Evidence mapPaperPMID 29649221Full record

SynthesisPloS one2018

Long-acting insulin analogues for type 1 diabetes: An overview of systematic reviews and meta-analysis of randomized controlled trials.

Fernanda O Laranjeira, Keitty R C de Andrade, Ana C M G Figueiredo, Everton N Silva, Mauricio G Pereira

Open access · goldAbstract readMeta-AnalysisReview
In one paragraph

Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 4 pooled it
5.0field-weighted citation impact, top 4% 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

17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 42 citations in OpenAlex.

  1. Guideline
  2. 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
  3. Guideline
  4. Pooled it
  5. Trial
  6. Review
  7. Article
  8. Review
  9. Review
  10. Article
  11. Review
  12. Glucose-lowering therapy in patients undergoing percutaneous coronary intervention.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021
    Review
  13. Article
  14. Article
  15. Insulin Therapy in Adults with Type 1 Diabetes Mellitus: a Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020 · on this map
    Review
  16. HbABMJ (Clinical research ed.) · 2019
    Observational
  17. 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

5 authors at 1 institution in 1 country.

Fernanda O LaranjeiraFaculty of Health Sciences, University of Brasilia, Brasilia, Federal District, Brazil.
Keitty R C de AndradeFaculty of Medical Sciences, University of Brasilia, Brasilia, Federal District, Brazil.ORCID 0000-0002-8882-6856
Ana C M G FigueiredoFaculty of Health Sciences, University of Brasilia, Brasilia, Federal District, Brazil.
Everton N SilvaFaculty of Health Sciences, University of Brasilia, Brasilia, Federal District, Brazil.
Mauricio G PereiraFaculty of Medical Sciences, University of Brasilia, Brasilia, Federal District, Brazil.
Universidade de Brasília · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe comparison between long acting insulin analogues (LAIA) and human insulin (NPH) has been investigated for decades, with many randomized controlled trials (RCTs) and systematic reviews giving mixed results. This overlapping and contradictory evidence has increased uncertainty on coverage decisions at health systems level.

aimTo conduct an overview of systematic reviews and update existing reviews, preparing new meta-analysis to determine whether LAIA are effective for T1D patients compared to NPH.

methodsWe identified systematic reviews of RCTs that evaluated the efficacy of LAIA glargine or detemir, compared to NPH insulin for T1D, assessing glycated hemoglobin (A1C) and hypoglycemia. Data sources included Pubmed, Cochrane Library, EMBASE and hand-searching. The methodological quality of studies was independently assessed by two reviewers, using AMSTAR and Jadad scale. We found 11 eligible systematic reviews that contained a total of 25 relevant clinical trials. Two reviewers independently abstracted data.

resultsWe found evidence that LAIA are efficacious compared to NPH, with estimates showing a reduction in nocturnal hypoglycemia episodes (RR 0.66; 95% CI 0.57; 0.76) and A1C (95% CI 0.23; 0.12). No significance was found related to severe hypoglycemia (RR 0.94; 95% CI 0.71; 1.24).

conclusionThis study design has allowed us to carry out the most comprehensive assessment of RCTs on this subject, filling a gap in diabetes research. Our paper addresses a question that is important not only for decision makers but also for clinicians.

Indexed as

Diabetes Mellitus, Type 1Glycated HemoglobinHumansHypoglycemiaHypoglycemic AgentsInsulin DetemirInsulin GlargineInsulin, Long-ActingModels, StatisticalRandomized Controlled Trials as TopicRegression AnalysisGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulin DetemirInsulin GlargineInsulin, Long-Acting

Identifiers

PMID29649221
PMCPMC5896894
OpenAlexW2796961649

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.