Evidence map›Paper›PMID 19460913›Full record

Trial reportDiabetes care2009

Effects of structured versus usual care on renal endpoint in type 2 diabetes: the SURE study: a randomized multicenter translational study.

Juliana C Chan, Wing-Yee So, Chun-Yip Yeung, Gary T Ko, Ip-Tim Lau, Man-Wo Tsang, Kam-Piu Lau, Sing-Chung Siu, June K Li, Vincent T Yeung and 3 more

2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes care, 2009. 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 59 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 10 pooled it
5.9field-weighted citation impact, top 3% of its field
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.

NCT02176278 nacompletednot on this mapstarted 2014, after this paper: background citation

Using a Diabetic Kidney Disease (DKD) Registry to Treat to Multiple Targets (TMT) (DKD-TMT)

TypeinterventionalSponsorAsia Diabetes FoundationRan2014 to 2019Enrolled2,400ConditionsDiabetic Kidney DiseaseArmsTelephone Reminder, Doctor-Nurse Follow Up, Personalized Risk Report for Patient Empowerment
NCT02364323 nacompletednot on this mapstarted 2015, after this paper: background citation

A Randomized Clinical Trial to Compare a Strategy Utilizing Genetic Testing and Personalized Risk Counseling With Standard Care on Patient Empowerment, Risk Factors Control and the Risk of Diabetic Complications

TypeinterventionalSponsorChinese University of Hong KongRan2015 to 2018Enrolled435ConditionsDiabetic ComplicationArmsPersonalized Risk Counselling, Normal usual care
3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 10 syntheses or guidelines pooled it, 142 citations in OpenAlex.

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  3. Education programmes for people with chronic kidney disease and diabetes.The Cochrane database of systematic reviews · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 1 country.

Juliana C ChanDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China. jchan@cuhk.edu.hk
Wing-Yee So
Chun-Yip Yeung
Gary T Ko
Ip-Tim Lau
Man-Wo Tsang
Kam-Piu Lau
Sing-Chung Siu
June K Li
Vincent T Yeung
Wilson Y Leung
Peter C Tong
SURE Study Group
Chinese University of Hong Kong · CNTseung Kwan O Hospital · CNTung Wah Eastern Hospital · CNUnited Christian Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMultifaceted care has been shown to reduce mortality and complications in type 2 diabetes. We hypothesized that structured care would reduce renal complications in type 2 diabetes. RESEARCH DESIGN AND

methodsA total of 205 Chinese type 2 diabetic patients from nine public hospitals who had plasma creatinine levels of 150-350 micromol/l were randomly assigned to receive structured care (n = 104) or usual care (n = 101) for 2 years. The structured care group was managed according to a prespecified protocol with the following treatment goals: blood pressure <130/80 mmHg, A1C <7%, LDL cholesterol <2.6 mmol/l, triglyceride <2 mmol/l, and persistent treatment with renin-angiotensin blockers. The primary end point was death and/or renal end point (creatinine >500 micromol/l or dialysis).

resultsOf these 205 patients (mean +/- SD age 65 +/- 7.2 years; disease duration 14 +/- 7.9 years), the structured care group achieved better control than the usual care group (diastolic blood pressure 68 +/- 12 vs. 71 +/- 12 mmHg, respectively, P = 0.02; A1C 7.3 +/- 1.3 vs. 8.0 +/- 1.6%, P < 0.01). After adjustment for age, sex, and study sites, the structured care (23.1%, n = 24) and usual care (23.8%, n = 24; NS) groups had similar end points, but more patients in the structured care group attained >or=3 treatment goals (61%, n = 63, vs. 28%, n = 28; P < 0.001). Patients who attained >or=3 treatment targets (n = 91) had reduced risk of the primary end point (14 vs. 34; relative risk 0.43 [95% CI 0.21-0.86] compared with that of those who attained <or=2 targets (n = 114).

conclusionsAttainment of multiple treatment targets reduced the renal end point and death in type 2 diabetes. In addition to protocol, audits and feedback are needed to improve outcomes.

Indexed as

AdultAgedCholesterol, LDLCreatinineDiabetes Mellitus, Type 2Diabetic NephropathiesGlycated HemoglobinHumansHypoglycemic AgentsKidney Failure, ChronicMiddle AgedMonitoring, PhysiologicPatient Care TeamRenal Replacement TherapyRiskTime FactorsCholesterol, LDLCreatinineGlycated HemoglobinHypoglycemic AgentsTriglycerides

Identifiers

PMID19460913
PMCPMC2681013
OpenAlexW2103707205

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.