Trial reportDiabetic medicine : a journal of the British Diabetic Association2005

Does metformin decrease blood pressure in patients with Type 2 diabetes intensively treated with insulin?

M G Wulffelé, A Kooy, P Lehert, D Bets, A J M Donker, C D A Stehouwer

Open access · greenAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Diabetic medicine : a journal of the British Diabetic Association, 2005. The graph read 1 number from its abstract, feeding 1 cell of the map: it finds no clear difference in 1. Cited by 8 papers, 4 of them syntheses that pooled it.

1number the graph read from it
1cell of the map it votes in
8citing papers in PubMed, 4 pooled it
0.5field-weighted citation impact, top 32% 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.

← favours the treatmentfavours the comparator →
1.500 · no effect
Blood pressureno clear difference · against placebo · hypertension, t2dfeeds one cell of the map
Δ 1.50P = 0.15
Office BP measurements did not differ significantly between the placebo- and metformin-treated groups for any BP measure, but showed a non-significant trend for SBP reduction with metformin use (mean baseline-adjusted difference, metformin minus placebo: -4.2 mmHg, 95% CI, -9.9 to +1.5; P = 0.15).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Metformin×blood pressure

InconclusiveOpen on the map →What to test next →

6 readable studies in this cell: 2 favour the treatment, 3 find no difference, 1 favour the comparator.

Belief with this paper
0.40contested · 1 family supports, 1 contradict · against placebo
Without it
0.40This paper does not move the number.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2005
Δ 1.50
NCT00676338820 enrolled · 2008
Δ 0.36-1.02 to 1.73
4 · 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

8 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2010 · on this map
    Pooled it
  5. Article
  6. Article
  7. Article
  8. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

M G WulffeléDepartment of Internal Medicine, Bethesda General Hospital, Hoogeveen, The Netherlands.
A Kooy
P Lehert
D Bets
A J M Donker
C D A Stehouwer
Ziekenhuis Bethesda · NLMerck (Netherlands) · NLUniversity of Mons · BE

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

aimsWe investigated in a double-blind study whether metformin reduces blood pressure (BP) in patients with Type 2 diabetes intensively treated with insulin.

methodsA total of 220 patients with Type 2 diabetes were asked to undergo 24-h ambulatory BP monitoring (24-h ABPM). One hundred and eighty-two gave informed consent. Eighty-nine were randomized to metformin and 93 to placebo. Thirty-five subjects dropped out (13 placebo, 22 metformin users); 147 patients underwent a second 24-h ABPM, 16 weeks after randomization.

resultsSystolic BP (SBP), diastolic BP (DBP), pulse BP (PP), mean BP (MP) and heart rate (HR) were measured as office BP measurements and as 24-h ABPM for 24-h, day and night. Office BP measurements did not differ significantly between the placebo- and metformin-treated groups for any BP measure, but showed a non-significant trend for SBP reduction with metformin use (mean baseline-adjusted difference, metformin minus placebo: -4.2 mmHg, 95% CI, -9.9 to +1.5; P = 0.15). The baseline-adjusted differences of the ambulatory measurements were -0.2 mmHg (95% CI, -2.9 to +2.6) for the 24-h SBP, and +1.1 mmHg (95% CI, -0.7 to +2.8) for the 24-h DBP. On the whole, BP differences between metformin- and placebo-treated groups were not statistically significant. The only significant difference was for night-time PP (baseline-adjusted difference: -2.2 mmHg; 95% CI, -4.2 to -0.2). These results were not different after adjustment for age and diabetes duration, or for (changes in) body mass index, glycated haemoglobin, insulin dose or plasma homocysteine.

conclusionMetformin does not significantly affect BP in patients with Type 2 diabetes intensively treated with insulin.

Indexed as

Age FactorsBlood PressureBlood Pressure Monitoring, AmbulatoryBody Mass IndexDiabetes Mellitus, Type 2Double-Blind MethodDrug Administration ScheduleFemaleGlycated HemoglobinHeart RateHomocysteineHumansHypoglycemic AgentsInsulinMaleMetforminGlycated HemoglobinHomocysteineHypoglycemic AgentsInsulinMetformin

Identifiers

PMID15975107
OpenAlexW2143033481

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

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.