Evidence mapPaperPMID 27208320Full record

Trial reportDiabetes care2016

Glucose Variability in a 26-Week Randomized Comparison of Mealtime Treatment With Rapid-Acting Insulin Versus GLP-1 Agonist in Participants With Type 2 Diabetes at High Cardiovascular Risk.

FLAT-SUGAR Trial Investigators

3 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Diabetes care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT01524705. Cited by 50 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 2 pooled it
18.8field-weighted citation impact, top 1% 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.

NCT01524705 phase4completed

FLAT-SUGAR: FLuctuATion Reduction With inSULin and Glp-1 Added togetheR

Ran2012Enrolled102Registered outcomes4Posted comparisons3ConditionsType 2 DiabetesArmsexenatide, Insulin glargine, Metformin, Prandial insulin
Open the trial in the graph
NCT06243536 phase4unknown statusstarted 2024, after this paper: background citation

The Effect of Semaglutide on Disordered Eating Behaviour in Type 2 Diabetic Patients

Ran2024Enrolled60Registered outcomes3Posted comparisons0ConditionsDisordered Eating Behaviors, Overweight, Type 2 DiabetesArmssemaglutide, Standard of care
Open the trial in the graph
NCT05653518 narecruitingnot on this mapstarted 2023, after this paper: background citation

Using Closed-Loop Artificial Pancreas Technology to Reduce Glycemic Variability and Subsequently Improve Cardiovascular Health in Type 1 Diabetes

TypeinterventionalSponsorUniversity of VirginiaRan2023 to 2027Enrolled40ConditionsType 1 DiabetesArmsTandem t:slim X2 with Control-IQ Technology, Sensor augmented pump (SAP) therapy
3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 131 citations in OpenAlex.

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  6. Use of flash glucose-sensing technology in patients with type 2 diabetes treated with liraglutide combined with CSII: a pilot study.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2020
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

1 author at 1 institution in 2 countries.

FLAT-SUGAR Trial Investigators
TiGenix (Spain) · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveA1C is associated with diabetes complications but does not reflect glycemic variability (GV), which may worsen outcomes by inducing inflammation, oxidative stress, and cardiac arrhythmias. We tested whether a glucagon-like peptide 1 agonist-based regimen can reduce GV and cardiometabolic risk markers while maintaining similar A1C levels in people with insulin-requiring type 2 diabetes and high cardiovascular risk. RESEARCH DESIGN AND

methodsAfter run-in on metformin and basal-bolus insulin (BBI), 102 participants continued metformin and basal insulin and were randomized to exenatide dosing before the two largest meals (glucacon-like peptide-1 receptor agonist and insulin [GLIPULIN group]) or continuation of rapid-acting insulin analogs (BBI group). Indices of GV by continuous glucose monitoring (CGM), hypoglycemia, weight, risk markers, and cardiac arrhythmias were assessed. The primary end point was change in glucose coefficients of variation (CV) by CGM from baseline to 26 weeks.

resultsAt randomization, the median A1C was 7.3% (57 mmol/mol) for GLIPULIN and 7.4% (56.3 mmol/mol) for BBI, and glucose CVs were 30.3 for BBI and 31.9 for GLIPULIN. At 26 weeks, A1C levels were similar (7.1% [54 mmol/mol] vs. 7.2% [55 mmol/mol]), whereas mean CV improved with GLIPULIN (-2.4 vs. 0.4, P = 0.047). Other GV indices followed similar nonsignificant patterns of improvement with GLIPULIN. There were no differences in hypoglycemic events during CGM or arrhythmias during electrocardiographic monitoring. On-trial changes in body weight (-4.8 kg vs. +0.7 kg, P < 0.001), alanine aminotransferase (P = 0.0002), and serum amyloid A (P = 0.023) favored GLIPULIN.

conclusionsGLIPULIN reduced GV, weight, and some cardiometabolic risk markers while maintaining equivalent A1C levels versus BBI and might improve clinical outcomes in a larger trial.

Indexed as

MealsAdultAgedAlanine TransaminaseArrhythmias, CardiacBlood GlucoseBody WeightCardiovascular DiseasesDiabetes Mellitus, Type 2Drug Therapy, CombinationExenatideFemaleGlycated HemoglobinHumansHypoglycemiaHypoglycemic AgentsAlanine TransaminaseBlood GlucoseExenatideGlycated HemoglobinHypoglycemic AgentsInsulin, Short-ActingMetforminPeptidesSerum Amyloid A ProteinVenoms

Identifiers

PMID27208320
OpenAlexW2403039904

What Socratic holds

Texttitle and abstract
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.