Authors' objectives:

The objectives were to to evaluate the clinical and economic implications of using SAIAs for the treatment of DM, relative to HI and to oral anti-diabetic agents (OADs).

Authors' recommendations: 1. For type 1 DM, treatment with ILis or IAsp significantly reduced HbA1c levels, compared to HI. The episodes of overall and severe hypoglycemia were similar, but nocturnal hypoglycemia was less frequent with ILis than with HI. 2. For type 2 DM, treatment with SAIAs did not demonstrate differences in HbA1c levels, compared to HI. SAIAs did not result in significant reductions in hypoglycemic episodes. When compared with OADs, improvements in HbA1c were seen with ILis and IAsp. 3. Publicly funding SAIAs would increase drug budgets. For example, funding SAIAs in Ontario would be expected to cost an additional 116 Canadian dollars and 240 Canadian dollars yearly per patient switched. There is some evidence suggesting that these costs will be offset by other health care costs in the first 12 months. 4. Uncertainty remains regarding long-term impact and use in gestational DM. No differences in patient mortality or quality of life have been demonstrated in patients with DM. The impact on health care costs beyond 12 months is unknown. Patients with gestational DM did not experience significant differences in overall hypoglycaemia rates with ILis, compared to HI, although post-meal glucose levels were improved.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.cadth.ca/index.php/en/publication/706

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)