Do analogues make a difference

Background & aim Type of insulin is prescribed according to the glycaemic status of the patient, affordability, and preference of the patient. Analogues are considered to be the good therapeutic treatment for patients with type 1 diabetes, as they closely mimic physiological insulin kinetics and minimize the risk of hypoglycemia as compared to other insulin formulations. In this study, we aimed to assess the effectiveness of different insulin regimen (analogue insulins, regular insulins, and NPH insulins) in patients with type 1 diabetes in Ahmedabad, western India. Method A retrospective study was carried out on patients with type 1 diabetes aged below 18 years. They were categorized into three groups as per their insulin regimen-on analogues, on regular insulin and on premix insulin. Their mean HbA1c was extracted from the database in order to know the effectiveness of their respective insulin regimen. Only those patients were studied who had undergone HbA1c from January 2018 to January 2020, who were regular in their visit to the clinic (>3 visits/year in past 2 years), were on stable insulin regimen and had absence of lipodystrophy.Outcome was analyzed based on glycosylated hemoglobin concentration. Because of retrospective nature of the analysis, accurate capture of hypoglycemia data was not possible. Results .450 patients were studied and out of that 180 were on analogue insulin, 210 were on regular insulin and, 60 patients were on premix insulin. Mean duration of diabetes 7.7 years, 8.2 years and 8.5 years, respectively. The mean Hba1c value in the corresponding insulin regimen was 9.37%, 9.3%, and 9.7% respectively. The difference in HbA1C values was statistically not significant. Conclusion There is no difference in HbA1c levels with the use of any three insulin regimens in patients with type 1 diabetes. Further prospective studies are required in a controlled manner in Indian patients to corroborate these preliminary findings and also compute the risk of hypoglycaemia.