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Cochrane Database of Systematic Reviews Protocol - Intervention

Intermediate acting versus long acting insulin for type 1 diabetes mellitus

This is not the most recent version

Table 1. Search strategy

Electronic searches

Unless otherwise stated, search terms are free text terms; MeSH = Medical subject heading (Medline medical index term); exp = exploded MeSH; the dollar sign ($) stands for any character(s); the question mark (?) = to substitute for one or no characters; tw = text word; pt = publication type; sh = MeSH; adj = adjacent.


Diabetes mellitus, type 1:

1 exp diabetes mellitus, insulin dependent/
2 exp Diabetic Ketoacidosis/
3 IDDM.tw.
4 (insulin? depend$ or insulin?depend$).tw.
5 ((typ$ 1 or typ$ I) adj diabet$).tw.
6 (earl$ adj diabet$).tw.
7 ((juvenil$ or child$ or keto$ or Labil$ or brittl$) adj diabet$).tw.
8 ((auto?immun$ or sudden onset) adj diabet$).tw.
9 (insulin? defic$ adj absolut$).tw.
10 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9
11 exp diabetes insipidus/
12 diabet$ insipidus.tw.
13 11 or 12
14 10 not 13

Controlled or randomised clinical trials:

Phase I
1 randomised controlled trial.pt.
2 controlled clinical trial.pt.
3 Randomised Controlled Trials/
4 Random Allocation/
5 Double‐Blind Method/
6 Single Blind Method/
7 1 or 2 or 3 or 4 or 5 or 6
8 Animal/ not Human/
9 7 not 8

Phase II
10 clinical trial.pt.
11 exp Clinical Trials/
12 (clinic$ adj25 trial$).tw.
13 ((singl$ or doubl$ or trebl$ or tripl$) adj (mask$ or blind$)).tw.
14 Placebos/
15 placebo$.tw.
16 random$.tw.
17 Research Design/
18 (latin adj square).tw.
19 10 or 13 or 12 or 13 or 14 or 15 or 16 or 17 or 18
20 19 not 8
21 20 not 9

Phase III
22 Comparative Study/
23 exp Evaluation Studies/
24 Follow‐Up Studies/
25 Prospective Studies/
26 (control$ or prospectiv$ or volunteer$).tw.
27 Cross‐Over Studies/
28 22 or 23 or 24 or 25 or 26 or 27
29 28 not 8
30 29 not (9 or 21)

All phases
33 9 or 21 or 30

Meta‐analysis or systematic reviews:
1 exp meta‐analysis/
2 exp Review Literature/
3 meta‐analysis.pt.
4 review.pt.
5 1 or 2 or 3 or 4
6 letter.pt.
7 comment.pt.
8 editorial.pt.
9 historical‐article.pt.
10 6 or 7 or 8 or 9
11 5 not 10
12 ((systematic$ or quantitativ$ or methodologic$) adj (review$ or overview$)).tw.
13 meta?anal$.tw.
14 (integrativ$ research review$ or research integration$).tw.
15 quantitativ$ synthes$.tw.
16 (pooling$ or pooled analys$ or mantel$ haenszel$).tw.
17 (peto$ or der?simonian$ or fixed effect$ or random effect$).tw.
18 12 or 13 or 14 or 15 or 16 or 17
19 11 or 18
20 limit 19 to human [Limit not valid in: Pre‐MEDLINE; records were retained]

Long acting or intermediate acting insulin:
1 exp Insulin, Long‐Acting/
2 exp Insulin, Isophane/
3 glargine.tw
4 ultralente.tw
5 detemir.tw
6 lantus.tw
7 levemir.tw
8 lente.tw
9 NPH.tw
10 1 or 2 or 3 or 4 or 5or 6 or 7 or 8 or 9

Figures and Tables -
Table 1. Search strategy
Table 2. Study quality (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

Randomised controlled clinical trial (RCT)

Non‐inferiority / equivalence trial

Controlled clinical trial

Design: parallel, crossover, factorial RCT

Design: crossover study

Design: factorial study

Crossover study: wash‐out phase

Crossover study: carryover effect tested

Crossover study: period effect tested

Method of randomisation

Unit of randomisation (individuals, cluster ‐ specify)

Randomisation stratified for centres

Randomisation ratio

Concealment of allocation

Stated blinding (open; single, double, triple blind)

