Evidence map›Paper›PMID 32618405›Full record

ReviewDiabetes, obesity & metabolism2020

Practical use of insulin degludec/insulin aspart in a multinational setting: beyond the guidelines.

Roopa Mehta, Roger Chen, Takahisa Hirose, Mathew John, Adri Kok, Roger Lehmann, Ambika Gopalakrishnan Unnikrishnan, Dilek Gogas Yavuz, Gregory Fulcher

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Diabetes, obesity & metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
1.6field-weighted citation impact, top 16% 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

16 citing papers in PubMed, 19 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Insulin Therapy for the Management of Diabetes Mellitus: A Narrative Review of Innovative Treatment Strategies.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023
    Review
  10. Expert Panel Guidance and Narrative Review of Treatment Simplification of Complex Insulin Regimens to Improve Outcomes in Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2022
    Review
  11. New Horizons: Next-Generation Insulin Analogues: Structural Principles and Clinical Goals.The Journal of clinical endocrinology and metabolism · 2022
    Review
  12. Article
  13. Article
  14. Observational
  15. Review
  16. Review
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

9 authors at 8 institutions in 7 countries.

Roopa MehtaUnidad de Investigación en Enfermedades Metabólicas, Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.ORCID 0000-0002-2509-8054
Roger ChenDepartment of Endocrinology, St Vincent's Hospital, Sydney, Australia.
Takahisa HiroseDivision of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo, Japan.
Mathew JohnProvidence Endocrine and Diabetes Specialty Centre, Thiruvananthapuram, Kerala, India.ORCID 0000-0002-6435-7995
Adri KokNetcare Union and Clinton Hospitals, Alberton, South Africa.
Roger LehmannDepartment of Endocrinology, University Hospital Zurich, Zurich, Switzerland.
Ambika Gopalakrishnan UnnikrishnanDepartment of Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India.
Dilek Gogas YavuzDepartment of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey.
Gregory FulcherNorthern Clinical School, University of Sydney, Sydney, Australia.
The University of Sydney · AUChellaram Hospital · INInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán · MXMarmara University · TRSoftware Training and Development Centre · INToho University · JPUniversity Hospital of Zurich · CHUniversity of the Witwatersrand · ZA

Funding

Medical writing and editorial assistance were funded by Novo Nordisk
6 · The paper itself

Abstract

Insulin degludec/insulin aspart (IDegAsp) is a fixed-ratio co-formulation of insulin degludec, which provides long-lasting basal insulin coverage, and insulin aspart, which targets postprandial glycaemia. This review provides expert opinion on the practical clinical use of IDegAsp, including: dose timings relative to meals, when and how to intensify treatment from once-daily (OD) to twice-daily (BID) dose adjustments, and use in special populations (including hospitalized patients). IDegAsp could be considered as one among the choices for initiating insulin treatment, preferential to starting on basal insulin alone, particularly for people with severe hyperglycaemia and/or when postprandial hyperglycaemia is a major concern. The recommended starting dose of IDegAsp is 10 units with the most carbohydrate-rich meal(s), followed by individualized dose adjustments. Insulin doses should be titrated once weekly in two-unit steps, guided by individualized fasting plasma glucose targets and based on patient goals, preferences and hypoglycaemia risk. Options for intensification from IDegAsp OD are discussed, which should be guided by HbA1c, prandial glucose levels, meal patterns and patient preferences. Recommendations for switching to IDegAsp from basal insulin, premixed insulins OD/BID, and basal-plus/basal-bolus regimens are discussed. IDegAsp can be co-administered with other antihyperglycaemic drugs; however, sulphonylureas frequently need to be discontinued or the dose reduced, and the IDegAsp dose may need to be decreased when sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists are added. Considerations around the initiation or continuation of IDegAsp in hospitalized individuals are discussed, as well as in those undergoing medical procedures.

Indexed as

Diabetes Mellitus, Type 2HypoglycemiaBlood GlucoseGlycated HemoglobinHumansHypoglycemic AgentsInsulin AspartInsulin, Long-ActingBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulin Aspartinsulin degludecInsulin, Long-Actingantidiabetic druginsulin analoguestype 2 diabetes

Identifiers

PMID32618405
PMCPMC7689716
OpenAlexW3039256686

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.