Evidence mapPaperPMID 27208332Full record

Trial reportDiabetes care2016

Mitigating Meal-Related Glycemic Excursions in an Insulin-Sparing Manner During Closed-Loop Insulin Delivery: The Beneficial Effects of Adjunctive Pramlintide and Liraglutide.

Jennifer L Sherr, Neha S Patel, Camille I Michaud, Miladys M Palau-Collazo, Michelle A Van Name, William V Tamborlane, Eda Cengiz, Lori R Carria, Eileen M Tichy, Stuart A Weinzimer

Open access · bronzeAbstract readClinical Trial
In one paragraph

Trial report in Diabetes care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed
8.2field-weighted citation impact, top 2% 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

36 citing papers in PubMed, 96 citations in OpenAlex.

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  17. Adjunctive Therapies to Optimize Closed-loop Glucose Control.Journal of diabetes science and technology · 2021
    Article
  18. Review
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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

10 authors at 1 institution in 1 country.

Jennifer L SherrYale School of Medicine, New Haven, CT jennifer.sherr@yale.edu.
Neha S PatelYale School of Medicine, New Haven, CT.
Camille I MichaudYale School of Medicine, New Haven, CT.
Miladys M Palau-CollazoYale School of Medicine, New Haven, CT.
Michelle A Van NameYale School of Medicine, New Haven, CT.
William V TamborlaneYale School of Medicine, New Haven, CT.
Eda CengizYale School of Medicine, New Haven, CT.
Lori R CarriaYale School of Medicine, New Haven, CT.
Eileen M TichyYale School of Medicine, New Haven, CT.
Stuart A WeinzimerYale School of Medicine, New Haven, CT.
Yale University · US

Funding

Yale Diabetes Research CenterP30DK045735 · YALE UNIVERSITY · 1993 to 2025
$10.2M
Yale Clinical and Translational Science AwardUL1TR001863 · YALE UNIVERSITY · 2025 to 2025
$9.9M
Institutional Career Development CoreKL2TR001862 · YALE UNIVERSITY · 2025 to 2025
$1.3M
NCATS NIH HHS KL2 TR001862NCATS NIH HHS UL1 TR000142NCATS NIH HHS UL1 TR001863NIDDK NIH HHS K12 DK094714NIDDK NIH HHS P30 DK045735NIDDK NIH HHS R01 DK085618
6 · The paper itself

Abstract

objectiveClosed-loop (CL) insulin delivery effectively maintains glucose overnight but struggles when challenged with meals. Use of single-day, 30-μg/meal pramlintide lowers meal excursions during CL. We sought to further elucidate the potential benefits of adjunctive agents after 3-4 weeks of outpatient dose titration. RESEARCH DESIGN AND

methodsTwo CL studies were conducted: one evaluating adjunctive pramlintide and the other liraglutide. Ten subjects (age 16-23 years; A1C 7.2 ± 0.6% [55 ± 6.6 mmol/mol]) completed two 24-h sessions: one on CL alone and one on CL plus 60-μg pramlintide (CL + P), after a 3-4-week outpatient dose escalation. Eleven subjects (age 18-27 years; A1C 7.5 ± 0.9% [58 ± 9.8 mmol/mol]) were studied before and after treatment with 1.8 mg liraglutide (CL + L) after a similar 3-4-week dose escalation period. Timing and content of meals during CL were identical within experiments; meals were not announced.

resultsPramlintide delayed the time to peak plasma glucose (PG) excursion (CL 1.6 ± 0.5 h vs. CL + P 2.6 ± 0.9 h, P < 0.001) with concomitant blunting of peak postprandial increments in PG (P < 0.0001) and reductions in postmeal incremental PG area under the curve (AUC) (P = 0.0002). CL + L also led to reductions in PG excursions (P = 0.05) and incremental PG AUC (P = 0.004), with a 28% reduction in prandial insulin delivery. Outpatient liraglutide therapy led to a weight loss of 3.2 ± 1.8 kg, with a 26% reduction in total daily insulin dose.

conclusionsAdjunctive pramlintide and liraglutide treatment mitigated postprandial hyperglycemia during CL control; liraglutide demonstrated the additional benefit of weight loss in an insulin-sparing manner. Further investigations of these and other adjunctive agents in long-term outpatient CL studies are needed.

Indexed as

AdolescentAdultBlood GlucoseDiabetes Mellitus, Type 1Drug Therapy, CombinationFemaleHumansHyperglycemiaHypoglycemic AgentsInsulinInsulin Infusion SystemsIslet Amyloid PolypeptideLiraglutideMaleMealsPostprandial PeriodBlood GlucoseHypoglycemic AgentsInsulinIslet Amyloid PolypeptideLiraglutidepramlintide

Identifiers

PMID27208332
PMCPMC4915555
OpenAlexW2346591553

What Socratic holds

Textmetadata
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.