Evidence mapPaperPMID 10666428Full record

Trial reportThe New England journal of medicine2000

Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy.

Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group, John M Lachin, Saul Genuth, Patricia Cleary, Matthew D Davis, David M Nathan

Erratum issued 4 registry-linked trialsOpen access · bronzeAbstract readClinical TrialControlled Clinical Trial
In one paragraph

Trial report in The New England journal of medicine, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 4 registered trials, which are not on this map. Cited by 468 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
468citing papers in PubMed, 9 pooled it
66.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00360893 active not recruitingnot on this map

Epidemiology of Diabetes Interventions and Complications (EDIC)

TypeobservationalSponsorGeorge Washington UniversityRan1994 to 2027Enrolled1,441ConditionsType 1 Diabetes Mellitus
NCT00743808 completednot on this mapstarted 2006, after this paper: background citation

Improving Hypertension Control in Individuals With Diabetes

TypeobservationalSponsorHealthPartners InstituteRan2006 to 2010Enrolled11,510ConditionsHypertensionArmsquality improvement
NCT00846092 phase1completednot on this mapstarted 2007, after this paper: background citation

Phase 1 Study To Determine the Effects of Short Term Near-infrared Light (NIR) Therapy on Anatomic and Functional Abnormalities of Diabetic Macular Edema, and Assess Safety of Short Term Near-infrared Light Therapy in Eyes With Diabetic Macular Edema.

TypeinterventionalSponsorMedical College of WisconsinRan2007 to 2013Enrolled4ConditionsDiabetic Macular EdemaArmsWarp 10 LED Device, Near-infrared light (NIR)
NCT02384265 nacompletednot on this mapstarted 2012, after this paper: background citation

Financial Incentives and SMS to Improve African American Womens' Glycemic Control: Friends & Relatives Improving the Effectiveness of Networks for Diabetes Support Through Text Messaging (FRIENDS Text)

TypeinterventionalSponsorUniversity of California, Los AngelesRan2012 to 2021Enrolled41ConditionsDiabetes MellitusArmsIM/SMS + Incentive Condition
3 · Its place in the literature

Who cites it

468 citing papers in PubMed, 9 syntheses or guidelines pooled it, 1,527 citations in OpenAlex.

  1. Guideline
  2. Pooled it
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  5. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  6. Pooled it
  7. Guideline
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  9. Clinical significance of 'cardiometabolic memory': a systematic review of randomized controlled trials.Hypertension research : official journal of the Japanese Society of Hypertension · 2017
    Pooled it
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  18. Avoidant coping and diabetes-related distress: Pathways to adolescents' Type 1 diabetes outcomes.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2017
    Trial
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408 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Erratum issued
5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group
John M Lachin
Saul Genuth
Patricia Cleary
Matthew D Davis
David M Nathan
Diabetes UK · GB

Funding

EPIDEMIOLOGY OF DIABETES INTERVENTIONS &COMPLICATIONSN01DK062204 · GEORGE WASHINGTON UNIVERSITY · 1996 to 2004
$2.1M
NIDDK NIH HHS N01 DK062204
6 · The paper itself

Abstract

backgroundAmong patients with type 1 diabetes mellitus, intensive therapy (with the aim of achieving near-normal blood glucose and glycosylated hemoglobin concentrations [hemoglobin A1c]) markedly reduces the risk of microvascular complications as compared with conventional therapy. To assess whether these benefits persist, we compared the effects of former and intensive conventional therapy on the recurrence and severity of retinopathy and nephropathy for four years after the end of the Diabetes Control and Complications Trial (DCCT).

methodsAt the end of the DCCT, the patients in the conventional-therapy group were offered intensive therapy, and the care of all patients was transferred to their own physicians. Retinopathy was evaluated on the basis of centrally graded fundus photographs in 1208 patients during the fourth year after the DCCT ended, and nephropathy was evaluated on the basis of urine specimens obtained from 1302 patients during the third or fourth year, approximately half of whom were from each treatment group.

resultsThe difference in the median glycosylated hemoglobin values between the conventional-therapy and intensive-therapy groups during the 6.5 years of the DCCT (average, 9.1 percent and 7.2 percent, respectively) narrowed during follow-up (median during 4 years, 8.2 percent and 7.9 percent, respectively, P<0.001). Nevertheless, the proportion of patients who had worsening retinopathy, including proliferative retinopathy, macular edema, and the need for laser therapy, was lower in the intensive-therapy group than in the conventional-therapy group (odds reduction, 72 percent to 87 percent, P<0.001). The proportion of patients with an increase in urinary albumin excretion was significantly lower in the intensive-therapy group.

conclusionsThe reduction in the risk of progressive retinopathy and nephropathy resulting from intensive therapy in patients with type 1 diabetes persists for at least four years, despite increasing hyperglycemia.

Indexed as

AdolescentAdultDiabetes Mellitus, Type 1Diabetic NephropathiesDiabetic RetinopathyDisease ProgressionFemaleFollow-Up StudiesGlycated HemoglobinHumansIncidenceInsulinMaleRandomized Controlled Trials as TopicRegression AnalysisRiskGlycated HemoglobinInsulin

Identifiers

PMID10666428
PMCPMC2630213
OpenAlexW2760585829

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.