Evidence map›Paper›PMID 35675498›Full record

Trial reportDiabetes care2022

Efficacy and Safety of Intensive Versus Nonintensive Supplemental Insulin With a Basal-Bolus Insulin Regimen in Hospitalized Patients With Type 2 Diabetes: A Randomized Clinical Study.

Priyathama Vellanki, Saumeth Cardona, Rodolfo J Galindo, Maria A Urrutia, Francisco J Pasquel, Georgia M Davis, Maya Fayfman, Alexandra Migdal, Limin Peng, Guillermo E Umpierrez

Open access · bronzeAbstract readRandomized Controlled TrialEquivalence Trial
In one paragraph

Trial report in Diabetes care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  2. Article
  3. 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

10 authors at 1 institution in 1 country.

Priyathama VellankiDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.ORCID 0000-0002-6544-015X
Saumeth CardonaDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.
Rodolfo J GalindoDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.ORCID 0000-0002-9295-3225
Maria A UrrutiaDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.
Francisco J PasquelDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.ORCID 0000-0002-3845-6703
Georgia M DavisDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.
Maya FayfmanDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.ORCID 0000-0002-8733-3160
Alexandra MigdalDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.
Limin PengRollins School of Public Health, Emory University, Atlanta, GA.
Guillermo E UmpierrezDivision of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA.ORCID 0000-0002-3252-5026
Emory University · US

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Translational Research Core - Engagement and Behavior ChangeP30DK111024 · NIDDK · EMORY UNIVERSITY · PI Mohammed Kumail Ali · 2016 to 2026
$13.4M
Metabolic Phenotyping During Stress Hyperglycemia in Cardiac Surgery PatientsK23GM128221 · NIGMS · EMORY UNIVERSITY · PI PASQUEL, FRANCISCO J · 2018 to 2022
$957k
Use of Continuous Glucose Monitoring (CGM) in End-Stage Renal Disease(ESRD) Patients with Type 2 DiabetesK23DK123384 · NIDDK · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI GALINDO, RODOLFO · 2020 to 2024
$934k
Perioperative Stress Hyperglycemia in General and Vascular Surgery PatientsK23DK122199 · NIDDK · EMORY UNIVERSITY · PI DAVIS, GEORGIA M · 2020 to 2024
$891k
Epigenetic Markers of Short- and Long- Term Near-Normoglycemia Remission in Patients with Ketosis-Prone DiabetesK23DK113241 · NIDDK · EMORY UNIVERSITY · PI VELLANKI, PRIYATHAMA · 2019 to 2021
$646k
NCATS NIH HHS UL1 TR002378NIDDK NIH HHS K23 DK113241NIDDK NIH HHS K23 DK122199NIDDK NIH HHS K23 DK123384NIDDK NIH HHS P30 DK111024NIGMS NIH HHS K23 GM128221
6 · The paper itself

Abstract

objectiveAdministration of supplemental sliding scale insulin for correction of hyperglycemia in non-intensive care unit (ICU) patients with type 2 diabetes is frequently used with basal-bolus insulin regimens. In this noninferiority randomized controlled trial we tested whether glycemic control is similar with and without aggressive sliding scale insulin treatment before meals and bedtime in patients treated with basal-bolus insulin regimens. RESEARCH DESIGN AND

methodsPatients with type 2 diabetes with admission blood glucose (BG) 140-400 mg/dL treated with basal-bolus insulin were randomized to intensive (correction for BG >140 mg/dL, n = 108) or to nonintensive (correction for BG >260 mg/dL, n = 107) administration of rapid-acting sliding scale insulin before meals and bedtime. The groups received the same amount of sliding scale insulin for BG >260 mg/dL. Primary outcome was difference in mean daily BG levels between the groups during hospitalization.

resultsMean daily BG in the nonintensive group was noninferior to BG in the intensive group with equivalence margin of 18 mg/dL (intensive 172 ± 38 mg/dL vs. nonintensive 173 ± 43 mg/dL, P = 0.001 for noninferiority). There were no differences in the proportion of target BG readings of 70-180 mg/dL, <70 or <54 mg/dL (hypoglycemia), or >350 mg/dL (severe hyperglycemia) or total, basal, or prandial insulin doses. Significantly fewer subjects received sliding scale insulin in the nonintensive (n = 36 [34%]) compared with the intensive (n = 98 [91%] [P < 0.0001]) group with no differences in sliding scale insulin doses between the groups among those who received sliding scale insulin (intensive 7 ± 4 units/day vs. nonintensive 8 ± 4 units/day, P = 0.34).

conclusionsAmong non-ICU patients with type 2 diabetes on optimal basal-bolus insulin regimen with moderate hyperglycemia (BG <260 mg/dL), a less intensive sliding scale insulin treatment did not significantly affect glycemic control.

Indexed as

Diabetes Mellitus, Type 2HyperglycemiaBlood GlucoseHumansHypoglycemic AgentsInsulinInsulin GlargineInsulin, Regular, HumanBlood GlucoseHypoglycemic AgentsInsulinInsulin GlargineInsulin, Regular, Human

Identifiers

PMID35675498
PMCPMC9643128
OpenAlexW4282938962

What OpenQuestion holds

Textmetadata
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.