Evidence mapPaperPMID 35045841Full record

ArticleBMC endocrine disorders2022

Effectiveness and safety of basal insulin therapy in type 2 diabetes mellitus patients with or without metformin observed in a national cohort in China.

Puhong Zhang, Minyuan Chen, Heng Zhang, Yingying Luo, Dongshan Zhu, Xian Li, Jiachao Ji, Du Wang, Nadila Duolikun, Linong Ji

Open access · goldFull text read
In one paragraph

Article in BMC endocrine disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Observational
  5. 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

10 authors at 3 institutions in 2 countries.

Puhong Zhang *The George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China.
Minyuan Chen *The George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China.
Heng Zhang *The George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China.
Yingying LuoDepartment of Endocrinology and Metabolism, Peking University People's Hospital, 100040, Beijing, China.
Dongshan ZhuThe George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China.
Xian LiThe George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China.
Jiachao JiThe George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China.
Du WangThe George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China.
Nadila DuolikunThe George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China.
Linong JiThe George Institute for Global Health at Peking University Health Science Center, 100600, Beijing, China. jiln@bjmu.edu.cn.
Peking University · CNGeorge Institute for Global Health · CNUNSW Sydney · AU

Funding

Sanofi China Investment Company N/A
6 · The paper itself

Abstract

backgroundThough many randomized control trials had examined the effectiveness and safety of taking insulin therapy with or without metformin, there are limited real-world data, especially among Chinese type 2 diabetes patients initiating basal insulin (BI) with uncontrolled hyperglycemia by oral agents. This study was designed to assess the effectiveness and safety of BI therapy combined with or without metformin in a real-world national cohort study.

methodsPatients with type 2 diabetes mellitus who initiated BI treatment due to uncontrolled hyperglycemia (HbA1c≥7 %) by oral antidiabetic drugs (OADs) were recruited in Chinese real-world settings between 2011 and 2013. A total of 12,358 patients initiated BI without bolus insulin and completed a 6-month follow-up were selected as the study population and divided into BI with metformin or BI without metformin group based on whether metformin was simultaneously prescribed or not at baseline. Propensity score adjustment was used to balance baseline covariates between two groups. A sub-analysis was also conducted among 8,086 patients who kept baseline treatment regimen during the follow-up. Outcomes were HbA1c, hypoglycemia, weight gain and insulin dose in two groups.

results53.6 % (6,621 out of 12,358) patients initiated BI therapy concomitant with metformin. After propensity score adjustment, multivariate regression analysis controlled with number of OADs, total insulin dose, physical activity and diet consumption showed that BI with metformin group had a slightly higher control rate of HbA1c <7.0 % (39.9 % vs. 36.4 %, P = 0.0011) at 6-month follow-up, and lower dose increment from baseline to 6-month (0.0064 vs. 0.0068 U/day/kg, P = 0.0035). The sub-analysis with patients remained at same BI therapy further showed that BI with metformin group had higher HbA1c control rate (47.9 % vs. 41.9 %, P = 0.0001), less weight gain (-0.12 vs. 0.15 kg P = 0.0013), and lower dose increment during 6-month follow-up (0.0033 vs. 0.0037 U/day/kg, P = 0.0073) when compared with BI without metformin group.

conclusionsIn alliance with current guidelines, the real-world findings also support the insulin initiation together with metformin. Continuous patients' education and clinicians training are needed to improve the use of metformin when initiating BI treatment.

Indexed as

AdolescentAdultAgedAged, 80 and overChinaDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansHypoglycemic AgentsInsulinMaleMetforminMiddle AgedWeight GainGlycated HemoglobinHypoglycemic AgentsInsulinMetformin

Identifiers

PMID35045841
PMCPMC8767735
OpenAlexW4220727219

What Socratic holds

Textfull text, public
LicenceCC BY
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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.