Evidence map›Paper›PMID 14666364›Full record

ArticleDiabetologia2004

Beta-cell dysfunction and glucose intolerance: results from the San Antonio metabolism (SAM) study.

A Gastaldelli, E Ferrannini, Y Miyazaki, M Matsuda, R A DeFronzo, San Antonio metabolism study

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Diabetologia, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04131582 (Effect of a Quadruple Therapy on Pancreatic Islet Function, Insulin Resistance and Cardiovascular Function in Patients With Mixed Prediabetes and Obesity), which is not on this map. Cited by 139 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
139citing papers in PubMed, 1 pooled it
–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.

NCT04131582 phase3unknown statusstarted 2019, after this paper: background citation

Effect of a Quadruple Therapy on Pancreatic Islet Function, Insulin Resistance and Cardiovascular Function in Patients With Mixed Prediabetes and Obesity: Randomized Clinical Trial

Ran2019Enrolled34Registered outcomes4Posted comparisons0ConditionsInsulin Resistance, Prediabetic StateArmsLinagliptin + metformin and Empagliflozin + metformin, Metformin
PMID 28332871PMID 28768320PMID 11333990PMID 11707218PMID 12502499PMID 1357346PMID 1541241PMID 15491793PMID 17409288PMID 18640587PMID 19490819PMID 19640291other papers from this trial
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3 · Its place in the literature

Who cites it

139 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  10. Dapagliflozin lowers plasma glucose concentration and improves β-cell function.The Journal of clinical endocrinology and metabolism · 2015
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79 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

A GastaldelliMetabolism Unit, C.N.R. Institute of Clinical Physiology, Pisa, Italy.
E Ferrannini
Y Miyazaki
M Matsuda
R A DeFronzo
San Antonio metabolism study

Funding

ZOLEDRONATE VS AREDIA IN MULTIPLE MYELOMA/BREAST CANCER W /BONE DISORDERSM01RR001346 · NCRR · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI WALSH, NICOLAS EUGENE · 1985 to 2008
$23.1M
SGLT2 Inhibitors, Ketogenesis, and KetoacidosisR01DK024092 · NIDDK · YALE UNIVERSITY · PI RALPH A DEFRONZO · 1986 to 2026
$12.7M
Regulation of Hepatic and Peripheral Glucose MetabolismR56DK024092 · NIDDK · UNIVERSITY OF TEXAS HLTH SCI CTR SAN ANT · PI DEFRONZO, RALPH A · 2005 to 2005
$73k
NCRR NIH HHS M0I-RR-01346NIDDK NIH HHS DK24092
6 · The paper itself

Abstract

aims/hypothesisBoth insulin resistance and beta-cell dysfunction play a role in the transition from normal glucose tolerance (NGT) to Type 2 diabetes (T2DM) through impaired glucose tolerance (IGT). The aim of the study was to define the level of glycaemia at which beta-cell dysfunction becomes evident in the context of existing insulin resistance.

methodsInsulin response (OGTT) and insulin sensitivity (euglycaemic insulin clamp) were evaluated in 388 subjects in the San Antonio Metabolism (SAM) study (138 NGT, 49 IGT and 201 T2DM). In all subjects the insulin secretion/insulin resistance index (DeltaI/DeltaG/IR) was calculated as the ratio of the increment in plasma insulin to the increment in plasma glucose during the OGTT divided by insulin resistance, as measured during the clamp.

resultsIn lean NGTs with a 2-h plasma glucose concentration (2-h PG) between 5.6 and 6.6 and between 6.7 and 7.7 mmol/l, there was a progressive decline in DeltaI/DeltaG/IR compared with NGTs with a 2-h PG less than 5.6 mmol/l. There was a further decline in DeltaI/DeltaG/IR in IGTs with a 2-h PG between 7.8 and 9.3 and between 9.4 and 11.0 mmol/l, and in Type 2 diabetic patients with a 2-h PG greater than 11.1 mmol/l. Lean and obese subjects showed coincident patterns of relation of 2-h PG to DeltaI/DeltaG/IR. CONCLUSION/

interpretationWhen the plasma insulin response to oral glucose is related to the glycaemic stimulus and severity of insulin resistance, there is a progressive decline in beta-cell function that begins in "normal" glucose tolerant individuals.

Indexed as

AdultBlood GlucoseFemaleGlucoseGlucose Clamp TechniqueGlucose IntoleranceGlucose Tolerance TestHumansHyperinsulinismInsulinInsulin ResistanceIslets of LangerhansLiverMaleMiddle AgedTexasBlood GlucoseGlucoseInsulin

Identifiers

PMID14666364

What OpenQuestion holds

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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 OpenQuestion graph.