Evidence mapPaperPMID 39907628Full record

SynthesisJournal of diabetes investigation2025

Efficacy and safety of premixed versus basal-bolus regimens as intensification of insulin therapy in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized clinical trials.

Mohsen Dehghani, Masoumeh Sadeghi, Farzaneh Barzkar, Mohammad Ebrahim Khamseh, Ashkan Torshizian, Hamid Reza Baradaran

Abstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal of diabetes investigation, 2025. 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
field-weighted citation impact
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.

  1. Article
  2. 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

6 authors.

Mohsen DehghaniDepartment of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Masoumeh SadeghiDepartment of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Farzaneh BarzkarEndocrinology Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Mohammad Ebrahim KhamsehEndocrinology Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Ashkan TorshizianMetabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.ORCID https://orcid.org/0000-0002-5798-7737
Hamid Reza BaradaranDepartment of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Funding

Iran University of Medical Sciences 111937
6 · The paper itself

Abstract

aimTo estimate the efficacy and safety of the basal-bolus and premixed insulin as intensification regimens in patients with type 2 diabetes mellitus (T2DM).

methodsA comprehensive search of online databases was performed until December 2022 to identify randomized controlled trials (RCTs) comparing premixed insulin versus basal-bolus regimen with treat-to-target intention. The Cochrane ROB-2 tool and GRADE approach were used for quality assessment and certainty of the evidence, respectively. Pooled weighted mean difference (WMD) and odds ratio (OR) were calculated using random-effects meta-analysis models.

resultsEighteen RCTs were included in the meta-analysis, and 66% had a low risk of bias. We found no significant difference between the two regimens regarding HbA1c reduction (WMD: 0.03% [-0.05%, 0.10%]). The basal-bolus regimen improved fasting plasma glucose (FPG) more than the premixed regimen (WMD: 6.35 mg/dL [0.31, 12.39]). Both had similar effects on weight gain. The odds of developing overall, nocturnal, and severe hypoglycemia were comparable (pooled OR: 0.9, 1.02, and 1.00, respectively) with no heterogeneity. Findings of the model were robust. The certainty of the evidence was moderate to high for all outcomes except FPG.

conclusionsTwo regimens are clinically comparable. Patient preference should be considered when adopting an individualized approach in a real-world setting.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsInsulinBlood GlucoseGlycated HemoglobinHumansRandomized Controlled Trials as TopicTreatment OutcomeBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulinBasal‐bolus InsulinPremixed InsulinType 2 Diabetes Mellitus

Identifiers

PMID39907628
PMCPMC12057386

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.