Evidence map›Paper›PMID 36516054›Full record

Trial reportDiabetes care2023

Multicenter Randomized Trial of Intermittently Scanned Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in Individuals With Type 2 Diabetes and Recent-Onset Acute Myocardial Infarction: Results of the LIBERATES Trial.

Ramzi A Ajjan, Simon R Heller, Colin C Everett, Armando Vargas-Palacios, Ruchi Higham, Linda Sharples, Diana A Gorog, Alice Rogers, Catherine Reynolds, Catherine Fernandez and 4 more

Open access · bronzeAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 5 pooled it
4.5field-weighted citation impact, top 4% 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

22 citing papers in PubMed, 5 syntheses or guidelines pooled it, 36 citations in OpenAlex.

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  17. Perspective of Continuous Glucose Monitoring-Based Interventions at the Various Stages of Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024
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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

14 authors at 6 institutions in 3 countries.

Ramzi A AjjanClinical Population and Sciences Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, U.K.ORCID 0000-0002-1636-3725
Simon R HellerDepartment of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, U.K.ORCID 0000-0002-2425-9565
Colin C EverettLeeds Institute of Clinical Trials Research, University of Leeds, Leeds, U.K.
Armando Vargas-PalaciosAcademic Unit of Health Economics, University of Leeds, Leeds, U.K.
Ruchi HighamDepartment of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, U.K.
Linda SharplesDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, U.K.
Diana A GorogSchool of Life and Medical Science, University of Hertfordshire, Hertfordshire, U.K.
Alice RogersPatient representative.
Catherine ReynoldsClinical Population and Sciences Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, U.K.
Catherine FernandezDepartment of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, U.K.
Pedro RodriguesAcademic Unit of Health Economics, University of Leeds, Leeds, U.K.
Thozhukat SathyapalanAcademic Diabetes, Endocrinology and Metabolism, Allam Diabetes Centre, Hull York Medical School, University of Hull, Hull, U.K.
Robert F StoreyDepartment of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, Sheffield, U.K.
Deborah D StockenLeeds Institute of Clinical Trials Research, University of Leeds, Leeds, U.K.
University of Leeds · GBUniversity of Sheffield · GBHouse of Representatives · NLHull York Medical School · GBUniversity of Hertfordshire · GBUniversity of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo analyze the impact of modern glucose-monitoring strategies on glycemic and patient-related outcomes in individuals with type 2 diabetes (T2D) and recent myocardial infarction (MI) and assess cost effectiveness. RESEARCH DESIGN AND

methodsLIBERATES was a multicenter two-arm randomized trial comparing self-monitoring of blood glucose (SMBG) with intermittently scanned continuous glucose monitoring (isCGM), also known as flash CGM, in individuals with T2D and recent MI, treated with insulin and/or a sulphonylurea before hospital admission. The primary outcome measure was time in range (TIR) (glucose 3.9-10 mmol/L/day) on days 76-90 post-randomization. Secondary and exploratory outcomes included time in hypoglycemia, hemoglobin A1c (HbA1c), clinical outcome, quality of life (QOL), and cost effectiveness.

resultsOf 141 participants randomly assigned (median age 63 years; interquartile range 53, 70), 73% of whom were men, isCGM was associated with increased TIR by 17 min/day (95% credible interval -105 to +153 min/day), with 59% probability of benefit. Users of isCGM showed lower hypoglycemic exposure (<3.9 mmol/L) at days 76-90 (-80 min/day; 95% CI -118, -43), also evident at days 16-30 (-28 min/day; 95% CI -92, 2). Compared with baseline, HbA1c showed similar reductions of 7 mmol/mol at 3 months in both study arms. Combined glycemic emergencies and mortality occurred in four isCGM and seven SMBG study participants. QOL measures marginally favored isCGM, and the intervention proved to be cost effective.

conclusionsCompared with SMBG, isCGM in T2D individuals with MI marginally increases TIR and significantly reduces hypoglycemic exposure while equally improving HbA1c, explaining its cost effectiveness. Studies are required to understand whether these glycemic differences translate into longer-term clinical benefit.

Indexed as

Diabetes Mellitus, Type 1Diabetes Mellitus, Type 2Blood GlucoseBlood Glucose Self-MonitoringFemaleGlycated HemoglobinHumansHypoglycemic AgentsMaleMiddle AgedQuality of LifeBlood GlucoseGlycated HemoglobinHypoglycemic Agents

Identifiers

PMID36516054
PMCPMC9887626
OpenAlexW4311472352

What Socratic holds

Textmetadata
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.