Evidence mapPaperPMID 40826913Full record

ArticleDiabetes, obesity & metabolism2025

Acidosis is associated with lower insulin sensitivity and incident type 2 diabetes in indigenous Americans: A prospective cohort study.

Andrés M Treviño-Alvarez, Tomás Cabeza de Baca, Emma J Stinson, Marci E Gluck, Paolo Piaggi, Jonathan Krakoff, Douglas C Chang

Abstract read
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing 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

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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

1 citing paper in PubMed.

  1. 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

7 authors.

Andrés M Treviño-AlvarezObesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.
Tomás Cabeza de BacaObesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.ORCID https://orcid.org/0000-0003-3322-2163
Emma J StinsonObesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.
Marci E GluckObesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.
Paolo PiaggiObesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.ORCID https://orcid.org/0000-0003-2774-9161
Jonathan KrakoffObesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.
Douglas C ChangObesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.

Funding

Etiology of obesity--Pathophysiological consequencesZ01DK069015 · DIABETES, DIGESTIVE, KIDNEY DISEASES · 1986 to 2005
Genetics Of Type 2 Diabetes MellitusZ01DK069028 · DIABETES, DIGESTIVE, KIDNEY DISEASES · 1990 to 2005
Intramural NIH HHS Z01 DK069015Intramural NIH HHS Z01 DK069028NIDDK NIH HHS DK069015-36NIDDK NIH HHS DK069028
6 · The paper itself

Abstract

aimWhether markers of acid accumulation [decreased plasma bicarbonate, increased anion gap (AG) and corrected anion gap (CAG)] are associated with insulin sensitivity and alter diabetes risk is unclear. We aimed to examine the association of these markers with the gold-standard measure of insulin sensitivity and incident type 2 diabetes. MATERIALS AND

methodsHealthy adults without diabetes enrolled in a longitudinal study had baseline measures of acidosis (bicarbonate, AG, CAG), insulin sensitivity by hyperinsulinaemic-euglycaemic clamp, and body composition. In cross-sectional analysis (n = 296, 188 male), the relationship between acid markers and insulin sensitivity (M-low) was evaluated. Progression to type 2 diabetes was evaluated by Cox regression models (per 1-SD change) in those with appropriate follow-up visits (n = 233).

resultsIncreased AG and CAG were associated with lower M-low, adjusting for age, sex, body fat (%) and estimated glomerular filtration rate (AG: partial r = -0.22, CAG: partial r = -0.24, both p < 0.0001) but not with bicarbonate. During a median follow-up time of 8.0 years, 50 participants developed type 2 diabetes. CAG was associated with increased risk of type 2 diabetes (HR: 1.32, 95% CI 1.01-1.74, p = 0.044) in a model adjusted for age, sex, body fat (%) and baseline plasma glucose, but not after further adjusting for M-low (p = 0.17). Bicarbonate and AG were not associated with risk of diabetes.

conclusionAcidosis was associated with lower insulin sensitivity and increased risk of type 2 diabetes that was attenuated by measures of lower insulin sensitivity. Acidosis as reflected by CAG may be a target for intervention.

Indexed as

AcidosisDiabetes Mellitus, Type 2Insulin ResistanceAcid-Base EquilibriumAdultAgedBicarbonatesCross-Sectional StudiesFemaleGlucose Clamp TechniqueHumansIncidenceLongitudinal StudiesMaleMiddle AgedProspective StudiesBicarbonatesanion gapbicarbonateinsulin resistancetype 2 diabetes

Identifiers

PMID40826913
PMCPMC12515791

What Socratic holds

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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.