Evidence map›Paper›PMID 31865632›Full record

ReviewDiabetes, obesity & metabolism2020

The importance of the initial period of basal insulin titration in people with diabetes.

Kamlesh Khunti, Francesco Giorgino, Lori Berard, Didac Mauricio, Stewart B Harris

Open access · bronzeAbstract readReview
In one paragraph

Review in Diabetes, obesity & metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
2.9field-weighted citation impact, top 8% 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

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Pharmacokinetic and Pharmacodynamic Properties of Once-Weekly Insulin Efsitora Alfa in Japanese Patients with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
    Article
  7. Article
  8. An SMS-Guided Basal Insulin Titration in People with Type 2 Diabetes New on Insulin.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024
    Article
  9. Review
  10. Article
  11. Review
  12. Expert Opinion: A Call for Basal Insulin Titration in Patients with Type 2 Diabetes in Daily Practice: Southeast European Perspective.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021
    Article
  13. Article
  14. Article
  15. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 4 countries.

Kamlesh KhuntiDiabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.ORCID 0000-0003-2343-7099
Francesco GiorginoUniversity of Bari Aldo Moro, Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Bari, Italy.
Lori BerardWinnipeg Regional Health Authority, Health Sciences Centre, Winnipeg, Manitoba, Canada.ORCID 0000-0002-9695-2094
Didac MauricioInstitut Investigació Biomèdica Sant Pau, Barcelona, Spain.ORCID 0000-0002-2868-0250
Stewart B HarrisThe Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Hospital de Sant Pau · ESUniversity of Bari Aldo Moro · ITUniversity of Leicester · GBWestern University · CAWinnipeg Regional Health Authority · CA

Funding

Sanofi
6 · The paper itself

Abstract

Achieving target glycaemic control is essential in people with diabetes to minimize the risk of long-term complications, and many people with type 2 diabetes will ultimately require basal insulin (BI) therapy to achieve their individualized glycaemic targets. Usually, the first 12 weeks following initiation of BI therapy represents the period when the greatest dose increases and glycaemic reductions occur. Effective glycaemic control combined with minimizing the risk of hypoglycaemia is important to enable the achievement of glycaemic control in the longer term. However, substantial therapeutic inertia exists in clinical practice, both in initiation and up-titration of BI, owing to patient-, physician- and healthcare system-related barriers, including fear of hypoglycaemia and the perception of a burdensome regimen. The more prolonged duration of action, reduced glycaemic variability and lower risk of hypoglycaemia seen with second-generation versus first-generation BI analogues may help alleviate patients' and physicians' concerns and facilitate titration. In turn, optimal BI titration and subsequent metabolic benefits may help improve therapy adherence and self-management. This review details the clinical implications of prompt titration of BI to achieve early glycaemic control, and the importance of minimizing hypoglycaemia risk within the initial titration period. Facilitation of patients' self-management of BI is also addressed.

Indexed as

Diabetes Mellitus, Type 2HypoglycemiaBlood GlucoseHumansHypoglycemic AgentsInsulinBlood GlucoseHypoglycemic AgentsInsulinbasal insulinglycaemic controlhypoglycaemiainsulin analoguesinsulin therapy

Identifiers

PMID31865632
PMCPMC7187252
OpenAlexW2996036402

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.