From the News Wire: Lantus vs NPH: Safer not better control
Long-Acting Insulins in Type 1 Diabetes Safer Than Traditional Agents
For type 1 diabetes, long-acting insulins such as glargine (Lantus) reduce severe hypoglycemic episodes but don't offer clinically significant improved glycemic control, according to a meta-analysis.
Interestingly, the standard of using NPH as the control misses the fact that the Lente series (consisting of Semilente, Lente and Ultralente) was widely-regarded as superior in terms of phamcokinetics/pharmacodynamics (PK/PD), yet because it is more difficult to make, it was among the first range of older products to be removed from the market. However, a better review might compare Lantus/Levemir to Lente products (still sold in a number of other countries) to see if there is any difference in the incidence of hypoglycemia -- I would bet that analogues would not show much of statistical difference reducing severe hypoglycemic episodes if they compared it to Lente.
Interestingly, the standard of using NPH as the control misses the fact that the Lente series (consisting of Semilente, Lente and Ultralente) was widely-regarded as superior in terms of phamcokinetics/pharmacodynamics (PK/PD), yet because it is more difficult to make, it was among the first range of older products to be removed from the market. However, a better review might compare Lantus/Levemir to Lente products (still sold in a number of other countries) to see if there is any difference in the incidence of hypoglycemia -- I would bet that analogues would not show much of statistical difference reducing severe hypoglycemic episodes if they compared it to Lente.
ReplyDeleteSee http://www.hbns.org/getDocument.cfm?documentID=1741 for more.