Evidence mapPaperPMID 21978180Full record

Trial reportCardiovascular diabetology2011

Age, gender, insulin and blood glucose control status alter the risk of ischemic heart disease and stroke among elderly diabetic patients.

Toshio Hayashi, Seinosuke Kawashima, Hideki Nomura, Hideki Itoh, Hiroshi Watanabe, Takashi Ohrui, Koutaro Yokote, Hirohito Sone, Yoshiyuki Hattori, Masao Yoshizumi and 3 more

Open access · goldAbstract readClinical TrialComparative StudyMulticenter Study
In one paragraph

Trial report in Cardiovascular diabetology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% 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.

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

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  11. Screening for heat stress in workers and athletes.Proceedings (Baylor University. Medical Center) · 2012
    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

13 authors at 11 institutions in 1 country.

Toshio HayashiDepartment of Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan. hayashi@med.nagoya-u.ac.jp
Seinosuke Kawashima
Hideki Nomura
Hideki Itoh
Hiroshi Watanabe
Takashi Ohrui
Koutaro Yokote
Hirohito Sone
Yoshiyuki Hattori
Masao Yoshizumi
Koichiro Ina
Kiyoshi Kubota
Japan Cholesterol and Diabetes Mellitus Investigation Group
Nagoya University · JPChiba University · JPDokkyo University · JPHamamatsu University School of Medicine · JPHiroshima University · JPNagoya University Hospital · JPNational Hospital Organization Mito Medical Center · JPSaiseikai Nakatsu Hospital · JPThe University of Tokyo · JPTohoku University · JPTokyo Metropolitan Geriatric Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe analyzed the effects of insulin therapy, age and gender on the risk of ischemic heart disease (IHD) and cerebrovascular accident (CVA) according to glycemic control. METHODS AND

resultsWe performed a prospective cohort study (Japan Cholesterol and Diabetes Mellitus Study) of type 2 diabetes patients (n = 4014) for 2 years. The primary endpoint was the onset of fatal/non-fatal IHD and/or CVA, which occurred at rates of 7.9 and 7.2 per 1000 person-years, respectively. We divided diabetic patients into four groups based on age (≤ 70 and > 70) and hemoglobin A1C levels (≤ 7.0 and > 7.0%). Multiple regression analysis revealed that IHD was associated with high systolic blood pressure and low HDL-C in patients under 70 years of age with fair glycemic control and was associated with low diastolic blood pressure in the older/fair group. Interestingly, insulin use was associated with IHD in the older/poor group (OR = 2.27, 95% CI = 1.11-5.89; p = 0.026) and was associated with CVA in the older/fair group (OR = 2.09, 95% CI = 1.06-4.25; p = 0.028). CVA was associated with lower HDL-C and longer duration of diabetes in younger/poor glycemic control group. Results by stepwise analysis were similar. Next, patients were divided into four groups based on gender and diabetic control(hemoglobinA1C < or > 7.0%). Multiple regression analysis revealed that IHD was associated with high systolic blood pressure in male/fair glycemic control group, age in male/poor control group, and short duration of diabetic history in females in both glycemic control groups. Interestingly, insulin use was associated with IHD in the male/poor group(OR = 4.11, 95% CI = 1.22-8.12; p = 0.018) and with CVA in the female/poor group(OR = 3.26, 95% CI = 1.12-6.24; p = 0.02). CVA was associated with short duration of diabetes in both female groups.

conclusionsIHD and CVA risks are affected by specific factors in diabetics, such as treatment, gender and age. Specifically, insulin use has a potential role in preventing IHD but may also be a risk factor for CVA among the diabetic elderly, thus revealing a need to develop improved treatment strategies for diabetes in elderly patients. The Japan Cholesterol and Diabetes Mellitus Study was formulated to evaluate them(Umin Clinical Trials Registry, clinical trial reg. no. UMIN00000516; http://www.umin.ac.jp/ctr/index.htm).

Indexed as

AdultAgedAged, 80 and overAge FactorsBlood GlucoseCohort StudiesDiabetes Mellitus, Type 2FemaleFollow-Up StudiesHumansInsulinLongitudinal StudiesMaleMiddle AgedMyocardial IschemiaProspective StudiesBlood GlucoseInsulin

Identifiers

PMID21978180
PMCPMC3200162
OpenAlexW2109888497

What Socratic holds

Textmetadata
LicenceCC BY
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.