Evidence map›Paper›PMID 18040663›Full record

Trial reportDiabetologia2008

Intensive insulin therapy improves endothelial function and microvascular reactivity in young people with type 1 diabetes.

V L Franklin, F Khan, G Kennedy, J J F Belch, S A Greene

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Diabetologia, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03328845 (Impact on the Oxidative Stress of the Different Analogues of Insulin in People With Type 1 Diabetes. Clinical Trial of Low Level of Intervention.), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing 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.

NCT03328845 phase4completednot on this mapstarted 2017, after this paper: background citation

Impact on the Oxidative Stress of the Different Analogues of Insulin in People With Type 1 Diabetes. Clinical Trial of Low Level of Intervention. (Ineox Study)

TypeinterventionalSponsorFundación Pública Andaluza para la Investigación de Málaga en Biomedicina y SaludRan2017 to 2021Enrolled300ConditionsType 1 Diabetes MellitusArmsToujeo SoloStar, Tresiba, Humalog Kwikpen, NovoRapid, Apidra
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Article
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  4. Vascular Aging: Assessment and Intervention.Clinical interventions in aging · 2023
    Review
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  10. AKT2 maintains brain endothelial claudin-5 expression and selective activation of IR/AKT2/FOXO1-signaling reverses barrier dysfunction.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020
    Article
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  13. Review
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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

5 authors.

V L FranklinMaternal and Child Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK. victoria.franklin@nhs.net
F Khan
G Kennedy
J J F Belch
S A Greene

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisMacrovascular disease is an important cause of the increased morbidity and mortality rates associated with type 1 diabetes, and this vascular impairment begins in childhood. The aim of this study was to determine whether introducing intensive diabetes management [intensive insulin therapy (IIT) and 'Sweet Talk' text-messaging support] produces measurable improvements in endothelial function.

methodsOne hundred and twenty-six patients fulfilled the eligibility criteria (type 1 diabetes for >1 year; on conventional insulin therapy (CIT); aged between 8 and 18 years), of whom 92 enrolled. Patients were randomised to group 1, CIT only (n=28); group 2, CIT and Sweet Talk (n=33); or group 3, IIT and Sweet Talk (n=31). Vascular assessments (including measures of endothelial damage, activation, dysfunction and oxidative stress) and HbA1c were performed at baseline and repeated after 12 months of the study.

resultsGlycaemic control deteriorated in patients on CIT, but improved significantly in patients allocated to IIT (p=0.007). IIT was associated with significantly greater improvements in E-selectin (p<0.0001) than CIT (group 1, p=0.026 and group 2, p=0.053). Vascular responses to acetylcholine improved in patients on IIT (p=0.017), but not in patients receiving CIT. These changes were all independent of HbA1c level. CONCLUSIONS/

interpretationIIT appears to be associated with improvements in vascular markers, independently of changes in HbA1c, suggesting that IIT may confer vascular protection in addition to improving glycaemic control.

Indexed as

AdolescentBlood GlucoseChildDiabetes Mellitus, Type 1Diabetic AngiopathiesEndotheliumFemaleGlycated HemoglobinHumansHypoglycemic AgentsInsulinLipid MetabolismMaleMicrocirculationTreatment OutcomeBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulin

Identifiers

PMID18040663

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.