Evidence mapPaperPMID 38962812Full record

Trial reportDiabetes, obesity & metabolism2024

Renal function as an effect modifier of intensive glucose control in delaying cognitive function decline among individuals with type 2 diabetes: A revisit to the ACCORD MIND trial.

Piaopiao Li, Hamed Kianmehr, Dawei Guan, Ambar Kulshreshtha, K M Venkat Narayan, Mohammed K Ali, Guillermo E Umpierrez, Xin Hu, Vivian A Fonseca, Lizheng Shi and 1 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Diabetic kidney disease-Recent updates.Journal of diabetes · 2024
    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

11 authors.

Piaopiao LiHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.ORCID 0000-0003-0941-5563
Hamed KianmehrDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Dawei GuanDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Ambar KulshreshthaDepartment of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA.
K M Venkat NarayanHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Mohammed K AliHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Guillermo E UmpierrezDivision of Endocrinology, School of Medicine, Emory University, Atlanta, Georgia, USA.ORCID 0000-0002-3252-5026
Xin HuDepartment of Public Health Sciences, University of Virginia School of Medicine, Charlotteville, Virginia, USA.
Vivian A FonsecaDepartment of Medicine and Pharmacology, School of Medicine, Tulane University, New Orleans, Louisiana, USA.ORCID 0000-0002-3381-7151
Lizheng ShiDepartment of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA.ORCID 0000-0002-7827-6766
Hui ShaoHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.ORCID 0000-0002-4088-546X

Funding

Technologies Advancing Translation - Regional CoreP30DK111024 · EMORY UNIVERSITY · 2025 to 2025
$775k
Building Equity Improvement into Quality Improvement in the use of New Glucose-lowering Drugs (GLDs) through Individualized Drug Value Assessment in People with DiabetesR01DK133465 · UNIVERSITY OF FLORIDA · 2025 to 2025
$593k
NIDDK NIH HHS P30 DK111024NIDDK NIH HHS R01 DK133465
6 · The paper itself

Abstract

aimDysglycaemia accelerates cognitive decline. Intensive glucose control may help delay or prevent cognitive function decline (CFD). We aimed to determine how patient characteristics influence the effect of intensive glucose control [glycated haemoglobin (HbA1c) <6.0%] on delaying CFD in people with type 2 diabetes. RESEARCH DESIGN AND

methodsIn this post-hoc analysis of 2977 type 2 diabetes participants from the ACCORD MIND trial, we applied the causal forest and causal tree algorithms to identify the effect modifier of intensive glucose control in delaying CFD from 68 variables (demographics, disease history, medications, vitals and baseline biomarkers). The exposure was intensive versus standard glucose control (HbA1c <6.0% vs. 7.0%-7.9%). The main outcome was cognitive function changes from baseline to the 40th month follow-up, which were evaluated using the digit symbol substitution test, Rey auditory verbal learning test, mini-mental state examination and Stroop test. We used Cohen's d, a measure of standardized difference, to quantify the effect size of intensive glucose control on delaying CFD.

resultsAmong all the baseline characteristics, renal function was the most significant effect modifier. Participants with urinary albumin levels <0.4 mg/dl [absolute function change (AFC): 0.51 in mini-mental state examination, 95% confidence interval (CI): 0.04, 0.98, Cohen's d: 0.25] had slower CFD with intensive glucose control. Patients with preserved renal function (estimated glomerular filtration rate between 60 and 90 ml/min/1.73 m

conclusionsOur findings linked renal function with the benefits of intensive glucose control in delaying CFD, informing personalized HbA1c goals for those with diabetes and at risk of CFD.

Indexed as

Cognitive DysfunctionDiabetes Mellitus, Type 2Glycated HemoglobinGlycemic ControlAgedBlood GlucoseCognitionFemaleGlomerular Filtration RateHumansHypoglycemic AgentsKidneyMaleMiddle AgedBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic Agentsclinical trialdiabetes complicationseffectivenessglycaemic controltype 2 diabetes

Identifiers

PMID38962812
PMCPMC11300148

What Socratic holds

Textmetadata
LicenceTDM
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.