Evidence map›Paper›PMID 25047649›Full record

Trial reportDiabetologia2014

Estimates of insulin sensitivity from the intravenous-glucose-modified-clamp test depend on suppression of lipolysis in type 2 diabetes: a randomised controlled trial.

Sabine Kahl, Bettina Nowotny, Simon Piepel, Peter J Nowotny, Klaus Strassburger, Christian Herder, Giovanni Pacini, Michael Roden

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

Trial report in Diabetologia, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01397279 (Assessment of Liver Glucose Metabolism in Diabetic Subjects), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 23% 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.

NCT01397279 nacompletednot on this map

Assessment of Liver Glucose Metabolism in Diabetic Subjects

TypeinterventionalSponsorGerman Diabetes CenterRan2011 to 2013Enrolled22ConditionsNewly Diagnosed Type 2 Diabetes (During the Last 12 Months)Armsintravenous glucose tolerance test, hyperinsulinemic euglycemic clamp
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Cohort profile: the German Diabetes Study (GDS).Cardiovascular diabetology · 2016
    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

8 authors at 4 institutions in 2 countries.

Sabine KahlDepartment of Endocrinology and Diabetology, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
Bettina Nowotny
Simon Piepel
Peter J Nowotny
Klaus Strassburger
Christian Herder
Giovanni Pacini
Michael Roden
Heinrich Heine University Düsseldorf · DEDeutsches Diabetes-Zentrum e.V. · DEGerman Center for Diabetes Research · DENational Research Council · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisThe combined IVGTT-hyperinsulinaemic-euglycaemic clamp (Botnia clamp) allows the assessment of insulin secretion and sensitivity in one experiment. It remains unclear whether this clamp yields results comparable with those of the standard hyperinsulinaemic-euglycaemic clamp (SHEC) in diabetes patients. We hypothesised that the IVGTT induces responses affecting insulin sensitivity assessment.

methodsOf 22 randomised diet- or metformin-treated patients with well-controlled type 2 diabetes, 19 randomly underwent a Botnia clamp and an SHEC, spaced by 2 weeks, in one clinical research centre in a crossover study. The main outcomes were whole-body and hepatic insulin sensitivity as measured by the clamp and [6,6-(2)H2]glucose. Substrate utilisation was assessed from indirect calorimetry and beta cell function from insulin dynamics during IVGTT.

resultsThe values of whole-body insulin sensitivity obtained from Botnia clamp and SHEC were correlated (r = 0.87, p < 0.001), but also revealed intra-individual variations. Hepatic insulin sensitivity did not differ between experiments during the clamp, but differed after IVGTT. The contribution of glucose oxidation to glucose disposal increased by 2.2 ± 0.3 and 1.2 ± 0.4 mg kg fat-free mass (FFM)(-1) min(-1) (Botnia and SHEC, p < 0.05), whereas lipid oxidation decreased by 0.8 ± 0.1 and 0.4 ± 0.1 mg kg FFM(-1) min(-1) (p < 0.05) from baseline. Differences in NEFA (r = -0.60, p < 0.01), but not C-peptide (r = -0.16, p = 0.52) or hepatic insulin sensitivity between IVGTT and placebo before the clamps correlated with individual variations of insulin sensitivity. CONCLUSIONS/

interpretationThe Botnia clamp provides similar estimates of insulin sensitivity as SHEC in patients with type 2 diabetes, but changes in NEFA during IVGTT may affect insulin sensitivity and thereby the discrimination between insulin-sensitive and insulin-resistant individuals.

trial registrationClinicalTrials.gov NCT01397279

fundingThe study was funded by the Ministry of Science and Research of the State of North Rhine-Westphalia and the German Federal Ministry of Health, and supported in part by grants from the Federal Ministry for Research to the Centers for Diabetes Research, Helmholtz Alliance Imaging and Curing Environmental Metabolic Diseases and the Schmutzler-Stiftung.

Indexed as

AdultBlood GlucoseCalorimetry, IndirectDiabetes Mellitus, Type 2FemaleGas Chromatography-Mass SpectrometryGlucose Clamp TechniqueHumansInsulinInsulin ResistanceLipolysisMaleMiddle AgedBlood GlucoseInsulin

Identifiers

PMID25047649
OpenAlexW2018492592

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.