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. 2021 Mar 4;2021(3):CD013498. doi: 10.1002/14651858.CD013498.pub2

Comparison 1. Insulin detemir versus NPH insulin.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 All‐cause mortality 9 3334 Peto Odds Ratio (Peto, Fixed, 95% CI) 4.97 [0.79, 31.38]
1.1.1 Adults 6 2558 Peto Odds Ratio (Peto, Fixed, 95% CI) 4.97 [0.79, 31.38]
1.1.2 Children 3 776 Peto Odds Ratio (Peto, Fixed, 95% CI) Not estimable
1.2 All‐cause mortality (published vs. unpublished data) 9 3334 Risk Ratio (M‐H, Random, 95% CI) 3.64 [0.42, 31.40]
1.2.1 Published 2 842 Risk Ratio (M‐H, Random, 95% CI) 4.47 [0.24, 82.58]
1.2.2 Unpublished 7 2492 Risk Ratio (M‐H, Random, 95% CI) 2.85 [0.12, 69.55]
1.3 Severe hypoglycaemia 8 3219 Risk Ratio (M‐H, Random, 95% CI) 0.69 [0.52, 0.92]
1.3.1 Adults 5 2443 Risk Ratio (M‐H, Random, 95% CI) 0.71 [0.49, 1.03]
1.3.2 Children 3 776 Risk Ratio (M‐H, Random, 95% CI) 0.61 [0.30, 1.23]
1.4 Severe hypoglycaemia (published vs. unpublished data) 8 3175 Risk Ratio (M‐H, Random, 95% CI) 0.69 [0.51, 0.93]
1.4.1 Published 6 2677 Risk Ratio (M‐H, Random, 95% CI) 0.62 [0.50, 0.78]
1.4.2 Unpublished 2 498 Risk Ratio (M‐H, Random, 95% CI) 1.42 [0.77, 2.62]
1.5 Hypoglycaemia reported as a serious adverse event 8 3219 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.51, 1.71]
1.5.1 Adults 5 2443 Risk Ratio (M‐H, Random, 95% CI) 0.94 [0.48, 1.86]
1.5.2 Children 3 776 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.16, 5.57]
1.6 Cardiovascular mortality 9   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
1.6.1 Adults 6   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
1.6.2 Children 3   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
1.7 Non‐fatal myocardial infarction 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.8 Serious adverse events 9 3332 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.75, 1.21]
1.8.1 Adults 6 2556 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.73, 1.28]
1.8.2 Children 3 776 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.56, 1.43]
1.9 Serious adverse events (published vs. unpublished data) 9 3332 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.75, 1.21]
1.9.1 Published 2 641 Risk Ratio (M‐H, Random, 95% CI) 0.66 [0.40, 1.09]
1.9.2 Unpublished 7 2691 Risk Ratio (M‐H, Random, 95% CI) 1.06 [0.80, 1.39]
1.10 Diabetic ketoacidosis 6 2012 Risk Ratio (M‐H, Random, 95% CI) 0.80 [0.36, 1.76]
1.10.1 Adults 3 1236 Risk Ratio (M‐H, Random, 95% CI) 0.84 [0.24, 2.92]
1.10.2 Children 3 776 Risk Ratio (M‐H, Random, 95% CI) 0.77 [0.27, 2.15]
1.11 Diabetic ketoacidosis (published vs. unpublished data) 6 2012 Risk Ratio (M‐H, Random, 95% CI) 0.80 [0.36, 1.76]
1.11.1 Published data 2 694 Risk Ratio (M‐H, Random, 95% CI) 0.83 [0.27, 2.52]
1.11.2 Unpublished data 4 1318 Risk Ratio (M‐H, Random, 95% CI) 0.77 [0.25, 2.38]
1.12 Non‐serious adverse events 9 3332 Risk Ratio (M‐H, Random, 95% CI) 0.98 [0.95, 1.01]
1.12.1 Adults 6 2556 Risk Ratio (M‐H, Random, 95% CI) 0.99 [0.95, 1.03]
1.12.2 Children 3 776 Risk Ratio (M‐H, Random, 95% CI) 0.96 [0.90, 1.02]
1.13 Non‐serious adverse events (published vs unpublished data) 9 3332 Risk Ratio (M‐H, Random, 95% CI) 0.98 [0.94, 1.01]
1.13.1 Published data 3 1141 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.90, 1.01]
1.13.2 Unpublished data 6 2191 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.95, 1.04]
1.14 Withdrawals due to adverse events 8 3222 Risk Ratio (M‐H, Random, 95% CI) 2.23 [0.98, 5.05]
