Evidence mapPaperPMID 35483674Full record

Trial reportDiabetes & metabolism journal2022

Comparison of Serum Ketone Levels and Cardiometabolic Efficacy of Dapagliflozin versus Sitagliptin among Insulin-Treated Chinese Patients with Type 2 Diabetes Mellitus.

Chi-Ho Lee, Mei-Zhen Wu, David Tak-Wai Lui, Darren Shing-Hei Chan, Carol Ho-Yi Fong, Sammy Wing-Ming Shiu, Ying Wong, Alan Chun-Hong Lee, Joanne King-Yan Lam, Yu-Cho Woo and 3 more

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Diabetes & metabolism journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
1.7field-weighted citation impact, top 15% 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

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
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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 1 institution in 2 countries.

Chi-Ho LeeDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Mei-Zhen WuDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
David Tak-Wai LuiDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Darren Shing-Hei ChanDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Carol Ho-Yi FongDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Sammy Wing-Ming ShiuDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Ying WongDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Alan Chun-Hong LeeDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Joanne King-Yan LamDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Yu-Cho WooDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Karen Siu-Ling LamDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Kelvin Kai-Hang YiuDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Kathryn Choon-Beng TanDepartment of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Queen Mary Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInsulin-treated patients with long duration of type 2 diabetes mellitus (T2DM) are at increased risk of ketoacidosis related to sodium-glucose co-transporter 2 inhibitor (SGLT2i). The extent of circulating ketone elevation in these patients remains unknown. We conducted this study to compare the serum ketone response between dapagliflozin, an SGLT2i, and sitagliptin, a dipeptidyl peptidase-4 inhibitor, among insulin-treated T2DM patients.

methodsThis was a randomized, open-label, active comparator-controlled study involving 60 insulin-treated T2DM patients. Participants were randomized 1:1 for 24-week of dapagliflozin 10 mg daily or sitagliptin 100 mg daily. Serum β-hydroxybutyrate (BHB) levels were measured at baseline, 12 and 24 weeks after intervention. Comprehensive cardiometabolic assessments were performed with measurements of high-density lipoprotein cholesterol (HDL-C) cholesterol efflux capacity (CEC), vibration-controlled transient elastography and echocardiography.

resultsAmong these 60 insulin-treated participants (mean age 58.8 years, diabetes duration 18.2 years, glycosylated hemoglobin 8.87%), as compared with sitagliptin, serum BHB levels increased significantly after 24 weeks of dapagliflozin (P=0.045), with a median of 27% increase from baseline. Change in serum BHB levels correlated significantly with change in free fatty acid levels. Despite similar glucose lowering, dapagliflozin led to significant improvements in body weight (P=0.006), waist circumference (P=0.028), HDL-C (P=0.041), CEC (P=0.045), controlled attenuation parameter (P=0.007), and liver stiffness (P=0.022). Average E/e', an echocardiographic index of left ventricular diastolic dysfunction, was also significantly lower at 24 weeks in participants treated with dapagliflozin (P=0.037).

conclusionAmong insulin-treated T2DM patients with long diabetes duration, compared to sitagliptin, dapagliflozin modestly increased ketone levels and was associated with cardiometabolic benefits.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Sodium-Glucose Transporter 2 InhibitorsBenzhydryl CompoundsBlood GlucoseChinaCholesterol, HDLGlucosidesHumansInsulinKetonesMiddle AgedSitagliptin PhosphateBenzhydryl CompoundsBlood GlucoseCholesterol, HDLdapagliflozinGlucosidesInsulinKetonesSitagliptin PhosphateSodium-Glucose Transporter 2 InhibitorsDapagliflozinDiabetes mellitus, type 2Heart disease risk factorsKetonesSitagliptin phosphate

Identifiers

PMID35483674
PMCPMC9723203
OpenAlexW4225007661

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.