Evidence map›Paper›PMID 35546449›Full record

Trial reportDiabetes, obesity & metabolism2022

Reduced hypoglycaemia using liver-targeted insulin in individuals with type 1 diabetes.

Ruth S Weinstock, Bruce W Bode, Satish K Garg, David C Klonoff, Caroline El Sanadi, W Blair Geho, Douglas B Muchmore, Marc S Penn

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 23% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Review
  3. 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

8 authors at 6 institutions in 1 country.

Ruth S WeinstockSUNY Upstate Medical University, Syracuse, New York.
Bruce W BodeAtlanta Diabetes Associates, Atlanta, Georgia.
Satish K GargBarbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado.
David C KlonoffMills-Peninsula Medical Center, San Mateo, California.ORCID 0000-0001-6394-6862
Caroline El SanadiDiasome Pharmaceuticals, Inc., Cleveland, Ohio.
W Blair GehoDiasome Pharmaceuticals, Inc., Cleveland, Ohio.
Douglas B MuchmoreDiasome Pharmaceuticals, Inc., Cleveland, Ohio.
Marc S PennDiasome Pharmaceuticals, Inc., Cleveland, Ohio.ORCID 0000-0002-2174-7467
Viamet Pharmaceuticals (United States) · USAtlanta Diabetes Associates · USMills Peninsula Health Services · USSumma Health System · USSUNY Upstate Medical University · USUniversity of Colorado Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo investigate whether an increased bolus: basal insulin ratio (BBR) with liver-targeted bolus insulin (BoI) would increase BoI use and decrease hypoglycaemic events (HEv). PATIENT POPULATION AND

methodsWe enrolled 52 persons (HbA1c 6.9% ± 0.12%, mean ± SEM) with type 1 diabetes using multiple daily injections. Hepatic-directed vesicle (HDV) was used to deliver 1% of peripheral injected BoI to the liver. A 90-day run-in period was used to introduce subjects to unblinded continuous glucose monitoring and optimize standard basal insulin (BaI) (degludec) and BoI (lispro) dosing. At 90 days, BoI was changed to HDV-insulin lispro and subjects were randomized to an immediate 10% or 40% decrease in BaI dose.

resultsAt 90 days postrandomization, total insulin dosing was increased by ~7% in both cohorts. The -10% and -40% BaI cohorts were on 7.7% and 13% greater BoI with 6.9% and 30% (P = .02) increases in BBR, respectively. Compared with baseline at randomization, nocturnal level 2 HEv were reduced by 21% and 43%, with 54% and 59% reductions in patient-reported HEv in the -10% and -40% BaI cohorts, respectively.

conclusionsOur study shows that liver-targeted BoI safely decreases HEv and symptoms without compromising glucose control. We further show that with initiation of liver-targeted BoI, the BBR can be safely increased by significantly lowering BaI dosing, leading to greater BoI usage.

Indexed as

Diabetes Mellitus, Type 1Diabetes Mellitus, Type 2HypoglycemiaBlood GlucoseBlood Glucose Self-MonitoringGlycated HemoglobinHumansHypoglycemic AgentsInsulinInsulin GlargineInsulin LisproInsulin, Long-ActingInsulin, Regular, HumanLiverBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulinInsulin GlargineInsulin LisproInsulin, Long-ActingInsulin, Regular, Humanclinical trialhypoglycaemiainsulin therapytype 1 diabetes

Identifiers

PMID35546449
PMCPMC9546184
OpenAlexW4280593521

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.