Evidence mapPaperPMID 41320960Full record

ArticleJournal of diabetes2025

Association Between Insulin Therapy and In-Hospital Death in Chronic Heart Failure Patients With Type 2 Diabetes Mellitus: Mediated by Plasma Volume.

Xiaofei Luo, Lin Zhang, Boxuan Feng, Xiangqin Ou, Jingyi Lin, Danping Zhuo, Haohao Gao, Li Liu, Minghao Xu, Jialing Liu and 2 more

Abstract read
In one paragraph

Article in Journal of diabetes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

12 authors.

Xiaofei LuoFirst Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.ORCID https://orcid.org/0009-0000-7486-503X
Lin ZhangFirst Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.ORCID https://orcid.org/0000-0003-3064-7975
Boxuan FengFirst Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Xiangqin OuTianjin University of Traditional Chinese Medicine, Tianjin, China.
Jingyi LinTianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China.
Danping ZhuoFirst Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Haohao GaoFirst Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Li LiuFirst Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Minghao XuTianjin University of Traditional Chinese Medicine, Tianjin, China.
Jialing LiuTianjin University of Traditional Chinese Medicine, Tianjin, China.
Fan JiaDepartment of Biostatistics and Data Science, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA.
Guanwei FanFirst Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.

Funding

China Postdoctoral Science Foundation 2025M773980National Natural Science Foundation of China 82430121
6 · The paper itself

Abstract

aimsTo examine the association of insulin therapy with in-hospital death and whether this association is mediated by elevated plasma volume among chronic heart failure (CHF) patients with type 2 diabetes mellitus (T2DM). MATERIALS AND

methodsA retrospective study combining two electronic medical records: the Medical Information Mart for Intensive Care (MIMIC) database and the Tianjin Heart Failure with Integrated Treatment (TJHFIT) database. Propensity score matching (1:2 ratio) was conducted in CHF-T2DM patients to eliminate the differences in demographics, comorbidity, and the severity of diabetes. Then, conditional logistic regression, restricted cubic spline (RCS) modeling, and mediation analysis were processed.

resultsA total of 7997 CHF-T2DM patients were included, with 6112 from MIMIC (2241 received insulin therapy and 3871 not), and 1885 from TJHFIT (911 received insulin therapy and 974 not). Multivariable conditional logistic regression revealed a significant association between insulin therapy during hospitalization and in-hospital death in both cohorts (MIMIC: OR, 1.37 [95% CI, 1.14-1.63]; TJHFIT: OR, 2.56 [95% CI, 1.53-4.27]). Insulin therapy was associated with a higher likelihood of ΔePVS > 0 (MIMIC: OR, 1.11 [95% CI, 1.02-1.28]; TJHFIT: OR, 1.37 [95% CI, 1.13-1.66]). RCS revealed both ePVS and ΔePVS were associated with in-hospital death in a nonlinear fashion. The ePVS at discharge mediated insulin-associated in-hospital death with a proportion of 12.0% (MIMIC) and 13.2% (TJHFIT).

conclusionsInsulin therapy was associated with elevated odds of in-hospital death among CHF-T2DM patients, which was mediated by plasma volume.

trial registrationThe research has been registered (ChiCTR2300077220).

Indexed as

Diabetes Mellitus, Type 2Heart FailureHospital MortalityHypoglycemic AgentsInsulinPlasma VolumeAgedChronic DiseaseFemaleHospitalizationHumansMaleMiddle AgedRetrospective StudiesHypoglycemic AgentsInsulinchronic heart failurein‐hospital deathinsulintype 2 diabetes mellitus

Identifiers

PMID41320960
PMCPMC12665801

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.