ArticleBMJ (Clinical research ed.)1991
Risk of severe hypoglycaemia in insulin treated diabetic patients transferred to human insulin: a case control study.
Article in BMJ (Clinical research ed.), 1991. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 69 citations in OpenAlex.
- Double blind clinical and laboratory study of hypoglycaemia with human and porcine insulin in diabetic patients reporting hypoglycaemia unawareness after transferring to human insulin.BMJ (Clinical research ed.) · 1993Trial
- Influence of human insulin on symptoms and awareness of hypoglycaemia: a randomised double blind crossover trial.BMJ (Clinical research ed.) · 1991Trial
- Drug-induced disorders of glucose metabolism. Mechanisms and management.Drug safety · 1996Review
- Costs of insulin-dependent diabetes mellitus.PharmacoEconomics · 1996Review
- Adverse effects of exogenous insulin. Clinical features, management and prevention.Drug safety · 1993Review
- Treating hypoglycaemia in general practice.BMJ (Clinical research ed.) · 1993Article
- Human insulin and hypoglycaemia: burning issue or hot air?BMJ (Clinical research ed.) · 1992Article
- Human insulin and unawareness of hypoglycaemia: need for a large randomised trial.BMJ (Clinical research ed.) · 1992Article
- Human insulin.BMJ (Clinical research ed.) · 1991Article
Corrections and comments
- Commented on byHuman insulin.1991
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine whether transfer from animal insulin to human insulin is associated with an increased risk of severe hypoglycaemia.
designMatched case-control study of insulin treated diabetic patients admitted to hospital because of hypoglycaemia during 1984-7, the period when human insulin was introduced into treatment.
settingCase admissions and control admissions were obtained from eight public hospitals within the Swiss canton of Berne and a second control group comprised members of the Bernese section of the Swiss Diabetes Association. SUBJECTS: 94 patients with insulin treated diabetes with a total of 112 admissions for hypoglycaemia during 1984-7 (case admissions), 182 patients with insulin treated diabetes seen in the same hospitals for reasons other than hypoglycaemia with a total of 225 admissions (control admissions), and 86 insulin treated diabetic patients who were members of the Bernese section of the Swiss Diabetes Association.
main outcome measuresType of insulin used at time of admission, glycaemic control as measured by amount of glycated haemoglobin or glucose concentration; severity of hypoglycaemia.
resultsTreatment with human insulin at admission was more common in cases than controls (52/112 (46%) admissions v 77/225 (34%); p = 0.003). 116 out of 129 (90%) of admissions taking human insulin had been transferred from animal insulin, mainly because of non-availability of porcine insulins. The ratio of rate of hypoglycaemia in those taking human insulin to the rate in those taking animal insulin was 2.4 (95% confidence interval 1.3 to 4.4). Other risk factors for hypoglycaemia were a history of hypoglycaemic coma (rate ratio of history to no history 3.8, 2.3 to 6.4) and good glycaemic control (rate ratio of good to poor control 3.9, 1.4 to 7.5). With multivariate analysis the increase in rate ratio associated with use of human insulin rose to 3.0 (1.4 to 6.4). Comparison with the diabetes association controls also showed an increased risk associated with use of human insulin (2.2; 1.1 to 4.8).
conclusionsTransfer of treatment from animal insulin to human insulin was associated with an increased risk of severe hypoglycaemia. Caution should be exercised when transferring diabetic patients to human insulin. Further studies are required to elucidate why this effect occurs.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.