Evidence mapPaperPMID 33200487Full record

Trial reportDiabetes, obesity & metabolism2021

The majority of people with type 1 diabetes and multiple daily insulin injections benefit from using continuous glucose monitoring: An analysis based on the GOLD randomized trial (GOLD-5).

Arndís F Ólafsdóttir, Jan Bolinder, Tim Heise, William Polonsky, Magnus Ekelund, Magnus Wijkman, Aldina Pivodic, Elsa Ahlén, Erik Schwarcz, Thomas Nyström and 3 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.3field-weighted citation impact, top 18% 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

10 citing papers in PubMed, 14 citations in OpenAlex.

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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

13 authors at 11 institutions in 5 countries.

Arndís F ÓlafsdóttirDepartment of Medicine, NU-Hospital Group, Uddevalla, Sweden.ORCID 0000-0002-2083-2512
Jan BolinderDepartment of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden.
Tim HeiseProfil, Neuss, Germany.ORCID 0000-0002-8346-2037
William PolonskyBehavioral Diabetes Institute, San Diego, Californa.
Magnus EkelundDepartment of Clinical Sciences, Lund University, Lund, Sweden.
Magnus WijkmanDepartment of Internal Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden.
Aldina PivodicStatistiska Konsultgruppen, Gothenburg, Sweden.
Elsa AhlénDepartment of Medicine, NU-Hospital Group, Uddevalla, Sweden.
Erik SchwarczDepartment of Internal Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Thomas NyströmDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Jarl HellmanDepartment of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden.
Irl B HirschSchool of Medicine, University of Washington, Seattle, Washington.
Marcus LindDepartment of Medicine, NU-Hospital Group, Uddevalla, Sweden.ORCID 0000-0002-3796-9283
NU Hospital Group · SEKarolinska Institutet · SEKarolinska University Hospital · SELinköping University · SELund University · SEÖrebro University · SEProfil Institute for Metabolic Research · DEStatisticon (Sweden) · SEUniversity of California System · USUniversity of Washington · USUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo identify responders to continuous glucose monitoring (CGM) in relation to reductions in HbA1c and percentage of time spent in hypoglycaemia after initiation of CGM for individuals with type 1 diabetes treated with multiple daily insulin injections. MATERIALS AND

methodsWe analysed data from 142 participants in the GOLD randomized clinical trial. We evaluated how many lowered their HbA1c by more than 0.4% (>4.7 mmol/mol) or decreased the time spent in hypoglycaemia over 24 hours by more than 20 or 30 minutes, and which baseline variables were associated with those improvements.

resultsLower reduction of HbA1c was associated with greater reduction of hypoglycaemia (r = -0.52; P < .0001). During CGM, 47% of participants lowered their HbA1c values by more than 0.4% (>4.7 mmol/mol) than with self-measurement of blood glucose, and 47% decreased the time spent in hypoglycaemia by more than 20 minutes over 24 hours. Overall, 78% either reduced their HbA1c by more than 0.4% (>4.7 mmol/mol) or the time spent in hypoglycaemia by more than 20 minutes over 24 hours, but only 14% improved both. Higher HbA1c, a lower percentage of time at less than 3.0 or 3.9 mmol/L, a lower coefficient of variation (CV) and a higher percentage of time above 13.9 mmol/L (P = .016) were associated with greater HbA1c reduction during CGM. The variables associated with a greater reduction of time in hypoglycaemia were female sex, greater time with glucose levels at less than 3.0 mmol/L, higher CV, and higher hypoglycaemia confidence as evaluated by a hypoglycaemic confidence questionnaire.

conclusionThe majority of people with type 1 diabetes managed by multiple daily insulin injections benefit from CGM; some experienced reduced HbA1c while others reduced the time spent in hypoglycaemia. These factors need to be considered by healthcare professionals and decision-makers for reimbursement and diabetes guidelines.

Indexed as

Diabetes Mellitus, Type 1HypoglycemiaBlood GlucoseBlood Glucose Self-MonitoringFemaleGlycated HemoglobinHumansHypoglycemic AgentsInsulinMaleBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulinclinical trial, CGM, randomized trial, type 1 diabetes

Identifiers

PMID33200487
PMCPMC7839699
OpenAlexW3099004750

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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.