Real-world comparative effectiveness of analogue and human insulin on glycemic control in children and adolescents with Type 1 diabetes in Lebanon using continuous glucose monitoring data
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: In high income settings, insulin analogues were associated with improved glycemic control among adults with diabetes, mainly measured through HbA1c and hypoglycemic episodes. In low- and middle-income countries, especially those affected by humanitarian crises, analogue insulins may be helpful as proper diabetes care for this population remains challenging; yet, supporting evidence is lacking. Materials & methods: Routinely collected continuous glucose sensor data from patients with Type 1 diabetes, aged 4 to 18 years old, between April 2019 and December 2022 was retrospectively extracted. Changes in glycemic metrics while using analogue insulins were compared with human insulin using multiple linear regression with random effects. Results: Forty-five patients included in the study used continuous glucose monitor devices for an average duration of 73 days (±53) while using human insulin and 170 days (±83) while using analogue insulins. Compared with human insulin, analogue insulins were associated with an additional 26 min (95% CI; 15, 37, p < 0.001) per day spent within the normal target range and a reduction of 11 min (95% CI; -16, -5) and 10 min (95% CI; -13, -7) in overall and nocturnal hypoglycemia, respectively. Analogue insulin was also associated with a reduction of 6 mg/dl in 24 h mean glucose. Conclusion: Insulin analogues were associated with slight improvements in time within and below range compared with human insulin, yet within patient glycemic variability remains high. Further research is needed to explore its acceptability among patients, impact on quality of life and its cost-effectiveness and sustainability in low resource contexts.
Plain language summary: Effect of using analogue insulins compared with human insulin on management of Type 1 diabetes among children & adolescents in Lebanon
What is this article about?
Patients living with Type 1 diabetes (T1D) are required to use synthetic insulin, a hormone used to manage their blood glucose levels. For many years, synthetic human insulin was the standard treatment, yet recent studies have shown that newer formulations of insulin, analogue insulins, result in better management of disease overall. These studies, however, have mainly been done in high income countries where analogue insulins are widely accessible. For patients in low-middle income countries, human insulin remains the standard treatment and access to analogues is limited.
This study aimed to provide evidence on the real-world effectiveness of these analogue insulins compared with human insulin among children and adolescents with T1D in Lebanon.
What were the results?
Data used in this study was collected from continuous glucose monitoring devices that measure blood glucose levels over a 24 h period for the whole time the sensor is worn. Blood glucose levels were compared while using human insulin and analogue insulins over a long period of time.
Results showed that analogue insulin use was associated with improved diabetes management where patients had spent more time in the target range and less time in the dangerous lower ranges of blood glucose.
Why is this important?
This study aimed to provide evidence from a population that has not been studied before. The researchers hope these results will help advocate for wider access to analogues at affordable prices for patients living with T1D in Lebanon.
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© 2026 Médecins Sans Frontières. This work is licensed under the Creative Commons Attribution 4.0 License
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Received: 6 February 2026
Accepted: 23 June 2026
Published online: 16 July 2026
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Real-world comparative effectiveness of analogue and human insulin on glycemic control in children and adolescents with Type 1 diabetes in Lebanon using continuous glucose monitoring data. (2026) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2026-0036
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