Evidence mapPaperPMID 18955637Full record

ArticleArchives of internal medicine2008

National trends in treatment of type 2 diabetes mellitus, 1994-2007.

G Caleb Alexander, Niraj L Sehgal, Rachael M Moloney, Randall S Stafford

4 registry-linked trialsAbstract read
In one paragraph

Article in Archives of internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 84 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 4 pooled it
field-weighted citation impact
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.

NCT01386671 phase3completedstarted 2014, after this paper: background citation

Safety and Efficacy of Metformin Glycinate vs Metformin Hydrochloride on Metabolic Control and Inflammatory Mediators in Type 2 Diabetes Patients

Ran2014Enrolled203Registered outcomes13Posted comparisons0ConditionsType 2 DiabetesArmsMetformin glycinate, Metformin hydrochloride
Open the trial in the graph
NCT04943692 phase3suspendedstarted 2021, after this paper: background citation

Efficacy and Safety of Metformin Glycinate Compared to Metformin Hydrochloride on the Progression of Type 2 Diabetes

Ran2021Enrolled500Registered outcomes13Posted comparisons0ConditionsType 2 DiabetesArmsMetformin glycinate, Metformin hydrochloride
Open the trial in the graph
NCT02002143 naunknown statusnot on this mapstarted 2014, after this paper: background citation

Group Medical Visits (GMVs) in Primary Care: An RCT of Group-Based Versus Individual Appointments to Reduce HbA1c in Older People

TypeinterventionalSponsorUniversity of British ColumbiaRan2014 to 2020Enrolled128ConditionsType 2 Diabetes Mellitus (T2DM)ArmsGroup Appointments, Individual Appointments (IAs)
NCT04097483 nacompletednot on this mapstarted 2017, after this paper: background citation

The TELE-DD Project: a Nurse-led Randomised Controlled Trial on Treatment Adherence in Patients With Type 2 Diabetes and Comorbid Depression

TypeinterventionalSponsorAlicia Monreal BartoloméRan2017 to 2020Enrolled428ConditionsDiabetes Mellitus, Type 2, DepressionArmsTelephone Intervention Group
3 · Its place in the literature

Who cites it

84 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  17. Trends in Diabetes Management Among US Adults: 1999-2016.Journal of general internal medicine · 2020
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  18. Review
  19. Article
  20. Article

24 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

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

5 · Who and what money

Authors and funding

4 authors.

G Caleb AlexanderDepartment of Medicine, Section of General Internal Medicine, The University of Chicago, Chicago, IL 60637, USA. galexand@uchicago.edu
Niraj L Sehgal
Rachael M Moloney
Randall S Stafford

Funding

AHRQ HHS K08 HS015699AHRQ HHS K08 HS15699-01A1NHLBI NIH HHS K24 HL086703
6 · The paper itself

Abstract

backgroundDiabetes mellitus is common, costly, and increasingly prevalent. Despite innovations in therapy, little is known about patterns and costs of drug treatment.

methodsWe used the National Disease and Therapeutic Index to analyze medications prescribed between 1994 and 2007 for all US office visits among patients 35 years and older with type 2 diabetes. We used the National Prescription Audit to assess medication costs between 2001 and 2007.

resultsThe estimated number of patient visits for treated diabetes increased from 25 million (95% confidence interval [CI], 23 million to 27 million) in 1994 to 36 million (95% CI, 34 million to 38 million) by 2007. The mean number of diabetes medications per treated patient increased from 1.14 (95% CI, 1.06-1.22) in 1994 to 1.63 (1.54-1.72) in 2007. Monotherapy declined from 82% (95% CI, 75%-89%) of visits during which a treatment was used in 1994 to 47% (43%-51%) in 2007. Insulin use decreased from 38% of treatment visits in 1994 to a nadir of 25% in 2000 and then increased to 28% in 2007. Sulfonylurea use decreased from 67% of treatment visits in 1994 to 34% in 2007. By 2007, biguanides (54% of treatment visits) and glitazones (thiazolidinediones) (28%) were leading therapeutic classes. Increasing use of glitazones, newer insulins, sitagliptin phosphate, and exenatide largely accounted for recent increases in the mean cost per prescription ($56 in 2001 to $76 in 2007) and aggregate drug expenditures ($6.7 billion in 2001 to $12.5 billion in 2007).

conclusionsIncreasingly complex and costly diabetes treatments are being applied to an increasing population. The magnitude of these rapid changes raises concerns about whether these more costly therapies will result in proportionately improved outcomes.

Indexed as

BiguanidesDiabetes MellitusDrug CombinationsDrug TherapyHumansHypoglycemic AgentsInsulinOffice VisitsPrimary Health CareSulfonylurea CompoundsThiazolidinedionesBiguanidesDrug CombinationsHypoglycemic AgentsInsulinSulfonylurea CompoundsThiazolidinediones

Identifiers

PMID18955637
PMCPMC2868588

What Socratic holds

Textmetadata
LicenceTDM
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.