Evidence map›Paper›PMID 35331007›Full record

Trial reportStroke2022

Intensive Versus Standard Treatment of Hyperglycemia in Acute Ischemic Stroke Patient: A Randomized Clinical Trial Subgroups Analysis.

Michel T Torbey, Qi Pauls, Nina Gentile, Mercedes Falciglia, William Meurer, Creed L Pettigrew, Valerie L Durkalski, Thomas Bleck, Askiel Bruno, Neurological Emergencies Treatment Trials Network and SHINE Trial Investigators

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
3.9field-weighted citation impact, top 6% 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

15 citing papers in PubMed, 27 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Article
  10. Article
  11. Review
  12. Diabetes and the treatment of ischemic stroke.Journal of diabetes and its complications · 2022
    Review
  13. Article
  14. Article
  15. 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

10 authors at 8 institutions in 2 countries.

Michel T TorbeyDepartment of Neurology, University of New Mexico, Albuquerque (M.T.T.).ORCID 0000-0001-8187-9683
Qi PaulsDepartment of Public Health Sciences, Medical University of South Carolina, Charleston (Q.P., V.L.D.).
Nina GentileDepartment of Emergency Medicine, Temple University, Philadelphia, PA (N.G.).ORCID 0000-0002-1222-5966
Mercedes FalcigliaDepartment of Internal Medicine and Cincinnati VAMC, University of Cincinnati College of Medicine, OH (M.F.).ORCID 0000-0001-7675-6902
William MeurerDepartment of Emergency Medicine, University of Michigan, Ann Arbor (W.M.).ORCID 0000-0002-1158-5302
Creed L PettigrewDepartment of Neurology, University of Kentucky, Lexington (C.L.P.).ORCID 0000-0001-7878-5803
Valerie L DurkalskiDepartment of Public Health Sciences, Medical University of South Carolina, Charleston (Q.P., V.L.D.).
Thomas BleckDepartment of Neurology, Northwestern University, Chicago, IL (T.B.).ORCID 0000-0002-8267-9787
Askiel BrunoDepartment of Neurology, Augusta University, GA (A.B.).ORCID 0000-0003-0133-585X
Neurological Emergencies Treatment Trials Network and SHINE Trial Investigators
Medical University of South Carolina · USAugusta University · USCincinnati VA Medical Center · USNorthwestern University · USTemple University · USUniversity of Kentucky · USUniversity of Michigan · USUniversity of New Mexico · US

Funding

Neurologic Emergencies Treatment Trials Network: Clinical Coordinating CenterU01NS056975 · NINDS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARSAN, WILLIAM G · 2006 to 2015
$40.4M
The Stroke Hyperglycemia Insulin Network Effort (SHINE) TrialU01NS069498 · NINDS · UNIVERSITY OF VIRGINIA · PI BRUNO, ASKIEL, HALL, CHRISTIANA · 2011 to 2017
$27.7M
Neurological Emergencies Treatment Trials Network Statistical and Data ManagementU01NS059041 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI DURKALSKI, VALERIE L, PALESCH, YUKO Y · 2006 to 2015
$9.1M
NINDS NIH HHS U01 NS056975NINDS NIH HHS U01 NS059041NINDS NIH HHS U01 NS069498
6 · The paper itself

Abstract

backgroundBenefit from blood glucose (BG) control during acute ischemic stroke may depend on glycemic parameters. We evaluated for associations between the SHINE (Stroke Hyperglycemia Insulin Network Effort) randomized treatment group and the SHINE predefined 90-day functional outcome, within-patient subgroups defined by various glycemic parameters.

methodsThe SHINE Trial randomized 1151 patients within 12 hours with acute ischemic stroke and hyperglycemia to standard (target BG 80-179 mg/dL) or intensive (target BG 80-130 mg/dL) BG control for 72 hours. We predefined 6 glycemic parameters: acute BG level, absence versus presence of diagnosed and undiagnosed diabetes, hemoglobin A1c, glycemic gap (acute BG-average daily hemoglobin A1c based BG), stress hyperglycemia ratio (acute BG/average daily hemoglobin A1c based BG), and BG variability (SD). Favorable functional outcome was defined by the SHINE Trial and based on the modified Rankin Scale score at 90 days, adjusted for stroke severity. We computed relative risks adjusted for baseline stroke severity and thrombolysis use.

resultsLikelihood for favorable outcome was lowest among patients with undiagnosed diabetes compared to patients with true nondiabetes (adjusted relative risk, 0.42 [99% CI, 0.19-0.94]). We did not find any relationship between the favorable outcome rate and baseline BG or any of the glycemic parameters. No differences between SHINE treatment groups were identified among any of these patient subgroups.

conclusionsIn this exploratory subgroup analysis, intensive versus standard insulin treatment of hyperglycemia in acute ischemic stroke patient subgroups, did not influence the 90-day functional outcomes, nor did we identify associations between these glycemic parameters and 90-day functional outcomes.

Indexed as

Diabetes MellitusHyperglycemiaInsulinsIschemic StrokeStrokeBlood GlucoseGlycated HemoglobinHumansBlood GlucoseGlycated HemoglobinInsulinsdiabetesglucosehemoglobininsulinischemic stroke

Identifiers

PMID35331007
PMCPMC9022682
OpenAlexW4221002470

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.