Evidence map›Paper›PMID 38411378›Full record

SynthesisEndocrinology, diabetes & metabolism2024

What are the consequences of over and undertreatment of type 2 diabetes mellitus in a frail population? A systematic review.

Helen O'Neil, Adam Todd, Mark Pearce, Andrew Husband

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Endocrinology, diabetes & metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
4.5field-weighted citation impact, top 5% 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, 3 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Review
  7. Observational
  8. Review
  9. 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

4 authors at 3 institutions in 2 countries.

Helen O'NeilSchool of Pharmacy, Newcastle University, Newcastle, UK.ORCID 0000-0001-8041-4171
Adam ToddSchool of Pharmacy, Newcastle University, Newcastle, UK.
Mark PearcePopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Andrew HusbandSchool of Pharmacy, Newcastle University, Newcastle, UK.
University of Newcastle Australia · AUAcademic Health Science Network North East and North Cumbria · GBNewcastle University · GB

Funding

NIHR North East and North Cumbria Applied Research Collaboration (NIHR NENC ARC)
6 · The paper itself

Abstract

aimsThis review aims to identify the evidence base for the consequences of over and undertreatment of type 2 diabetes mellitus in a frail population.

methodIn this systematic review, we searched MEDLINE, Embase, PubMed, CINAHL and the Cochrane Library for studies from January 2001 to 15th August 2022. We included a variety of study types that assessed and reported frailty including patients ≥18 years old. Studies included those that reported the prevalence of over or undertreatment of diabetes mellitus in a frail population and those examining outcomes related to glucose control in frail older people living with diabetes. Data were extracted using a bespoke extraction table using a narrative synthesis approach.

resultsA total of 4114 articles were identified with 112 meeting inclusion criteria. These included 15,130 participants across the 11 studies with sample sizes ranging from 101 to 11,140. Several areas were identified in the included studies where under or overtreatment of diabetes impacted outcomes for patients. These included hospital admissions, readmissions, length of stay, falls, mortality, cognitive impairment and cardiovascular disease outcomes.

conclusionThe results showed that there was a high heterogeneity of outcomes between the studies and that many examined small numbers of participants. In this review, both over and undertreatment were shown to increase adverse outcomes in frail older people. Further research around optimal glycaemic control for frail older people living with diabetes is required with the aim to identify ideal target ranges and produce practical clinical guidelines to promote attainment of these.

Indexed as

Diabetes Mellitus, Type 2Frail ElderlyAgedAged, 80 and overFemaleFrailtyHumansUndertreatmentdiabetesfrailtyglycaemic control

Identifiers

PMID38411378
PMCPMC10897870
OpenAlexW4392198408

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.