Evidence mapPaperPMID 31255662Full record

ReviewMetabolism: clinical and experimental2019

Initial injectable therapy in type 2 diabetes: Key considerations when choosing between glucagon-like peptide 1 receptor agonists and insulin.

Anastasia-Stefania Alexopoulos, John B Buse

Open access · greenAbstract readReview
In one paragraph

Review in Metabolism: clinical and experimental, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
2.1field-weighted citation impact, top 12% 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

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Cost consequence analysis of adding semaglutide to treatment regimen for patients with Type II diabetes in Saudi Arabia.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2024
    Article
  4. Efficacy and Safety of a Biosimilar Liraglutide (MelitideDiabetes therapy : research, treatment and education of diabetes and related disorders · 2023
    Article
  5. Article
  6. Review
  7. [Injection therapy of diabetes].Wiener klinische Wochenschrift · 2023
    Article
  8. Article
  9. Observational
  10. Article
  11. Article
  12. 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

2 authors at 2 institutions in 1 country.

Anastasia-Stefania AlexopoulosDuke University Medical Center, Durham, NC, United States. Electronic address: asa61@duke.edu.
John B BuseUniversity of North Carolina, Chapel Hill, NC, United States.
Duke Medical Center · USUniversity of North Carolina at Chapel Hill · US

Funding

Endocrinology and Metabolism Training ProgramT32DK007012 · DUKE UNIVERSITY · 1986 to 2025
$1.3M
NCATS NIH HHS UL1 TR002489NIDDK NIH HHS T32 DK007012
6 · The paper itself

Abstract

Managing type 2 diabetes is complex and necessitates careful consideration of patient factors such as engagement in self-care, comorbidities and costs. Since type 2 diabetes is a progressive disease, many patients will require injectable agents, usually insulin. Recent ADA-EASD guidelines recommend glucagon-like peptide 1 receptor agonists (GLP-1 RAs) as first injectable therapy in most cases. The basis for this recommendation is the similar glycemic efficacy of GLP-1 RAs and insulin, but with GLP-1 RAs promoting weight loss instead of weight gain, at lower hypoglycemia risk, and with cardiovascular benefits in patients with pre-existing cardiovascular disease. GLP-1 RAs also reduce burden of glucose self-monitoring. However, tolerability and costs are important considerations, and notably, rates of drug discontinuation are often higher for GLP-1 RAs than basal insulin. To minimize risk of gastrointestinal symptoms patients should be started on lowest doses of GLP-1 RAs and up-titrated slowly. Overall healthcare costs may be lower with GLP-1 RAs compared to insulin. Though patient-level costs may still be prohibitive, GLP-1 RAs can replace 50-80 units of insulin daily and reduce costs associated with glucose self-monitoring. Decisions regarding initiating injectable therapy should be individualized. This review provides a framework to guide decision-making in the real-world setting.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsAnimalsDiabetes Mellitus, Type 2Glucagon-Like Peptide 1HumansHypoglycemic AgentsInjectionsInsulinGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsInsulin

Identifiers

PMID31255662
PMCPMC6690751
OpenAlexW2954613645

What Socratic holds

Textmetadata
LicenceTDM
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.