The growing use of Insulin preparations in T1DM and T2DM has raised the issue of CVD safety and the economic burden. The evidence indicates that across Type 1 and 2 diabetes, for both rapid- and
long-acting new analogue insulins, there is no clear advantage over human insulins, with inconsistent statistically significant advantages and lack of clinically important benefits. The type of insulin does not appear to affect cardiovascular outcomes, as illustrated by the findings of the HEART 2D trial. Studies like DCCT/EDIT ,4T, and BARI 2D, showed the safety of using old insulins.
Analogue insulins have not consistently been demonstrated to be cost-effective, and uncertainty remains regarding the association between analogue insulins and increased cancer risk.
It should be noted that the trials assessing analogue insulins are of relatively low quality, given the lack of blinding of participants and outcome assessors, with resultant potential for bias with patient-reported outcomes (ie hypoglycaemia).
Also, most trials are linked to the pharmaceutical industry, suggesting that there may be some degree of publication bias.
The current evidence does not indicate a strong advantage for analogue insulins compared to regular human insulin for both Type 1 and 2 diabetes.