Evidence map›Paper›PMID 26426904›Full record

Observational studyPloS one2015

The Effect of Comorbidity on Glycemic Control and Systolic Blood Pressure in Type 2 Diabetes: A Cohort Study with 5 Year Follow-Up in Primary Care.

Hilde Luijks, Marion Biermans, Hans Bor, Chris van Weel, Toine Lagro-Janssen, Wim de Grauw, Tjard Schermer

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 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

20 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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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

7 authors.

Hilde LuijksDepartment of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands.
Marion BiermansDepartment of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands.
Hans BorDepartment of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands.
Chris van WeelDepartment of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands; Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia.
Toine Lagro-JanssenDepartment of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands.
Wim de GrauwDepartment of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands.
Tjard SchermerDepartment of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo explore the longitudinal effect of chronic comorbid diseases on glycemic control (HbA1C) and systolic blood pressure (SBP) in type 2 diabetes patients.

methodsIn a representative primary care cohort of patients with newly diagnosed type 2 diabetes in The Netherlands (n = 610), we tested differences in the five year trend of HbA1C and SBP according to comorbidity profiles. In a mixed model analysis technique we corrected for relevant covariates. Influence of comorbidity (a chronic disease already present when diabetes was diagnosed) was tested as total number of comorbid diseases, and as presence of specific disease groups, i.e. cardiovascular, mental, and musculoskeletal disease, malignancies, and COPD. In subgroup effect analyses we tested if potential differences were modified by age, sex, socioeconomic status, and BMI.

resultsThe number of comorbid diseases significantly influenced the SBP trend, with highest values after five years for diabetes patients without comorbidity (p = 0.005). The number of diseases did not influence the HbA1C trend (p = 0.075). Comorbid musculoskeletal disease resulted in lower HbA1C at the time of diabetes diagnosis, but in higher values after five years (p = 0.044). Patients with cardiovascular diseases had sustained elevated levels of SBP (p = 0.014). Effect modification by socioeconomic status was observed in some comorbidity subgroups.

conclusionsPresence of comorbidity in type 2 diabetes patients affected the long-term course of HbA1C and SBP in this primary care cohort. Numbers and types of comorbidity showed differential effects: not the simple sum of diseases, but specific types of comorbid disease had a negative influence on long-term diabetes control parameters. The complex interactions between comorbidity, diabetes control and effect modifiers require further investigation and may help to personalize treatment goals.

Indexed as

Blood PressureAdultBlood GlucoseCohort StudiesComorbidityDiabetes Mellitus, Type 2FemaleFollow-Up StudiesGlycated HemoglobinHumansMalePrimary Health CareBlood GlucoseGlycated Hemoglobin

Identifiers

PMID26426904
PMCPMC4591264

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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.