Evidence mapPaperPMID 38441838Full record

ArticleJournal of endocrinological investigation2024

Temporal trends in the starting of insulin therapy in type 2 diabetes in Italy: data from the AMD Annals initiative.

A Giandalia, A Nicolucci, M Modugno, G Lucisano, M C Rossi, V Manicardi, A Rocca, G Di Cianni, P Di Bartolo, R Candido and 2 more

Open access · hybridAbstract read
In one paragraph

Article in Journal of endocrinological investigation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 22% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Observational
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

12 authors at 7 institutions in 1 country.

A GiandaliaDepartment of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98100, Messina, Italy. agiandalia@yahoo.it.
A NicolucciCenter for Outcomes Research and Clinical Epidemiology, CORESEARCH, Pescara, Italy.
M ModugnoASLBA-DSS10 Poliambulatorio, Triggiano, BA, Italy.
G LucisanoCenter for Outcomes Research and Clinical Epidemiology, CORESEARCH, Pescara, Italy.
M C RossiCenter for Outcomes Research and Clinical Epidemiology, CORESEARCH, Pescara, Italy.
V ManicardiFondazione AMD, Rome, Italy.
A RoccaSS Diabetes and Metabolic disease, Bassini Hospital Cinisello Balsamo, Milan, Italy.
G Di CianniDiabetes and Metabolic Diseases Unit, Livorno Hospital, Livorno, Italy.
P Di BartoloDiabetes Unit, Local Healthcare Authority of Romagna, Ravenna, Italy.
R CandidoSS Diabetes and Metabolic disease, Bassini Hospital Cinisello Balsamo, Milan, Italy.
D CucinottaDepartment of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98100, Messina, Italy.
G T RussoDepartment of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98100, Messina, Italy.
Center for Outcomes Research and Clinical Epidemiology · ITUniversity of Messina · ITAzienda Unità Sanitaria Locale Della Romagna · ITFondazione Roma · ITOspedale Bassini · ITOspedale di Livorno · ITUniversity of Trieste · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsOpportunities and needs for starting insulin therapy in Type 2 diabetes (T2D) have changed overtime. We evaluated clinical characteristics of T2D subjects undergoing the first insulin prescription during a 15-year-observation period in the large cohort of the AMD Annals Initiative in Italy.

methodsData on clinical and laboratory variables, complications and concomitant therapies and the effects on glucose control after 12 months were evaluated in T2D patients starting basal insulin as add-on to oral/non-insulin injectable agents, and in those starting fast-acting in add-on to basal insulin therapy in three 5-year periods (2005-2019).

resultsWe evaluated data from 171.688 T2D subjects who intensified therapy with basal insulin and 137.225 T2D patients who started fast-acting insulin. Overall, intensification with insulin occurred progressively earlier over time in subjects with shorter disease duration. Moreover, the percentage of subjects with HbA1c levels > 8% at the time of basal insulin initiation progressively decreased. The same trend was observed for fast-acting formulations. Clinical characteristics of subjects starting insulin did not change in the three study-periods, although all major risk factors improved overtime. After 12 months from the starting of basal or fast-acting insulin therapy, mean HbA1c levels decreased in all the three investigated time-periods, although mean HbA1c levels remained above the recommended target.

conclusionsIn this large cohort of T2D subjects, a progressively earlier start of insulin treatment was observed during a long observation period, suggesting a more proactive prescriptive approach. However, after 12 months from insulin prescription, in many patients, HbA1c levels were still out-of-target.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 2Hypoglycemic AgentsInsulinAgedFemaleFollow-Up StudiesGlycated HemoglobinHumansItalyMaleMiddle AgedTime FactorsBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinAMD Annals InitiativeClinical inertiaInsulin therapyObservational studyType 2 diabetes

Identifiers

PMID38441838
PMCPMC11266210
OpenAlexW4392472598

What Socratic holds

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Registered trials

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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.