ObjectiveTo systematically review the efficacy and safety of premixed insulin lispro versus insulin glargine for type 2 diabetes mellitus (T2DM). MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 3, 2013), PubMed, EMbase, ClinicalTrials.gov, CBM, CNKI and WanFang Data were searched up to October 2013 for randomized controlled trials (RCTs) about the clinical efficacy and safety of premixed insulin lispro versus insulin glargine for T2DM. Two reviewers independently screened literature according to the exclusion and inclusion criteria, extracted data, and assessed methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 13 RCTs involving 4 557 patients were included. The results of meta-analysis showed that:compared to insulin glargine, premixed insulin lispro was more effective in reducing levels of HbA1c (parallel trials:WMD=-0.18, 95%CI-0.33 to-0.02, P=0.03; cross-over trials:WMD=-0.38, 95%CI-0.52 to-0.24, P < 0.000 01). However, insulin glargine was more effective in reducing levels of FPG (parallel trials:WMD=0.82, 95%CI 0.65 to 0.99, P < 0.000 01; cross-over trials:WMD=0.64, 95%CI 0.26 to 1.02, P=0.000 9), weight gain (parallel trials:WMD=0.93, 95%CI 0.31 to 1.56, P=0.003; cross-over trials:WMD=0.74, 95%CI 0.19 to 1.29, P=0.009), and decreased the incidence of hypoglycemia (parallel trials:OR=1.26, 95%CI 1.10 to 1.45, P=0.000 6; cross-over trials:OR=2.24, 95%CI 1.45 to 3.46, P=0.000 3). ConclusionFor T2DM patients, premixed insulin lispro and insulin glargine have different advantages in clinical efficacy and safety. Doctors should select appropriate insulin treatment according to patients' health conditions.