Evidence map›Paper›PMID 22638938›Full record

ReviewCurrent diabetes reports2012

Glycemic control in diabetic dialysis patients and the burnt-out diabetes phenomenon.

Jongha Park, Paungpaga Lertdumrongluk, Miklos Z Molnar, Csaba P Kovesdy, Kamyar Kalantar-Zadeh

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Current diabetes reports, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed
–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.

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

27 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Observational
  10. Article
  11. Burnt Out? The Phenomenon of Type 2 Diabetes Mellitus in End-Stage Renal Disease.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2020
    Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Review
  18. Review
  19. Article
  20. Nutrition Intervention for Advanced Stages of Diabetic Kidney Disease.Diabetes spectrum : a publication of the American Diabetes Association · 2015
    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.

Jongha ParkHarold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90509-2910, USA.
Paungpaga Lertdumrongluk
Miklos Z Molnar
Csaba P Kovesdy
Kamyar Kalantar-Zadeh

Funding

MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
Examining Racial and Cardiovascular Paradoxes in Chronic Kidney DiseaseR01DK078106 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALANTAR-ZADEH, KAMYAR · 2007 to 2011
$1.1M
Understanding Sources of Bias and Outcomes in Peritoneal Dialysis Patient ResearcR21DK077341 · NIDDK · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI KALANTAR-ZADEH, KAMYAR · 2009 to 2010
$409k
NIDDK NIH HHS K24 DK091419NIDDK NIH HHS K24-DK091419NIDDK NIH HHS R01 DK078106NIDDK NIH HHS R0-DK078106NIDDK NIH HHS R21 DK077341NIDDK NIH HHS R21-DK077341
6 · The paper itself

Abstract

Diabetes mellitus (DM) is the most common cause of end-stage kidney disease and a major risk of morbidity and mortality. It is not clear whether medical management of DM has any significant beneficial effect on clinical outcomes at the end-stage of diabetic nephropathy with full-blown micro- and macro-angiopathic complications. Both loss of kidney function and dialysis treatment interfere with glucose homeostasis and confound glycemic control. Given the unique nature of uremic milieu and dialysis therapy related alterations, there have been some debates about reliance on the conventional measures of glycemic control, in particular the clinical relevance of hemoglobin A1c and its recommended target range of <7 % in diabetic dialysis patients. Moreover, a so-called burnt-out diabetes phenomenon has been described, in that many diabetic dialysis patients experience frequent hypoglycemic episodes prompting cessation of their anti-diabetic therapies transiently or even permanently. By reviewing the recent literature we argue that the use of A1c for management of diabetic dialysis patients should be encouraged if appropriate target ranges specific for these patients (e.g. 6 to 8 %) are used. We also argue that "burnt-out diabetes" is a true biologic phenomenon and highly prevalent in dialysis patients with established history and end-stage diabetic nephropathy and explore the role of protein-energy wasting to this end. Similarly, the J- or U-shaped associations between A1c or blood glucose concentrations and mortality are likely biologically plausible phenomena that should be taken into consideration in the management of diabetic dialysis patients to avoid hypoglycemia and its fatal consequences in diabetic dialysis patients.

Indexed as

Insulin ResistanceRenal DialysisBlood GlucoseDiabetes Mellitus, Type 2Diabetic NephropathiesDisease ProgressionFemaleGlycated HemoglobinHumansKidney Failure, ChronicKidney Function TestsMaleRisk FactorsSurvival RateBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, human

Identifiers

PMID22638938
PMCPMC5796524

What Socratic holds

Textmetadata
LicenceTDM
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.