Evidence mapPaperPMID 21457427Full record

ArticleDiabetes, obesity & metabolism2011

Treatment intensification in patients with type 2 diabetes who failed metformin monotherapy.

A Z Fu, Y Qiu, M J Davies, L Radican, S S Engel

Registry-linked trialAbstract read
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In one paragraph

Article in Diabetes, obesity & metabolism, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05535322 (Real-world Evaluation of GLP-1 Receptor Agonists), which is not on this map. Cited by 26 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 2 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.

NCT05535322 completedstarted 2014, after this paper: background citation

Real-world Evaluation of GLP-1 Receptor Agonists (GLP-1RA) on Efficacy and Persistence, Adherence and Therapeutic Inertia Among Type 2 Diabetes Adults With Obesity in the Department of Health of Valencia Clínico-Malvarrosa

Ran2014Enrolled26,944Registered outcomes12Posted comparisons0ConditionsObesity, Type 2 DiabetesArmsGLP-1RA, Insulin, Miscellany, SGLT2i
Open the trial in the graph
3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Evaluating Therapeutic Inertia in Two Telehealth Interventions for Type 2 Diabetes: Secondary Analyses of a Randomized Trial.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024
    Trial
  4. Article
  5. Article
  6. Therapeutic Inertia in the Management of Type 2 Diabetes: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024
    Review
  7. Observational
  8. Article
  9. Review
  10. Addressing Therapeutic Inertia in 2020 and Beyond: A 3-Year Initiative of the American Diabetes Association.Clinical diabetes : a publication of the American Diabetes Association · 2020
    Article
  11. Review
  12. Why Are We Stuck? Therapeutic Inertia in Diabetes Education.Diabetes spectrum : a publication of the American Diabetes Association · 2020
    Article
  13. Article
  14. Review
  15. Review
  16. Article
  17. Article
  18. Review
  19. Efficacy and Safety of Initial Combination Therapy in Treatment-Naïve Type 2 Diabetes Patients: A Systematic Review and Meta-analysis.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2018
    Article
  20. Ertugliflozin and Sitagliptin Co-initiation in Patients with Type 2 Diabetes: The VERTIS SITA Randomized Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2018
    Article
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

5 authors.

A Z FuDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, USA. fuz@ccf.org
Y Qiu
M J Davies
L Radican
S S Engel

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo evaluate the time to and factors associated with treatment intensification in patients with type 2 diabetes who failed metformin monotherapy.

methodsIn a retrospective analysis using a large US electronic medical record database, eligible patients included those with type 2 diabetes and an HbA(1c) of ≥7.0% or at least two fasting blood glucose levels of ≥126 mg/dl while on metformin monotherapy for at least 6 months within the period of 1 January 1997 to 31 December 2008. Time to treatment intensification was calculated as the time between index date (date on which HbA(1c) ≥ 7% after metformin monotherapy for at least 6 months) and first prescription for additional antihyperglycaemic agent during follow-up period. All patients were required to have data for at least 12 months prior to and following the index date. A Cox proportional hazards model was employed to determine patient baseline characteristics associated with time to treatment intensification.

resultsOf the 12 566 patients identified, mean age at index date was 63 years and 51% were female. Mean index HbA(1c) was 8.0% overall, with 66, 19 and 15% of patients having an index HbA(1c) of 7 to <8%, 8 to <9% and ≥9%, respectively. Median time to treatment intensification was 14.0 months overall and 19.0, 8.7 and 4.5 months for patients with index HbA(1c) of 7 to <8%, 8 to <9% and ≥9%, respectively. Factors associated with treatment intensification included higher index HbA(1c) , younger age, higher Charlson co-morbidity index, metformin daily dose ≥ 1500 mg and later index date (all p < 0.05).

conclusionsIn US clinical practice, median time to receive additional antihyperglycaemic medication is more than 1 year for patients with type 2 diabetes who failed metformin monotherapy.

Indexed as

Blood GlucoseDatabases, FactualDiabetes Mellitus, Type 2Drug Administration ScheduleFemaleGlycated HemoglobinHumansHypoglycemic AgentsMaleMetforminMiddle AgedRetrospective StudiesTreatment FailureBlood GlucoseGlycated HemoglobinHypoglycemic AgentsMetformin

Identifiers

What Socratic holds

Texttitle and abstract
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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.