Evidence map›Paper›PMID 36782190›Full record

ArticleBMC endocrine disorders2023

Comparison of simplicity, convenience, safety, and cost-effectiveness between use of insulin pen devices and disposable plastic syringes by patients with type 2 diabetes mellitus: a cross-sectional study from Bangladesh.

A B M Kamrul-Hasan, Mohammad Abdul Hannan, Muhammad Shah Alam, Mohammad Motiur Rahman, Md Asaduzzaman, Marufa Mustari, Ajit Kumar Paul, Md Lutful Kabir, Sumon Rahman Chowdhury, Samir Kumar Talukder and 6 more

Open access · goldAbstract read
In one paragraph

Article in BMC endocrine disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 18% 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, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

16 authors at 8 institutions in 1 country.

A B M Kamrul-HasanDepartment of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh. rangassmc@gmail.com.ORCID http://orcid.org/0000-0002-5681-6522
Mohammad Abdul HannanDepartment of Endocrinology, North East Medical College, Sylhet, Bangladesh.
Muhammad Shah AlamDepartment of Medicine, Army Medical College, Cumilla, Bangladesh.
Mohammad Motiur RahmanDepartment of Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh.
Md AsaduzzamanDepartment of Endocrinology, Shaheed Sheikh Abu Naser Specialized Hospital, Khulna, Bangladesh.
Marufa MustariDepartment of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Ajit Kumar PaulDepartment of Endocrinology, Mainamoti Medical College, Cumilla, Bangladesh.
Md Lutful KabirDepartment of Endocrinology, Rangpur Medical College, Rangpur, Bangladesh.
Sumon Rahman ChowdhuryDepartment of Diabetes, Endocrinology and Metabolism, Chittagong Diabetic General Hospital, Chattogram, Bangladesh.
Samir Kumar TalukderDepartment of Endocrinology, Rangpur Medical College, Rangpur, Bangladesh.
Sourav SarkarDepartment of Medicine, Boalkhali Upazila Health Complex, Chattogram, Bangladesh.
Muhammad Abdul HannanDepartment of Medicine, 250-Bedded General Hospital, Sherpur, Bangladesh.
Md Rashedul IslamDepartment of Neurology, BIRDEM General Hospital, Dhaka, Bangladesh.
Mohammad Hasan IftekharDepartment of Biochemistry, Abdul Malek Ukil Medical College, Noakhali, Bangladesh.
Md Abdul Bari RobelDepartment of Endocrinology, Cumilla Medical College, Cumilla, Bangladesh.
Shahjada SelimDepartment of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Bangladesh Medical University · BDComilla Medical College · BDDinajpur Medical College · BDNorth East University · BDBangladesh Institute of Research and Rehabilitation for Diabetes Endocrine and Metabolic Disorders · BDMymensingh Medical College Hospital · BDRajshahi Medical College · BDShaheed Suhrawardy Medical College · BD

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInsulin pen devices and disposable plastic insulin syringes are two common tools for insulin administration. This study aims to compare the simplicity, convenience, safety, and cost-effectiveness of insulin pens versus syringe devices in patients with type 2 diabetes mellitus (T2DM).

methodsA cross-sectional study was conducted at 14 diabetes clinics throughout Bangladesh from November 2021 to April 2022 among adults with T2DM injecting insulin by pen devices or disposable insulin syringes at least once a day for at least one year by purposive sampling. The simplicity, convenience, and safety of insulin devices were assessed using a structured questionnaire, and the study subjects were scored based on their answers; higher scores indicated a poorer response. Total scores for simplicity, convenience, and safety were obtained by adding the scores for relevant components. Their average monthly medical expense and cost of insulin therapy were recorded. The median values of the total scores and monthly expenses were compared between pen devices and disposable syringe users.

results737 subjects were evaluated; 406 were pen users, and 331 were vial syringe users. The pen users had lower median scores for simplicity [6.0 (5.0-8.0) vs. 7.0 (5.0-9.0), p = 0.002], convenience [4.0 (3.0-6.0) vs. 5.0 (4.0-6.0), p < 0.001], and safety [7.0 (6.0-8.0) vs. 7.0 (6.0-9.0), p = 0.008] than vial syringe users. Pen devices were more expensive than vial syringes in terms of average medical expense per month [BDT 5000 (3500-7000) vs. 3000 (2000-5000), p < 0.001], the total cost of insulin therapy per month [BDT 2000 (1500-3000) vs. 1200 (800-1700), p < 0.001] and cost per unit of insulin used [BDT 2.08 (1.39-2.78) vs. 0.96 (0.64-1.39), p < 0.001]. Non-significant differences in favor of pens were observed in HbA1c levels [8.7 (7.8-10) vs. 8.9 (7.9-10)%, p = 0.607] and proportions of subjects having HbA1c < 7% (6.9 vs. 6.3%, p = 0.991).

conclusionInsulin pens are simpler, more convenient, and safe but more expensive than vial syringes. Glycemic control is comparable between pen and syringe users. Long-term follow-up studies are needed to determine the clinical and economic impacts of such benefits of insulin pens.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsInsulinAdultBangladeshCost-Benefit AnalysisCross-Sectional StudiesDisposable EquipmentDrug Delivery SystemsGlycated HemoglobinHumansRetrospective StudiesSyringesGlycated HemoglobinHypoglycemic AgentsInsulinConvenienceCost-effectivenessInsulin penInsulin syringesSafetySimplicity

Identifiers

PMID36782190
PMCPMC9926700
OpenAlexW4320482939

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.