Trial reportDiabetes research and clinical practice1998
Better glycaemic control and risk reduction of diabetic complications in Type 2 diabetes: comparison with the DCCT.
Trial report in Diabetes research and clinical practice, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 15 papers.
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.
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.
Does Glycated Hemoglobin Variability in Type 2 Diabetes Differ Depending on the Diabetes Treatment Threshold Used in the Qatari Population: Implication on Diabetes Complication Risk?
A Randomized Trial of Care Navigator to Support Younger Latinx Adults Newly Diagnosed With Type 2 Diabetes (AURORA)
Who cites it
15 citing papers in PubMed, 50 citations in OpenAlex.
- Testing patient-informed approaches for visually depicting the hemoglobin A1c value to patients with poorly controlled diabetes: a randomized, controlled trial.BMC health services research · 2020Trial
- Translating the hemoglobin A1C with more easily understood feedback: a randomized controlled trial.Journal of general internal medicine · 2014Trial
- Effect of renal impairment on the pharmacokinetics of exenatide.British journal of clinical pharmacology · 2007Trial
- Initiation of Continuous Glucose Monitoring Is Linked to Improved Glycemic Control and Fewer Clinical Events in Type 1 and Type 2 Diabetes in the Veterans Health Administration.Diabetes care · 2023Observational
- Management of Patients with Newly Diagnosed Diabetic Mellitus: Ophthalmologic Outcomes in Intensive versus Conventional Glycemic Control.Clinical ophthalmology (Auckland, N.Z.) · 2021Review
- Glycated Albumin Predicts Long-term Survival in Patients Undergoing Hemodialysis.International journal of medical sciences · 2016Article
- Prevalence of diabetic retinopathy in individuals with type 2 diabetes who had recorded diabetic retinopathy from retinal photographs in Catalonia (Spain).The British journal of ophthalmology · 2015Article
- Insulin degludec: pharmacokinetic properties in subjects with hepatic impairment.Clinical drug investigation · 2014Article
- Factors associated with diabetic retinopathy in chinese patients with type 2 diabetes mellitus.International journal of endocrinology · 2012Article
- Reliability and validity of diabetes specific Health Beliefs Model scales in patients with diabetes and serious mental illness.Diabetes research and clinical practice · 2011Article
- Cost effectiveness and cost utility of the noncoding blood glucose meter CONTOUR TS.Diabetes, metabolic syndrome and obesity : targets and therapy · 2011Article
- The effect of continuous positive airway pressure on glucose control in diabetic patients with severe obstructive sleep apnea.Sleep & breathing = Schlaf & Atmung · 2005Article
- Cost effectiveness of combination therapy with pioglitazone for type 2 diabetes mellitus from a german statutory healthcare perspective.PharmacoEconomics · 2004Review
- Race and kidney disease: the scope of the problem.Journal of the National Medical Association · 2002Article
- The association of low birthweight and chronic renal failure among Medicaid young adults with diabetes and/or hypertension.Public health reports (Washington, D.C. : 1974)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo construct dose response curves relating the development of diabetic complications (retinopathy and microalbuminuria) to mean glycaemic exposure in a cohort of Type 2 patients followed over a period of several years. This allows a comparison with similar data on Type 1 subjects reported by the Diabetes Control and Complications Trial (DCCT) and provides a rational basis for deciding what levels of glycaemic control should be aimed for in advising individual patients and in setting guidelines for conducting health services. RESEARCH DESIGN AND
methodsThis was an analysis of data prospectively collected in our computerized data base for Type 2 patients who attended and were followed up at the Complications Assessment Service of our Diabetes Center. The initial development of retinopathy and microalbuminuria was analyzed with respect to the mean HbA1c during the follow up period. Statistical procedures identical to those employed in the DCCT were used to construct the dose response curve.
resultsA smooth relationship between the development of retinopathy with increasing hyperglycaemia was found. For every 10% decrease in HbA1c, there was a 24%) (confidence interval (CI): 16-32) reduction in relative risk, about 2/3 of that reported for insulin-dependent diabetes mellitus (IDDM) patients. The relationship between microalbuminuria and HbAc was more linear and less steep with a relative risk reduction of 9% (CI: -2-19%) for any 10% fall in HbA1c, about 1/3 of that reported for IDDM subjects. No threshold of HbA1c can be found for the relative risk of developing complications. However, more cases of complications are prevented by the same degree of improvement in glycaemic control at higher levels of HbA1c.
conclusionsThe development of diabetic retinopathy in Type 2 subjects is also related to the magnitude of hyperglycaemia although the degree of dependence is less than that in Type 1. Glycaemic control has less influence on microalbuminuria in Type 2. In terms of relative risk, no threshold of 'safe HbA1c' can be found but in absolute terms more cases of diabetic complications can be prevented by improving the glycaemic control of the very hyperglycaemic patients.
Indexed as
Identifiers
What Socratic holds
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.