Evidence map›Paper›PMID 29188338›Full record

Trial reportDiabetologia2018

Effects of hypoglycaemia on working memory and regional cerebral blood flow in type 1 diabetes: a randomised, crossover trial.

Michael Gejl, Albert Gjedde, Birgitte Brock, Arne Møller, Eelco van Duinkerken, Hanne L Haahr, Charlotte T Hansen, Pei-Ling Chu, Kirstine L Stender-Petersen, Jørgen Rungby

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetologia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01789593 (A Trial Investigating the Effect of Acute Hypoglycaemia on Cognitive Function and Brain Activation Patterns in Subjects With Type 1 Diabetes), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.8field-weighted citation impact, top 14% 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.

NCT01789593 phase1completednot on this map

A Trial Investigating the Effect of Acute Hypoglycaemia on Cognitive Function and Brain Activation Patterns in Subjects With Type 1 Diabetes

TypeinterventionalSponsorNovo Nordisk A/SRan2013 to 2013Enrolled29ConditionsDiabetes, Diabetes Mellitus, Type 1Armsglucose clamp
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 25 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. Article
  6. Driving Safety in Adolescents and Young Adults With Type 1 Diabetes.Diabetes spectrum : a publication of the American Diabetes Association · 2020
    Article
  7. Review
  8. 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 7 institutions in 4 countries.

Michael GejlDepartment of Biomedicine, Aarhus University, Bartholins Allé 6, Building 1242, 8000, Aarhus C, Denmark. mg@biomed.au.dk.
Albert GjeddeDepartment of Neuroscience, University of Copenhagen, Copenhagen, Denmark.
Birgitte BrockDepartment of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
Arne MøllerDepartment of Biomedicine, Aarhus University, Bartholins Allé 6, Building 1242, 8000, Aarhus C, Denmark.
Eelco van DuinkerkenVU University Medical Centre, Amsterdam, the Netherlands.
Hanne L HaahrNovo Nordisk A/S, Søborg, Denmark.
Charlotte T HansenNovo Nordisk A/S, Søborg, Denmark.
Pei-Ling ChuNovo Nordisk Inc., Plainsboro, NJ, USA.
Kirstine L Stender-PetersenNovo Nordisk A/S, Søborg, Denmark.
Jørgen RungbyDepartment of Biomedicine, Aarhus University, Bartholins Allé 6, Building 1242, 8000, Aarhus C, Denmark.
Novo Nordisk (Denmark) · DKAarhus University · DKAarhus University Hospital · DKNovo Nordisk (United States) · USPontifical Catholic University of Rio de Janeiro · BRSteno Diabetes Center · DKUniversity of Copenhagen · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisThe aim of this randomised, crossover trial was to compare cognitive functioning and associated brain activation patterns during hypoglycaemia (plasma glucose [PG] just below 3.1 mmol/l) and euglycaemia in individuals with type 1 diabetes mellitus.

methodsIn this patient-blinded, crossover study, 26 participants with type 1 diabetes mellitus attended two randomised experimental visits: one hypoglycaemic clamp (PG 2.8 ± 0.2 mmol/l, approximate duration 55 min) and one euglycaemic clamp (PG 5.5 mmol/l ± 10%). PG levels were maintained by hyperinsulinaemic glucose clamping. Cognitive functioning was assessed during hypoglycaemia and euglycaemia conditions using a modified version of the digit symbol substitution test (mDSST) and control DSST (cDSST). Simultaneously, regional cerebral blood flow (rCBF) was measured in pre-specified brain regions by six H

resultsWorking memory was impaired during hypoglycaemia as indicated by a statistically significantly lower mDSST score (estimated treatment difference [ETD] -0.63 [95% CI -1.13, -0.14], p = 0.014) and a statistically significantly longer response time (ETD 2.86 s [7%] [95% CI 0.67, 5.05], p = 0.013) compared with euglycaemia. During hypoglycaemia, mDSST task performance was associated with increased activity in the frontal lobe regions, superior parietal lobe and thalamus, and decreased activity in the temporal lobe regions (p < 0.05). Working memory activation (mDSST - cDSST) statistically significantly increased blood flow in the striatum during hypoglycaemia (ETD 0.0374% [95% CI 0.0157, 0.0590], p = 0.002). CONCLUSIONS/

interpretationDuring hypoglycaemia (mean PG 2.9 mmol/l), working memory performance was impaired. Altered performance was associated with significantly increased blood flow in the striatum, a part of the basal ganglia implicated in regulating motor functions, memory, language and emotion.

trial registrationNCT01789593, clinicaltrials.gov

fundingThis study was funded by Novo Nordisk.

Indexed as

AdultCerebrovascular CirculationCognitionCross-Over StudiesDiabetes Mellitus, Type 1FemaleHumansHypoglycemiaMaleMemory, Short-TermMiddle AgedYoung AdultClinical diabetesHypoglycaemiaImaging (MRI/PET/other)Insulin therapy

Identifiers

PMID29188338
PMCPMC6448973
OpenAlexW2770388488

What OpenQuestion holds

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LicenceCC BY
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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.