Condition

Diabetes mellitus type 1

Clinical trials and treatment information for Diabetes mellitus type 1

19.6M

People Affected

Active Trials

294K

New Cases/Year

49K

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Insulin Therapy (Basal-Bolus Regimen)

95% Effectiveness• 98% Confidence• 55% Safety• 21 trials• 2M participants

HIGH EvidenceExcellent ValueDose: Highly individualized, typically 0.4-1.0 units/kg/day

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

Immediate for acute effects, weeks-months for stable control

Duration

Lifetime

Response Rate

90%

Remission Rate

Common Side Effects:

Hypoglycemia: 60%

Weight Gain: 30%

Lipohypertrophy: 25%

Annual Cost of Care

Drug Cost

$5,000

Monitoring

$1,500

Side Effects

$500

Total Annual

$7,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

Cost per Responder

$7,778

Treatment Outcomes

Primary Outcomes

Glycated Hemoglobin (HbA1c)9.0%

-16.7% (-1.5%)

Fasting Plasma Glucose200 mg/dL

-35% (-70 mg/dL)

2-hour Postprandial Glucose280 mg/dL

-35.7% (-100 mg/dL)

Time in Range (70-180 mg/dL)30%

+116.7% (+35%)

Secondary Benefits

Severe Hypoglycemic Events0.5 events/patient/year

-60% (-0.3 events/patient/year)

Diabetes Distress Scale (DDS) score3.5/6 (average item score)

-28.6% (-1.0 point)

Diabetic Ketoacidosis (DKA) Events0.2 events/patient/year

-50% (-0.1 events/patient/year)

Common Side Effects

Hypoglycemia

+60%

Weight Gain

+30%

Lipohypertrophy

+25%

Clinical Trial Phases:

Phase 4

Automated Insulin Delivery (AID) Systems

90% Effectiveness• 92% Confidence• 55% Safety• 45 trials• 10K participants

HIGH EvidenceGood ValueDose: Automated algorithm-driven insulin delivery

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

Days-weeks for optimized control

Duration

Lifetime

Response Rate

90%

Remission Rate

Common Side Effects:

Hypoglycemia: 40%

Infusion site irritation/occlusion: 15%

Diabetic Ketoacidosis (DKA): 1%

Annual Cost of Care

Drug Cost

$5,000

Monitoring

$9,000

Side Effects

$500

Total Annual

$14,500

Cost-Effectiveness

GOOD

QALYs Gained

ICER

$80,000/QALY

Cost per Responder

$16,111

Treatment Outcomes

Primary Outcomes

Time in Range (TIR) 70-180 mg/dL58%

+20.7% (+12 percentage points)

HbA1c7.8%

-9% (-0.7 percentage points)

Time in Hypoglycemia (<70 mg/dL)2.5%

-60% (-1.5 percentage points)

Time above 180 mg/dL38%

-36.8% (-14 percentage points)

Secondary Benefits

Diabetes Distress Scale (DDS) total score2.7/6.0 (higher scores indicate more distress)

-18.5% (-0.5 points)

Fear of Hypoglycemia (HFS-R) score2.5/5.0 (higher scores indicate more fear)

-16% (-0.4 points)

Pittsburgh Sleep Quality Index (PSQI) global score8.5/21.0 (higher scores indicate poorer sleep)

-17.6% (-1.5 points)

Common Side Effects

Hypoglycemia

+40%

Infusion site irritation/occlusion

+15%

Diabetic Ketoacidosis (DKA)

+1%

Clinical Trial Phases:

Phase 4

Continuous Glucose Monitoring (CGM)

85% Effectiveness• 95% Confidence• 90% Safety• 417 trials• 50K participants

HIGH EvidenceGood ValueDose: Continuous wear of sensor

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

Immediate (data display), weeks-months for improved control

Duration

Lifetime (continuous use)

Response Rate

85%

Remission Rate

Common Side Effects:

Skin irritation at sensor site: 10%

Sensor malfunction: 2%

Annual Cost of Care

Drug Cost

Monitoring

$3,500

Side Effects

$50

Total Annual

$3,550

Cost-Effectiveness

GOOD

QALYs Gained

ICER

$50,000/QALY

Cost per Responder

$4,176

Treatment Outcomes

Primary Outcomes

HbA1c8.2%

-9.8% (-0.8%)

