SynthesisJournal of the American Heart Association2015
Effect of Intensive Versus Standard Blood Glucose Control in Patients With Type 2 Diabetes Mellitus in Different Regions of the World: Systematic Review and Meta-analysis of Randomized Controlled Trials.
Synthesis in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 6 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
19 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Agreement Between Mega-Trials and Smaller Trials: A Systematic Review and Meta-Research Analysis.JAMA network open · 2024Pooled it
- Performance of prediction models for nephropathy in people with type 2 diabetes: systematic review and external validation study.BMJ (Clinical research ed.) · 2021Pooled it
- Impact of high glucose levels and glucose lowering on risk of ischaemic stroke: a Mendelian randomisation study and meta-analysis.Diabetologia · 2021Pooled it
- Diagnosis, prevention, and treatment of cardiovascular diseases in people with type 2 diabetes and prediabetes: a consensus statement jointly from the Japanese Circulation Society and the Japan Diabetes Society.Diabetology international · 2021Guideline
- Addressing Regional Differences in Diabetes Progression: Global Calibration for Diabetes Simulation Model.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2019Pooled it
- Different intensities of glycaemic control for pregnant women with pre-existing diabetes.The Cochrane database of systematic reviews · 2016Pooled it
- Post hoc efficacy and safety analysis of insulin glargine/lixisenatide fixed- ratio combination in North American patients compared with the rest of world.BMJ open diabetes research & care · 2019Trial
- Visual Analysis of Hyperglycemia After Enteral Nutrition in Critically Ill Patients.Journal of nutrition and metabolism · 2025Article
- Article
- Causal Association of Cardiovascular Risk Factors and Lifestyle Behaviors With Peripheral Artery Disease: A Mendelian Randomization Approach.Journal of the American Heart Association · 2022Article
- Value of Patient-Centered Glycemic Control in Patients with Type 2 Diabetes.Current diabetes reports · 2021Review
- A Target HbA1c Between 7 and 7.7% Reduces Microvascular and Macrovascular Events in T2D Regardless of Duration of Diabetes: a Meta-Analysis of Randomized Controlled Trials.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021Article
- Cardiovascular Outcome Trials in Type 2 Diabetes: What Do They Mean for Clinical Practice?Clinical diabetes : a publication of the American Diabetes Association · 2019Article
- Eligibility of patients with type 2 diabetes for sodium-glucose cotransporter 2 inhibitor cardiovascular outcomes trials: a global perspective from the DISCOVER study.BMJ open diabetes research & care · 2019Article
- Importance of fasting blood glucose goals in the management of type 2 diabetes mellitus: a review of the literature and a critical appraisal.Journal of diabetes, metabolic disorders & control · 2018Article
- SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2017Review
- Dynamin-related protein 1 mediates low glucose-induced endothelial dysfunction in human arterioles.American journal of physiology. Heart and circulatory physiology · 2017Article
- Edetate Disodium-Based Treatment for Secondary Prevention in Post-Myocardial Infarction Patients.Current cardiology reports · 2016Review
- LEADER 7: cardiovascular risk profiles of US and European participants in the LEADER diabetes trial differ.Diabetology & metabolic syndrome · 2016 · on this mapArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRegional variation in type 2 diabetes mellitus care may affect outcomes in patients treated with intensive versus standard blood glucose control. We sought to evaluate these differences between North America and the rest of the world. METHODS AND
resultsDatabases were searched from their inception through December 2013. Randomized controlled trials comparing the effects of intensive therapy with standard therapy for macro- and microvascular complications in adults with type 2 diabetes mellitus were selected. We calculated summary odds ratios (ORs) and 95% CIs with the random-effects model. The analysis included 34 967 patients from 17 randomized controlled trials (7 in North America and 10 in the rest of the world). There were no significant differences between intensive and standard therapy groups for all-cause mortality (OR 1.03, 95% CI 0.93 to 1.13) and cardiovascular mortality (OR 1.09, 95% CI 0.90 to 1.32). For trials conducted in North America, intensive therapy compared with standard glycemic control resulted in significantly higher all-cause mortality (OR 1.21, 95% CI 1.05 to 1.40) and cardiovascular mortality (OR 1.41, 95% CI 1.05 to 1.90) than trials conducted in the rest of the world (all-cause mortality OR 0.93, 95% CI 0.85 to 1.03; interaction P=0.006; cardiovascular mortality OR 0.89, 95% CI, 0.79 to 1.00; interaction P=0.007). Analysis of individual macro- and microvascular outcomes revealed no significant regional differences; however, the risk of severe hypoglycemia was significantly higher in trials of intensive therapy in North America (OR 3.52, 95% CI 3.07 to 4.03) compared with the rest of the world (OR 1.45, 95% CI 0.85 to 2.47; interaction P=0.001).
conclusionRandomization to intensive glycemic control in type 2 diabetes mellitus patients was associated with increases in all-cause mortality, cardiovascular mortality, and severe hypoglycemia in North America compared with the rest of the world. Further investigation into the pathobiology or patient variability underlying these findings is warranted.
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What Socratic holds
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.