired glucose tolerance.

    abstract:AIM:The aim of this study was to investigate early-stage atherosclerosis in newly diagnosed, untreated type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT). METHODS:The study subjects underwent an oral glucose tolerance test (OGTT) and were then divided into three groups, according to plasma glucose le...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Gong W,Lu B,Yang Z,Ye W,Du Y,Wang M,Li Q,Zhang W,Pan Y,Feng X,Zhou W,Zhang Y,Yang Z,Yang Y,Zhu X,Hu R

    更新日期:2009-12-01 00:00:00

  • Cystatin C improves the diagnosis and stratification of chronic kidney disease, and the estimation of glomerular filtration rate in diabetes.

    abstract:AIMS:Estimation of glomerular filtration rate (GFR) is recommended to diagnose and stratify chronic kidney disease (CKD). Can cystatin-C (cysC) assay improve the results in diabetic patients? METHODS:In 124 diabetic patients with a wide range of GFR, as determined by 51Cr-EDTA clearance (i-GFR), we estimated 'e-GFR' b...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Rigalleau V,Beauvieux MC,Le Moigne F,Lasseur C,Chauveau P,Raffaitin C,Perlemoine C,Barthe N,Combe C,Gin H

    更新日期:2008-11-01 00:00:00

  • The association of type 2 diabetes and insulin resistance/secretion with persistent organic pollutants in two First Nations communities in northern Ontario.

    abstract:AIMS:Recent evidence suggests an association between persistent organic pollutants (POPs) and type 2 diabetes. In two First Nations communities where wild food is consumed by a large portion of the population, we compared pollutants in plasma between diabetic and non-diabetic individuals, and investigated the strength ...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Pal S,Blais JM,Robidoux MA,Haman F,Krümmel E,Seabert TA,Imbeault P

    更新日期:2013-12-01 00:00:00

  • Competing risk analysis on visit-to-visit glucose variations and risk of depression: The Taiwan Diabetes Study.

    abstract:AIM:Patients with diabetes have higher rates of depression than does the general population, but diabetes management mainly aims to maintain glucose stability. For this reason, our study assessed the relationship between 1-year variations in fasting plasma glucose (FPG) and risk of depression in Chinese patients with t...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Li CI,Liu CS,Lin CH,Lin WY,Lee YD,Yang SY,Li TC,Lin CC

    更新日期:2020-06-01 00:00:00

  • Association between metabolically unhealthy overweight/obesity and chronic kidney disease: the role of inflammation.

    abstract:AIM:Our study explored the association between subtypes of increased fat mass (with or without associated metabolic alterations) and the presence of chronic kidney disease (CKD). METHODS:In this cross-sectional survey in China, body mass index (BMI) was used to assess fat mass. Metabolically healthy was defined as no ...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Chen S,Zhou S,Wu B,Zhao Y,Liu X,Liang Y,Shao X,Holthöfer H,Zou H

    更新日期:2014-12-01 00:00:00

  • Improving diabetes management with electronic medical records.

    abstract::Most primary-care physicians have adopted electronic medical records (EMRs) for the management of patients in ambulatory care. Observational trials suggest that the use of EMRs improves the achievement of the recommended standards of diabetes care and intermediate outcomes. A French group of general practitioners has ...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Varroud-Vial M

    更新日期:2011-12-01 00:00:00

  • Factors associated with screening for glucose abnormalities after gestational diabetes mellitus: baseline cohort of the interventional IMPACT study.

    abstract:INTRODUCTION:Although it is important to screen women who have had gestational diabetes mellitus (GDM) for abnormal post-partum glucose levels, such testing is rarely performed. The aim of this study was to use data from the first observational phase of the IMPACT study to determine rates of screening within 6 months o...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,多中心研究


    authors: Bihan H,Cosson E,Khiter C,Vittaz L,Faghfouri F,Leboeuf D,Carbillon L,Dauphin H,Reach G,Valensi P

