Review: long-acting insulin analogues reduce risk for hypoglycemia compared with NPH insulin in type 2 diabetes.

M e t h o d s Data sources: Cochrane Library, MEDLINE, EMBASE/Excerpta Medica, DARE, NHSEED, and HTA (to December 2006); online registries of clinical trials; Web sites of the European Medicines Agency and the U.S. Food and Drug Administration; reference lists; and pharmaceutical companies. Study selection and assessment: Randomized controlled trials (RCTs) ≥ 24 weeks in duration that compared long-acting insulin analogues (insulin glargine or insulin detemir) with NPH insulin, given subcutaneously, in adults with type 2 diabetes. In the case of combination therapy, the additional antihyperglycemic agent had to be used in both treatment groups. 9 RCTs (n = 4193, mean age range 55 to 62 y, 40% to 64% men) with a median duration of 26 weeks (range 24 to 52 wk) met the selection criteria. Outcomes: Incidence of overall, symptomatic, severe, and nocturnal hypoglycemia; and glycemic control (measured by hemoglobin A1c [HbA1c] level).