Evidence map›Paper›PMID 19655124›Full record

SynthesisDiabetologia2009

Intensive glucose control and macrovascular outcomes in type 2 diabetes.

Control Group, F M Turnbull, C Abraira, R J Anderson, R P Byington, J P Chalmers, W C Duckworth, G W Evans, H C Gerstein, R R Holman and 7 more

Erratum issued Registry-linked trialAbstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Diabetologia, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It reports registered trial NCT00032487. Cited by 422 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
422citing papers in PubMed, 16 pooled it
46.8field-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.

NCT00032487 phase3completed

CSP #465 - Glycemic Control and Complications in Diabetes Mellitus Type 2 (VADT)

Ran2000Enrolled1,791Registered outcomes2Posted comparisons1ConditionsType 2 Diabetes MellitusArmsGlimepiride, Insulin, Metformin, Rosiglitazone
PMID 19092145PMID 18671796PMID 21775749PMID 21059830PMID 19726779PMID 19720420PMID 18406632PMID 16784922PMID 16627388PMID 16504835PMID 16043738PMID 14583175other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

422 citing papers in PubMed, 16 syntheses or guidelines pooled it, 1,195 citations in OpenAlex.

  1. Guideline
  2. The Use of Sodium-Glucose Cotransporter-2 Inhibitors in Coronary Revascularization: Where Are We Now? A Systematic Review.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Guideline
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Atencion primaria · 2018
    Guideline
  17. Trial
  18. Trial
  19. Trial
  20. Trial

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 12 institutions in 5 countries.

Control GroupThe George Institute for International Health, University of Sydney, Sydney, NSW 2050, Australia. fturnbull@george.org.au
F M Turnbull
C Abraira
R J Anderson
R P Byington
J P Chalmers
W C Duckworth
G W Evans
H C Gerstein
R R Holman
T E Moritz
B C Neal
T Ninomiya
A A Patel
S K Paul
F Travert
M Woodward
The George Institute for Global Health · AUUniversity of Sydney · AUWake Forest University · USChicago Department of Public Health · USEdward Hines, Jr. VA Hospital · USHamilton Health Sciences · CAIcahn School of Medicine at Mount Sinai · USOxford Centre for Diabetes, Endocrinology and Metabolism · GBPhoenix VA Health Care System · USUniversité Paris Cité · FRUniversity of Oxford · GBVeterans Health Administration · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisImproved glucose control in type 2 diabetes is known to reduce the risk of microvascular events. There is, however, continuing uncertainty about its impact on macrovascular disease. The aim of these analyses was to generate more precise estimates of the effects of more-intensive, compared with less-intensive, glucose control on the risk of major cardiovascular events amongst patients with type 2 diabetes.

methodsA prospectively planned group-level meta-analysis in which characteristics of trials to be included, outcomes of interest, analyses and subgroup definitions were all pre-specified.

resultsA total of 27,049 participants and 2,370 major vascular events contributed to the meta-analyses. Allocation to more-intensive, compared with less-intensive, glucose control reduced the risk of major cardiovascular events by 9% (HR 0.91, 95% CI 0.84-0.99), primarily because of a 15% reduced risk of myocardial infarction (HR 0.85, 95% CI 0.76-0.94). Mortality was not decreased, with non-significant HRs of 1.04 for all-cause mortality (95% CI 0.90-1.20) and 1.10 for cardiovascular death (95% CI 0.84-1.42). Intensively treated participants had significantly more major hypoglycaemic events (HR 2.48, 95% CI 1.91-3.21). Exploratory subgroup analyses suggested the possibility of a differential effect for major cardiovascular events in participants with and without macrovascular disease (HR 1.00, 95% CI 0.89-1.13, vs HR 0.84, 95% CI 0.74-0.94, respectively; interaction p = 0.04). CONCLUSIONS/

interpretationTargeting more-intensive glucose lowering modestly reduced major macrovascular events and increased major hypoglycaemia over 4.4 years in persons with type 2 diabetes. The analyses suggest that glucose-lowering regimens should be tailored to the individual.

Indexed as

Blood GlucoseBlood PressureCholesterolClinical Trials as TopicDiabetes Mellitus, Type 2Diabetic AngiopathiesFastingFollow-Up StudiesGlycated HemoglobinHomeostasisHumansPatient CompliancePatient SelectionRisk Reduction BehaviorTreatment OutcomeBlood GlucoseCholesterolGlycated Hemoglobin

Identifiers

PMID19655124
OpenAlexW1983269691

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.