Chinese General Practice ›› 2023, Vol. 26 ›› Issue (15): 1892-1901.DOI: 10.12114/j.issn.1007-9572.2022.0574
Special Issue: 老年问题最新文章合集
• Original Research·Diabetes Medication • Previous Articles Next Articles
Received:
2022-08-15
Revised:
2022-10-12
Published:
2023-05-20
Online:
2022-11-14
Contact:
CHENG Kangyao
通讯作者:
程康耀
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0574
步骤 | 检索策略 |
---|---|
1 | Mesh descriptor:[Diabetes Mellitus,Type 2] explode all trees |
2 | (diabetes mellitus,non-insulin dependent OR diabetes mellitus,ketosis resistant OR diabetes mellitus,type II OR type 2 diabetes mellitus OR diabetes,type 2 OR NIDDM):ti,ab,kw |
3 | #1 OR #2 |
4 | Mesh descriptor:[Insulin Infusion System] explode all trees |
5 | (continuous subcutaneous insulin infusion OR insulin pump OR artificial endocrine pancreas OR artificial beta cell OR CSII):ti,ab,kw |
6 | #4 OR #5 |
7 | (multiple daily injections OR MDI OR flexible multiple daily insulin OR FMDI OR multiple subcutaneous injections OR MSI OR intensive insulin therapy OR multiple injection regimens):ti,ab,kw |
8 | #6 AND #7 |
9 | Mesh descriptor:[Aged] explode all trees |
10 | (old* OR elderly OR senile OR aging OR senior citizen OR geriatric OR seniors OR older adult):ti,ab,kw |
11 | #9 OR #10 |
12 | Mesh descriptor:[Randomized Controlled Trial (Publication Type)] explode all trees |
13 | ("randomized controlled trial" ):pt |
14 | (randomised OR randomized OR controlled OR RCT OR randomly):ti,ab,kw |
15 | #12 OR #13 OR #14 |
16 | #3 AND #8 AND #11 AND #15 |
Table 1 Strategy for searching RCTs in the Cochrane Library
步骤 | 检索策略 |
---|---|
1 | Mesh descriptor:[Diabetes Mellitus,Type 2] explode all trees |
2 | (diabetes mellitus,non-insulin dependent OR diabetes mellitus,ketosis resistant OR diabetes mellitus,type II OR type 2 diabetes mellitus OR diabetes,type 2 OR NIDDM):ti,ab,kw |
3 | #1 OR #2 |
4 | Mesh descriptor:[Insulin Infusion System] explode all trees |
5 | (continuous subcutaneous insulin infusion OR insulin pump OR artificial endocrine pancreas OR artificial beta cell OR CSII):ti,ab,kw |
6 | #4 OR #5 |
7 | (multiple daily injections OR MDI OR flexible multiple daily insulin OR FMDI OR multiple subcutaneous injections OR MSI OR intensive insulin therapy OR multiple injection regimens):ti,ab,kw |
8 | #6 AND #7 |
9 | Mesh descriptor:[Aged] explode all trees |
10 | (old* OR elderly OR senile OR aging OR senior citizen OR geriatric OR seniors OR older adult):ti,ab,kw |
11 | #9 OR #10 |
12 | Mesh descriptor:[Randomized Controlled Trial (Publication Type)] explode all trees |
13 | ("randomized controlled trial" ):pt |
14 | (randomised OR randomized OR controlled OR RCT OR randomly):ti,ab,kw |
15 | #12 OR #13 OR #14 |
16 | #3 AND #8 AND #11 AND #15 |
第一作者 | 年份(年) | 国家 | 样本量(试验组/对照组) | 患者年龄(试验组/对照组,岁) | 干预方法 | 干预时间 | 评价指标 | |
---|---|---|---|---|---|---|---|---|
试验组 | 对照组 | |||||||
HERMAN[ | 2005 | 美国 | 48/50 | 66.6±5.9/66.2±4.5 | A | B | 12个月 | ①④ |
裴泂[ | 2007 | 中国 | 30/28 | 72.3±8.6/72.3±7.6 | A | D | 3个月 | ①②③④⑦ |
谢国庆[ | 2007 | 中国 | 16/15 | 71.0±6.0/72.0±8.0 | A | B | 3个月 | ①②③⑦ |
