Evidence map›Paper›PMID 29322300›Full record

ReviewEndocrine2018

Glycemic control in type 2 diabetes: from medication nonadherence to residual vascular risk.

Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Endocrine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03918148 (Effects of Gliflozins on Markers of Cardiovascular Risk in Type 2 Diabetes), which is not on this map. Cited by 31 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 3 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.

NCT03918148 completednot on this map

Effects of Gliflozins on Markers of Cardiovascular Risk in Type 2 Diabetes (GIOIA): a Multicenter Pragmatic Prospective Cohort Study

TypeobservationalSponsorUniversity of Campania Luigi VanvitelliRan2018 to 2023Enrolled1,150ConditionsType 2 Diabetes MellitusArmsSGLT-2i, DPP-4i
3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  6. The Long-Term Cost-Effectiveness of Tirzepatide 5 mg versus Dulaglutide 0.75 mg for the Treatment of People with Type 2 Diabetes in Japan.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
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  8. Understanding the struggle: Unique challenges of adherence in male diabetic patients in Tshwane.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024
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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

4 authors.

Dario GiuglianoDivision of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Luigi Vanvitelli University, Naples, Italy. dario.giugliano@unicampania.it.ORCID http://orcid.org/0000-0002-9377-873X
Maria Ida MaiorinoDiabetes Unit, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Luigi Vanvitelli University, Naples, Italy.
Giuseppe BellastellaDivision of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Luigi Vanvitelli University, Naples, Italy.
Katherine EspositoDiabetes Unit, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Luigi Vanvitelli University, Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite the availability of many new treatment options for type 2 diabetes, the proportion of patients achieving the HbA1c target < 7.0% remains around 50%. We put forward the hypothesis that the unchanged HbA1c results, observed in the last decade in type 2 diabetes patients, are also a consequence of medication nonadherence and clinical inertia. Poor medication-taking behavior is usually defined as medication nonadherence and is responsible for uncontrolled hemoglobin A1c level in 23% of cases. Medication nonadherence may also affect clinical outcomes, as diabetic patients with good adherence (≥80%) had a significant 10% lower rate of hospitalization events and a significant 28% lower rate of all-cause mortality when compared with patients with poor adherence (<80%). Residual vascular risk may be defined as the risk of macrovascular (major cardiovascular events) and microvascular (retinopathy, nephropathy, neuropathy) complications that remains after intensive and successful glycemic control in type 2 diabetes. For major cardiovascular events, risk reduction following intensive glycemic control is 9% and, therefore, residual vascular risk is 91%. For microvascular complications, as nephropathy, residual vascular risk is as high as 80%. Residual vascular risk remains high in type 2 diabetes despite intensive glycemic control. Medication nonadherence by the diabetic patient and clinical inertia by the clinician may have contributed to the high level of residual vascular risk (both macro and microvascular) of type 2 diabetic patients.

Indexed as

Medication AdherenceBlood GlucoseDiabetes Mellitus, Type 2Diabetic AngiopathiesHumansHypoglycemic AgentsRisk FactorsBlood GlucoseHypoglycemic AgentsClinical inertiaGlycemic controlMedication nonadherenceResidual vascular riskType 2 diabetes

Identifiers

PMID29322300

What Socratic holds

Textmetadata
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.