Evidence map›Paper›PMID 28404658›Full record

Trial reportDiabetes care2017

Association of Glycemic Variability in Type 1 Diabetes With Progression of Microvascular Outcomes in the Diabetes Control and Complications Trial.

John M Lachin, Ionut Bebu, Richard M Bergenstal, Rodica Pop-Busui, F John Service, Bernard Zinman, David M Nathan, DCCT/EDIC Research Group

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 2 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

97 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  2. Pooled it
  3. Trial
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  9. Exploring residual risk for diabetes and microvascular disease in the Diabetes Prevention Program Outcomes Study (DPPOS).Diabetic medicine : a journal of the British Diabetic Association · 2017 · on this map
    Trial
  10. Observational
  11. Article
  12. Article
  13. Review
  14. Article
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  17. Review
  18. Review
  19. Article
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37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

John M LachinThe Biostatistics Center, The George Washington University, Rockville, MD jml@bsc.gwu.edu.ORCID 0000-0001-9838-2841
Ionut BebuThe Biostatistics Center, The George Washington University, Rockville, MD.
Richard M BergenstalInternational Diabetes Center at Park Nicollet, Minneapolis, MN.
Rodica Pop-BusuiUniversity of Michigan, Ann Arbor, MI.
F John ServiceMayo Clinic College of Medicine, Rochester, MN.
Bernard ZinmanLunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
David M NathanMassachusetts General Hospital and Harvard Medical School, Boston, MA.
DCCT/EDIC Research Group

Funding

Vector and Transgenic Mouse CoreP30DK017047 · NIDDK · UNIVERSITY OF WASHINGTON · 1986 to 2025
$12.6M
Epidemiology of Diabetes Interventions and Complications (EDIC) StudyU01DK094157 · CASE WESTERN RESERVE UNIVERSITY · 2025 to 2025
$8.0M
Continuation of Epidemiology of Diabetes Interventions and Complications (EDIC) Study Biostatistics CenterU01DK094176 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI Ionut Bebu, Barbara Halina Braffett · 2022 to 2022
$4.3M
NIDDK NIH HHS P30 DK017047NIDDK NIH HHS U01 DK094157NIDDK NIH HHS U01 DK094176
6 · The paper itself

Abstract

objectiveThe Diabetes Control and Complications Trial (DCCT) demonstrated the beneficial effects of intensive versus conventional therapy on the development and progression of microvascular complications of type 1 diabetes. These beneficial effects were almost completely explained by the difference between groups in the levels of HbA RESEARCH DESIGN AND

methodsMeasures of variability included the within-day and updated mean (over time) of the SD, mean amplitude of glycemic excursions (MAGE), and M-value, and the longitudinal within-day, between-day, and total variances. Imputation methods filled in the 16.3% of expected glucose values that were missing.

resultsCox proportional hazards models assessed the association of each measure of glycemic variation, as a time-dependent covariate, with the risk of retinopathy and nephropathy, and a longitudinal logistic regression model did likewise for cardiovascular autonomic neuropathy. Adjusted for mean blood glucose, no measure of within-day variability was associated with any outcome. Only the longitudinal mean M-value (over time) was significantly associated with microalbuminuria when adjusted for the longitudinal mean blood glucose and corrected for multiple tests using the Holm procedure.

conclusionsOverall, within-day glycemic variability, as determined from quarterly glucose profiles, does not play an apparent role in the development of microvascular complications beyond the influence of the mean glucose.

Indexed as

AdultAlbuminuriaBlood GlucoseCardiovascular SystemDiabetes Mellitus, Type 1Diabetic NephropathiesDiabetic NeuropathiesDiabetic RetinopathyDisease ProgressionFemaleFollow-Up StudiesGlycated HemoglobinHumansLogistic ModelsLongitudinal StudiesMaleBlood GlucoseGlycated Hemoglobin

Identifiers

PMID28404658
PMCPMC5439414

What Socratic holds

Textmetadata
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.