Evidence map›Paper›PMID 34758497›Full record

ArticleAmerican journal of perinatology2022

Correlates of Insulin Selection as a First-Line Pharmacological Treatment for Gestational Diabetes.

Anna Palatnik, Rachel K Harrison, Madhuli Y Thakkar, Rebekah J Walker, Leonard E Egede

Open access · greenAbstract readComparative Study
In one paragraph

Article in American journal of perinatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 31% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. 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

5 authors at 1 institution in 1 country.

Anna PalatnikDepartment of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin.ORCID 0000-0001-6568-0201
Rachel K HarrisonDepartment of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Madhuli Y ThakkarCenter for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin.
Rebekah J WalkerCenter for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin.
Leonard E EgedeCenter for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin.
Medical College of Wisconsin · US

Funding

HOME DM-BAT: Home-based Diabetes-Modified Behavioral Activation Treatment for Low Income Seniors with T2DM Diversity SupplementR01DK118038 · NIDDK · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI EGEDE, LEONARD E. · 2019 to 2023
$3.5M
Financial Incentives And Nurse Coaching to Enhance Diabetes Outcomes (FINANCE-DM) - Diversity SupplementR01DK120861 · NIDDK · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI EGEDE, LEONARD E. · 2019 to 2023
$3.4M
Lowering the Impact of Food insecurity in African American Adults with Type 2 Diabetes Mellitus (LIFT-DM) - Diversity SupplementR01MD013826 · NIMHD · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI EGEDE, LEONARD E., WALKER, REBEKAH J · 2019 to 2023
$3.4M
Technology Intensified Diabetes Education Study in AA with T2DM (TIDES)K24DK093699 · NIDDK · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI EGEDE, LEONARD E. · 2011 to 2020
$1.5M
NIDDK NIH HHS K24 DK093699NIDDK NIH HHS R01 DK118038NIDDK NIH HHS R01 DK120861NIMHD NIH HHS R01 MD013826
6 · The paper itself

Abstract

objectiveThe aim of this study was to investigate prenatal factors associated with insulin prescription as a first-line pharmacotherapy for gestational diabetes mellitus (GDM; compared with oral antidiabetic medication) after failed medical nutrition therapy. STUDY

designThis is a retrospective cohort study of 437 women with a singleton pregnancy and diagnosis of A2GDM (GDM requiring pharmacotherapy), delivering in a university hospital between 2015 and 2019. Maternal sociodemographic and clinical characteristics, as well as GDM-related factors, including provider type that manages GDM, were compared between women who received insulin versus oral antidiabetic medication (metformin or glyburide) as the first-line pharmacotherapy using univariable and multivariable analyses.

resultsIn univariable analysis, maternal age, race and ethnicity, insurance, chronic hypertension, gestational age at GDM diagnosis, glucose level after 50-g glucose loading test, and provider type were associated with insulin prescription. In multivariable analysis, after adjusting for sociodemographic and clinical maternal factors, GDM characteristics and provider type, Hispanic ethnicity (0.26, 95% confidence interval [CI]: 0.09-0.73), and lack of insurance (0.34, 95% CI: 0.13-0.89) remained associated with lower odds of insulin prescription, whereas endocrinology management of GDM (compared with obstetrics and gynecology [OBGYN]) (8.07, 95% CI: 3.27-19.90) remained associated with higher odds of insulin prescription.

conclusionWomen of Hispanic ethnicity and women with no insurance were less likely to receive insulin and more likely to receive oral antidiabetic medication for GDM pharmacotherapy, while management by endocrinology was associated with higher odds of insulin prescription.This finding deserves more investigation to understand if differences are due to patient choice or a health disparity in the choice of pharmacologic agent for A2GDM. KEY POINTS: · Insulin is recommended as a first-line pharmacotherapy for gestational diabetes.. · Women of Hispanic ethnicity were less likely to receive insulin as first line.. · Lack of insurance was also associated with lower odds of insulin prescription..

Indexed as

Hispanic or LatinoMedically UninsuredAdministration, OralAdultAnalysis of VarianceBlood GlucoseDiabetes, GestationalFemaleGlyburideHealthcare DisparitiesHumansHypoglycemic AgentsInsulinMetforminPractice Patterns, Physicians'PregnancyBlood GlucoseGlyburideHypoglycemic AgentsInsulinMetformin

Identifiers

PMID34758497
PMCPMC8812314
OpenAlexW3212894960

What OpenQuestion holds

Textmetadata
LicenceTDM
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.