■糖尿病影响着全球数百万人,尽管有治疗选择,坚持和其他因素构成障碍。每周一次的胰岛素Icodec,一种具有一周半衰期的新型基础胰岛素类似物,提供潜在的好处,增强便利性,坚持,和生活质量改善血糖控制。这项系统评价和荟萃分析旨在评估每周一次的胰岛素Icodec与每天一次的甘精胰岛素U-100在II型糖尿病(T2D)患者中的疗效和安全性。
方法:使用PubMed进行了全面的文献检索,和2023年9月之前的CochraneLibrary数据库,以根据PRISMA指南确定无语言限制的相关随机对照试验(RCT)。Cochrane偏差风险工具用于质量评估。所有统计分析均使用RevMan(版本5.4;哥本哈根:北欧科克伦中心,科克伦合作,2014).
结果:包括2020年至2023年发布的四个RCT,累积样本量为1035。合并平均差(MD)显示,与甘精胰岛素U-100相比,胰岛素Icodec的TIR(%)延长了4.68%[{95%CI(0.69,8.68),p=0.02}],发现两组间HbA1c(%)和FPG(mg%)的估计平均变化不显著[MD=-0.12{95%CI(-0.26,0.01),p=0.07}]和[MD=-2.59{95%CI(-6.95,1.78),p=0.25}],分别。两种治疗方案1.04之间低血糖的总OR也无统计学意义[{95%CI(0.71,1.52),p=0.84}]。两组之间的其他安全性参数相似。
结论:从每日甘精胰岛素U-100转换为每周胰岛素Icodec显示更长的TIR(%)以及相似的血糖控制和安全性。因此,这可能是管理长期T2D的一个很好的替代选择。
UNASSIGNED: Diabetes affects millions of people globally, despite treatment options, adherence and other factors pose obstacles. Once-weekly Insulin Icodec, a novel basal Insulin analog with a week-long half-life, offers potential benefits, enhancing convenience, adherence, and quality of life for improved glycemic control. This systematic
review and meta-analysis aimed to assess the efficacy and safety of once-weekly Insulin Icodec compared to once-daily Insulin Glargine U-100 in individuals with type II diabetes (T2D).
METHODS: A comprehensive literature search was conducted using PubMed, and Cochrane Library databases before September 2023 to identify relevant Randomized control trials (RCTs) with no language restrictions following PRISMA guidelines. The Cochrane risk-of-bias tool was used for quality assessment. All statistical analyses were conducted using RevMan (version 5.4; Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014).
RESULTS: Four RCTs published from 2020 to 2023 with a cumulative sample size of 1035 were included. The pooled mean difference (MD) revealed a 4.68% longer TIR (%) with Insulin Icodec compared to Insulin Glargine U-100 [{95% CI (0.69, 8.68), p = 0.02}], the estimated mean changes in HbA1c (%) and FPG (mg%) were found to be insignificant between the two groups [MD = - 0.12 {95% CI (- 0.26, 0.01), p = 0.07}] and [MD = - 2.59 {95% CI (- 6.95, 1.78), p = 0.25}], respectively. The overall OR for hypoglycemia was also nonsignificant between the two regimens 1.04 [{95% CI (0.71, 1.52), p = 0.84}]. Other safety parameters were similar between the two groups.
CONCLUSIONS: Switching from daily Insulin Glargine U-100 to weekly Insulin Icodec showed longer TIR (%) as well as similar blood glycemic control and safety profile. Hence, it may be a good alternate option for management of longstanding T2D.