Evidence mapPaperPMID 36699039Full record

Trial reportFrontiers in endocrinology2022

Stratified glucose-lowering response to vildagliptin and pioglitazone by obesity and hypertriglyceridemia in a randomized crossover trial.

Rebecca Brandon, Yannan Jiang, Rui Qian Yeu, Ry Tweedie-Cullen, Kate Smallman, Glenn Doherty, Kerry A Macaskill-Smith, Rebekah J Doran, Penny Clark, Allan Moffitt and 10 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Frontiers in endocrinology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 23% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Reduced Weight Gain with Pioglitazone vs Vildagliptin inDiabetes, metabolic syndrome and obesity : targets and therapy · 2025
    Article
  2. Review
  3. Article
  4. Article
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

20 authors at 8 institutions in 2 countries.

Rebecca BrandonDepartment of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Yannan JiangDepartment of Statistics, Faculty of Sciences, The University of Auckland, Auckland, New Zealand.
Rui Qian YeuDepartment of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Ry Tweedie-CullenDepartment of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Kate SmallmanDiabetes Foundation Aotearoa, Auckland, New Zealand.
Glenn DohertyTongan Health Society, Auckland, New Zealand.
Kerry A Macaskill-SmithVentures/Pinnacle Incorporated, Hamilton, New Zealand.
Rebekah J DoranVentures/Pinnacle Incorporated, Hamilton, New Zealand.
Penny ClarkVentures/Pinnacle Incorporated, Hamilton, New Zealand.
Allan MoffittProcare Primary Health Organisation, Auckland, New Zealand.
Troy MerryMaurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand.
Norma NehrenTe Hiku Hauora, Northland District Health Board, Kaitaia, New Zealand.
Frances KingNgāti Porou Hauora, Tairāwhiti, New Zealand.
Jennie Harré HindmarshNgāti Porou Hauora, Tairāwhiti, New Zealand.
Megan Patricia LeaskMaurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand.
Tony R MerrimanMaurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand.
Brandon Orr-WalkerMiddlemore Clinical Trials, Auckland, New Zealand.
Peter R ShepherdMaurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand.
Ryan PaulMaurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand.
Rinki MurphyDepartment of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Maurice Wilkins Centre · NZUniversity of Auckland · NZCancer Society of New Zealand · NZManaaki Whenua – Landcare Research · NZMiddlemore Clinical Trials · NZNorthland District Health Board · NZUniversity of Otago · NZUniversity of Waikato · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Understanding which group of patients with type 2 diabetes will have the most glucose lowering response to certain medications (which target different aspects of glucose metabolism) is the first step in precision medicine. Aims: We hypothesized that people with type 2 diabetes who generally have high insulin resistance, such as people of Māori/Pacific ethnicity, and those with obesity and/or hypertriglyceridemia (OHTG), would have greater glucose-lowering by pioglitazone (an insulin sensitizer) versus vildagliptin (an insulin secretagogue). Methods: A randomised, open-label, two-period crossover trial was conducted in New Zealand. Adults with type 2 diabetes, HbA1c>58mmol/mol (>7.5%), received 16 weeks of either pioglitazone (30mg) or vildagliptin (50mg) daily, then switched to the other medication over for another 16 weeks of treatment. Differences in HbA1c were tested for interaction with ethnicity or OHTG, controlling for baseline HbA1c using linear mixed models. Secondary outcomes included weight, blood pressure, side-effects and diabetes treatment satisfaction. Results: 346 participants were randomised (55% Māori/Pacific) between February 2019 to March 2020. HbA1c after pioglitazone was lower than after vildagliptin (mean difference -4.9mmol/mol [0.5%]; 95% CI -6.3, -3.5; p<0.0001). Primary intention-to-treat analysis showed no significant interaction effect by Māori/Pacific vs other ethnicity (1.5mmol/mol [0.1%], 95% CI -0.8, 3.7), and per-protocol analysis (-1.2mmol/mol [0.1%], 95% CI -4.1, 1.7). An interaction effect (-4.7mmol/mol [0.5%], 95% CI -8.1, -1.4) was found by OHTG status. Both treatments generated similar treatment satisfaction scores, although there was greater weight gain and greater improvement in lipids and liver enzymes after pioglitazone than vildagliptin. Conclusions: Comparative glucose-lowering by pioglitazone and vildagliptin is not different between Māori/Pacific people compared with other New Zealand ethnic groups. Presence of OHTG predicts greater glucose lowering by pioglitazone than vildagliptin. Clinical trial registration: www.anzctr.org.au, identifier (ACTRN12618001907235).

Indexed as

Diabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsHypertriglyceridemiaThiazolidinedionesAdultCross-Over StudiesGlucoseGlycated HemoglobinHumansHypoglycemic AgentsNitrilesObesityPioglitazonePyrrolidinesVildagliptinDipeptidyl-Peptidase IV InhibitorsGlucoseGlycated HemoglobinHypoglycemic AgentsNitrilesPioglitazonePyrrolidinesThiazolidinedionesVildagliptindipeptidyl peptidase inhibitorMāoriobesityPacificpioglitazoneprecision medicinestratified drug responsethiazolidinedione

Identifiers

PMID36699039
PMCPMC9869378
OpenAlexW4313988018

What Socratic holds

Textmetadata
LicenceCC BY
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.