Long-acting insulin is safer

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MunichLong-acting insulins are the better alternative for patients with type 1 diabetes: Compared to substances with a medium-long duration of action, this drug achieves a more stable blood sugar control. This reduces the risk of dreaded complications from diabetes - including cardiovascular diseases, blindness, impotence and foot amputations.

To treat their type 1 diabetes, diabetics use long- or medium-acting insulins, which form the basis of blood sugar control. In addition, there are short-acting injections that cushion the blood sugar peaks after meals.

Canadian researchers led by Andrea Tricco from St. Michaels Hospital in Toronto evaluated 39 studies in a meta-analysis that examined the safety and effectiveness of the different basic preparations. They compared the effectiveness of slow-acting (delayed) insulins that you only take once a day with those that have a medium-long action time and are therefore administered twice a day.

More stable blood sugar

Compared to participants who injected medium-acting insulin, participants who used the delayed insulins had better HA1C values across all studies. These values show how well the blood sugar was controlled over a longer period of time.

In addition, the test subjects suffered significantly less life-threatening hypoglycaemia - compared to patients who used medium-acting insulins, their risk was 39 percent lower. Another benefit: Diabetics on long-acting insulin gained less weight.

Delayed-acting insulins have been on the market since the early 2000s. They work very evenly and their blood sugar lowering effect lasts for up to 26 hours.

Paralyzed insulin production

Type 1 diabetes is one of the so-called autoimmune diseases: the body's own defense substances (antibodies) destroy the insulin-producing cells of the pancreas. It is much rarer than type 2 diabetes, which is based on exhaustion of the pancreas and does not always have to be treated with insulin. (cf)

Source: Andrea C Tricco: Safety, effectiveness, and cost effectiveness of long acting versus intermediate acting insulin for patients with type 1 diabetes: systematic review and network meta-analysis, BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g5459 (Published 01 October 2014) Cite this as: BMJ 2014; 349: g545

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