SynthesisDiabetologia2009
Optimal insulin regimens in type 2 diabetes mellitus: systematic review and meta-analyses.
Synthesis in Diabetologia, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Effects of insulin regimens for type 2 diabetes mellitus: a systematic review and network meta-analysis.Diabetologia · 2026Pooled it
- Diabetes: glycaemic control in type 2 (drug treatments).BMJ clinical evidence · 2012Pooled it
- Efficacy of insulin analogs in achieving the hemoglobin A1c target of <7% in type 2 diabetes: meta-analysis of randomized controlled trials.Diabetes care · 2011Pooled it
- A pragmatic study of mid-mixture insulin and basal insulin treatment in patients with type 2 diabetes uncontrolled with oral antihyperglycaemic medications: A lesson from real-world experience.Diabetes, obesity & metabolism · 2020Trial
- Trial
- Prandial-basal insulin regimens plus oral antihyperglycaemic agents to improve mealtime glycaemia: initiate and progressively advance insulin therapy in type 2 diabetes.Diabetes, obesity & metabolism · 2010Trial
- GZR101, a Novel Premixed Insulin for the Treatment of Diabetes Mellitus.Naunyn-Schmiedeberg's archives of pharmacology · 2025Article
- Management of hyperglycaemia in people with obesity.Clinical medicine (London, England) · 2023Article
- Management of diabesity: Current concepts.World journal of diabetes · 2023Review
- Body Weight Considerations in the Management of Type 2 Diabetes.Advances in therapy · 2019Review
- Premixed insulin regimens for type 2 diabetes.Endocrine · 2016Article
- Clinical Characteristics of Patients Responding to Once-Daily Basal Insulin Therapy in Korean Subjects with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2015Article
- Practical Guidance on the Use of Premix Insulin Analogs in Initiating, Intensifying, or Switching Insulin Regimens in Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2015Article
- Insulin initiation: bringing objectivity to choice.Journal of diabetes and metabolic disorders · 2015Article
- Evaluation of insulin regimens as an effective option for glycemic control in patients with type 2 diabetes: A propensity score-matched cohort study across Japan (JDDM31).Journal of diabetes investigation · 2014Article
- Clinical study of treatment switching from premixed insulin to basal insulin combined with oral hypoglycemic drugs in patients with type 2 diabetes.Diabetology & metabolic syndrome · 2014Article
- Role of premixed insulin analogues in the treatment of patients with type 2 diabetes mellitus: a narrative review.Journal of diabetes · 2014Review
- Trends in insulin initiation and treatment intensification among patients with type 2 diabetes.Journal of general internal medicine · 2014Observational
- Evidence-based clinical use of insulin premixtures.Diabetology & metabolic syndrome · 2013Article
- Hypoglycemia: The neglected complication.Indian journal of endocrinology and metabolism · 2013Review
Corrections and comments
- Commented on by
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisWe compared the effect of biphasic, basal or prandial insulin regimens on glucose control, clinical outcomes and adverse events in people with type 2 diabetes.
methodsWe searched the Cochrane Library, MEDLINE, EMBASE and major American and European conference abstracts for randomised controlled trials up to October 2008. A systematic review and meta-analyses were performed.
resultsTwenty-two trials that randomised 4,379 patients were included. Seven trials reported both starting insulin dose and titration schedules. Hypoglycaemia definitions and glucose targets varied. Meta-analyses were performed pooling data from insulin-naive patients. Greater HbA(1c) reductions were seen with biphasic and prandial insulin, compared with basal insulin, of 0.45% (95% CI 0.19-0.70, p = 0.0006) and 0.45% (95% CI 0.16-0.73, p = 0.002), respectively, but with lesser reductions of fasting glucose of 0.93 mmol/l (95% CI 0.21-1.65, p = 0.01) and 2.20 mmol/l (95% CI 1.70-2.70, p < 0.00001), respectively. Larger insulin doses at study end were reported in biphasic and prandial arms compared with basal arms. No studies found differences in major hypoglycaemic events, but minor hypoglycaemic events for prandial and biphasic insulin were inconsistently reported as either higher than or equivalent to basal insulin. Greater weight gain was seen with prandial compared with basal insulin (1.86 kg, 95% CI 0.80-2.92, p = 0.0006). CONCLUSIONS/
interpretationGreater HbA(1c) reduction may be obtained in type 2 diabetes when insulin is initiated using biphasic or prandial insulin rather than a basal regimen, but with an unquantified risk of hypoglycaemia. Studies with longer follow-up are required to determine the clinical relevance of this finding.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.