'Summary of findings' tables outcome measures (for both insulin lispro and insulin aspart)		All‐cause mortality	Hypoglycaemic episodes	Morbidity	Adverse events other than hypoglycaemic episodes	Time to resolution of diabetic ketoacidosis	Patient satisfaction	Socioeconomic effects (length of hospital stay)
Trial limitations (risk of bias)a	Was random sequence generation used (i.e. no potential for selection bias)?	Unclear	Yes/unclear	N/A	N/I	Unclear	N/I	Yes/unclear
	Was allocation concealment used (i.e. no potential for selection bias)?	Unclear	Unclear			Unclear		Unclear
	Was there blinding of participants and personnel (i.e. no potential for performance bias)?	No	No (↓)			No (↓)		No (↓)
	Was there blinding of outcome assessment (i.e. no potential for detection bias)?	Unclear	Unclear			Unclear		No (↓)
	Was an objective outcome used?	Yes	Yes			Yes		Yes
	Were more than 80% of participants enrolled in trials included in the analysis (i.e. no potential reporting bias)?e	Yes	Yes			Yes		Yes
	Were data reported consistently for the outcome of interest (i.e. no potential selective reporting)?	Yes	Yes			Unclear		Yes
	No other biases reported (i.e. no potential for other bias)?	Yes	Yes			Yes		Yes
	Did the trials end as scheduled (i.e. not stopped early)?	Yes	No			Yes		Yes
Inconsistencyb	Point estimates did not vary widely?	N/A	Yesf			Yesf		Yesf
	To what extent did confidence intervals overlap (substantial: all confidence intervals overlap at least 1 of the included studies' point estimate; some: confidence intervals overlap, but not all overlap at least 1 point estimate; no: at least 1 outlier: where the confidence interval of some of the studies does not overlap with those of most included studies)?	N/A	Substantialf			Substantialf		Substantialf
	Was the direction of effect consistent?	Yes	Yesf			No (↓)f		Yesf
	What was the magnitude of statistical heterogeneity (as measured by I²): low (I² < 40%), moderate (I² 40% ‐ 60%), high (I² > 60%)?	N/A	Lowf			High (↓)f		Lowf
	Was the test for heterogeneity statistically significant (P < 0.1)?	N/A	Not statistically significantf			Not statistically significantf		Not statistically significantf
Indirectnessa	Were the populations in the included studies applicable to the decision context?	Highly applicable	Highly applicable			Highly applicable		Highly applicable
	Were the interventions in the included studies applicable to the decision context?	Highly applicable	Highly applicable			Highly applicable		Highly applicable
	Was the included outcome not a surrogate outcome?	Yes	Yes			Yes		Yes
	Was the outcome time frame sufficient?	Sufficient	Sufficient			Sufficient		Sufficient
	Were the conclusions based on direct comparisons?	Yes	Yes			Yes		Yes
Imprecisionc	Was the confidence interval for the pooled estimate not consistent with benefit and harm?	N/A	No (↓)f			No (↓)f		No (↓)f
	What is the magnitude of the median sample size (high: 300 participants, intermediate: 100‐300 participants, low: < 100 participants)?e	Intermediateg	Intermediateg			Low (↓)		Low (↓)
	What was the magnitude of the number of included studies (large: > 10 studies, moderate: 5‐10 studies, small: < 5 studies)?e	Small (↓)	Small (↓)			Small (↓)		Small (↓)
	Was the outcome a common event (e.g. occurs more than 1/100)?	N/A	Yes			N/A		N/A
Publication biasd	Was a comprehensive search conducted?	Yes	Yes			Yes		Yes
	Was grey literature searched?	No (↓)	No (↓)			No (↓)		No (↓)
	Were no restrictions applied to study selection on the basis of language?	Yes	Yes			Yes		Yes
	There was no industry influence on studies included in the review?	No (↓)	No (↓)			No (↓)		No (↓)
	There was no evidence of funnel plot asymmetry?	N/A	Unclear			Unclear		Unclear
	There was no discrepancy in findings between published and unpublished trials?	Unclear	Unclear			Unclear		Unclear
aQuestions on risk of bias are answered in relation to the majority of the aggregated evidence in the meta‐analysis rather than to individual trials bQuestions on inconsistency are primarily based on visual assessment of forest plots and the statistical quantification of heterogeneity based on I² cWhen judging the width of the confidence interval, it is recommended to use a clinical decision threshold to assess whether the imprecision is clinically meaningful dQuestions address comprehensiveness of the search strategy, industry influence, funnel plot asymmetry and discrepancies between published and unpublished trials eDepends on the context of the systematic review area fN/A for insulin aspart gLow for insulin aspart (↓): key item for possible downgrading the quality of the evidence (GRADE) as shown in the footnotes of the 'Summary of findings' table(s) GRADE: Grading of Recommendations Assessment, Development and Evaluation; N/A: not applicable; N/I: not investigated