Evidence map›Paper›PMID 29961246›Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2018

Glycemic Control in Hospitalized Patients with Diabetes Receiving Corticosteroids Using a Neutral Protamine Hagedorn Insulin Protocol: A Randomized Clinical Trial.

Ameer Khowaja, Jamil B Alkhaddo, Zaighum Rana, Lisa Fish

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01970241 (Inpatient Diabetes on Corticosteroids), which is not on this map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
–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.

NCT01970241 phase4completednot on this map

Inpatient Diabetes on Corticosteroids

TypeinterventionalSponsorHennepin Healthcare Research InstituteRan2014 to 2016Enrolled85ConditionsDiabetes MellitusArmsNPH, Correction Factor
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Glucocorticoid-Induced Hyperglycemia Including Dexamethasone-Associated Hyperglycemia in COVID-19 Infection: A Systematic Review.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Pooled it
  2. Pooled it
  3. Guideline
  4. Review
  5. Review
  6. Review
  7. Review
  8. Article
  9. Review
  10. Review
  11. Review
  12. Review
  13. Prandial Insulins: A Person-Centered Choice.Current diabetes reports · 2024
    Review
  14. Article
  15. Article
  16. Insulin Dosing and Glycemic Outcomes Among Steroid-treated Hospitalized Patients.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Article
  17. Review
  18. Management of diabetes and hyperglycaemia in the hospital.The lancet. Diabetes & endocrinology · 2021 · on this map
    Review
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

4 authors.

Ameer KhowajaDivision of Diabetes, Endocrinology and Metabolism, University of Minnesota, Minneapolis, MN, USA. ameer.khowaja@hcmed.org.
Jamil B AlkhaddoDivision of Diabetes, Endocrinology and Metabolism, University of Minnesota, Minneapolis, MN, USA.
Zaighum RanaDivision of Diabetes, Endocrinology and Metabolism, University of Minnesota, Minneapolis, MN, USA.
Lisa FishDivision of Diabetes, Endocrinology and Metabolism, University of Minnesota, Minneapolis, MN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHospitalized patients with diabetes receiving corticosteroids are at risk of developing hyperglycemia and related complications. This study evaluated a neutral protamine Hagedorn (NPH) insulin-based protocol in improving glycemic control in hospitalized patients receiving corticosteroids.

methodsThis was a randomized, prospective, non-blinded study in an inpatient setting involving patients with diabetes who were hospitalized and receiving prednisone ≥ 10 mg per day or equivalent. High dose corticosteroids group (prednisone > 40 mg/day or equivalent) received NPH insulin 0.3 U/kg between 0600 and 2000 hours if eating or 0.2 U/kg between 2000 and 0600 hours if not eating. Low dose corticosteroids group (prednisone 10-40 mg/day or equivalent) received 0.15 U/kg between 0600 and 2000 hours if eating or 0.1 U/kg between 2000 and 0600 hours if not eating. Primary outcome measure was mean blood glucose level measured pre-meal and at bedtime for days 1-5.

resultsMean blood glucose level was lower in the intervention (n = 29) than in the usual care (n = 31) group [226.12 vs. 268.57 mg/dL, respectively, (95% CI for difference - 63.195 to - 21.695), p < 0.0001]. Significant differences in mean glucose level were noted at fasting [170.96 vs. 221.13 mg/dL, respectively, (95% CI for difference - 72.70 to - 27.63), p < 0.0001] and pre-lunch [208 vs. 266.48 mg/dL, respectively, (95% CI for difference - 86.61 to - 30.36), p < 0.0001].

conclusionIn hospitalized patients with diabetes receiving corticosteroids, an NPH insulin-based protocol improves glycemic control.

trial registrationClinicalTrials.gov Identifier: NCT01970241.

fundingEli Lilly and Company.

Indexed as

Diabetes mellitusDMNeutral protamine Hagedorn insulinNPHSteroids

Identifiers

PMID29961246
PMCPMC6064602

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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.