Analogue or human insulins OK for type 2 diabetes

NEW YORK (Reuters Health) - People with type 2 diabetes who need insulin to control their blood glucose levels can choose either human insulin or a structurally similar synthetic version to do the job, a study shows.

"There is no difference between premixed human insulin and premixed insulin analogues," Dr. Rehan Qayyum from Johns Hopkins Hospital, Baltimore, told Reuters Health.

Qayyum and colleagues reviewed clinical studies of the effectiveness and safety of premixed insulin analogues compared with other anti-diabetes agents in adults with type 2 diabetes.

Premixed insulin analogues provided tighter glucose control than long-acting insulin and non-insulin agents, according to the investigators' report in the Annals of Internal Medicine. Premixed insulin analogues were comparable to premixed human insulin in lowering A1C levels, an indicator of relatively long-term glucose control.

The occurrence of episodes of too-low glucose levels, i.e., hypoglycemia, was similar with premixed insulin analogues and with premixed human insulin.

"I have found in my previous comparative research that the benefits of new treatments and interventions are often exaggerated by industry and academia (unfortunately)," Qayyum added.

"Studies with longer follow-up are needed to determine whether the effects observed early in treatment are sustainable long-term," the team concludes.

SOURCE: Annals of Internal Medicine, online September 15, 2008.