Evidence map›Paper›PMID 31364233›Full record

ArticleDiabetes, obesity & metabolism2019

Fixed versus flexible combination of GLP-1 receptor agonists with basal insulin in type 2 diabetes: A retrospective multicentre comparative effectiveness study.

Mario Luca Morieri, Mauro Rigato, Vera Frison, Natalino Simioni, Michele D'Ambrosio, Federica Tadiotto, Agostino Paccagnella, Annunziata Lapolla, Angelo Avogaro, Gian Paolo Fadini

Registry-linked trialOpen access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes, obesity & metabolism, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT03959865. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% 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.

NCT03959865 unknown status

Effectiveness and Persistence of Therapy With GLP-1 Receptor Agonists in Clinical Practice. A Multicenter Retrospective Study

Ran2018Enrolled6,000Registered outcomes4Posted comparisons0ConditionsType 2 DiabetesArmsExendin-based GLP-1RA, Fixed ratio BI/GLP-1RA combination, Flexible BI/GLP-1RA combination, Human-based GLP-1RA, Long-acting GLP-1RA
PMID 27717195PMID 27717130PMID 30291106PMID 29221659PMID 19444259other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
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  7. Observational
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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

10 authors at 4 institutions in 2 countries.

Mario Luca MorieriDepartment of Medicine, University of Padova, Padova, Italy.
Mauro RigatoDiabetology Service, ULSS2, Treviso, Italy.
Vera FrisonInternal Medicine and Diabetology Service, ULSS6, Cittadella, Italy.
Natalino SimioniInternal Medicine and Diabetology Service, ULSS6, Cittadella, Italy.
Michele D'AmbrosioDiabetology Service, ULSS6, Monselice, Italy.
Federica TadiottoDiabetology Service, ULSS6, Monselice, Italy.
Agostino PaccagnellaDiabetology Service, ULSS2, Treviso, Italy.
Annunziata LapollaDepartment of Medicine, University of Padova, Padova, Italy.
Angelo AvogaroDepartment of Medicine, University of Padova, Padova, Italy.ORCID 0000-0002-1177-0516
Gian Paolo FadiniDepartment of Medicine, University of Padova, Padova, Italy.ORCID 0000-0002-6510-2097
University of Padua · ITAULSS 2 Marca Trevigiana · ITCasa di Cura Città di Roma · ITUniversity of Mons · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThe combination of basal insulin (BI) and GLP-1 receptor agonists (GLP-1RAs) is a rational and effective therapy for patients with uncontrolled type 2 diabetes (T2D). We compared the effectiveness of fixed and flexible BI/GLP-1RA combinations using routinely accumulated clinical data.

methodsThis was a retrospective, multicentre, real-world study concerning T2D patients initiating a fixed or flexible BI/GLP-1RA combination (NCT03959865). The primary endpoint was change in HbA1c. Secondary endpoints were changes in body weight, fasting plasma glucose (FPG) and systolic blood pressure (SBP). Confounding was addressed by propensity score matching (PSM) or multivariable adjustment (MVA).

resultsA total of 609 patients were included in the study, 131 in the fixed group and 478 in the flexible group. The two groups differed in terms of diabetes duration, body weight and concomitant medications. After 5.7 months, observed HbA1c reductions were 0.6% and 0.8%, and body weight reductions were 2.8 kg and 1.2 kg in the flexible and fixed groups, respectively. Following PSM, HbA1c declined similarly in the two groups, whereas reduction in body weight was significantly in favour of the flexible combination. Findings were robust in sensitivity analyses, with the exception that, with MVA, a significantly higher reduction in HbA1c was detected in the fixed group. Final doses of BI were higher in the fixed group, whereas those of GLP-1RA were higher in the flexible group.

conclusionsIn routine specialist care, initiation of the fixed or flexible BI/GLP-1RA combination allowed similar improvement in glycaemic control, but greater weight loss was observed with the flexible combination. This difference reflected dosages of BI and GLP-1RAs.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsAgedBlood GlucoseDiabetes Mellitus, Type 2Drug Therapy, CombinationFemaleGlucagon-Like Peptide-1 ReceptorGlycated HemoglobinHumansHypoglycemic AgentsInsulinMaleMiddle AgedRetrospective StudiesBlood GlucoseGlucagon-Like Peptide-1 ReceptorGlucagon-Like Peptide-1 Receptor AgonistsGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinbasal insulinGLP-1 analogueobservational studytype 2 diabetes

Identifiers

PMID31364233
PMCPMC6852173
OpenAlexW2965089458

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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.