甘精胰岛素对比地特胰岛素治疗中国2型糖尿病的系统评价

Systematic review on efficacy comparison between insulin Glargine and insulin Detemir treatment in Chinese patients with type 2 diabetes

目的系统评价甘精胰岛素和地特胰岛素治疗中国T2DM疗效的差异。方法检索CNKI、CBM、VIP和万方数据库,收集甘精胰岛素对比地特胰岛素治疗T2DM的随机对照研究,检索年限均为2000年1月至2015年7月,对纳入研究进行文献质量评价。采用Rev Man 5.2统计软件对同质性结果进行合并分析。结果共纳入14项研究,946例患者。Meta分析结果显示,甘精胰岛素和地特胰岛素HbA_1c、FPG和低血糖发生率比较,差异均无统计学意义;体重增加比较,差异有统计学意义。结论甘精胰岛素和地特胰岛素在控制血糖和低血糖发生率方面相似,但地特胰岛素减少患者体重增加有一定优势。

Objective To systematically evaluate the differences of clinical efficacy between insulin Glargine and insulin Detemir treatment in Chinese patients with type 2 diabetes（T2DM）.Methods Retrieved from CNKI,CBM,VIP and Wanfang database online version,RCTs about comparing clinical efficacy between insulin glargine and insulin detemir T2 DM treatment from the time of setting database to May 2015.Meta-analysis was performed using Rev Man 5.2 software.Results A total of 14 studies were included,and 946 T2 DM patients were involved.Meta-analysis showed that there was no statistically significant differences between insulin Glargine and insulin Detemir in the levels of HbA_1c[MD=0.07,95%CI（-0.02~0.17）,P〉0.05]and FPG[MD=-0.11,95%CI（-0.25~0.03）,P〉0.05]and the incidences of hypoglycemia[RR=0.67,95%CI（0.44~1.03）,P〉0.05].There was significant differences in weight gain[MD=-0.84,95%CI（-0.97^-0.70）,P〈0.01].Conclusion Insulin Glargine and insulin Detemir have similar efficacy in glycemic control and hypoglycemia incidence in T2 DM patients.Insulin detemir may achieve extra benefit in reducing weight gain.