Evidence mapPaperPMID 32025860Full record

SynthesisActa diabetologica2020

Intranasal versus injectable glucagon for hypoglycemia in type 1 diabetes: systematic review and meta-analysis.

Antonio E Pontiroli, Elena Tagliabue

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Acta diabetologica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 9% 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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Managing Severe Hypoglycaemia in Patients with Diabetes: Current Challenges and Emerging Therapies.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023
    Review
  6. Article
  7. Article
  8. Review
  9. Glucagon use by U.S. adults with type 1 and type 2 diabetes.Journal of diabetes and its complications · 2021
    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.

Antonio E PontiroliDipartimento di Scienze della Salute, Università degli Studi di Milano, Ospedale San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy. antonio.pontiroli@unimi.it.ORCID http://orcid.org/0000-0002-8217-7672
Elena TagliabueIRCCS MultiMedica, Milan, Italy.
MultiMedica · ITUniversity of Milan · IT

Funding

gruppo Multimedica not applicableMinistero della Salute ricerca correnteUniversità degli Studi di Milano not applicable
6 · The paper itself

Abstract

aimsGlucagon is used to resolve severe hypoglycemia in unconscious patients with diabetes, requiring third-party assistance. A few studies have shown that intranasal (IN) glucagon causes resolution of hypoglycemia in insulin-treated patients with type 1 (T1DM) diabetes. This systematic review and meta-analysis updates the comparison of the effectiveness of IN glucagon with injected intramuscular/subcutaneous (IM/SC) glucagon in treatment of hypoglycemia in T1DM.

methodsControlled randomized studies were considered; eight studies, published in English, were included in a meta-analysis (random-effects model). Intervention effect (resolution of hypoglycemia) was expressed as odds ratio (OR), with 95% confidence intervals. Meta-regression was employed to correlate the effect with size of studies, age of patients, basal blood glucose levels.

resultsIn a total of 467 treatments in 269 patients with IN and IM/SC glucagon, the OR IN versus IM/SC was 0.61 (CI 0.13-2.82); since four of eight studies showed 100% effectiveness, a simulation was made with 1 failure for each treatment; in this simulation analysis, the OR was 0.80 (95% CI 0.28-2.32). Heterogeneity was low and not statistically significant. Publication bias was absent, and quality of papers was high. At meta-regression, no correlation was found between the effect and number of patients in each study, age of patients, basal blood glucose levels. No study formally compared IN versus IM/SC in unconscious patients.

conclusionsThis meta-analysis indicates that in conscious T1DM patients IN glucagon and IM/SC glucagon are equally effective in resolution of hypoglycemia.

Indexed as

Administration, IntranasalBlood GlucoseDiabetes Mellitus, Type 1GlucagonHumansHypoglycemiaInjections, IntramuscularInjections, SubcutaneousInsulinRandomized Controlled Trials as TopicTreatment OutcomeBlood GlucoseGlucagonInsulinGlucagonHypoglycemiaInsulinMeta-analysisNasal glucagonType 1 diabetes

Identifiers

PMID32025860
OpenAlexW3004952652

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.