Evidence map›Paper›PMID 24916838›Full record

Trial reportDiabetes/metabolism research and reviews2015

A comparison of continuous intravenous insulin and subcutaneous insulin among patients with type 2 diabetes and congestive heart failure exacerbation.

Kathleen M Dungan, Kwame Osei, Trudy Gaillard, Jared Moore, Philip Binkley

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes/metabolism research and reviews, 2015. 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
0.9field-weighted citation impact, top 26% 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, 8 citations in OpenAlex.

  1. Article
  2. Article
  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

5 authors at 2 institutions in 1 country.

Kathleen M DunganDivision of Endocrinology, Diabetes, and Metabolism, The Ohio State University, Columbus, OH, USA.
Kwame Osei
Trudy Gaillard
Jared Moore
Philip Binkley
The Ohio State University · USLung Institute · US

Funding

University of Iowa Clinical and Translational Science Program (TL1)UL1RR025755 · NCRR · OHIO STATE UNIVERSITY · PI JACKSON, REBECCA D · 2008 to 2011
$26.3M
The Ohio State University Center for clinical and Translational ScienceUL1TR001070 · NCATS · OHIO STATE UNIVERSITY · PI JACKSON, REBECCA D · 2013 to 2017
$22.6M
Intensive glycemic control for congestive heart failure exacerbationK23DK080891 · NIDDK · OHIO STATE UNIVERSITY · PI DUNGAN, KATHLEEN MARIE · 2008 to 2012
$748k
Glycemic control and variability in congestive heart failure exacerbationR21DK081877 · NIDDK · OHIO STATE UNIVERSITY · PI DUNGAN, KATHLEEN MARIE · 2008 to 2009
$413k
NCATS NIH HHS UL1 TR001070NCRR NIH HHS UL1 RR025755NCRR NIH HHS UL1RR025755NIDDK NIH HHS K23 DK080891NIDDK NIH HHS K23DK080891NIDDK NIH HHS R21 DK081877NIDDK NIH HHS R21DK081877
6 · The paper itself

Abstract

backgroundThe study aims to determine whether the route of insulin administration influences glycaemic variability and inflammatory or neurohormonal markers in patients with type 2 diabetes and congestive heart failure (CHF) exacerbation.

methodsPatients (n = 65) were randomized to intravenous (IV) insulin (duration 48 h) or subcutaneous (SQ) insulin. Inflammatory cytokines and markers of lipid oxidation, high-frequency heart rate variability (n = 27) and cardiac impedance (pre-ejection period, n = 28) were used to estimate parasympathetic and sympathetic tone in patients with valid cardiac data. Glycaemic variability was measured using a continuous glucose monitor.

resultsMean glucose was lower (7.7 ± 1.2 vs 9.4 ± 2.7 mmol/L, p = 0.004), coefficient of variation was higher (p = 0.03) and glycaemic lability index was similar on day 1 in the IV group compared with the SQ group, but groups were similar by day 2. The IV group had more confirmed hypoglycaemia (p = 0.005). There were no differences in hospital readmission or hospital length of stay between groups. There were no differences in CHF biomarkers, heart rate variability or pre-ejection period between groups. Increasing log glycaemic lability index was associated with lower on-treatment pre-ejection period (p = 0.03) while increasing coefficient of variation was associated with increasing brain natriuretic peptide (p = 0.004) and paroxonase-1 (p = 0.02). Other univariable analyses were not significant.

conclusionsThere were modest, transient differences in glucose control between IV and SQ insulin in hospitalized CHF patients. However, the analyses do not support a link between insulin route and inflammatory markers or autonomic tone. Further study is needed to assess outcomes in hospitalized CHF patients.

Indexed as

Administration, IntravenousAgedBlood GlucoseDiabetes Mellitus, Type 2Disease ProgressionFemaleHeart FailureHumansInjections, SubcutaneousInsulinInsulin AspartInsulin Infusion SystemsInsulin LisproMaleMiddle AgedTreatment OutcomeBlood GlucoseInsulinInsulin AspartInsulin Lisproheart failureinsulintype 2 diabetes

Identifiers

PMID24916838
PMCPMC4262716
OpenAlexW1903751746

What OpenQuestion holds

Textmetadata
LicenceTDM
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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 OpenQuestion graph.