毛春谱[ | 2010 | 中国 | 17/19 | 71.4±8.9/70.8±9.8 | A | B | 1个月 | ①⑥⑦ |
杨秋伟[ | 2011 | 中国 | 28/28 | 71.8±8.1/69.1±8.5 | A | D | 2周 | ②③④⑥ |
傅明捷[ | 2013 | 中国 | 40/40 | 65.2±3.2/64.5±3.7 | A | B | 2周 | ①②③④⑥⑦ |
李思瓯[ | 2013 | 中国 | 25/23 | 71.8±8.3/71.4±8.1 | A | B | 3个月 | ①②③ |
张琦[ | 2013 | 中国 | 30/30 | 68±6/68±6 | A | B | 2周 | ②③⑥⑦ |
徐育良[ | 2014 | 中国 | 35/35 | 68.2±6.4/69.4±6.8 | A | B | 7 d | ②③ |
马丽辉[ | 2015 | 中国 | 40/40 | 65.7±5.5/66.6±6.3 | A | B | 2周 | ⑤ |
张雪云[ | 2016 | 中国 | 39/33 | 73.62±2.84/73.88±2.96 | A | B | 10~14 d | ⑤ |
孙世萌[ | 2017 | 中国 | 48/47 | 68.8±6.1/70.1±6.3 | A | B | 2周 | ②③ |
崔小伟[ | 2017 | 中国 | 35/35 | 67.8±3.6/69.1±2.8 | A | B | 10~14 d | ⑤ |
冯兰超[ | 2019 | 中国 | 42/42 | 67.34±5.26/66.40±5.32 | A | C | 30 d | ②③⑥ |
郎名丽[ | 2019 | 中国 | 45/45 | 70.5±2.7/71.3±2.3 | A | B | 2周 | ②③④⑥⑦ |
邱金梅[ | 2019 | 中国 | 50/50 | 71.85±10.29/72.13±10.34 | A | C | 4周 | ②③ |
Table 2 Basic characteristics of included RCTs
第一作者 | 年份(年) | 国家 | 样本量(试验组/对照组) | 患者年龄(试验组/对照组,岁) | 干预方法 | 干预时间 | 评价指标 | |
---|---|---|---|---|---|---|---|---|
试验组 | 对照组 | |||||||
HERMAN[ | 2005 | 美国 | 48/50 | 66.6±5.9/66.2±4.5 | A | B | 12个月 | ①④ |
裴泂[ | 2007 | 中国 | 30/28 | 72.3±8.6/72.3±7.6 | A | D | 3个月 | ①②③④⑦ |
谢国庆[ | 2007 | 中国 | 16/15 | 71.0±6.0/72.0±8.0 | A | B | 3个月 | ①②③⑦ |
毛春谱[ | 2010 | 中国 | 17/19 | 71.4±8.9/70.8±9.8 | A | B | 1个月 | ①⑥⑦ |
杨秋伟[ | 2011 | 中国 | 28/28 | 71.8±8.1/69.1±8.5 | A | D | 2周 | ②③④⑥ |
傅明捷[ | 2013 | 中国 | 40/40 | 65.2±3.2/64.5±3.7 | A | B | 2周 | ①②③④⑥⑦ |
李思瓯[ | 2013 | 中国 | 25/23 | 71.8±8.3/71.4±8.1 | A | B | 3个月 | ①②③ |
张琦[ | 2013 | 中国 | 30/30 | 68±6/68±6 | A | B | 2周 | ②③⑥⑦ |
徐育良[ | 2014 | 中国 | 35/35 | 68.2±6.4/69.4±6.8 | A | B | 7 d | ②③ |
马丽辉[ | 2015 | 中国 | 40/40 | 65.7±5.5/66.6±6.3 | A | B | 2周 | ⑤ |
张雪云[ | 2016 | 中国 | 39/33 | 73.62±2.84/73.88±2.96 | A | B | 10~14 d | ⑤ |
孙世萌[ | 2017 | 中国 | 48/47 | 68.8±6.1/70.1±6.3 | A | B | 2周 | ②③ |
崔小伟[ | 2017 | 中国 | 35/35 | 67.8±3.6/69.1±2.8 | A | B | 10~14 d | ⑤ |
冯兰超[ | 2019 | 中国 | 42/42 | 67.34±5.26/66.40±5.32 | A | C | 30 d | ②③⑥ |
郎名丽[ | 2019 | 中国 | 45/45 | 70.5±2.7/71.3±2.3 | A | B | 2周 | ②③④⑥⑦ |
邱金梅[ | 2019 | 中国 | 50/50 | 71.85±10.29/72.13±10.34 | A | C | 4周 | ②③ |
第一作者 | 选择偏倚 | 分配隐藏 | 实施偏倚 | 测量偏倚 | 随访偏倚 | 报告偏倚 | 其他偏倚 |
---|---|---|---|---|---|---|---|
HERMAN[ | 低风险 | 低风险 | 高风险 | 低风险 | 低风险 | 低风险 | 低风险 |
裴泂[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
谢国庆[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
毛春谱[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
杨秋伟[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
傅明捷[ | 低风险 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
李思瓯[ | 不清楚 | 不清楚 | 低风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
张琦[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 低风险 |
徐育良[ | 低风险 | 不清楚 | 高风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
马丽辉[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 低风险 |
张雪云[ | 低风险 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
孙世萌[ | 低风险 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 低风险 |
崔小伟[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
冯兰超[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
