Evidence mapPaperPMID 29713649Full record

ArticleJournal of diabetes research2018

Treatment Discontinuation and Clinical Events in Type 2 Diabetes Patients Treated with Dipeptidyl Peptidase-4 Inhibitors or NPH Insulin as Third-Line Therapy.

Cristiano S Moura, Zale B Rosenberg, Michal Abrahamowicz, Sasha Bernatsky, Hassan Behlouli, Louise Pilote

Open access · goldFull text read
In one paragraph

Article in Journal of diabetes research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 23% 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, 9 citations in OpenAlex.

  1. Article
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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

6 authors at 2 institutions in 1 country.

Cristiano S MouraCentre for Outcome Research & Evaluation (CORE), McGill University, Montréal, QC, Canada H3A 0G4.ORCID 0000-0002-2109-0709
Zale B RosenbergCentre for Outcome Research & Evaluation (CORE), McGill University, Montréal, QC, Canada H3A 0G4.
Michal AbrahamowiczCentre for Outcome Research & Evaluation (CORE), McGill University, Montréal, QC, Canada H3A 0G4.
Sasha BernatskyCentre for Outcome Research & Evaluation (CORE), McGill University, Montréal, QC, Canada H3A 0G4.ORCID 0000-0002-9515-2802
Hassan BehlouliCentre for Outcome Research & Evaluation (CORE), McGill University, Montréal, QC, Canada H3A 0G4.
Louise PiloteCentre for Outcome Research & Evaluation (CORE), McGill University, Montréal, QC, Canada H3A 0G4.ORCID 0000-0002-6159-0628
McGill University · CAMcGill University Health Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare dipeptidyl peptidase-4 (DPP-4) inhibitors with neutral protamine Hagedorn (NPH) insulin, in terms of effectiveness and safety for the management of patients with type 2 diabetes mellitus (DM2) not controlled on metformin and sulfonylureas.

methodsA retrospective cohort study of individuals with DM2 newly dispensed with either DPP-4 inhibitors or NPH as third-line therapy, after metformin and sulfonylurea. Treatment discontinuation, macrovascular outcomes, and hypoglycemia were compared using multivariable Cox regression models, adjusted for sex, age, year of cohort entry, place of residence, hypertension, past history of hypoglycemia, diabetic ketoacidosis, comorbidities, and number of visits to emergency departments, outpatient physician, and hospitalizations.

resultsTreatment discontinuation and hypoglycemia occurred more frequently with NPH than with DPP-4 inhibitor users. In the adjusted Cox model, the use of NPH compared to that of DPP-4 inhibitors was associated with a higher risk of discontinuation (HR: 1.33; 95% CI 1.27-1.40) and hypoglycemia (HR: 2.98; 95% CI 2.72-3.28). Risk of cardiovascular events was similar across groups.

conclusionsThis real-world analysis suggests that DM2 patients initiating third-line therapy with NPH have poorer control of diabetes when compared to DPP-4 inhibitor initiators.

Indexed as

Blood GlucoseAgedDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsFemaleHumansHypoglycemiaHypoglycemic AgentsInsulin, IsophaneMaleMetforminMiddle AgedRetrospective StudiesSulfonylurea CompoundsWithholding TreatmentBlood GlucoseDipeptidyl-Peptidase IV InhibitorsHypoglycemic AgentsInsulin, IsophaneMetforminSulfonylurea Compounds

Identifiers

PMID29713649
PMCPMC5866860
OpenAlexW2789737616

What Socratic holds

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Registered trials

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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.