    更新日期:2014-04-01 00:00:00

  • Initiating oral glucose-lowering therapy with metformin in type 2 diabetic patients: an evidence-based strategy to reduce the burden of late-developing diabetes complications.

    abstract::A major aim of glucose-lowering therapy in people with diabetes is to delay or prevent the late-developing complications of diabetes that threaten the quality and duration of life. While intensive interventions to control hyperglycaemia may impair well-being to some extent, the balance of quality of life is usually hi...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Consoli A,Gomis R,Halimi S,Home PD,Mehnert H,Strojek K,Van Gaal LF

    更新日期:2004-12-01 00:00:00

  • Review and case report of idiopathic lower extremity compartment syndrome and its treatment in diabetic patients.

    abstract::Diabetic muscle infarction is a rare complication of diabetes mellitus. However, idiopathic compartment syndrome in the diabetic patient is even a rarer disease, which has been reported only in three cases up to date. The disease seems to occur in patients affected by type 1 diabetes mellitus with a history of poorly ...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Pamoukian VN,Rubino F,Iraci JC

    更新日期:2000-12-01 00:00:00

  • How can we measure insulin sensitivity/resistance?

    abstract::Insulin resistance represents a major public health problem, as it plays a major role in the pathophysiology of type 2 diabetes mellitus; it is also associated with increased cardiovascular risk and atherogenic dyslipidaemia, and is a central component of the cluster of metabolic abnormalities that comprise the metabo...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Antuna-Puente B,Disse E,Rabasa-Lhoret R,Laville M,Capeau J,Bastard JP

    更新日期:2011-06-01 00:00:00

  • Renal involvement is related to body height in newly diagnosed diabetic women aged 40 years or over.

    abstract::We scrutinized the relation between body height and renal involvement in a large population-based sample of newly diagnosed diabetic patients aged 40 years or over. The urinary albumin concentration (UAC) was measured in freshly voided morning urine in 1,284 newly diagnosed diabetic patients. The course of insulin tre...

    journal_title:Diabetes & metabolism

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Olivarius Nde F,Vestbo E,Andreasen AH,Mogensen CE

    更新日期:2001-02-01 00:00:00

  • Skeletal muscle magnesium content in identical twins, discordant for type 2 diabetes.

    abstract:BACKGROUND:Low magnesium (Mg) status has been implied as a factor in the development of type 2 diabetes mellitus (DM) and its complications. We therefore studied Mg-status in identical twins, discordant for type 2 DM and in matched controls. Through correlation analysis, possible associations between Mg-status and gluc...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Djurhuus MS,Vaag A,Altura BM,Altura BT,Klitgaard NA

    更新日期:2002-06-01 00:00:00

  • Associations between specific plasma ceramides and severity of coronary-artery stenosis assessed by coronary angiography.

    abstract:AIM:Recent prospective studies have identified distinct plasma ceramides as strong predictors of major adverse cardiovascular events in patients with established or suspected coronary artery disease (CAD). Currently, it is uncertain whether higher levels of distinct plasma ceramides are associated with greater angiogra...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Mantovani A,Bonapace S,Lunardi G,Canali G,Dugo C,Vinco G,Calabria S,Barbieri E,Laaksonen R,Bonnet F,Byrne CD,Targher G

    更新日期:2020-04-01 00:00:00

  • Insulin-dependent diabetes and human leucocyte antigens.

    abstract::The association of diabetes with HLA class I alleles in the early 1970s and with HLA class II alleles in the late 1970s provided a crucial, though indirect, indication of the role of immune phenomena in the development of insulin-dependent diabetes mellitus (IDDM). Genotyping of HLA alleles in the mid-1980s opened up ...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Boitard C,Caillat-Zucman S,Timsit J

    更新日期:1997-03-01 00:00:00

  • Bone density and markers of bone remodeling in type 1 male diabetic patients.