1.14.1 Adults 5 2445 Risk Ratio (M‐H, Random, 95% CI) 2.25 [0.94, 5.41]
1.14.2 Children 3 777 Risk Ratio (M‐H, Random, 95% CI) 2.08 [0.22, 19.90]
1.15 Any nocturnal hypoglycaemia 8 3219 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.87, 0.95]
1.15.1 Adults 5 2443 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.98]
1.15.2 Children 3 776 Risk Ratio (M‐H, Random, 95% CI) 0.87 [0.81, 0.94]
1.16 Mild nocturnal hypoglycaemia 7 3073 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.85, 0.96]
1.16.1 Adults 4 2149 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.83, 1.00]
1.16.2 Children 3 924 Risk Ratio (M‐H, Random, 95% CI) 0.88 [0.78, 1.00]
1.17 Nocturnal hypoglycaemia (symptoms) 6 2578 Risk Ratio (M‐H, Random, 95% CI) 0.88 [0.79, 0.98]
1.17.1 Adults 4 2149 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.82, 1.01]
1.17.2 Children 2 429 Risk Ratio (M‐H, Random, 95% CI) 0.55 [0.19, 1.61]
1.18 Severe nocturnal hypoglycaemia 7 2925 Risk Ratio (M‐H, Random, 95% CI) 0.67 [0.39, 1.17]
1.18.1 Adults 4 2149 Risk Ratio (M‐H, Random, 95% CI) 0.57 [0.35, 0.93]
1.18.2 Children 3 776 Risk Ratio (M‐H, Random, 95% CI) 0.64 [0.13, 3.17]
1.19 Any nocturnal hypoglycaemia (published vs. unpublished data) 8 3219 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.87, 0.95]
1.19.1 Published 6 2677 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.86, 0.95]
1.19.2 Unpublished 2 542 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.80, 1.04]
1.20 Mild nocturnal hypoglycaemia (published vs. unpublished data) 7 3073 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.85, 0.96]
1.20.1 Published 4 2084 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.98]
1.20.2 Unpublished 3 989 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.75, 1.07]
1.21 Nocturnal hypoglycaemia, symptoms only (published vs. unpublished data) 6 2578 Risk Ratio (M‐H, Random, 95% CI) 0.88 [0.79, 0.98]
1.21.1 Published 3 1589 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.81, 0.99]
1.21.2 Unpublished 3 989 Risk Ratio (M‐H, Random, 95% CI) 0.79 [0.57, 1.08]
1.22 Severe nocturnal hypoglycaemia (published vs. unpublished data) 7 2925 Risk Ratio (M‐H, Random, 95% CI) 0.67 [0.39, 1.17]
1.22.1 Published 5 2383 Risk Ratio (M‐H, Random, 95% CI) 0.63 [0.32, 1.25]
1.22.2 Unpublished 2 542 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.33, 2.45]
1.23 Nocturnal hypoglycaemia, asymptomatic (children vs. adults) 2 429 Risk Ratio (M‐H, Random, 95% CI) 0.96 [0.78, 1.18]
1.24 Mild/moderate hypoglycaemia 8 3219 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.94, 0.99]
1.24.1 Adults 5 2443 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.93, 1.02]
1.24.2 Children 3 776 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.93, 1.01]
1.25 Mild/moderate hypoglycaemia (published vs. unpublished data) 8 3219 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.94, 0.99]
1.25.1 Published 6 2677 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.93, 1.00]
1.25.2 Unpublished 2 542 Risk Ratio (M‐H, Random, 95% CI) 0.98 [0.92, 1.05]
1.26 HbA1c 8 3122 Mean Difference (IV, Random, 95% CI) 0.01 [‐0.08, 0.10]
1.26.1 Adults 5 2354 Mean Difference (IV, Random, 95% CI) ‐0.03 [‐0.14, 0.07]
1.26.2 Children 3 768 Mean Difference (IV, Random, 95% CI) 0.13 [‐0.04, 0.31]
1.27 HbA1c (published vs. unpublished data) 8 3122 Mean Difference (IV, Random, 95% CI) 0.00 [‐0.09, 0.09]
1.27.1 Published 6 2624 Mean Difference (IV, Random, 95% CI) ‐0.02 [‐0.13, 0.09]
1.27.2 Unpublished 2 498 Mean Difference (IV, Random, 95% CI) 0.10 [‐0.08, 0.28]