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

Comparison 2. Insulin glargine versus NPH insulin.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
2.1 All‐cause mortality 8 2175 Peto Odds Ratio (Peto, Fixed, 95% CI) 0.14 [0.00, 6.98]
2.1.1 Adults 4 1365 Peto Odds Ratio (Peto, Fixed, 95% CI) 0.14 [0.00, 6.98]
2.1.2 Children 4 810 Peto Odds Ratio (Peto, Fixed, 95% CI) Not estimable
2.2 Health‐realted quality of life 2 880 Mean Difference (IV, Random, 95% CI) 0.62 [‐0.71, 1.96]
2.3 Severe hypoglycaemia 9 2350 Risk Ratio (M‐H, Random, 95% CI) 0.84 [0.67, 1.04]
2.3.1 Adults 5 1540 Risk Ratio (M‐H, Random, 95% CI) 0.78 [0.58, 1.05]
2.3.2 Children 4 810 Risk Ratio (M‐H, Random, 95% CI) 1.14 [0.59, 2.21]
2.4 Severe hypoglycaemia (published vs. unpublished data) 9 2350 Risk Ratio (M‐H, Random, 95% CI) 0.84 [0.67, 1.04]
2.4.1 Published 7 1691 Risk Ratio (M‐H, Random, 95% CI) 0.87 [0.63, 1.22]
2.4.2 Unpublished 2 659 Risk Ratio (M‐H, Random, 95% CI) 0.83 [0.56, 1.25]
2.5 Hypoglycaemia reported as a serious adverse event 8 2229 Risk Ratio (M‐H, Random, 95% CI) 0.94 [0.64, 1.39]
2.5.1 Adults 4 1419 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.57, 1.37]
2.5.2 Children 4 810 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.32, 2.87]
2.6 Cardiovascular mortality 8   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
2.6.1 Adults 4   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
2.6.2 Children 4   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
2.7 Non‐fatal myocardial infarction 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.8 Non‐fatal stroke 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.9 Serious adverse events 8 2229 Risk Ratio (M‐H, Random, 95% CI) 1.08 [0.63, 1.84]
2.9.1 Adults 4 1419 Risk Ratio (M‐H, Random, 95% CI) 0.99 [0.72, 1.35]
2.9.2 Children 4 810 Risk Ratio (M‐H, Random, 95% CI) 1.02 [0.28, 3.64]
2.10 Serious adverse events (published vs. unpublished data) 8 2229 Risk Ratio (M‐H, Random, 95% CI) 1.08 [0.63, 1.84]
2.10.1 Published 4 1284 Risk Ratio (M‐H, Random, 95% CI) 1.11 [0.45, 2.70]
2.10.2 Unpublished 4 945 Risk Ratio (M‐H, Random, 95% CI) 1.10 [0.46, 2.60]
2.11 Diabetic ketoacidosis 7 2054 Risk Ratio (M‐H, Random, 95% CI) 0.53 [0.19, 1.44]
2.11.1 Adults 3 1244 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.11, 9.58]
2.11.2 Children 4 810 Risk Ratio (M‐H, Random, 95% CI) 0.45 [0.15, 1.39]
2.12 Diabetic ketoacidosis (published vs. unpublished data) 7 2054 Risk Ratio (M‐H, Random, 95% CI) 0.53 [0.19, 1.44]
2.12.1 Published 3 685 Risk Ratio (M‐H, Random, 95% CI) 0.39 [0.11, 1.31]
2.12.2 Unpublished 4 1369 Risk Ratio (M‐H, Random, 95% CI) 1.01 [0.18, 5.77]
2.13 Non‐serious adverse events 8 2229 Risk Ratio (M‐H, Random, 95% CI) 1.01 [0.96, 1.06]
2.13.1 Adults 4 1419 Risk Ratio (M‐H, Random, 95% CI) 1.01 [0.95, 1.07]
2.13.2 Children 4 810 Risk Ratio (M‐H, Random, 95% CI) 1.02 [0.93, 1.12]
2.14 Non‐serious adverse events (published vs. unpublished data) 8 2229 Risk Ratio (M‐H, Random, 95% CI) 1.01 [0.96, 1.06]
2.14.1 Published 5 1308 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.94, 1.05]
