Evidence map›Paper›PMID 25426948›Full record

SynthesisPloS one2014

A meta-analysis of the relative risk of mortality for type 1 diabetes patients compared to the general population: exploring temporal changes in relative mortality.

Tom W C Lung, Alison J Hayes, William H Herman, Lei Si, Andrew J Palmer, Philip M Clarke

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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

  1. Pooled it
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  5. Benefits and Hurdles of Pancreatic β-Cell Replacement.Stem cells translational medicine · 2022
    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

6 authors.

Tom W C LungCentre for Health Policy, Programs and Economics, School of Population Health, University of Melbourne, Melbourne, VIC 3053, Australia.
Alison J HayesSydney School of Public Health, Edward Ford Building (A27), The University of Sydney, Sydney, NSW 2006, Australia.
William H HermanThe Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48105, United States of America.
Lei SiThe Menzies Research Institute Tasmania, University of Tasmania, Hobart, TAS 7000, Australia.
Andrew J PalmerThe Menzies Research Institute Tasmania, University of Tasmania, Hobart, TAS 7000, Australia.
Philip M ClarkeCentre for Health Policy, Programs and Economics, School of Population Health, University of Melbourne, Melbourne, VIC 3053, Australia.

Funding

PUBLIC HEALTH DEMONSTRATIONP60DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MYERS, MARTIN G · 1985 to 2012
$26.5M
Regional Pilot And Feasibility Study Grants ProgramP30DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Mehboob A Hussain · 2013 to 2026
$24.3M
Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
NIDDK NIH HHS P30 DK020572NIDDK NIH HHS P30 DK092926NIDDK NIH HHS P30DK092926NIDDK NIH HHS P60 DK020572NIDDK NIH HHS P60DK020572
6 · The paper itself

Abstract

aimsType 1 diabetes has been associated with an elevated relative risk (RR) of mortality compared to the general population. To review published studies on the RR of mortality of Type 1 diabetes patients compared to the general population, we conducted a meta-analysis and examined the temporal changes in the RR of mortality over time.

methodsSystematic review of studies reporting RR of mortality for Type 1 diabetes compared to the general population. We conducted meta-analyses using a DerSimonian and Laird random effects model to obtain the average effect and the distribution of RR estimates. Sub-group meta-analyses and multivariate meta-regression analysis was performed to examine heterogeneity. Summary RR with 95% CIs was calculated using a random-effects model.

results26 studies with a total of 88 subpopulations were included in the meta-analysis and overall RR of mortality was 3.82 (95% CI 3.41, 3.4.29) compared to the general population. Observations using data prior to 1971 had a much larger estimated RR (5.80 (95% CI 4.20, 8.01)) when compared to: data between; 1971 and 1980 (5.06 (95% CI 3.44, 7.45)); 1981-90 (3.59 (95% CI 3.15, 4.09)); and those after 1990 (3.11 (95% CI 2.47, 3.91)); suggesting mortality of Type 1 diabetes patients when compared to the general population have been improving over time. Similarly, females (4.54 (95% CI 3.79-5.45)) had a larger RR estimate when compared to males (3.25 (95% CI 2.82-3.73) and the meta-regression found evidence for temporal trends and sex (p<0.01) accounting for heterogeneity between studies.

conclusionsType 1 diabetes patients' mortality has declined at a faster rate than the general population. However, the largest relative improvements have occurred prior to 1990. Emphasis on intensive blood glucose control alongside blood pressure control and statin therapy may translate into further reductions in mortality in coming years.

Indexed as

Diabetes Mellitus, Type 1FemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleRegression AnalysisRiskHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID25426948
PMCPMC4245211

What OpenQuestion holds

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Registered trials

None linked

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.