Insulin analogues 'no better'
GPs should avoid using newer insulin analogues as there is no evidence they are any more effective than older treatments, a review has concluded.Cochrane researchers found glargine and detemir appeared to have no benefits for 'patient-orientated outcomes like mortality, morbidity, quality of life or costs'.Neither was there any statistically significant difference between newer and older treatments for severe hypoglycaemia, although 'the rate of symptomatic, overall and nocturnal hypoglycaemia was statistically significantly lower in patients treated with either glargine or detemir'.Review leader Dr Karl Horvath, a researcher in the department of internal medicine at the University of Graz in Austria, said: 'Our analysis suggests, if at all, only a minor clinical benefit with long-acting insulin analogues for patients with type 2 diabetes. 'Until long-term efficacy and safety data are available, we suggest a cautious approach to therapy with insulin glargine or detemir.'But GP Dr Mark Browne, clinical diabetes lead for Derby City PCT, defended the use of insulin analogues.He said: 'We have had real restrictions here so we have gone against local guidelines in using glargine. But our experience is that it quickly gets patients down to satisfactory blood sugar levels. It does makes you question why we should be using the old ones.'