Evidence mapPaperPMID 32450102Full record

ArticleDiabetes research and clinical practice2020

Prevalence of microvascular and macrovascular disease in the Glycemia Reduction Approaches in Diabetes - A Comparative Effectiveness (GRADE) Study cohort.

Kieren J Mather, Ionut Bebu, Chelsea Baker, Robert M Cohen, Jill P Crandall, Cyrus DeSouza, Jennifer B Green, M Sue Kirkman, Heidi Krause-Steinrauf, Mary Larkin and 7 more

Registry-linked trialOpen access · greenAbstract read
In one paragraph

Article in Diabetes research and clinical practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT01794143. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% 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.

NCT01794143 phase3completed

Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study

Ran2013Enrolled7,850Registered outcomes4Posted comparisons0ConditionsComparative Effectiveness of Glycemia-lowering Medications, Type 2 DiabetesArmsDPP-4 inhibitor (sitagliptin), GLP-1 receptor agonist (liraglutide), Insulin (glargine), Sulfonylurea (glimepiride)
Open the trial in the graph
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  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. Trial
  3. Glycemia Reduction in Type 2 Diabetes - Microvascular and Cardiovascular Outcomes.The New England journal of medicine · 2022 · on this map
    Trial
  4. Article
  5. Article
  6. Review
  7. The conundrum of diabetic neuropathies-Past, present, and future.Journal of diabetes and its complications · 2022
    Review
  8. Article
  9. Article
  10. Article
  11. Observational
  12. Review
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

17 authors at 14 institutions in 1 country.

Kieren J MatherDivision of Endocrinology & Metabolism, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.
Ionut BebuThe Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD, United States. Electronic address: grademail@bsc.gwu.edu.
Chelsea BakerDivision of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States.
Robert M CohenDivision of Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Cincinnati College of Medicine & Endocrine Section, Cincinnati VA Medical Center, Cincinnati OH, United States.
Jill P CrandallDivision of Endocrinology and Fleischer Institute for Diabetes & Metabolism, Albert Einstein College of Medicine, Bronx, NY, United States.
Cyrus DeSouzaDivision of Diabetes, Endocrinology & Metabolism, University of Nebraska College of Medicine, Omaha, NE, United States.
Jennifer B GreenDivision of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC, United States.
M Sue KirkmanDivision of Endocrinology & Metabolism, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States.
Heidi Krause-SteinraufThe Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD, United States.
Mary LarkinMassachusetts General Hospital Diabetes Center and Harvard Medical School, Boston, MA, United States.
Jeremy PettusDivision of Endocrinology & Metabolism, Department of Medicine, University of California, San Diego, CA, United States.
Elizabeth R SeaquistDivision of Diabetes and Endocrinology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States.
Elsayed Z SolimanEpidemiological Cardiology Research Center, Department of Epidemiology and Prevention and Department of Internal Medicine-Cardiology Section, Wake Forest School of Medicine, Winston Salem, NC, United States.
Emily B SchroederInstitute for Health Research, Kaiser Permanente Colorado, Aurora, CO, United States.
Deborah J WexlerMassachusetts General Hospital Diabetes Center and Harvard Medical School, Boston, MA, United States.
Rodica Pop-BusuiDivision of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.
GRADE Research Group
George Washington University · USMassachusetts General Hospital · USAlbert Einstein College of Medicine · USCincinnati VA Medical Center · USDuke Medical Center · USIndiana University – Purdue University Indianapolis · USKaiser Permanente · USUniversity of California, San Diego · USUniversity of Colorado Denver · USUniversity of Michigan–Ann Arbor · USUniversity of Minnesota · USUniversity of Nebraska at Omaha · USUniversity of North Carolina at Chapel Hill · USWake Forest University · US

