Evidence mapPaperPMID 36894921Full record

Trial reportCardiovascular diabetology2023

The vascular function effects of adding exenatide or meal insulin to basal insulin therapy in early type 2 diabetes.

Ravi Retnakaran, Jiajie Pu, Chang Ye, Alexandra Emery, Caroline K Kramer, Bernard Zinman

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02194595 (Preserving Beta-cell Function in Type 2 Diabetes With Exenatide and Insulin), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.6field-weighted citation impact, top 30% 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.

NCT02194595 phase3completednot on this map

Preserving Beta-cell Function in Type 2 Diabetes With Exenatide and Insulin (PREVAIL)

TypeinterventionalSponsorMount Sinai Hospital, CanadaRan2014 to 2022Enrolled105ConditionsType 2 DiabetesArmsBasal insulin and exenatide, Basal insulin only, Basal insulin and bolus insulin
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

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

6 authors at 1 institution in 1 country.

Ravi RetnakaranLeadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada. Ravi.Retnakaran@sinaihealth.ca.ORCID 0000-0003-1989-027X
Jiajie PuLeadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
Chang YeLeadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
Alexandra EmeryLeadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
Caroline K KramerLeadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
Bernard ZinmanLeadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
Mount Sinai Hospital · CA

Funding

CIHR MOP 136938
6 · The paper itself

Abstract

objectiveBasal insulin glargine has a neutral effect on cardiovascular risk in type 2 diabetes (T2DM). In practice, basal insulin is often paired with a glucagon-like peptide-1 receptor agonist (GLP1-RA) or meal insulin; however, the cardiovascular implications of these combinations have not been fully elucidated. In this context, we sought to evaluate the vascular function effects of adding the GLP1-RA exenatide or meal insulin lispro to basal glargine therapy in early T2DM.

methodsIn this 20-week trial, adults with T2DM of < 7-years duration were randomized to 8-weeks treatment with (i) insulin glargine (Glar), (ii) glargine + thrice-daily lispro (Glar/Lispro), or (iii) glargine + twice-daily exenatide (Glar/Exenatide), followed by 12-weeks washout. At baseline, 8-weeks, and washout, fasting endothelial function was assessed with reactive hyperemia index (RHI) measurement by peripheral arterial tonometry.

resultsAt baseline, there were no differences in blood pressure (BP), heart rate (HR) or RHI between participants randomized to Glar (n = 24), Glar/Lispro (n = 24), and Glar/Exenatide (n = 25). At 8-weeks, Glar/Exenatide decreased systolic BP (mean - 8.1 mmHg [95%CI - 13.9 to - 2.4], p = 0.008) and diastolic BP (mean - 5.1 mmHg [- 9.0 to - 1.3], p = 0.012) compared to baseline, with no significant changes in HR or RHI. Notably, baseline-adjusted RHI (mean ± SE) did not differ between the groups at 8-weeks (Glar 2.07 ± 0.10; Glar/Lispro 2.00 ± 0.10; Glar/Exenatide 1.81 ± 0.10; p = 0.19), nor did baseline-adjusted BP or HR. There were no differences between the groups in baseline-adjusted RHI, BP or HR after 12-weeks washout.

conclusionAdding either exenatide or lispro to basal insulin therapy does not appear to affect fasting endothelial function in early T2DM.

trial registrationClinicalTrials.Gov NCT02194595.

Indexed as

Diabetes Mellitus, Type 2AdultBlood GlucoseExenatideHumansHypoglycemic AgentsInsulinInsulin GlargineInsulin LisproInsulin, Long-ActingBlood GlucoseExenatideHypoglycemic AgentsInsulinInsulin GlargineInsulin LisproInsulin, Long-ActingEndo-PATEndothelial functionGLP-1Peripheral arterial tonometryReactive hyperemia

Identifiers

PMID36894921
PMCPMC9998007
OpenAlexW4323656511

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.