郎名丽[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
邱金梅[ | 低风险 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
Table 3 Risk of bias assessment for included RCTs
第一作者 | 选择偏倚 | 分配隐藏 | 实施偏倚 | 测量偏倚 | 随访偏倚 | 报告偏倚 | 其他偏倚 |
---|---|---|---|---|---|---|---|
HERMAN[ | 低风险 | 低风险 | 高风险 | 低风险 | 低风险 | 低风险 | 低风险 |
裴泂[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
谢国庆[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
毛春谱[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
杨秋伟[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
傅明捷[ | 低风险 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
李思瓯[ | 不清楚 | 不清楚 | 低风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
张琦[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 低风险 |
徐育良[ | 低风险 | 不清楚 | 高风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
马丽辉[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 低风险 |
张雪云[ | 低风险 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
孙世萌[ | 低风险 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 低风险 |
崔小伟[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 不清楚 | 低风险 | 不清楚 |
冯兰超[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
郎名丽[ | 不清楚 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
邱金梅[ | 低风险 | 不清楚 | 高风险 | 低风险 | 低风险 | 低风险 | 不清楚 |
Figure 3 Forest plot comparing the effectiveness of insulin administered by two methods on 2-hour postprandial plasma glucose among older adults with T2DM
Figure 5 Forest plot comparing the effectiveness of insulin administered by two methods on the incidence of hypoglycaemia among older adults with T2DM
Figure 7 Forest plot comparing the effectiveness of insulin administered by two methods on the mean amplitude of glycemic excursions among older adults with T2DM
血糖控制标准 | 研究数量 | MD(95%CI) | P值 |
---|---|---|---|
空腹血糖<7.8 mmol/L;餐后2 h血糖<11.1 mmol/L | 2[ | -4.99(-8.80,-1.18) | 0.010 |
空腹血糖<7 mmol/L;餐后2 h血糖<11.1 mmol/L | 1[ | -2.20(-3.14,-1.26) | <0.001 |
空腹血糖<7 mmoL/L;餐后2 h血糖<10.0 mmol/L | 3[ | -3.79(-5.94,-1.65) | 0.000 5 |
Table 4 Effect of insulin administered by two methods on the time to reach the glycemic target among older adults with T2DM
血糖控制标准 | 研究数量 | MD(95%CI) | P值 |
---|---|---|---|
空腹血糖<7.8 mmol/L;餐后2 h血糖<11.1 mmol/L | 2[ | -4.99(-8.80,-1.18) | 0.010 |
空腹血糖<7 mmol/L;餐后2 h血糖<11.1 mmol/L | 1[ | -2.20(-3.14,-1.26) | <0.001 |
空腹血糖<7 mmoL/L;餐后2 h血糖<10.0 mmol/L | 3[ | -3.79(-5.94,-1.65) | 0.000 5 |
Figure 9 The trial sequential analysis of the effect of insulin administered by two methods on 2-hour postprandial plasma glucose among older adults with T2DM
Figure 11 The trial sequential analysis of the effectiveness of insulin administered by two methods on the incidence of severe hypoglycaemia among older adults with T2DM
Figure 12 Funnel plot assessing potential publication bias in effectiveness of insulin administered by two methods on fasting plasma glucose among older adults with T2DM
Figure 13 Funnel plot assessing potential publication bias in effectiveness of insulin administered by two methods on 2-hour postprandial plasma glucose among older adults with T2DM
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