Evidence mapPaperPMID 30728218Full record

Trial reportDiabetes care2019

Association of Insulin Dose, Cardiometabolic Risk Factors, and Cardiovascular Disease in Type 1 Diabetes During 30 Years of Follow-up in the DCCT/EDIC Study.

Barbara H Braffett, Samuel Dagogo-Jack, Ionut Bebu, William I Sivitz, Mary Larkin, Orville Kolterman, John M Lachin, DCCT/EDIC Research Group

Open access · bronzeAbstract readObservational StudyRandomized Controlled Trial
In one paragraph

Trial report in Diabetes care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
5.1field-weighted citation impact, top 4% 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

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Review
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Review
  16. Review
  17. Observational
  18. Article
  19. Observational
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Barbara H BraffettBiostatistics Center, The George Washington University, Rockville, MD braffett@bsc.gwu.edu.ORCID 0000-0002-2184-9754
Samuel Dagogo-JackDivision of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN.ORCID 0000-0001-5318-9677
Ionut BebuBiostatistics Center, The George Washington University, Rockville, MD.ORCID 0000-0002-4944-7968
William I SivitzDivision of Endocrinology and Metabolism, Department of Internal Medicine, University of Iowa, Iowa City, IA.
Mary LarkinMassachusetts General Hospital Diabetes Center, Harvard Medical School, Boston, MA.
Orville KoltermanUniversity of California, San Diego, La Jolla, CA.
DCCT/EDIC Research Group
George Washington University · USHarvard University · USUniversity of California San Diego · USUniversity of Iowa · USUniversity of Tennessee Health Science Center · US

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/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study demonstrated the beneficial effects of intensive therapy on atherosclerosis and clinical cardiovascular disease (CVD) outcomes. The current analyses evaluated the relationship between longitudinal changes in insulin dose and CVD risk factors and outcomes. RESEARCH DESIGN AND

methodsA total of 1,441 participants were randomly assigned to intensive or conventional diabetes therapy during the DCCT. After an average of 6.5 years of follow-up, 96% of the surviving cohort enrolled in the EDIC observational study, which included annual visits with detailed medical history, physical examination, and laboratory testing. CVD events were adjudicated by a review committee. Generalized linear mixed models and Cox proportional hazards regression models were used to assess the association between insulin dose and cardiometabolic risk factors and CVD risk, respectively, over a total of 30 years.

resultsHigher insulin doses were significantly associated with a less favorable cardiometabolic risk profile (higher BMI, pulse rate, and triglycerides and lower HDL cholesterol) with the exception of lower diastolic blood pressure and lower LDL cholesterol. In a minimally adjusted model, a 0.1 unit/kg body wt/day increase in insulin dose was associated with a 6% increased risk of any CVD (95% CI 3, 9). However, the association with insulin dose was no longer significant after adjustment for other CVD risk factors.

conclusionsDuring DCCT/EDIC, higher insulin doses were associated with adverse trends in several cardiometabolic risk factors, even after multivariable adjustment, but not with incident CVD outcomes.

Indexed as

AdolescentAdultCardiotoxicityCardiovascular DiseasesCohort StudiesDiabetes Mellitus, Type 1FemaleFollow-Up StudiesHumansInsulinMaleProportional Hazards ModelsRisk FactorsYoung AdultInsulin

Identifiers

PMID30728218
PMCPMC6429630
OpenAlexW2913445920

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.