EFFICACY AND SAFETY OF INSULIN DEGLUDEC VERSUS INSULIN GLARGINE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF TWENTY CLINICAL TRIALS

Introduction: This study aimed to compare the efficacy and safety of insulin degludec with insulin glargine in patients with type 1 and type 2 diabetes. Methods: We systematically searched PubMed, Embase, Web of Science, and Cochrane Library databases for randomized controlled trials published prior to July 2019 (no language restrictions) which compared insulin degludec with insulin glargine. Our main endpoints were glycemic control, and hypoglycemic events. We assessed pooled data using random-effects models. Results: A total of 20 studies that included 22706 patients, 11929 in the insulin degludec arm of the studies and 10777 patients in the insulin glargine arm were identified and subsequently assessed. Our analysis showed that compared with insulin glargine, insulin degludec yielded an improved mean reduction in fasting plasma glucose (FPG) (MD – 6.747, 95% CI – (1.702 to 11.79), p = 0.013), improved mean reduction in glycosylated hemoglobin (HbA1c) (MD 0.095, 95% CI –(-0.155 to -0.035), p = 0.867) and a lower ratio of participants experiencing the severe hypoglycemic event and nocturnal hypoglycemia (95% CI – 1.67 to 0.37, p = 0.004).Results showed insulin degludec to produce a statistically significant decrease in FPG level. Conclusions: Insulin degludec and insulin glargine provide more or less similar glycemic control, but the risk of hypoglycemia with insulin degludec is lower than with Insulin glargine. Insulin degludec may be an alternative treatment for managing patients with diabetes who are prone to hypoglycemia with insulin glargine.