Evidence mapPaperPMID 24699860Full record

SynthesisJournal of endocrinological investigation2014

Achieving HbA1c targets in clinical trials and in the real world: a systematic review and meta-analysis.

Edoardo Mannucci, Matteo Monami, Ilaria Dicembrini, Attilio Piselli, Massimo Porta

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of endocrinological investigation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing 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

23 citing papers in PubMed.

  1. Trial
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  7. Real-World Effectiveness and Safety of Insulin Glargine 300 U/mL in Insulin-Naïve People with Type 2 Diabetes: the ATOS Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2022
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  8. Article
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  14. The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin.Pathophysiology : the official journal of the International Society for Pathophysiology · 2020
    Article
  15. Observational
  16. Observational
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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.

Edoardo MannucciDiabetes Agency, Careggi Teaching Hospital, Via delle Oblate n. 4, 50141, Florence, Italy, edoardo.mannucci@unifi.it.
Matteo Monami
Ilaria Dicembrini
Attilio Piselli
Massimo Porta

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo review the proportion of diabetic patients reaching recommended therapeutic goals, as reported in intervention trials and observational studies, and to analyse the factors associated with success or failure in achieving these targets.

methodsA systematic review and meta-analysis through a Medline and Embase search for "diabetes" and "HbA1c" has been performed between 1 January 1995 and 1 March 2012 on randomised clinical trials and observational studies on type 1 (T1DM) or type 2 diabetes (T2DM) enrolling at least 200 patient*year.

resultsOut of 169 patient groups in RCTs with results available for analysis, the overall proportion of patients reaching HbA1c ≤ 7 % was 36.6 (34.1-39.1) %. Of these, 8 groups included T1DM subjects [proportion at target (PAT) 27.2 (22.7-32.3) %] and 161 T2DM patients [PAT 37.1 (34.5-39.7) %]. In patients with T2DM on oral agents, at multivariate analysis, higher success rate was associated with higher age and body mass index (BMI), lower duration of diabetes, lower proportion of Caucasians and more recent publication year. Among the insulin treated, only duration of diabetes retained a significant association with success rate. Among 41 groups from cross-sectional studies, 6 and 22 were composed of patients with T1DM and T2DM, respectively, and the remaining 13 included both types. Patients at target for HbA1c were 19.8 (12.4-30.1), 36.1 (31.5-41.0), and 39.0 (32.9-45.3) %, respectively. Higher age, lower BMI, shorter duration of diabetes and a higher proportion of males and Caucasians were associated with a higher success rate.

conclusionsAvailable data show that a wide distance remains between recommended targets and actual achievements in routine clinical practice.

Indexed as

Practice Guidelines as TopicPrecision MedicineDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Glycated HemoglobinHumansHyperglycemiaHypoglycemic AgentsObservational Studies as TopicRandomized Controlled Trials as TopicGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic Agents

Identifiers

What Socratic holds

Textmetadata
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.