Summary

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• This summary is based on the review of six systematic review(s)/meta-analysis(es). ^[1-6]
• Insulin degludec demonstrated comparable effectiveness in reducing hemoglobin A1C (HbA1C) levels across both type 1 and type 2 diabetes populations, with no significant differences noted among various long-acting insulin regimens, including insulin glargine, insulin detemir, and Neutral Protamine Hagedorn (NPH).
• Insulin degludec showed a greater reduction in fasting plasma glucose (FPG) compared to insulin glargine (mean difference of 10.27 mg/dL) and other long-acting insulin analogues, indicating an advantage in glycemic control.
• In a subgroup analysis, insulin degludec/aspart may have specific effects on hypoglycemia outcomes in patients with a diabetes duration of 11 years or less, suggesting a need for tailored treatment approaches in this group.
• Insulin degludec was associated with significantly lower odds of overall, nocturnal, and severe hypoglycemic events compared to NPH and insulin lispro protamine (ILPS), with moderate to high certainty evidence. No significant difference in hypoglycemic events was observed between insulin degludec and insulin glargine (very low-certainty evidence).
• Insulin glargine, 300 U/mL, was linked to less weight gain compared to insulin degludec and other basal insulins, with a mean difference ranging from 2.9 kg to 4.1 kg, although this finding had low to very low certainty. There were no significant differences in the incidence of serious adverse events between insulin degludec and other long-acting insulins.
• A subgroup analysis indicates that patients with a duration of diabetes ≤ 11 years may experience a specific hypoglycemia profile with insulin degludec/aspart.