Funding

Continuation of the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) StudyU01DK098246 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI Heidi Krause-Steinrauf, JOHN M LACHIN · 2021 to 2022
$21.0M
PROMOTING OPHTHALMIC SCREENING IN MANAGED CAREP60DK020541 · YESHIVA UNIVERSITY · 1986 to 2005
$12.6M
Vector and Transgenic Mouse CoreP30DK017047 · NIDDK · UNIVERSITY OF WASHINGTON · 1986 to 2025
$12.6M
Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR002243 · VANDERBILT UNIVERSITY MEDICAL CENTER · 2025 to 2025
$10.7M
Washington University Institute of Clinical and Translational SciencesUL1TR002345 · WASHINGTON UNIVERSITY · 2025 to 2025
$9.3M
Georgia Clinical & Translational Science Alliance (Georgia CTSA)UL1TR002378 · EMORY UNIVERSITY · 2025 to 2025
$9.3M
Pilot and Feasibility ProgramP30DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 to 2025
$4.9M
Louisiana Clinical and Translational Science CenterU54GM104940 · LSU PENNINGTON BIOMEDICAL RESEARCH CTR · 2025 to 2025
$3.9M
NYR-Diabetes Research Center (NYR-DRC)P30DK020541 · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2025 to 2025
$2.4M
Pilot and Feasibility ProgramP30DK072476 · LSU PENNINGTON BIOMEDICAL RESEARCH CTR · 2005 to 2025
$2.2M
Translation CoreP30DK097512 · INDIANA UNIVERSITY INDIANAPOLIS · 2025 to 2025
$1.7M
UAB Diabetes Research CenterP30DK079626 · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2025 to 2025
$1.3M
NCATS NIH HHS UL1 TR000439NCATS NIH HHS UL1 TR000445NCATS NIH HHS UL1 TR001108NCATS NIH HHS UL1 TR001409NCATS NIH HHS UL1 TR001449NCATS NIH HHS UL1 TR002243NCATS NIH HHS UL1 TR002345NCATS NIH HHS UL1 TR002378NCATS NIH HHS UL1 TR002489NCATS NIH HHS UL1 TR002529NCATS NIH HHS UL1 TR002535NCATS NIH HHS UL1 TR002537NCATS NIH HHS UL1 TR002548NIDDK NIH HHS P30 DK017047NIDDK NIH HHS P30 DK020541NIDDK NIH HHS P30 DK020572NIDDK NIH HHS P30 DK072476NIDDK NIH HHS P30 DK079626NIDDK NIH HHS P30 DK092926NIDDK NIH HHS P30 DK097512NIDDK NIH HHS P30 DK111022NIDDK NIH HHS P60 DK020541NIDDK NIH HHS U01 DK098246NIDDK NIH HHS U34 DK088043NIGMS NIH HHS U54 GM104940
6 · The paper itself

Abstract

aimsThe Glycemia Reduction Approaches in Diabetes - A Comparative Effectiveness (GRADE) trial is a randomized clinical trial comparing glycemic effects of four diabetes medications added to metformin in type 2 diabetes (T2D). Microvascular and macrovascular diseases are secondary outcomes. We evaluated the prevalence and risk factor relationships for microvascular and macrovascular complications in the GRADE cohort at study entry.

methodsComplication prevalence and risk factors were analyzed based on data from screening in all consenting participants meeting GRADE eligibility. Logistic regression and Z-statistics were used to assess risk factor relationships with complications.

resultsWe enrolled 5047 T2D participants [mean age 57 years; 36% female; mean known T2D duration 4 years (all < 10 years); mean HbA1c 8.0% (∼64 mmol/mol) at screening]. Urinary albumin/creatinine ratio (ACR) ≥ 30 mg/gram was present in 15.9% participants; peripheral neuropathy (by Michigan Neuropathy Screening Instrument) in 21.5%; cardiovascular autonomic neuropathy by electrocardiography-derived indices in 9.7%; self-reported retinopathy in 1.0%. Myocardial infarction ascertained by self-report or electrocardiogram was present in 7.3%, and self-reported history of stroke in 2.0%.

conclusionsIn the GRADE cohort with < 10 years of T2D and a mean HbA1c of 8.0%, diabetes complications were present in a substantial fraction of participants, more so than might otherwise have been expected.

Indexed as

Cohort StudiesDiabetes ComplicationsDiabetes Mellitus, Type 2FemaleHumansMaleMiddle AgedPrevalenceComparative effectivenessComplicationsDiabetesPragmaticPrevalenceTreatment

Identifiers

PMID32450102
PMCPMC7416515
OpenAlexW3027597204

What Socratic holds

Textmetadata
LicenceTDM
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.