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. 2011 Sep 7;2011(9):CD006165. doi: 10.1002/14651858.CD006165.pub3

Maruyama 2008.

Methods RANDOMISED CONTROLLED CLINICAL TRIAL (RCT): yes, parallel RCT
RANDOMISATION RATIO: equal ratio assumed (not stated in manuscript)
NON‐INFERIORITY DESIGN: no
EQUIVALENCE DESIGN: no
ETHICS APPROVAL OBTAINED: yes
PATIENT CONSENT OBTAINED: yes
BLINDING OF PATIENT (P), EDUCATOR (E), RESEARCHER (R): P = no, E = no, R = unclear
ANALYSIS BY INTENTION TO TREAT: No, not stated in the manuscript
POWER CALCULATION: yes
Participants WHO PARTCIPATED:
SEX (female% / male%): Insulin 43%F (13/30): 57% M (17/30), SU 46% F (14/30) : 53% M(16/30)
AGE (mean years (SD)): Insulin: 54 years (13), SU 51 yrs (13)
ETHNIC GROUPS (%): not stated
DURATION OF DISEASE (mean years (SD)): insulin 1.7 yrs (1.9), SU 1.9 yrs (1.7)
INCLUSION CRITERIA: (1) diagnosis of diabetes according to ADA criteria (2) not treated with insulin at least 6 months after diagnosis of diabetes (3) positive GADA in 2 samples taken within 2 months (4) disease duration < 10 years (5) patients were unrelated
EXCLUSION CRITERIA: (1) history of ketonuria, diabetic ketoacidosis, marked hyperglycaemia requiring insulin, (2) renal or hepatic dysfunction affecting C‐peptide clearance and glucose tolerance,
DIAGNOSTIC CRITERIA: Diabetes diagnosed according to American Diabetes Association (ADA) standards
CO‐MORBIDITIES:Not given
CO‐MEDICATIONS: Not given
NUMBER: Insulin 30, SU 30
LOSS TO FOLLOW‐UP: 0%
Interventions NUMBER OF STUDY CENTRES:7
COUNTRY/ LOCATION: Japan
SETTING: out‐patient
INTERVENTION (ROUTE, TOTAL DOSE/DAY, FREQUENCY): subcutaneous insulin therapy
CONTROL (ROUTE, TOTAL DOSE/DAY, FREQUENCY): sulphonylurea (glibenclamide)
TREATMENT BEFORE STUDY:None
TITRATION PERIOD: None.
Outcomes PRIMARY OUTCOME(S) (as stated in the publication):Not stated but objectives states "to examine the ability of insulin to prevent progressive beta‐cell dysfunction in SPIDDM"
SECONDARY OUTCOMES (as stated in the publication):Not stated
ADDITIONAL OUTCOMES:
Collected at baseline and 4 years. 
 1. Stimulated C‐peptide and change in C‐peptide response (ng/ml), 2. Blood glucose, 3. HbA1c (%), 4. GADA (U/ml) 5. insulin dependent state 6. BMI
Study details DURATION OF INTERVENTION: 5 years
DURATION OF FOLLOW‐UP: 5 years (with 3‐monthly assessments)
RUN‐IN PERIOD: None
Publication details LANGUAGE OF PUBLICATION: English
COMMERCIAL FUNDING: not reported
NON‐COMMERCIAL FUNDING: not reported
PUBLICATION STATUS (PEER REVIEW JOURNAL): yes
PUBLICATION STATUS (JOURNAL SUPPLEMENT): no
PUBLICATION STATUS (ABSTRACT): Full paper
Stated aim for study Quote "to examine the ability of insulin to prevent progressive ß‐cell dysfunction in SPIDDM "
Notes Comment: This is a follow‐up study from Kobayashi 1996 and Maruyama 2003
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Patients were randomly assigned using a centralized, masked‐draw system.
Allocation concealment (selection bias) Low risk Unblinded
Blinding (performance bias and detection bias) 
 All outcomes Unclear risk Unblinded but there was no evidence that the analyst was blinded
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No problems identified
Selective reporting (reporting bias) Low risk No problems identified
Other bias Unclear risk Sponsorship not reported