Evidence map›Paper›PMID 27708063›Full record

ArticleScience translational medicine2016

Mechanistic modeling of hemoglobin glycation and red blood cell kinetics enables personalized diabetes monitoring.

Roy Malka, David M Nathan, John M Higgins

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Science translational medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
81citing papers in PubMed, 1 pooled it
–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

81 citing papers in PubMed, 1 synthesis or guideline pooled it.

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21 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Roy MalkaCenter for Systems Biology and Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA. Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA.
David M NathanDiabetes Center, Massachusetts General Hospital, Boston, MA 02114, USA. Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.
John M HigginsCenter for Systems Biology and Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA. Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA. john_higgins@hms.harvard.edu.

Funding

Systems Biology of In Vivo Human Blood Cell PopulationsDP2DK098087 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI HIGGINS, JOHN MATTHEW · 2012 to 2012
$2.6M
NIDDK NIH HHS DP2 DK098087
6 · The paper itself

Abstract

The amount of glycated hemoglobin (HbA1c) in diabetic patients' blood provides the best estimate of the average blood glucose concentration over the preceding 2 to 3 months. It is therefore essential for disease management and is the best predictor of disease complications. Nevertheless, substantial unexplained glucose-independent variation in HbA1c makes its reflection of average glucose inaccurate and limits the precision of medical care for diabetics. The true average glucose concentration of a nondiabetic and a poorly controlled diabetic may differ by less than 15 mg/dl, but patients with identical HbA1c values may have true average glucose concentrations that differ by more than 60 mg/dl. We combined a mechanistic mathematical model of hemoglobin glycation and red blood cell kinetics with large sets of within-patient glucose measurements to derive patient-specific estimates of nonglycemic determinants of HbA1c, including mean red blood cell age. We found that between-patient variation in derived mean red blood cell age explains all glucose-independent variation in HbA1c. We then used our model to personalize prospective estimates of average glucose and reduced errors by more than 50% in four independent groups of greater than 200 patients. The current standard of care provided average glucose estimates with errors >15 mg/dl for one in three patients. Our patient-specific method reduced this error rate to 1 in 10. Our personalized approach should improve medical care for diabetes using existing clinical measurements.

Indexed as

Models, BiologicalPrecision MedicineBlood GlucoseBlood Glucose Self-MonitoringDiabetes MellitusErythrocytesGlycated HemoglobinHumansKineticsBlood GlucoseGlycated Hemoglobin

Identifiers

PMID27708063
PMCPMC5714656

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.