{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:26:41Z","timestamp":1793759201672,"version":"4.6.1"},"reference-count":40,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2020YFC2006103"],"award-info":[{"award-number":["2020YFC2006103"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis aimed to compare GLP\u20101 receptor agonist (GLP\u20101RA)\u2010based prandial insulin de\u2010intensification with continued basal\u2013bolus insulin therapy (BBI) or multiple daily injections (MDI) in adult outpatients with type 2 diabetes receiving established BBI\/MDI at randomisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science were searched for randomised controlled trials enrolling adult outpatients with type 2 diabetes receiving established BBI\/MDI at randomisation. Eligible trials compared a GLP\u20101RA\u2010based strategy involving protocol\u2010directed withdrawal, replacement or substantial reduction of scheduled prandial insulin while maintaining basal insulin versus continued BBI\/MDI therapy. The primary outcome was change in HbA1c. Secondary outcomes included changes in body weight, total daily insulin dose (TDD), hypoglycaemia and de\u2010intensification\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven randomised controlled trials involving 1332 participants were included. Compared with continued BBI\/MDI therapy, GLP\u20101RA\u2010based prandial insulin de\u2010intensification was not associated with a significant difference in HbA1c change (mean difference [MD] \u22120.08 percentage points, 95% confidence interval [CI] \u22120.28 to 0.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.391). The de\u2010intensification strategy was associated with reductions in body weight (MD \u22124.94\u2009kg, 95% CI \u22127.37 to \u22122.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and total daily insulin dose (MD \u221233.32\u2009U\/day, 95% CI \u221252.23 to \u221214.41;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). The risk of experiencing at least one hypoglycaemic event was lower with GLP\u20101RA\u2010based de\u2010intensification (risk ratio [RR] 0.76, 95% CI 0.66 to 0.87;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In adults with type 2 diabetes receiving established BBI\/MDI therapy, GLP\u20101RA\u2010based prandial insulin de\u2010intensification was associated with maintenance of short\u2010term glycaemic control while reducing body weight and total daily insulin requirements. A potential reduction in hypoglycaemia remains uncertain. This strategy may represent an option for treatment optimisation in appropriately selected patients receiving intensive insulin therapy; however, further studies are needed to determine its long\u2010term sustainability and optimal implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71359","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:57:06Z","timestamp":1789433826000},"page":"11407-11417","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>GLP<\/scp>\n                    \u20101 Receptor Agonist\u2013Based Prandial Insulin De\u2010Intensification in Outpatients With Type 2 Diabetes Receiving Basal\u2013Bolus Insulin Therapy or Multiple Daily Injections: A Systematic Review and Meta\u2010Analysis of Randomised Controlled Trials"],"prefix":"10.1111","volume":"28","author":[{"given":"Hongxia","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Geriatrics Xiyuan Hospital of China Academy of Chinese Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianli","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Xiyuan Hospital of China Academy of Chinese Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Xiyuan Hospital of China Academy of Chinese Medical Sciences  Beijing China"},{"name":"Graduate School of Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Xiyuan Hospital of China Academy of Chinese Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Xiyuan Hospital of China Academy of Chinese Medical Sciences  Beijing China"},{"name":"Graduate School of Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2628-7711","authenticated-orcid":false,"given":"Zhengtang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Xiyuan Hospital of China Academy of Chinese Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2012.03605.x"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12689"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2006.00686.x"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc26-S009"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0034"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14901"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16645"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2018.03.001"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmet.2019.09.010"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc26-S010"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-0876"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-0001"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61335-0"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3082"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16057"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.70362"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_13_21_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions. 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