Evidence mapPaperPMID 32576561Full record

Trial reportBMJ open diabetes research & care2020

Effect of treatment with exenatide and pioglitazone or basal-bolus insulin on diabetic neuropathy: a substudy of the Qatar Study.

Georgios Ponirakis, Muhammad A Abdul-Ghani, Amin Jayyousi, Hamad Almuhannadi, Ioannis N Petropoulos, Adnan Khan, Hoda Gad, Osama Migahid, Ayman Megahed, Ralph DeFronzo and 6 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 3 pooled it
6.0field-weighted citation impact, top 3% 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

42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.

  1. Pooled it
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  3. Exploring the Role of GLP-1 Agents in Managing Diabetic Foot Ulcers: A Narrative and Systematic Review.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society
    Pooled it
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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

16 authors at 9 institutions in 5 countries.

Georgios PonirakisDepartment of Medicine, Weill Cornell Medicine, Doha, Qatar.ORCID 0000-0002-6936-1248
Muhammad A Abdul-GhaniDiabetes Division, University of Texas Health Science Center, San Antonio, Texas, USA.
Amin JayyousiDepartment of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar.
Hamad AlmuhannadiDepartment of Medicine, Weill Cornell Medicine, Doha, Qatar.
Ioannis N PetropoulosWeill Cornell Medical College in Qatar, Doha, Qatar.
Adnan KhanDepartment of Medicine, Weill Cornell Medicine, Doha, Qatar.
Hoda GadDepartment of Medicine, Weill Cornell Medicine, Doha, Qatar.
Osama MigahidDepartment of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar.
Ayman MegahedDepartment of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar.
Ralph DeFronzoUniversity of Texas Health Science Center at Houston, Houston, Texas, USA.
Ziyad MahfoudDepartment of Medicine, Weill Cornell Medicine, Doha, Qatar.
Mona HassanDepartment of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar.
Hanadi Al HamadDepartment of Geriatrics and Long Term Care, Qatar Rehabilitation Institute, Doha, Qatar.
Marwan RamadanDepartment of Geriatrics and Long Term Care, Qatar Rehabilitation Institute, Doha, Qatar.
Uazman AlamAintree University Hospitals NHS Foundation Trust, Liverpool, Liverpool, UK.
Rayaz A MalikDivision of Cardiovascular Sciences, University of Manchester, Manchester, UK ram2045@qatar-med.cornell.edu.ORCID 0000-0002-7188-8903
Cornell University · USHamad Medical Corporation · QAQatar Airways (Qatar) · QAManchester Metropolitan University · GBThe University of Texas Health Science Center at Houston · USThe University of Texas Health Science Center at San Antonio · USUniversity of Liverpool · GBUniversity of Manchester · GBWeill Cornell Medical College in Qatar · QA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTo assess the effect of exenatide and pioglitazone or basal-bolus insulin on diabetic peripheral neuropathy (DPN) in patients with poorly controlled type 2 diabetes (T2D). RESEARCH DESIGN AND

methodsThis is a substudy of the Qatar Study, an open-label, randomized controlled trial. 38 subjects with poorly controlled T2D were studied at baseline and 1-year follow-up and 18 control subjects were assessed at baseline only. A combination of exenatide (2 mg/week) and pioglitazone (30 mg/day) or glargine with aspart insulin were randomly assigned to patients to achieve an HbA1c <53 mmol/mol (<7%). DPN was assessed with corneal confocal microscopy (CCM), DN4, vibration perception and sudomotor function.

resultsSubjects with T2D had reduced corneal nerves, but other DPN measures were comparable with the control group. In the combination treatment arm (n=21), HbA1c decreased by 35.2 mmol/mol (3.8 %) (p<0.0001), body weight increased by 5.6 kg (p<0.0001), corneal nerve branch density increased (p<0.05), vibration perception worsened (p<0.05), and DN4 and sudomotor function showed no change. In the insulin treatment arm, HbA1c decreased by 28.7 mmol/mol (2.7 %) (p<0.0001), body weight increased by 4.6 kg (p<0.01), corneal nerve branch density and fiber length increased (p≤0.01), vibration perception improved (p<0.01), and DN4 and sudomotor function showed no change. There was no association between the change in CCM measures with change in HbA1c, weight or lipids.

conclusionsTreatment with exenatide and pioglitazone or basal-bolus insulin results in corneal nerve regeneration, but no change in neuropathic symptoms or sudomotor function over 1 year.

Indexed as

Diabetes Mellitus, Type 2Diabetic NeuropathiesBlood GlucoseExenatideGlycated HemoglobinHumansHypoglycemic AgentsPeptidesPioglitazoneQatarVenomsBlood GlucoseExenatideGlycated HemoglobinHypoglycemic AgentsPeptidesPioglitazoneVenomsdiabetic neuropathiesGlucagon-Like Peptide 1insulin glarginepioglitazone

Identifiers

PMID32576561
PMCPMC7312325
OpenAlexW3036137488

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.