Evidence map›Paper›PMID 25759182›Full record

Trial reportJournal of diabetes science and technology2015

Translating What Works: A New Approach to Improve Diabetes Management.

Lawrence S Phillips, Diana Barb, Chun Yong, Anne M Tomolo, Sandra L Jackson, Darin E Olson, Mary K Rhee, Ingrid M Duva, Qing He, Qi Long

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of diabetes science and technology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.2field-weighted citation impact, top 11% 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.

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

5 citing papers in PubMed, 26 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Glycemia management in a Slovenian general hospital.Wiener klinische Wochenschrift · 2017
    Article
  5. 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

10 authors at 4 institutions in 1 country.

Lawrence S PhillipsAtlanta VA Medical Center, Decatur, GA, USA Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA medlsp@emory.edu.
Diana BarbVA Medical Center, Gainesville, FL, USA Division of Endocrinology and Metabolism, Department of Medicine, University of Florida School of Medicine, Gainesville, FL, USA.
Chun YongDepartment of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
Anne M TomoloAtlanta VA Medical Center, Decatur, GA, USA Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Sandra L JacksonAtlanta VA Medical Center, Decatur, GA, USA Nutrition and Health Sciences, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA.
Darin E OlsonAtlanta VA Medical Center, Decatur, GA, USA Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
Mary K RheeAtlanta VA Medical Center, Decatur, GA, USA Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
Ingrid M DuvaAtlanta VA Medical Center, Decatur, GA, USA.
Qing HeDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Qi LongDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Atlanta VA Medical Center · USEmory University · USGeorgia Institute of Technology · USUniversity of Florida · US

Funding

Glycemia Reduction Approaches in Diabetes: A comparative effectiveness studyU01DK098246 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI KRAUSE-STEINRAUF, HEIDI, LACHIN, JOHN M · 2012 to 2022
$238.9M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Screening for IGT: Glucose Challenge vs Predictive ModelR18DK066204 · NIDDK · EMORY UNIVERSITY · PI PHILLIPS, LAWRENCE S · 2004 to 2007
$2.9M
Nutrition Sciences and HealthT32DK007734 · NIDDK · EMORY UNIVERSITY · PI RAMAKRISHNAN, USHA · 1997 to 2016
$2.5M
Prevention of Cystic Fibrosis DiabetesR01FD003527 · FDA · EMORY UNIVERSITY · PI STECENKO, ARLENE A · 2009 to 2015
$908k
Vitamin D for Type 2 Diabetes (D2D trial)U34DK091958 · NIDDK · TUFTS MEDICAL CENTER · PI PITTAS, ANASTASSIOS G · 2011 to 2012
$792k
Reach, Outcomes and System Impacts of the VA's National Weight Loss Program, MOVER21DK099716 · NIDDK · EMORY UNIVERSITY · PI PHILLIPS, LAWRENCE S · 2014 to 2015
$321k
FDA HHS R01 FD003527FDA HHS R01FD003527NCATS NIH HHS UL1 TR000454NCATS NIH HHS UL1TR000454NIDDK NIH HHS DK066204NIDDK NIH HHS R18 DK066204NIDDK NIH HHS R21 DK099716NIDDK NIH HHS R21DK099716NIDDK NIH HHS T32 DK007734NIDDK NIH HHS U01DK091958NIDDK NIH HHS U01 DK098246NIDDK NIH HHS U34 DK091958
6 · The paper itself

Abstract

backgroundThe most efficacious strategies to improve diabetes control include case management, health care team changes, patient education, and facilitated transmission of patient data to clinicians ("facilitated relay"), but these strategies have not been translated to permit general use in clinical practice.

methodsA web-based decision support program was developed to include these features, and assessed in patients who had A1c ≥7.0% despite using metformin with/without sulfonylureas or insulin. Staff entered patients' glucose data, obtained management recommendations, reviewed the plan with a clinician, and discussed the new plan with patients.

results113 subjects were 96% male and 32% black, with average age 65.6 years and BMI 32.8. During prior primary care, A1c averaged 8.32 ± 0.16% (SEM). In all patients, baseline A1c was 8.18 ± 0.11%, and decreased to 7.54 ± 0.12%, 7.16 ± 0.13%, and 7.54 ± 0.16% at 3, 6, and 12 months, respectively, all P < .001. In 42 subjects who provided glucose data and made requested changes in medications, A1c was 8.12 ± 0.09% at baseline and fell to 7.29 ± 0.11%, 6.98 ± 0.10%, and 7.05 ± 0.10% at 3, 6, and 12 months, respectively, all P < .001. Chart review of 16 subjects followed for 12 months demonstrated that hypoglycemia (symptoms and/or glucose <70 mg/dl) averaged less than 1 episode/patient/month, and there was no severe hypoglycemia.

conclusionsA novel decision support program improved A1c with little hypoglycemia. Use of this approach should allow primary care teams to keep patients well controlled, and reduce the need for specialist referrals.

Indexed as

Decision Support Systems, ClinicalAgedAlgorithmsBlood GlucoseDiabetes MellitusDouble-Blind MethodExenatideFemaleGeorgiaGlycated HemoglobinHospitals, VeteransHumansHypoglycemic AgentsInsulinInternetMaleBlood GlucoseExenatideGlycated HemoglobinHypoglycemic AgentsInsulinMetforminPeptidesSulfonylurea CompoundsVenomsclinical decision makingcomputerdecision supporthypoglycemiamanagementprimary caretype 2 diabetes

Identifiers

PMID25759182
PMCPMC4525659
OpenAlexW2133940413

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

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.