Time in Range (70-180 mg/dL)50%

+36% (+18 percentage points)

Time Above Range (>180 mg/dL)40%

-37.5% (-15 percentage points)

Time Below Range (<70 mg/dL)6.0%

-41.7% (-2.5 percentage points)

Secondary Benefits

Hypoglycemia Fear Survey (HFS-II) ScoreHFS-II score: 45/69

-17.8% (-8 points)

Problem Areas in Diabetes (PAID) Scale ScorePAID score: 35/100

-20% (-7 points)

Glycemic Variability (Standard Deviation of Glucose)65 mg/dL

-15.4% (-10 mg/dL)

Common Side Effects

Skin irritation at sensor site

+10%

Sensor malfunction

+2%

Clinical Trial Phases:

Phase 4

SGLT2 Inhibitor (Dapagliflozin)

70% Effectiveness• 80% Confidence• 60% Safety• 14 trials• 15K participants

MODERATE EvidenceModerate ValueDose: Dapagliflozin 5-10 mg orally once daily

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

Days-weeks for glycemic, months-years for CV/renal benefits

Duration

Lifetime (as needed)

Response Rate

70%

Remission Rate

Number Needed to Harm (NNH)

100

Common Side Effects:

Genital Mycotic Infections: 12%

Urinary Tract Infections: 7%

Euglycemic Diabetic Ketoacidosis (DKA): 1.5%

Dehydration: 6%

Annual Cost of Care

Drug Cost

$6,000

Monitoring

$200

Side Effects

$500

Total Annual

$6,700

Cost-Effectiveness

MODERATE

QALYs Gained

0.15

ICER

$120,000/QALY

Cost per Responder

$9,571

Treatment Outcomes

Primary Outcomes

HbA1c8.0%

-5% (-0.4% points)

Total Daily Insulin Dose60 units/day

-10% (-6 units/day)

Body Weight85 kg

-3% (-2.55 kg)

Time in Range (CGM)55%

+21.8% (+12 percentage points)

Secondary Benefits

Systolic Blood Pressure130 mmHg

-3.08% (-4 mmHg)

Urine Albumin-to-Creatinine Ratio (UACR)60 mg/g

-30% (-18 mg/g)

Health-Related Quality of Life (EQ-5D-5L Index)0.75 (scale 0-1)

+4% (+0.03 points)

Common Side Effects

Genital Mycotic Infections

+12%

Urinary Tract Infections

+7%

Euglycemic Diabetic Ketoacidosis (DKA)

+1.5%

Clinical Trial Phases:

Phase 4 (for T2D)Phase 3/4 (for T1D where approved)

Pramlintide

65% Effectiveness• 75% Confidence• 60% Safety• 38 trials• 8K participants

MODERATE EvidencePoor ValueDose: 60-120 mcg subcutaneously before each major meal

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

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Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

Immediate (postprandial glucose), months for weight effects

Duration

Lifetime (as needed)

Response Rate

60%

Remission Rate

Common Side Effects:

Nausea: 30%

Anorexia: 15%

Severe Hypoglycemia (with insulin): 8%

Annual Cost of Care

Drug Cost

$7,000

Monitoring

$100

Side Effects

$300

Total Annual

$7,400

Cost-Effectiveness

POOR

QALYs Gained

0.08

ICER

$200,000/QALY

Cost per Responder

$12,333

Treatment Outcomes

Primary Outcomes

Hemoglobin A1c (HbA1c)8.0%

-5% (-0.4% points)

2-hour Postprandial Glucose270 mg/dL

-29.6% (-80 mg/dL)

Total Daily Insulin Dose50 units/day

-15% (-7.5 units/day)

Body Weight90 kg

-1.7% (-1.5 kg)

Secondary Benefits

Glycemic Variability (Standard Deviation of Glucose)60 mg/dL

-12% (-7.2 mg/dL)

Time in Range (70-180 mg/dL)50% (of time)

+20% (+10% points)

Diabetes Treatment Satisfaction Questionnaire (DTSQ) Score25/36 points

+15.2% (+3.8 points)

Common Side Effects

Nausea

+30%

Anorexia

+15%

Severe Hypoglycemia (with insulin)

+8%

Clinical Trial Phases:

Phase 4