Glycemic Control With Insulin Glargine Plus Insulin Glulisine Versus Premixed Insulin Analogues in Real-World Practices: A Cost-Effectiveness Study With a Randomized Pragmatic Trial Design

Levin, Philip; Zhang, Quanwu; Mersey, James H.; Lee, Francis Y.; Bromberger, Lee A.; Bhushan, Madhu; Bhushan, Rajat

doi:10.1016/j.clinthera.2011.05.091

Cited by 23 publications

(26 citation statements)

References 41 publications

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“…Of the remaining 30 RCTs, 17 RCTs were excluded because they had arms with \30 participants (3 studies), evaluated both type 1 and type 2 diabetes (1 study), had no basal-bolus (5 studies) or premixed (1 study) arms, had outcomes outside the scope of the review (4 studies), compared premixed insulin regimens (2 studies), or evaluated surgical patients (1 study) (Supplementary Table 1). Finally, a total number of Endocrine 13 RCTs [19][20][21][22][23][24][25][26][27][28][29][30][31] were included for quantitative synthesis and meta-analysis.…”

Section: Search Resultsmentioning

confidence: 99%

“…The data extracted from the included RCTs for meta-analysis were sample sizes and HbA1c change from baseline. In all but one trial [25], the declared primary outcome was change in HbA1c from baseline to the endpoint or the HbA1c level at the endpoint.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Trial duration was 16-60 weeks. The trials had different design: four studies [20,27,30,31] compared a full basal-bolus design (one injection of basal insulin, for the most a long-acting insulin analog, plus 3 injections of a short-acting insulin analog) versus a thrice-daily premixed insulin regimen; two studies [26,29] compared a full basalbolus regimen (as above) versus a twice-daily premixed regimen; 6 studies [19,21,[23][24][25]28] compared a variable basal-bolus regimen (a basal insulin analog plus up to three injections of a short-acting insulin analog) versus a variable premixed regimen (up to three injections of premixed insulin analogs, as detailed in Table 1); and finally, one study [22] compared a slow intensity basal-bolus regimen (insulin glargine once daily and insulin lispro once daily) versus a twice-daily premixed regimen. The outcome measuring the effects of insulin regimens was HbA1c.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Intensification of insulin therapy with basal-bolus or premixed insulin regimens in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

et al. 2015

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The purpose of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the effect of intensified insulin regimens (basal-bolus versus premixed) on glycemic control in patients with type 2 diabetes. We conducted an electronic search until March 2015 on many electronic databases including online registries of ongoing trials. All RCTs comparing basal-bolus with premixed insulin regimens, with a duration of >12 weeks and with >30 patients per arm, were included. Investigators extracted data on study characteristics, outcome measures, and methodological quality. We found thirteen RCTs lasting 16-60 weeks and involving 5255 patients assessed for the primary endpoint (reduction of HbA1c from baseline). Meta-analysis of change in HbA1c level between basal-bolus and premixed insulin regimens resulted in a small and non-significant difference of 0.09% (95% CI -0.03 to 0.21), with substantial heterogeneity between studies (I(2) = 74.4%). There was no statistically significant difference in the event rate for overall hypoglycemia (0.16 episode/patient/year, 95%CI -2.07 to 2.3), weight change (-0.21 kg, -0.164 to 0.185), and daily insulin dose (-0.54 U/day, -2.7 to 1.6). The likelihood for reaching the HbA1c <7% was 8% higher (3-13%, I(2) = 68.8%) with the basal-bolus as compared with the premixed regimen. There is no clinically relevant difference in the efficacy of basal-bolus versus premixed insulin regimens for HbA1c decrease in type 2 diabetic patients. These findings may be helpful to adapt treatment to individual patient needs.

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Section: Search Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Intensification of insulin therapy with basal-bolus or premixed insulin regimens in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

et al. 2015

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“…From the current situation, the multimedia is fully integrated into classroom. Therefore, when teaching key knowledge points, teachers can use multimedia to show interesting and intuitive pragmatic background for students [6]. On the basis of creating a specific language background, the overall level of oral communication of students can be improved in all directions…”

Section: The Specific Ways Of Combining Teaching Chinese As a Foreignmentioning

confidence: 99%

Pragmatic Acquisition and Teaching Chinese as a Foreign Language

Chen¹

2017

Advances in Computer Science Research

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Abstract. From the basic characteristics, teaching Chinese as a foreign language is a key discipline in the linguistic system, which involves the basic linguistic principles of foreign language and the specific context which it is closely related to. Therefore, it can be seen that learning Chinese as a foreign language helps to enhance students' oral and external communication skills. In recent years, new curriculum reform has been fully promoted. In the face of the new situation, the teaching mode of teaching Chinese as a foreign language will also be subject to corresponding changes. In essence, the key to learn Chinese as a foreign language should be pragmatic acquisition. It is necessary to have a comprehensive grasp of a variety of pragmatic habits. Therefore, for the current Chinese class, pragmatic acquisition should be placed in the core position, combined with the real classroom situation of Chinese as a foreign language, to explore the improvement measures.In many cases, even if there is a relatively strong language ability, the student's corresponding pragmatic competence is not able to obtain synchronic improvement. This is because language communication itself has prominent systematical characteristics, which should contain specific context, communication motivations and other related elements. In the perspective of pragmatic acquisition, students should be able to fully understand and output the related language construction information when facing specific statements [1]. As a result, pragmatic acquisition should be taken as fundamental support during the whole process of learning Chinese. Teachers and students have to be concerned with the pragmatic acquisition of foreign language, in order to from the source optimize their own learning experience of foreign language and then to closely combine with the pragmatics and Chinese language learning.

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“…Guiding principles for pragmatic clinical trials are to identify patients from typical clinical practice sites, minimize inclusion and exclusion criteria to ensure generalizability, minimize requirements for studyrelated monitoring, limit protocol-mandated visits, limit restrictions on treatment, capture end points that are relevant to decision makers and consonant with usual care practice and data collection, engage with relevant stakeholders, capture patient-reported outcomes (PROs), and limit intervention to randomization if possible [23,24]. Despite their important methodological strengths and relevance to health-care decision makers, there have been few examples of pragmatic clinical trials in assessments of drug therapy because of the challenges associated with executing such studies [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Achieve control: a pragmatic clinical trial of insulin glargine 300 U/mL versus other basal insulins in insulin-naïve patients with type 2 diabetes

Oster

Sullivan

Dalal

et al. 2016

Postgraduate Medicine

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Glycemic Control With Insulin Glargine Plus Insulin Glulisine Versus Premixed Insulin Analogues in Real-World Practices: A Cost-Effectiveness Study With a Randomized Pragmatic Trial Design

Cited by 23 publications

References 41 publications

Intensification of insulin therapy with basal-bolus or premixed insulin regimens in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

Intensification of insulin therapy with basal-bolus or premixed insulin regimens in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

Pragmatic Acquisition and Teaching Chinese as a Foreign Language

Achieve control: a pragmatic clinical trial of insulin glargine 300 U/mL versus other basal insulins in insulin-naïve patients with type 2 diabetes

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