Evidence mapPaperPMID 20091571Full record

SynthesisThe Cochrane database of systematic reviews2010

Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for type 1 diabetes mellitus.

Marie L Misso, Kristine J Egberts, Matthew Page, Denise O'Connor, Jonathan Shaw

4 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT01589445. Cited by 166 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
166citing papers in PubMed, 14 pooled it
15.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

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.

2 · The registry

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.

NCT01589445 phase4completed

Modulation of Insulin Secretion and Insulin Sensitivity in Bangladeshi Type 2 Diabetic Subjects by an Insulin Sensitizer Pioglitazone and T2DM Association With PPARG Gene Polymorphism.

Ran2008Enrolled77Registered outcomes6Posted comparisons11ConditionsType 2 Diabetes MellitusArmsMetformin hydrochloride, pioglitazone hydrochloride
Open the trial in the graph
NCT02092051 nacompletednot on this mapstarted 2014, after this paper: background citation

A Randomized Trial of the Effect of Continuous Glucose Monitoring (CGM) in Individuals With Type 1 Diabetes Treated With Multiple Daily Insulin Injections (MDI)

TypeinterventionalSponsorVastra Gotaland RegionRan2014 to 2016Enrolled161ConditionsDiabetes Mellitus, Type 1ArmsContinuous glucose monitoring with DexCom G4 platina
NCT02423993 nacompletednot on this map

Efficiency Assessment of the Structured Education Program for Type 1 Diabetes Patients on Insulin Pump Therapy

TypeinterventionalSponsorEndocrinology Research Centre, MoscowRan2009 to 2013Enrolled77ConditionsDiabetes Mellitus, Type 1ArmsEducation by structured programme, CSII, CGM-RT, Screening for Complications, Glycaemic control assessment
NCT04409587 phase4completednot on this mapstarted 2018, after this paper: background citation

Basal Insulin Glycemic ControL With DEglugec vs Aspart Via Pump: A Comparison of Insulin Degludec to Continuous Subcutaneous Infusion of Insulin Aspart for Basal Insulin Delivery in Type 1 Diabetes

TypeinterventionalSponsorMountain Diabetes and Endocrine CenterRan2018 to 2020Enrolled59ConditionsType1 Diabetes MellitusArmsAspart
3 · Its place in the literature

Who cites it

166 citing papers in PubMed, 14 syntheses or guidelines pooled it, 403 citations in OpenAlex.

  1. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  2. Pooled it
  3. Tissue Response to Subcutaneous Infusion Catheter.Journal of diabetes science and technology · 2020
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Diabetes: glycaemic control in type 1.BMJ clinical evidence · 2011
    Pooled it
  12. Dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2008
    Pooled it
  13. Rosiglitazone for type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2007
    Pooled it
  14. Pioglitazone for type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2006 · on this map
    Pooled it
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

106 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Marie L MissoAustralasian Cochrane Centre, Monash Institute of Health Services Research, Monash University, 43-51 Kanooka Grove, Clayton, Victoria, Australia, 3168.
Kristine J Egberts
Matthew Page
Denise O'Connor
Jonathan Shaw
Monash University · AUBaker Heart and Diabetes Institute · AUThe Alfred Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundType 1 diabetes is a metabolic disorder resulting from a defect in insulin secretion. Onset of type 1 diabetes mellitus may occur at any age and it is one of the most common chronic diseases of childhood and adolescence. Since there are no interventions known to prevent onset, it is vital that effective treatment regimes are available. Glycaemic control is maintained by replacement of insulin and may be in the form of 'conventional' insulin therapy (multiple injections per day) or continuous subcutaneous insulin infusion (CSII).

objectivesTo assess the effects of CSII compared to multiple insulin injections (MI) in people with type 1 diabetes mellitus. SEARCH STRATEGY: Studies were obtained from electronic searches of The Cochrane Library, MEDLINE, EMBASE and CINAHL. SELECTION CRITERIA: Studies were included if they were randomised controlled trials comparing CSII with three or more insulin injections per day (MI) in people with type 1 diabetes mellitus. DATA COLLECTION AND ANALYSIS: Two authors independently assessed risk of bias and extracted characteristics of included studies. Authors contacted study investigators to obtain missing information. Generic inverse variance meta-analyses using a random-effects model were performed. MAIN

resultsTwenty three studies randomised 976 participants with type 1 diabetes to either intervention. There was a statistically significant difference in glycosylated haemoglobin A1c (HbA1c) favouring CSII (weighted mean difference -0.3% (95% confidence interval -0.1 to -0.4). There were no obvious differences between the interventions for non-severe hypoglycaemia, but severe hypoglycaemia appeared to be reduced in those using CSII. Quality of life measures suggest that CSII is preferred over MI. No significant difference was found for weight. Adverse events were not well reported, no information is available on mortality, morbidity and costs. AUTHORS'

conclusionsThere is some evidence to suggest that CSII may be better than MI for glycaemic control in people with type 1 diabetes. Non-severe hypoglycaemic events do not appear to be reduced with CSII. There is insufficient evidence regarding adverse events, mortality, morbidity and costs.

Indexed as

AdolescentAdultChildDiabetes Mellitus, Type 1HumansHypoglycemic AgentsInfusions, SubcutaneousInsulinRandomized Controlled Trials as TopicHypoglycemic AgentsInsulin

Identifiers

PMID20091571
PMCPMC12582037
OpenAlexW2187034653

What Socratic holds

Textmetadata
Read underepoch 390

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.