2.14.2 Unpublished 3 921 Risk Ratio (M‐H, Random, 95% CI) 1.03 [0.94, 1.14]
2.15 Withdrawals due to adverse events 8 2230 Risk Ratio (M‐H, Random, 95% CI) 0.83 [0.24, 2.81]
2.15.1 Adults 4 1419 Risk Ratio (M‐H, Random, 95% CI) 1.74 [0.29, 10.39]
2.15.2 Children 4 811 Risk Ratio (M‐H, Random, 95% CI) 0.30 [0.06, 1.53]
2.16 Nocturnal hypoglycaemia 7 2054 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.96, 1.05]
2.16.1 Adults 3 1244 Risk Ratio (M‐H, Random, 95% CI) 0.99 [0.92, 1.06]
2.16.2 Children 4 810 Risk Ratio (M‐H, Random, 95% CI) 1.01 [0.95, 1.08]
2.17 Mild nocturnal hypoglycaemia 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.18 Nocturnal hypoglycaemia (symptoms) 4 996 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.82, 1.05]
2.18.1 Adults 2 710 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.88, 1.08]
2.18.2 Children 2 286 Risk Ratio (M‐H, Random, 95% CI) 0.74 [0.55, 1.00]
2.19 Severe nocturnal hypoglycaemia 6 1893 Risk Ratio (M‐H, Random, 95% CI) 0.83 [0.62, 1.12]
2.19.1 Adults 3 1244 Risk Ratio (M‐H, Random, 95% CI) 0.87 [0.60, 1.27]
2.19.2 Children 3 649 Risk Ratio (M‐H, Random, 95% CI) 0.77 [0.47, 1.25]
2.20 Nocturnal hypoglycaemia (published vs. unpublished data) 7 2054 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.96, 1.05]
2.20.1 Published 5 1345 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.95, 1.06]
2.20.2 Unpublished 2 709 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.91, 1.08]
2.21 Symptomatic nocturnal hypoglycaemia (published vs. unpublished data) 4 996 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.82, 1.05]
2.21.1 Published 3 871 Risk Ratio (M‐H, Random, 95% CI) 0.87 [0.67, 1.12]
2.21.2 Unpublished 1 125 Risk Ratio (M‐H, Random, 95% CI) 0.94 [0.80, 1.10]
2.22 Mild/moderate hypoglycaemia 7 2054 Risk Ratio (M‐H, Random, 95% CI) 1.02 [1.00, 1.04]
2.22.1 Adults 3 1244 Risk Ratio (M‐H, Random, 95% CI) 1.02 [0.99, 1.06]
2.22.2 Children 4 810 Risk Ratio (M‐H, Random, 95% CI) 1.01 [0.99, 1.04]
2.23 Mild/moderate hypoglycaemia (published vs. unpublished data) 7 2054 Risk Ratio (M‐H, Random, 95% CI) 1.02 [1.00, 1.04]
2.23.1 Published 5 1395 Risk Ratio (M‐H, Random, 95% CI) 1.02 [1.00, 1.05]
2.23.2 Unpublished 2 659 Risk Ratio (M‐H, Random, 95% CI) 1.01 [0.98, 1.05]
2.24 HbA1c 9 2285 Mean Difference (IV, Random, 95% CI) 0.02 [‐0.06, 0.11]
2.24.1 Adults 5 1523 Mean Difference (IV, Random, 95% CI) ‐0.01 [‐0.16, 0.13]
2.24.2 Children 4 762 Mean Difference (IV, Random, 95% CI) 0.03 [‐0.13, 0.20]
2.25 HbA1c (published vs unpublished data) 9 2285 Mean Difference (IV, Random, 95% CI) 0.02 [‐0.06, 0.11]
2.25.1 Published 6 1868 Mean Difference (IV, Random, 95% CI) 0.02 [‐0.09, 0.14]
2.25.2 Unpublished 3 417 Mean Difference (IV, Random, 95% CI) ‐0.04 [‐0.26, 0.18]
2.26 HbA1c (NPH < 2x/day vs ≥ 2x/day) 9 2285 Mean Difference (IV, Random, 95% CI) 0.02 [‐0.06, 0.11]
2.26.1 NPH up to twice a day 8 2164 Mean Difference (IV, Random, 95% CI) 0.05 [‐0.03, 0.13]
2.26.2 NPH more than twice a day 1 121 Mean Difference (IV, Random, 95% CI) ‐0.50 [‐0.93, ‐0.07]