Evidence map›Paper›PMID 23061470›Full record

SynthesisDiabetes, obesity & metabolism2013

Combination therapy with GLP-1 receptor agonists and basal insulin: a systematic review of the literature.

R Balena, I E Hensley, S Miller, A H Barnett

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Diabetes, obesity & metabolism, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed
9.5field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 141 citations in OpenAlex.

  1. Trial
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  7. [Geriatric aspects of diabetes mellitus (Update 2026)].Wiener klinische Wochenschrift · 2026
    Review
  8. Review
  9. Article
  10. Observational
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
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  18. Encapsulated Peptides and Proteins with an Effect on Satiety.Nanomaterials (Basel, Switzerland) · 2023
    Review
  19. Article
  20. Article
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

4 authors at 2 institutions in 2 countries.

R BalenaEli Lilly and Company Ltd, Erl Wood Manor, Windlesham Surrey, UK.
I E Hensley
S Miller
A H Barnett
Eli Lilly (United States) · USHeart of England NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Treatment algorithms for type 2 diabetes call for intensification of therapy over time as the disease progresses and glycaemic control worsens. If diet, exercise and oral antihyperglycaemic medications (OAMs) fail to maintain glycaemic control then basal insulin is added and ultimately prandial insulin may be required. However, such an intensification strategy carries risk of increased hypoglycaemia and weight gain, both of which are associated with worse long-term outcomes. An alternative strategy is to intensify therapy by the addition of a short-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA) rather than prandial insulin. Short-acting GLP-1 RAs such as exenatide twice daily are particularly effective at reducing postprandial glucose while basal insulin has a greater effect on fasting glucose, providing a physiological rationale for this complementary approach. This review analyzes the latest randomized controlled clinical trials of insulin/GLP-1 RA combination therapy and examines results from 'real-world' use of the combinations as reported through observational and clinical practice studies. The most common finding across all types of studies was that combination therapy improved glycaemic control without weight gain or an increased risk of hypoglycaemia. Many studies reported weight loss and a reduction in insulin use when a GLP-1 RA was added to existing insulin therapy. Overall, the relative degree of benefit to glycaemic control and weight was influenced by the insulin titration employed in conjunction with the GLP-1 RA. The greatest glycaemic benefits were observed in studies with structured titration of insulin to glycaemic targets while the greatest weight benefits were observed in studies with a protocol-specified focus on insulin sparing. The adverse event profile of GLP-1 RAs in the reviewed trials was similar to that reported with GLP-1 RAs as monotherapy or in combination with OAMs with gastrointestinal events being the most commonly reported.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 2Disease ProgressionDrug Administration ScheduleDrug Therapy, CombinationExenatideFemaleGlucagon-Like Peptide 1Glycated HemoglobinHumansHypoglycemiaHypoglycemic AgentsInsulinMalePeptidesRandomized Controlled Trials as TopicBlood GlucoseExenatideGlucagon-Like Peptide 1Glycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinPeptidesVenoms

Identifiers

PMID23061470
PMCPMC3662998
OpenAlexW2033283875

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.