Evidence map›Paper›PMID 27402452›Full record

Trial reportPediatric diabetes2017

Ketone production in children with type 1 diabetes, ages 4-14 years, with and without nocturnal insulin pump suspension.

R Paul Wadwa, H Peter Chase, Dan Raghinaru, Bruce A Buckingham, Irene Hramiak, David M Maahs, Laurel Messer, Trang Ly, Tandy Aye, Paula Clinton and 4 more

Open access · greenAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Pediatric diabetes, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 39% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Review
  4. Practical Aspects and Exercise Safety Benefits of Automated Insulin Delivery Systems in Type 1 Diabetes.Diabetes spectrum : a publication of the American Diabetes Association · 2023
    Article
  5. Article
  6. Monitoring of Pediatric Type 1 Diabetes.Frontiers in endocrinology · 2020
    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

14 authors at 6 institutions in 2 countries.

R Paul WadwaBarbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA.
H Peter ChaseBarbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA.
Dan RaghinaruJaeb Center for Health Research, Tampa, Florida, USA.
Bruce A BuckinghamDivision of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, California, USA.
Irene HramiakDivision of Endocrinology & Metabolism, St. Joseph's Health Care, London, ON, Canada.
David M MaahsBarbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA.
Laurel MesserBarbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA.
Trang LyDivision of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, California, USA.
Tandy AyeDivision of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, California, USA.
Paula ClintonDivision of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, California, USA.
Craig KollmanJaeb Center for Health Research, Tampa, Florida, USA.
Roy W BeckJaeb Center for Health Research, Tampa, Florida, USA.
John LumJaeb Center for Health Research, Tampa, Florida, USA.
In Home Closed Loop Study Group
Jaeb Center for Health Research · USStanford University · USUniversity of Colorado Denver · USStanford Medicine · USSt Joseph's Health Care · CAUniversity of Colorado Health · US

Funding

In home closed loop reduction of nocturnal hypoglycemia and daytime hyperglycemiaR01DK085591 · NIDDK · JAEB CENTER FOR HEALTH RESEARCH, INC. · PI BECK, ROY W., BUCKINGHAM, BRUCE A · 2009 to 2013
$3.9M
NIDDK NIH HHS R01 DK085591
6 · The paper itself

Abstract

objectiveTo compare the frequency of elevated morning blood ketone levels according to age in 4-14 year olds with type 1 diabetes following overnight use of an automated low glucose insulin suspension system, or following control nights when the system was not used. RESEARCH DESIGN AND

methodsFor 28 children ages 4-9 years and 54 youth ages 10-14 years, elevation of morning blood ketone levels was assessed using the Precision Xtra Ketone meter following 1155 and 2345 nights, respectively. Repeated measures logistic regression models were used to compare age groups for blood ketone level elevation following control nights (system not activated) and following intervention nights with and without insulin suspension.

resultsElevated morning blood ketones (≥0.6 mmol/L) were present following 10% of 580 control nights in the 4-9 year olds compared with 2% of 1162 control nights in 10-14 year olds (P < 0.001). Likewise, the frequency was greater following intervention nights in the younger age group (13% of 575 nights vs 2% of 1183 nights, P < 0.001). A longer duration of pump suspension resulted in a higher percentage of mornings with elevated blood ketones in the younger age group (P = 0.002), but not in the older age group (P = 0.63). The presence of elevated morning ketone levels did not progress to ketoacidosis in any subject.

conclusionsElevated morning blood ketones are more common in younger children with type 1 diabetes with or without nocturnal insulin suspension. Care providers need to be aware of the differences in ketogenesis in younger age children relative to various clinical situations.

Indexed as

Insulin Infusion SystemsAdolescentChildChild, PreschoolDiabetes Mellitus, Type 1FemaleHumansHypoglycemic AgentsInsulinKetonesMaleHypoglycemic AgentsInsulinKetonesinsulin pumpketosispediatrictype 1 diabetes

Identifiers

PMID27402452
PMCPMC5233607
OpenAlexW2493910315

What Socratic holds

Textmetadata
LicenceTDM
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.