title: Efficacy and safety of premixed insulin analogs in Asian patients with type 2 diabetes: A systematic review.
abstract: OBJECTIVE
  The primary aim of this systematic review was to provide an overview of the efficacy and safety of premixed insulin analogs in Asians, specifically East Asians, with type 2 diabetes.
  
  
  METHODS
  The MEDLINE, Embase, Cochrane Library and ClinicalTrials.gov databases were searched from 1 January 1995 to 26 November 2015. Randomized controlled trials involving East Asians with type 2 diabetes treated with any premixed insulin analog were included. Major comparator treatments were basal insulin and basal-bolus insulin. Comparisons were also made between East Asian and Caucasian patients. The primary efficacy outcome was glycated hemoglobin change from baseline to end-point. The primary safety outcome was the incidence of hypoglycemia.
  
  
  RESULTS
  A total of 21 studies were included; most (n = 14) were carried out in China or Japan. The duration of treatment ranged from 12 to 48 weeks. The glycated hemoglobin mean/least squares mean change from baseline to end-point after treatment with premixed insulin analogs ranged from -0.12 to -4.2% (improvement was generally more pronounced with insulin initiation vs intensification). The incidence of hypoglycemia ranged from 8.3 to 72.0% in most studies, with the variability reflecting the definition of hypoglycemia used. Efficacy and safety outcomes for premixed insulin analogs were generally similar to those for basal or basal-bolus insulin. Limited evidence suggests that dosing, efficacy and safety profiles might differ slightly between East Asian and Caucasians receiving premixed insulin analogs.
  
  
  CONCLUSIONS
  These results support the current use of premixed insulin analogs for managing East Asian patients with type 2 diabetes.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.|College of Medicine, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wayne H-H
authors.initials: WH
authors.lastname: Sheu
authors.affiliation: Department of Endocrinology, Peking University People's Hospital, Beijing, China.
authors.forename: Linong
authors.initials: L
authors.lastname: Ji
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Woo Je
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Eli Lilly S.A., Dubai, United Arab Emirates.
authors.forename: Abdul
authors.initials: A
authors.lastname: Jabbar
authors.affiliation: Lilly Korea Ltd, Seoul, Korea.
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Han
authors.affiliation: Eli Lilly and Company (Taiwan) Inc., Taipei, Taiwan.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lew
mesh_terms: D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Asia; Premixed insulin; Type 2 diabetes mellitus