Evidence mapPaperPMID 26925237Full record

ArticleBMJ open diabetes research & care2016

Early treatment revisions by addition or switch for type 2 diabetes: impact on glycemic control, diabetic complications, and healthcare costs.

Phil Schwab, Vishal Saundankar, Jonathan Bouchard, Neil Wintfeld, Brandon Suehs, Chad Moretz, Elsie Allen, Antonio DeLuzio

Open access · goldAbstract read
In one paragraph

Article in BMJ open diabetes research & care, 2016. 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 14% 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, 20 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Evaluating Therapeutic Inertia in Two Telehealth Interventions for Type 2 Diabetes: Secondary Analyses of a Randomized Trial.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024
    Trial
  4. Article
  5. Article
  6. Clinical Inertia in Poorly Controlled Type 2 Diabetes Mellitus Patients with Obesity: An Observational Retrospective Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020
    Article
  7. Article
  8. Clinical Use of IDegLira: Initiation to Titration After Basal Insulin.Clinical diabetes : a publication of the American Diabetes Association · 2020
    Article
  9. Article
  10. Article
  11. Acceptability and Feasibility of Examining Physical Activity in Young Children with Type 1 Diabetes.Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
    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

8 authors at 2 institutions in 1 country.

Phil SchwabComprehensive Health Insights, Inc., A Humana Company , Louisville, Kentucky , USA.
Vishal SaundankarComprehensive Health Insights, Inc., A Humana Company , Louisville, Kentucky , USA.
Jonathan BouchardNovo Nordisk Inc. , Plainsboro, New Jersey , USA.
Neil WintfeldNovo Nordisk Inc. , Plainsboro, New Jersey , USA.
Brandon SuehsComprehensive Health Insights, Inc., A Humana Company , Louisville, Kentucky , USA.
Chad MoretzComprehensive Health Insights, Inc., A Humana Company , Louisville, Kentucky , USA.
Elsie AllenNovo Nordisk Inc. , Plainsboro, New Jersey , USA.
Antonio DeLuzioNovo Nordisk Inc. , Plainsboro, New Jersey , USA.
Humana (United States) · USNovo Nordisk (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe study examined the prevalence of early treatment revisions after glycosylated hemoglobin (HbA1c) ≥9.0% (75 mmol/mol) and estimated the impact of early treatment revisions on glycemic control, diabetic complications, and costs. RESEARCH DESIGN AND

methodsA retrospective cohort study of administrative claims data of plan members with type 2 diabetes and HbA1c ≥9.0% (75 mmol/mol) was completed. Treatment revision was identified as treatment addition or switch. Glycemic control was measured as HbA1c during 6-12 months following the first qualifying HbA1c ≥9.0% (75 mmol/mol) laboratory result. Complications severity (via Diabetes Complication Severity Index (DCSI)) and costs were measured after 12, 24, and 36 months. Unadjusted comparisons and multivariable models were used to examine the relationship between early treatment revision (within 90 days of HbA1c) and outcomes after controlling for potentially confounding factors measured during a 12-month baseline period.

results8463 participants were included with a mean baseline HbA1c of 10.2% (75 mmol/mol). Early treatment revision was associated with greater reduction in HbA1c at 6-12 months (-2.10% vs -1.87%; p<0.001). No significant relationship was observed between early treatment revision and DCSI at 12, 24, or 36 months (p=0.931, p=0.332, and p=0.418). Total costs, medical costs, and pharmacy costs at 12, 24, or 36 months were greater for the early treatment revision group compared with the delayed treatment revision group (all p<0.05).

conclusionsThe findings suggest that in patients with type 2 diabetes mellitus, treatment revision within 90 days of finding an HbA1c ≥9.0% is associated with a greater level of near-term glycemic control and higher cost. The impact on end points such as diabetic complications may not be realized over relatively short time frames.

Indexed as

A1CClaims Database AnalysisOutcomes ResearchType 2 Diabetes

Identifiers

PMID26925237
PMCPMC4761990
OpenAlexW2289580644

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.