Evidence map›Paper›PMID 20380649›Full record

SynthesisDiabetes, obesity & metabolism2010

Glycaemic variability and complications in patients with diabetes mellitus: evidence from a systematic review of the literature.

L Nalysnyk, M Hernandez-Medina, G Krishnarajah

3 registry-linked trialsAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Diabetes, obesity & metabolism, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 154 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
154citing papers in PubMed, 9 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.

NCT04203927 early_phase1unknown statusstarted 2020, after this paper: background citation

Effects of Empagliflozin on Cardiac Microvasculature and Insulin Sensitivity in Subjects With Type 2 Diabetes

Ran2020Enrolled50Registered outcomes4Posted comparisons0ConditionsInsulin Sensitivity, Type2 DiabetesArmsempagliflozin 25 mg
PMID 29166232PMID 26981940PMID 25633683PMID 27299675PMID 24711523PMID 23459195PMID 21617098PMID 21047922PMID 20978231PMID 19996061PMID 16386091PMID 16308832other papers from this trial
Open the trial in the graph
NCT04920058 nacompletednot on this mapstarted 2021, after this paper: background citation

Improving Cognitive-Behavioral and Cardio-Metabolic Health Through Continuous Glucose Monitoring (CGM)

TypeinterventionalSponsorUniversity of South FloridaRan2021 to 2022Enrolled66ConditionsMetabolic SyndromeArmsContinuous Glucose Monitor, <Active Comparator?>
NCT04986345 naunknown statusnot on this mapstarted 2021, after this paper: background citation

High-intensity Interval Training Prescriptions to Reduce the Risk of Complications Linked to Type 2 Diabetes: the Role of Interval Length on Clinical Benefits and on Physiological Mechanisms

TypeinterventionalSponsorUniversité de SherbrookeRan2021 to 2023Enrolled15ConditionsDiabetes Mellitus, Type 2ArmsHigh-intensity interval training (HIIT)-4, High-intensity interval training (HIIT)-10, Rest
3 · Its place in the literature

Who cites it

154 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

94 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

3 authors.

L NalysnykUnited BioSource Corporation, Lexington, MA 02420, USA. luba.nalysnyk@unitedbiosource.com
M Hernandez-Medina
G Krishnarajah

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe objective of this review was to assess the published evidence for an association between glycaemic variability and the development of chronic micro- and macrovascular complications in patients with diabetes mellitus (DM).

methodsA systematic review of English-language literature published from January 1990 through November 2008 was performed. Interventional and observational studies in patients with type 1 or type 2 DM reporting a measure of glycaemic variability and its impact on the development or progression of micro- and macrovascular diabetic complications were assessed.

resultsA total of 18 studies -8 on type 1 DM and 10 on type 2 DM patients-meeting the inclusion criteria were identified. Studies in patients with type 1 DM revealed that glucose variability has little impact on the development of diabetic complications. Only in two of the eight type 1 DM studies did glucose variability have a significant association with microvascular complications, but not with macrovascular complications. Among type 2 DM studies, a significant positive association between glucose variability and the development or progression of diabetic retinopathy, cardiovascular events and mortality was reported in 9 of 10 studies. Only one type 2 DM study reported no association between glucose variability and progression of retinopathy.

conclusionsBased on this overview of the available evidence, there appears to be a signal suggesting that glucose variability, characterized by extreme glucose excursions, could be a predictor of diabetic complications, independent of HbA1c levels, in patients with type 2 DM. Better daily control of blood glucose excursions, especially in the postprandial period, may reduce the risk of these complications. Future prospective trials evaluating and comparing the effect of the control of glycaemic variability on the development of diabetic micro- and macrovascular complications are needed to further strengthen the evidence base.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Diabetic AngiopathiesEvidence-Based MedicineFemaleHumansHyperglycemiaMaleRisk FactorsBlood Glucose

Identifiers

PMID20380649

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.