Meta Analysis Of The Effect Of Insulin Degludec Versus Insulin Glargine On Cardiovascular And Cerebrovascular Events In Patients With Type 2 Diabetes

Objective: This research plan uses the scientific method of Meta analysis to compare whether Insulin Degludec is better than Insulin Glargine in improving cardiocerebrovascular end points in patients with type 2 diabetes.To provide evidence-based medical proofs on end points of cardiocerebrovascular in diabetics when selecting long-acting basal insulin analogues for the clinic.Methods: In the first place,to obtain clinical randomization about the efficacy and safety of insulin glargine and insulin degludec in type 2 diabetics,by retrieving Chinese and English databases such as Ebase and cochrane library,Pubmed,and CNKI,Wanfang database,(the time limit before January 2020,no language restrictions).In the next placefiltering the retrieved randomized controlled trials,then to evaluate the quality of all the target literatures remained.In the end,using Rev ma5.1 software to make a Meta analysis.The main end points and indicators collected and analyzed in this research contained changes in glycated hemoglobin(Hb A1c),fasting blood glucose(FPG)before and after treatment,all-cause death,death from cardiovascular events,stroke,and non-fatal myocardial infarction.Results: This article finally included a total of 5 studies,involving 10974 patients,among them 6256 was in the degludec group and 4718 was in the insulin glargine group.Compared with insulin glargine,glycosylated hemoglobin(Hb A1c)[WMD = 0.02,95% Cl(-0.06 ～ 0.09),P = 0.62] before insulin degludec treatment;Meta-analysis results of glycated hemoglobin after treatment [WMD =0.02,95% Cl(-0.06 ～ 0.09),P = 0.62],so it is believed that insulin degludec and insulin glargine have no difference in improving glycated hemoglobin in patients with type 2 diabetes.However,compared with insulin glargine,insulin degludec can improve fasting blood glucose(FPG)in patients with type 2 [WMD =-0.44,95% Cl(-0,95 ～-0.05),P = 0.0002];In terms of endpoints,there is no statistical differences between insulin degludec and insulin glargine in the events listed,died of all causes [OR = 0.90,95% Cl(0.74 ～ 1.09),P = 0.26],cardiovascular death[OR = 0.87,95% Cl(0.60 ～ 1.27),P = 0.47],non-fatal cerebral infarction [OR =1.17,95% Cl(0.94 ～ 1.47),P = 0.16],stroke [OR = 0.94,95% Cl(0.69 ～ 1.28),P = 0.69].Conclusion: Compared with Insulin Glargine,Insulin Degludec can improve fasting blood glucose(FPG)levels in patients with type 2 diabetes,but no evidence that Insulin Degludec is more efficient than Insulin Glargine on improving cardiovascular endpoints such as glycated hemoglobin(Hb A1c),allcause death,cardiovascular death,cerebral infarction and etc.