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BMJ 2009; 338 doi: (Published 10 March 2009) Cite this as: BMJ 2009;338:b853

Do insulin analogues offer any benefits over conventional insulin? Sixty eight randomised controlled trials of rapid acting insulin analogues and 49 trials of long acting insulin analogues were added to two earlier systematic reviews. Most of the studies had a short to medium duration only, and were of low quality. In terms of glycaemic control, or reduced hypoglycaemia, the updated review found that neither rapid nor long acting insulin analogues offered much benefit over standard insulin. Longer studies are needed to answer the question of whether analogues reduce the risk of diabetic complications (CMAJ 2009;180:385-97, doi:10.1503/cmaj.081041).

If you need admission to hospital with a pulmonary embolism, try and arrange it for a weekday. You’ll have a significantly better chance of avoiding death in the short term than patients admitted with a pulmonary embolus on the weekend. The data showed a 30 day mortality rate of 11.1% for admissions at weekends compared with 8.8% on weekdays. The driving factor for the difference was increased mortality in the most severely ill patients at weekends …

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