Evidence map›Paper›PMID 26215435›Full record

Trial reportJournal of diabetes and its complications

Continuation or discontinuation of pioglitazone when starting bedtime insulin in patients with poorly controlled type 2 diabetes in an inner-city population.

Mona Mojtahedzadeh, Martin L Lee, Theodore C Friedman

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of diabetes and its complications. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 41% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Review
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

3 authors at 1 institution in 1 country.

Mona MojtahedzadehMartin Luther King, Jr. Outpatient Center (MLK-OC), Los Angeles, CA 90059, USA.
Martin L LeeMartin Luther King, Jr. Outpatient Center (MLK-OC), Los Angeles, CA 90059, USA; Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA.
Theodore C FriedmanMartin Luther King, Jr. Outpatient Center (MLK-OC), Los Angeles, CA 90059, USA. Electronic address: tfriedman@dhs.lacounty.gov.
Martin Luther King, Jr. Multi-Service Ambulatory Care Center · US

Funding

Workshop for Junior Biostatisticians in Health ResearchU54MD007598 · NIMHD · CHARLES R. DREW UNIVERSITY OF MED & SCI · PI Piwen Wang · 2012 to 2026
$60.0M
Drew MIDARP (Infrastructure in Drug Abuse Research)R24DA017298 · NIDA · CHARLES R. DREW UNIVERSITY OF MED &SCI · PI FRIEDMAN, THEODORE C · 2004 to 2018
$5.0M
NIDA NIH HHS R24 DA017298NIMHD NIH HHS U54 MD007598NIMHD NIH HHS U54MD007598
6 · The paper itself

Abstract

objectiveWe studied the impact of continuing versus discontinuing pioglitazone on hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and weight when starting bedtime insulin in patients with poor glycemic control.

methodsWe retrospectively analyzed data from a 13-month randomized control trial on 77 patients with type 2 diabetes mellitus (DM), who despite maximum doses of three oral diabetes medications (metformin, sulfonylurea and pioglitazone) had HbA1C levels above 7.5%. Patients were randomized to either continuing or discontinuing pioglitazone in addition to starting and up-titrating bedtime insulin. HbA1C, FPG, and weight were assessed at baseline, 3months, 7months and 13months with the differences from baseline for the two groups compared at each of the three time points using the Wilcoxon rank sum test.

resultsWe found that HbA1c was significantly lower at the 7-month (p=0.01) and 13-month time points (p=0.036), and FPG was significantly lower at all three time points in the group continuing pioglitazone compared with those discontinuing pioglitazone. Continuing pioglitazone resulted in a greater increase in weight at the 3-month (p=0.002), 7-month (p=0.0001) and 13-month (p=0.00003) time points. Patients with the lowest HbA1c (<8.2%) at baseline were more likely to benefit from continuing pioglitazone than those with higher baseline HbA1c. Patients who started insulin and discontinued pioglitazone had similar HbA1c, FPG and weight at the three time points as at baseline, suggesting that pioglitazone and bedtime insulin has similar glycemic effect in this population.

conclusionsWe conclude that in patients with uncontrolled type 2 DM, continuing pioglitazone while concurrently starting bedtime insulin within a 13-month period led to a significant decrease in both HbA1c and FPG levels compared with those who did not receive pioglitazone; however weight increased during this period.

Indexed as

Drug MonitoringDrug ResistanceAmbulatory Care FacilitiesBlood GlucoseDiabetes Mellitus, Type 2Drug Administration ScheduleDrug Therapy, CombinationFemaleGlycated HemoglobinHumansHyperglycemiaHypoglycemic AgentsInsulinLos AngelesMaleMedical RecordsBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinPioglitazoneThiazolidinedionesHbA1cMetforminPioglitazoneSulfonylureaThiazolidinedioneType 2 diabetes

Identifiers

PMID26215435
PMCPMC5014540
OpenAlexW762187710

What OpenQuestion holds

Textmetadata
LicenceTDM
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.