Evidence map›Paper›PMID 26104878›Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2015

Practical Guidance on the Use of Premix Insulin Analogs in Initiating, Intensifying, or Switching Insulin Regimens in Type 2 Diabetes.

Ted Wu, Bryan Betty, Michelle Downie, Manish Khanolkar, Gary Kilov, Brandon Orr-Walker, Gordon Senator, Greg Fulcher

Abstract read
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

20 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Trial
  3. Article
  4. Review
  5. An introduction to insulin use in type 2 diabetes mellitus.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023
    Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Expert Opinion: Patient Selection for Premixed Insulin Formulations in Diabetes Care.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2018
    Review
  15. Article
  16. Article
  17. Use of 50/50 Premixed Insulin Analogs in Type 2 Diabetes: Systematic Review and Clinical Recommendations.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2017
    Review
  18. Review
  19. Initiation and Intensification Strategies in Type 2 Diabetes Management: A Comparison of Basal Plus and Premix Regimens.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2016
    Review
  20. Choice of Insulin in Type 2 Diabetes: A Southeast Asian Perspective.Indian journal of endocrinology and metabolism
    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

8 authors.

Ted WuRoyal Prince Alfred Hospital, Camperdown, NSW, Australia. ted.wu@sswahs.nsw.gov.au.
Bryan BettyPorirua Union and Community Health Service, Cannons Creek, Porirua City, New Zealand.
Michelle DownieSouthland Hospital, Invercargill, New Zealand.
Manish KhanolkarAuckland District Health Board Diabetes Centre, Greenlane Clinical Centre, Auckland, New Zealand.
Gary KilovThe Seaport Practice, Launceston, TAS, Australia.
Brandon Orr-WalkerCounties Manukau District Health Board, Manukau, New Zealand.
Gordon SenatorSpecialist Medical Services, Southport, QLD, Australia.
Greg FulcherUniversity of Sydney, Sydney, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPremix insulin analogs are a well-established treatment for type 2 diabetes (T2D). However, there is a lack of simple, clear guidance on some aspects of their use. These include choosing a regimen for insulin initiation, recognizing when patients need intensification of therapy, and switching from basal-bolus to a premix insulin analog when appropriate.

methodsAn independent expert panel formulated recommendations on the use in T2D of the premix insulin analog formulations widely available in Australasia, based on the available evidence and their own experience.

resultsResults from trials in both initiation and intensification of insulin show that no single insulin or regimen is best on all endpoints, and that improved glycemic control can be expected regardless of which regimen is used. Thus, individual patient factors and preferences become more important. Guidance is presented to help the clinician choose between a premix insulin analog or basal analog for insulin initiation, and to intensify insulin therapy using premix insulin analogs. Recommendations are made on dosing, titration, the concomitant use of non-insulin glucose-lowering drugs, and other practical issues, and on the special case of switching from basal-bolus to premix insulin analog therapy.

conclusionThis guidance is intended to help both general and specialist practitioners make informed choices and provide optimal care for patients with T2D. It emphasizes the importance of taking into account individual patient factors and preferences so that the choice of insulin regimen is individualized to the patient in the same way that glycemic targets are now individualized.

fundingNovo Nordisk Region IO A/S.

Indexed as

Basal insulinBiphasic insulin aspartBiphasic insulin lisproInsulin initiationInsulin intensificationPremix insulin analogs

Identifiers

PMID26104878
PMCPMC4575300

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.