Actual blinding: participant

Actual blinding: caregiver / treatment administrator

Actual blinding: outcome assessor

Actual blinding: others

Blinding checked: participant

Blinding checked: caregiver / treatment administrator

Primary endpoint defined

[n] of primary endpoint(s)

[n] of secondary endpoints

Total [n] of endpoints

Prior publication of study design

Outcomes of prior / current publication identical

Power calculation

[n] participants per group calculated

Non‐inferiority trial: interval for equivalence specified

Intention‐to‐treat analysis (ITT)

Per‐protocol‐analysis

ITT defined

Analysis stratified for centres

Missing data: last‐observation‐carried‐forward (LOCF)

Missing data: other methods

LOCF defined

[n] of screened participants (I1/ I2 / C1 / total)

[n] of randomised participants for primary endpoint

I1: 400
I2: 350
C1: 700
Total: 1450

[n] of participants finishing the study

[n] of patients analysed

Description of discontinuing participants

Drop‐outs (reasons explained)

Withdrawals (reasons explained)

Losses‐to‐follow‐up (reasons explained)

[n] of participants who discontinued

[%] discontinuation rate

Discontinuation rate similar between groups

[%] crossover between groups

Differences [n] calculated to analysed patients

[n] of subgroups

Subgroups: pre‐defined

Subgroups: post‐hoc

Adjustment for multiple outcomes / repeated measurements

Baseline characteristics: clinically relevant differences

Treatment identical (apart from intervention)

Timing of outcomes' measurement comparable between groups

Compliance measured

Other important covariates measured (specify)

Co‐morbidities measured

Co‐medications measured

Specific doubts about study quality

Funding: commercial

Funding: non‐commercial

Publication status: peer review journal

Publication status: journal supplement

Publication status: abstract

Publication status: other

Notes

Symbols & abbreviations: Y = yes; N = no; ? = unclear I = intervention; C = control

Figures and Tables -
Table 2. Study quality (included studies)
Table 3. Baseline characteristics (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

[n] (I1/ I2 / C1 / total)

Sex [n,%]

Age [years] mean (SD)

I1: 43 (12)
I2: 41 (11)
C: 45 (12)
Total: 42 (10)

Ethnic groups [%]

Duration of disease [years] mean (SD)

Body mass index [kg/m2] mean (SD)

Pharmaco‐naive patients [n,%]

HbA1c [%] mean (SD)

Notes

Symbols & abbreviations: Y = yes; N = no; ? = unclear
I = intervention; C = control

Figures and Tables -
Table 3. Baseline characteristics (included studies)
Table 4. Adverse events (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

[n] of participants who died

[n] adverse events (I1/ I2 / C1 / total)

[%] adverse events

[n] serious adverse events

[%] serious adverse events

[n] drop‐outs due to adverse events

I1: 3/40
I2: 5/30
C1: 6/50
Total: 14/120

[%] drop‐outs due to adverse events

[n] hospitalisation

[%] hospitalisation

[n] out‐patient treatment

[%] out‐patient treatment

[n] hypoglycaemic episodes

[%] hypoglycaemic episodes

[n] severe hypoglycaemic episodes

[%] severe hypoglycaemic episodes

[n] nocturnal hypoglycaemic episodes

[%] nocturnal hypoglycaemic episodes

[n] with symptoms

[%] with symptoms

Symbols & abbreviations: Y = yes; N = no; ? = unclear I = intervention; C = control

Figures and Tables -
Table 4. Adverse events (included studies)
Table 5. Primary outcome data (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

All‐cause mortality: [n] of participants who died
(I1/ I2 / C1 / total)"

I1: 2/200
I2: 1/300
C1: 2/500
Total: 5/1000

Notes

Symbols & abbreviations: Y = yes; N = no; ? = unclear I = intervention; C = control

Figures and Tables -
Table 5. Primary outcome data (included studies)
Table 6. Secondary outcome data (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

Weight change [kg] at 12 weeks (mean/SD)
(I1/ I2 / C1 / total)

I1: ‐2.5 (1.2)
I2: ‐1.3 (0.8)
C1: +0.3 (0.4)
Total: ‐1.2 (0.9)

Notes

Symbols & abbreviations: Y = yes; N = no; ? = unclear; I = intervention; C = control

Figures and Tables -
Table 6. Secondary outcome data (included studies)