(Ultra‐)short‐acting insulin analogues for adults with type 1 diabetes mellitus on multiple daily injections: a network meta‐analysis

This Cochrane meta-analysis compared the effects of short- and ultra-short-acting insulin analogues with regular human insulin in adults with type 1 diabetes mellitus on multiple daily injections. The analysis included 15 randomized controlled trials with 6335 participants who had a mean HbA1c of 8.1% and mean age of 36.4 years. All tested insulin analogues (aspart, lispro, glulisine, ultra-rapid lispro, and fast-acting insulin aspart) showed little to no difference in glycemic control compared to regular human insulin. Some analogues, particularly ultra-rapid lispro, may have led to reduced severe hypoglycemia. However, the evidence was overall of low to very low certainty. The study found that 13 of 15 trials were funded by the pharmaceutical industry.