Evidence map›Paper›PMID 24599110›Full record

Trial reportDiabetologia2014

Association of blood glucose control and pancreatic reserve with diabetic retinopathy in the Veterans Affairs Diabetes Trial (VADT).

Nasrin Azad, Lily Agrawal, Nicholas V Emanuele, Ronald Klein, Gideon D Bahn, Peter Reaven, VADT Study Group

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Diabetologia, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00756613 (CSP #465FS - VA Diabetes Trial Long Term Follow-up Study), which is not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
4.0field-weighted citation impact, top 6% 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.

NCT00756613 completednot on this map

CSP #465FS - VA Diabetes Trial Long Term Follow-up Study

TypeobservationalSponsorVA Office of Research and DevelopmentRan2008 to 2017Enrolled1,044ConditionsDiabetes, Glycemic Control
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Glucose targets for preventing diabetic kidney disease and its progression.The Cochrane database of systematic reviews · 2017
    Pooled it
  2. Article
  3. Article
  4. Review
  5. Early Worsening of Retinopathy in Type 1 and Type 2 Diabetes After Rapid Improvement in Glycaemic Control: A Systematic Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2022
    Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Review of the veteran affairs diabetes trial: Lessons learned.Reviews in endocrine & metabolic disorders · 2020
    Review
  11. Review
  12. Article
  13. Article
  14. Future opportunities in diabetic retinopathy research.Current opinion in endocrinology, diabetes, and obesity · 2016
    Review
  15. Glucose Tolerance,Journal of diabetes research · 2016
    Article
  16. Review
  17. Review
  18. Type 2 diabetes in Brazil: epidemiology and management.Diabetes, metabolic syndrome and obesity : targets and therapy · 2015
    Review
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

7 authors at 4 institutions in 1 country.

Nasrin AzadEndocrinology Section, Edward Hines, Jr VA Hospital, Building 1, Room D139, Hines, IL, 60141, USA, Nasrin.azad@va.gov.
Lily Agrawal
Nicholas V Emanuele
Ronald Klein
Gideon D Bahn
Peter Reaven
VADT Study Group
Edward Hines, Jr. VA Hospital · USUniversity of Wisconsin–Madison · USCarl T. Hayden Veterans Affairs Medical Center · USThe Coordinating Center · US

Funding

Vascular Metabolic Memory in Type 2 DiabetesR01HL094775 · NHLBI · ARIZONA VETERANS RESEARCH AND EDUCATION FOUNDATION · PI REAVEN, PETER D · 2009 to 2013
$3.1M
Non-traditional Cardiovascular Risk Factors in DM type 2R01HL067690 · NHLBI · PHOENIX VA HEALTH CARE SYSTEM · PI REAVEN, PETER D · 2001 to 2004
$675k
NHLBI NIH HHS R01 HL067690NHLBI NIH HHS R01 HL094775
6 · The paper itself

Abstract

aims/hypothesisThe aim of this study was to test the hypothesis that intensive glycaemic control (INT) and higher plasma C-peptide levels in patients with poorly controlled diabetes would be associated with better eye outcomes.

methodsThe incidence and progression of diabetic retinopathy (DR) was assessed by grading seven-field stereoscopic fundus photographs at baseline and 5 years later in 858 of 1,791 participants in the Veterans Affairs Diabetes Trial (VADT).

resultsAfter adjustment for all covariates, risk of progression (but not incidence) of DR increased by 30% for each 1% increase in baseline HbA1c (OR 1.3; 95% CI 1.123, 1.503; p = 0.0004). Neither assignment to INT nor age was independently associated with DR in the entire cohort. However, INT showed a biphasic interaction with age. The incidence of DR was decreased in INT participants ≤55 years of age (OR 0.49; 95% CI 0.24, 1.0) but increased in those ≥70 years old (OR 2.88; 95% CI 1.0, 8.24) (p = 0.0043). The incidence of DR was reduced by 67.2% with each 1 pmol/ml increment in baseline C-peptide (OR 0.328; 95% CI 0.155, 0.7; p = 0.0037). Baseline C-peptide was also an independent inverse risk factor for the progression of DR, with a reduction of 47% with each 1 pmol/ml increase in C-peptide (OR 0.53; 95% CI 0.305, 0.921; p = 0.0244). CONCLUSIONS/

interpretationPoor glucose control at baseline was associated with an increased risk of progression of DR. INT was associated with a decreased incidence of DR in younger patients but with an increased risk of DR in older patients. Higher C-peptide at baseline was associated with reduced incidence and progression of DR.

Indexed as

AgedBlood GlucoseC-PeptideDiabetes Mellitus, Type 2Diabetic RetinopathyFemaleGlycated HemoglobinHumansMaleMiddle AgedPancreasVeteransBlood GlucoseC-PeptideGlycated Hemoglobin

Identifiers

PMID24599110
OpenAlexW2049265215

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.