Evidence map›Paper›PMID 29451706›Full record

SynthesisDiabetes, obesity & metabolism2018

The co-formulation of insulin degludec and insulin aspart lowers fasting plasma glucose and rates of confirmed and nocturnal hypoglycaemia, independent of baseline glycated haemoglobin levels, disease duration or body mass index: A pooled meta-analysis of phase III studies in patients with type 2 diabetes.

Martin Haluzík, Greg Fulcher, Thomas R Pieber, Lars Bardtrum, Deniz Tutkunkardas, Helena W Rodbard

5 registry-linked trialsAbstract readMeta-Analysis
In one paragraph

Synthesis in Diabetes, obesity & metabolism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing 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.

NCT01009580 phase3completednot on this map

A 26-week, Randomised, Open-labelled, Two-arm, Parallel-group, Treat-to-target Trial Comparing Efficacy and Safety of Soluble Insulin Analogue Combination (SIAC) Twice Daily (BID) With Biphasic Insulin Aspart (BIAsp) 30 BID, With or Without Metformin, With or Without DPP-4 Inhibitor, With or Without Pioglitazone in Subjects With Type 2 Diabetes in Inadequate Glycaemic Control on Once or Twice Daily Premixed or Self-mixed Insulin Regimen With or Without OADs (BOOST™: Intensify Premix 1)

TypeinterventionalSponsorNovo Nordisk A/SRan2009 to 2010Enrolled447ConditionsDiabetes, Diabetes Mellitus, Type 2Armsinsulin degludec/insulin aspart, biphasic insulin aspart 30
NCT01059812 phase3completednot on this map

A Pan Asian Trial Comparing Efficacy and Safety of NN5401 and Biphasic Insulin Aspart 30 in Type 2 Diabetes (BOOST™: INTENSIFY ALL)

TypeinterventionalSponsorNovo Nordisk A/SRan2010 to 2010Enrolled424ConditionsDiabetes, Diabetes Mellitus, Type 2Armsinsulin degludec/insulin aspart, biphasic insulin aspart 30
NCT01513590 phase3completednot on this map

A 26-week, Randomised, Open-label, Multinational, Treat-to-target Trial Comparing Efficacy and Safety of Insulin Degludec/Insulin Aspart (IDegAsp) Twice Daily (BID) and BIAsp 30 BID Both With Metformin in Insulin naïve Subjects With Type 2 Diabetes Mellitus Inadequately Controlled on Metformin Monotherapy or Metformin in Combination With One Additional Oral Antidiabetic Drug (OAD)

TypeinterventionalSponsorNovo Nordisk A/SRan2012 to 2012Enrolled394ConditionsDiabetes, Diabetes Mellitus, Type 2Armsinsulin degludec/insulin aspart
NCT01680341 phase3completednot on this map

A Trial Comparing the Efficacy and Safety of Two Different Titration Algorithms for Insulin Degludec/Insulin Aspart in Subjects With Type 2 Diabetes Mellitus Previously Treated With Insulin Glargine (BOOST®: SIMPLE vs. STEPWISE)

TypeinterventionalSponsorNovo Nordisk A/SRan2012 to 2013Enrolled272ConditionsDiabetes, Diabetes Mellitus, Type 2Armsinsulin degludec/insulin aspart
NCT01713530 phase3completednot on this map

A 26-week Trial Comparing Efficacy and Safety of Insulin Degludec/Insulin Aspart BID and Insulin Degludec OD Plus Insulin Aspart in Subjects With Type 2 Diabetes Mellitus Treated With Basal Insulin in Need of Treatment Intensification With Mealtime Insulin

TypeinterventionalSponsorNovo Nordisk A/SRan2013 to 2014Enrolled274ConditionsDiabetes, Diabetes Mellitus, Type 2Armsinsulin degludec/insulin aspart, insulin degludec, insulin aspart
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. 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

6 authors.

Martin HaluzíkInstitute for Clinical and Experimental Medicine and Charles University, Prague, Czech Republic.ORCID 0000-0002-0201-6888
Greg FulcherRoyal North Shore Hospital, University of Sydney, Sydney, Australia.
Thomas R PieberMedical University of Graz, Graz, Austria.
Lars BardtrumNovo Nordisk A/S, Søborg, Denmark.
Deniz TutkunkardasNovo Nordisk A/S, Søborg, Denmark.
Helena W RodbardEndocrine and Metabolic Consultants, Rockville, Maryland.ORCID 0000-0002-6187-8445

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo investigate whether the proven benefits of insulin degludec (IDeg) combined with insulin aspart (IAsp), known as IDegAsp, given twice daily, extend across a wide spectrum of patients with diabetes. MATERIALS AND

methodsThis was a post hoc pooled analysis of 5 phase III randomized, 26-week, open-label, treat-to-target trials comparing IDegAsp twice daily (n = 1111) with one of two comparators: premixed insulin (biphasic insulin aspart 30 [BIAsp 30]) twice daily (n = 561) or IDeg once daily + IAsp (n = 136). Patient data were stratified according to baseline glycated haemoglobin (HbA1c) or fasting plasma glucose (FPG) categories, as well as by baseline duration of diabetes or body mass index (BMI) categories.

resultsWe conducted a meta-analysis of 5 clinical trials: NCT01513590, NCT01009580, NCT01059812, NCT01680341 and NCT01713530. End-of-trial results were broadly consistent, with differences between IDegAsp and comparators observed in phase III trials. HbA1c results were similar for IDegAsp and the comparators in all baseline characteristic (HbA1c, duration of diabetes or BMI) and category groups (number ranges). Significantly lower FPG level was observed with IDegAsp vs comparators in all baseline characteristic and most category groups (excluding FPG <5.5 mmol/L). Significantly lower insulin doses were observed with IDegAsp vs comparators in all baseline characteristic and half of the category groups, and significantly lower rates of confirmed and nocturnal confirmed hypoglycaemia were observed with IDegAsp vs comparators in all baseline variable and category groups.

conclusionsIDegAsp retains a consistent safety and efficacy profile in patients with different baseline characteristics.

Indexed as

Activities of Daily LivingBlood GlucoseBody Mass IndexClinical Trials, Phase III as TopicDiabetes Mellitus, Type 2Disease ProgressionDrug Administration ScheduleDrug CombinationsGlycated HemoglobinHumansHyperglycemiaHypoglycemiaHypoglycemic AgentsInsulin, Long-ActingObesityRandomized Controlled Trials as TopicBlood GlucoseDrug CombinationsGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic Agentsinsulin degludec, insulin aspart drug combinationInsulin, Long-Actingglycaemic controlhypoglycaemiainsulin analoguesmeta-analysisrandomized trialtype 2 diabetes

Identifiers

PMID29451706
PMCPMC6033009

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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.