Evidence map›Paper›PMID 31888933›Full record

ArticleBMJ open2019

HbA1c variability in adults with type 1 diabetes on continuous subcutaneous insulin infusion (CSII) therapy compared to multiple daily injection (MDI) treatment.

Emma S Scott, Rachel T McGrath, Andrzej S Januszewski, Daniel Calandro, Anandwardhan A Hardikar, David N O'Neal, Gregory Fulcher, Alicia J Jenkins

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
2.2field-weighted citation impact, top 11% 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

11 citing papers in PubMed, 25 citations in OpenAlex.

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  4. Clinical Translation of Bio-Artificial Pancreas Therapies: Ethical, Legal and Psychosocial Interdisciplinary Considerations and Key Recommendations.Transplant international : official journal of the European Society for Organ Transplantation · 2023
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  8. Observational
  9. Imaging the eye and its relevance to diabetes care.Journal of diabetes investigation · 2021
    Review
  10. Article
  11. 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

8 authors at 2 institutions in 1 country.

Emma S ScottNHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.ORCID 0000-0002-6795-8198
Rachel T McGrathDepartment of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Andrzej S JanuszewskiNHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.
Daniel CalandroNHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.
Anandwardhan A HardikarNHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.
David N O'NealDepartment of Medicine, University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-0870-4032
Gregory FulcherDepartment of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Alicia J JenkinsNHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia alicia.jenkins@ctc.usyd.edu.au.
The University of Sydney · AUThe University of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine if continuous subcutaneous insulin infusion (CSII) therapy is associated with lower glycated haemoglobin (HbA1c) variability (long-term glycaemic variability; GV) relative to multiple daily injection (MDI) treatment in adults with type 1 diabetes mellitus (T1DM).

designRetrospective audit. SETTING AND

participantsClinic records from 506 adults with T1DM from two tertiary Australian hospitals. OUTCOME MEASURES: Long-term GV was assessed by HbA1c SD and coefficient of variation (CV) in adults on established MDI or CSII therapy, and in a subset changing from MDI to CSII.

resultsAdults (n=506, (164 CSII), 50% women, mean±SD age 38.0±15.3 years, 17.0±13.7 years diabetes, mean HbA1c 7.8%±1.2% (62±13 mmol/mol) on CSII, 8.0%±1.5% (64±16 mmol/mol) on MDI) were followed for 4.1±3.6 years. CSII use was associated with lower GV (HbA1c SD: CSII vs MDI 0.5%±0.41% (6±6 mmol/mol) vs 0.7%±0.7% (9±8 mmol/mol)) and CV: CSII vs MDI 6.7%±4.6% (10±10 mmol/mol) vs 9.3%±7.3% (14±13 mmol/mol), both p<0.001. Fifty-six adults (73% female, age 36±13 years, 16±13 years diabetes, HbA1c 7.8%±0.8% (62±9 mmol/mol)) transitioned from MDI to CSII. Mean HbA1c fell by 0.4%. GV from 1 year post-CSII commencement decreased significantly, HbA1c SD pre-CSII versus post-CSII 0.7%±0.5% (8±5 mmol/mol) vs 0.4%±0.4% (5±4 mmol/mol); p<0.001, and HbA1c CV 9.2%±5.5% (13±8 mmol/mol) vs 6.1%±3.9% (9±5 mmol/mol); p<0.001.

conclusionsIn clinical practice with T1DM adults relative to MDI, CSII therapy is associated with lower HbA1c GV.

Indexed as

Insulin Infusion SystemsAdultDiabetes Mellitus, Type 1FemaleGlycated HemoglobinHumansInjectionsInsulinMaleRetrospective StudiesTreatment OutcomeGlycated Hemoglobinhemoglobin A1c protein, humanInsulindiabetes & endocrinologygeneral diabetespaediatric endocrinology

Identifiers

PMID31888933
PMCPMC6937034
OpenAlexW2998540783

What OpenQuestion holds

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LicenceCC BY-NC
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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.