Evidence mapPaperPMID 34016530Full record

ArticleEndocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists2021

Insulin Requirements in Patients With Type 2 Diabetes Undergoing Bariatric Surgery in the Inpatient Setting and Upon Discharge: A Single-Center Retrospective Analysis of Insulin Management Strategies.

Kamonkiat Wirunsawanya, Sanjita Chittimoju, Kathryn L Fantasia, Katherine L Modzelewski, Devin Steenkamp, Sara M Alexanian

Registry-linked trialAbstract read
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In one paragraph

Article in Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06132477 (Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 40% 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.

NCT06132477 phase4recruitingstarted 2024, after this paper: background citation

Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric

Ran2024Enrolled150Registered outcomes5Posted comparisons0ConditionsDiabetes Mellitus, Hypertension, Metabolic Syndrome, Morbid ObesityArmsGLP-1 receptor agonist
Open the trial in the graph
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

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 at 1 institution in 1 country.

Kamonkiat WirunsawanyaSection of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.
Sanjita ChittimojuSection of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.
Kathryn L FantasiaSection of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.
Katherine L ModzelewskiSection of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.
Devin SteenkampSection of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.
Sara M AlexanianSection of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts. Electronic address: sara.alexanian@bmc.org.
Boston University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRapid improvement in blood glucose (BG) after weight-loss surgery (WLS) can make postoperative glucose management challenging in patients with type 2 diabetes mellitus (T2DM). Our study examined the safety and efficacy of insulin management strategies during hospitalization and after discharge following WLS.

methodsThis single-center retrospective cohort study included 160 adult patients with type 2 diabetes mellitus undergoing WLS. Patients with glycated hemoglobin A1C (HbA1C) level <7% (53 mmol/mol) and not on antihyperglycemic medications or metformin monotherapy were excluded. BG and insulin dosing during hospitalization and at 2-week follow-up, and impact of preoperative HbA1C level were analyzed.

resultsMean age was 46.3 years. Median preoperative HbA1C level was 8% (64 mmol/mol). Postoperatively, most patients received basal insulin plus sliding-scale insulin (SSI; 79/160, 49%) or SSI alone (77/160, 48%). The initial postoperative basal dose was 0.23 units/kg/day. The median basal insulin dose at discharge was 61% lower than preoperative dose. At 2-week follow-up, 34 of 44 patients (77%) had BG levels between 70-200 mg/dL and 1 of 44 (2.2%) had BG levels >200 mg/dL, with no hypoglycemia. Patients with HbA1C level >9% (75 mmol/mol) had higher BG on admission and during hospitalization, required higher insulin doses while hospitalized, and were more frequently discharged on insulin.

conclusionSSI is effective in managing BG in some patients immediately after WLS. However, about half of the patients may require basal insulin at doses similar to those required by other inpatients. Preoperative hyperglycemia may affect inpatient insulin needs and BG. Low-dose basal insulin appears safe and effective upon discharge for select patients.

Indexed as

Bariatric SurgeryDiabetes Mellitus, Type 2AdultBlood GlucoseGlycated HemoglobinHumansHypoglycemic AgentsInpatientsInsulinMiddle AgedPatient DischargeRetrospective StudiesBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulinbariatricglycemic controlinsulinpostoperative

Identifiers

PMID34016530
OpenAlexW3118469783

What Socratic holds

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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.