Evidence mapPaperPMID 29463812Full record

ArticleScientific reports2018

Metformin Use and Severe Dengue in Diabetic Adults.

Htet Lin Htun, Tsin Wen Yeo, Clarence C Tam, Junxiong Pang, Yee Sin Leo, David C Lye

Registry-linked trialFull text read
In one paragraph

Article in Scientific reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04377451 (Metformin as Adjunctive Therapy in Overweight and Obese Patients With Dengue), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing 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.

NCT04377451 phase1 / phase2completedstarted 2020, after this paper: background citation

Metformin as Adjunctive Therapy in Overweight and Obese Patients With Dengue: an Open-label Safety and Tolerability Trial

Ran2020Enrolled120Registered outcomes7Posted comparisons0ConditionsAnti-inflammatory Agents, Dengue, Metformin, ObesityArmsMetformin
Open the trial in the graph
3 · Its place in the literature

Who cites it

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

  1. The double burden of diabetes and global infection in low and middle-income countries.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2019
    Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Review
  7. Review
  8. Dengue Virus Infection: Immune Response and Therapeutic Targets.The American journal of tropical medicine and hygiene · 2025
    Review
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Dengue: Update on Clinically Relevant Therapeutic Strategies and Vaccines.Current treatment options in infectious diseases · 2023
    Review
  15. Article
  16. Article
  17. Review
  18. Review
  19. Article
  20. Article
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

6 authors.

Htet Lin HtunInstitute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore.ORCID 0000-0003-2307-0610
Tsin Wen YeoInstitute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore. tsin_wen_yeo@ttsh.com.sg.
Clarence C TamSaw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Junxiong PangSaw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Yee Sin LeoInstitute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore.
David C LyeInstitute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Diabetes mellitus is a risk factor for severe dengue in adults, but few studies have examined the association between metformin use and disease severity in dengue. In addition to its effect on glucose control, metformin has been associated with pleiotropic properties in preclinical studies. Using a cohort of laboratory-confirmed adult (≥21 years) dengue patients with diabetes mellitus admitted to Tan Tock Seng Hospital, we conducted a retrospective cohort study involving 131 (58.7%) metformin users and 92 (41.3%) non-users. Dengue severity was categorized as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS) in World Health Organization (WHO) 1997 criteria and severe dengue (SD) in WHO 2009 criteria. Multivariable Poisson regression with robust error variance was used to estimate risk ratio (RR). Compared with non-use, metformin use was associated with a decreased risk of developing severe dengue (adjusted risk ratio [aRR] = 0.60, 95% confidence interval [CI]: 0.37-0.98, P = 0.04). Additionally, there was an inverse dose-response relationship (aRR = 0.69, 95% CI: 0.49-0.98, P = 0.04) with dengue severity as classified by WHO 2009 criteria. Use of metformin, however, was not associated with dengue severity based on WHO 1997 criteria; and no dose-response relationship was noted. Our results suggest metformin use could attenuate disease severity in dengue-infected diabetes mellitus individuals.

Indexed as

AdultAgedAged, 80 and overDiabetes Mellitus, Type 2Dose-Response Relationship, DrugFemaleHumansHypoglycemic AgentsMaleMetforminMiddle AgedRetrospective StudiesRisk AssessmentSevere DengueSingaporeHypoglycemic AgentsMetformin

Identifiers

PMID29463812
PMCPMC5820327

What Socratic holds

Textfull text, public
LicenceCC BY
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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.