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. 2016 Sep 18;2016(9):CD006992. doi: 10.1002/14651858.CD006992.pub2

Kyllastinen 1985.

Methods Cross‐over randomised controlled clinical trial
Randomisation ratio: 1:1
Superiority design
Participants Inclusion criteria: elderly patients, type 2 diabetes inadequately controlled by insulin
Exclusion criteria: surgical operation; lack of co‐operation
Diagnostic criteria: not stated
Interventions Number of study centres: 1
Treatment before study: insulin 58 ± 3 IU/day (n = 1 once daily, n = 8 twice daily)
Titration period: none
Outcomes Primary outcome(s) (as stated in the publication): glycaemic control (HbA1c, FPG), daily insulin dose, C‐peptide, bodyweight, triglyceride, total cholesterol, HDL‐cholesterol, Na, K, creatinine, chloride
Study details Total study duration: 4 months
Run‐in period: none
Study terminated early (for benefit/because of adverse events): no
Publication details Language of publication: English
Funding source: none
Publication status: peer‐reviewed journal
Stated aim of study Quote from publication: "To determine whether glibenclamide could improve glycaemic control in patients not adequately controlled by insulin."
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Comment: not possible to judge whether the sequence generation was adequate
Allocation concealment (selection bias) Unclear risk Comment: not possible to judge whether the allocation to the intervention and control group was concealed
Blinding of participants and personnel (performance bias) 
 Adverse events Low risk Quote from publication: "A double blind, cross over trial was assigned ...after randomisation patients were given either glibenclamide or placebo....5 patients started with glibenclamide and 4 with placebo"
Comment: probably the participants and personnel were blinded
Blinding of participants and personnel (performance bias) 
 HbA1c, FPG, lipids Low risk Quote from publication: "A double blind, cross over trial was assigned...after randomisation patients were given either glibenclamide or placebo....5 patients started with glibenclamide and 4 with placebo"
Comment: probably the participants and personnel were blinded
Blinding of outcome assessment (detection bias) 
 Adverse events Unclear risk Comment: unclear if the outcome assessor was blinded
Blinding of outcome assessment (detection bias) 
 HbA1c, FPG, lipids Unclear risk Comment: unclear if the outcome assessor was blinded
Incomplete outcome data (attrition bias) 
 Adverse events Low risk Comment: data on weight gain were collected and reported
Incomplete outcome data (attrition bias) 
 HbA1c, FPG, lipids Low risk Comment: outcome data were collected and reported
Selective reporting (reporting bias) Low risk Comment: all outcomes of interest were reported
Other bias High risk Comment: only 9 participants included