    abstract:AIMS:To assess the prevalence and severity of bone disease in type 1 diabetic patients and to determine serum markers of bone remodeling as well as their relationship with bone mineral density (BMD). METHODS:BMD [by dual energy x-ray absorptiometry (DXA)] and serum markers of bone remodeling [osteocalcin, c-terminal t...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Alexopoulou O,Jamart J,Devogelaer JP,Brichard S,de Nayer P,Buysschaert M

    更新日期:2006-11-01 00:00:00

  • [Contribution of arterial hypertension to vascular risk in diabetic patients].

    abstract::Hypertension is a major cardiovascular risk factor in diabetic subjects. Recent trials have suggested that blood pressure objectives should be < or = 140/80 mmHg. However, there is currently no evidence supporting any particular preferential drug strategy for this treatment objective. ...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Marre M,Bouhanick B,Hadjadj S,Weekers L

    更新日期:1999-06-01 00:00:00

  • Early referral to a nephrologist is associated with better outcomes in type 2 diabetes patients with end-stage renal disease.

    abstract:OBJECTIVE:End-stage renal disease (ESRD) requiring renal replacement therapy (RRT) is a late complication of type 2 diabetes. The correlation between pre-ESRD medical care and outcome has been rarely studied in France. METHODS:Community-based study of case-incIdent ESRD patients. Medical care practices were described ...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Frimat L,Loos-Ayav C,Panescu V,Cordebar N,Briançon S,Kessler M

    更新日期:2004-02-01 00:00:00

  • Hypoglycaemic episodes in patients with type 2 diabetes--risk factors and associations with patient-reported outcomes: The PANORAMA Study.

    abstract:AIM:To explore the frequency of hypoglycaemic episodes, their risk factors, and associations with patient-reported outcomes in patients with type 2 diabetes enrolled in the PANORAMA cross-sectional study. METHODS:Five thousand seven hundred and eighty-three patients aged ≥ 40 years with type 2 diabetes duration ≥ 1 ye...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Simon D,de Pablos-Velasco P,Parhofer KG,Gönder-Frederick L,Duprat Lomon I,Vandenberghe H,Eschwège E,Bradley C

    更新日期:2015-12-01 00:00:00

  • Type 2 diabetes treatment intensification in general practice in France in 2008-2009: the DIAttitude Study.

    abstract:AIMS:To evaluate the current procedures in French general practice of intensifying hypoglycaemic treatment in orally treated type 2 diabetic patients, according to the French recommendations. METHODS:Type 2 diabetic patient characteristics, HbA(1c) values, hypoglycaemic treatment and physician characteristics were col...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Balkau B,Bouée S,Avignon A,Vergès B,Chartier I,Amelineau E,Halimi S

    更新日期:2012-03-01 00:00:00

  • Correspondence between first-trimester fasting glycaemia, and oral glucose tolerance test in gestational diabetes diagnosis.

    abstract:AIM:To evaluate the correspondence between first-trimester fasting glycaemia and the results of the OGTT in diagnosing gestational diabetes (GDM). METHODS:The medical records of all consecutive women who had undergone a diagnostic OGTT, performed according to the IADPSG, during the past year were retrospectively revie...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章


    authors: Corrado F,D'Anna R,Cannata ML,Interdonato ML,Pintaudi B,Di Benedetto A

    更新日期:2012-11-01 00:00:00

  • Effects of glucose-lowering agents on vascular outcomes in type 2 diabetes: a critical reappraisal.

    abstract::Type 2 diabetes mellitus (T2DM) is strongly associated with cardiovascular complications, especially coronary artery disease. Numerous epidemiological studies have shown a close relationship between major cardiovascular events and glycaemia, and several pathophysiological mechanisms have been described that explain ho...

    journal_title:Diabetes & metabolism

    pub_type: 杂志文章,评审


    authors: Scheen AJ,Charbonnel B

    更新日期:2014-06-01 00:00:00