Evidence map›Paper›PMID 29529063›Full record

Observational studyPloS one2018

Type 1 diabetes care: Improvement by standardization in a diabetes rehabilitation clinic. An observational report.

Helmuth Haslacher, Hannelore Fallmann, Claudia Waldhäusl, Edith Hartmann, Oswald F Wagner, Werner Waldhäusl

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
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 at 1 institution in 1 country.

Helmuth HaslacherDepartment of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria.ORCID 0000-0003-4605-2503
Hannelore FallmannRehabilitation Clinic for Diabetes and Metabolic Diseases, Moorbad Neydharting, Neydharting 4, Bad Wimsbach-Neydharting, Austria.
Claudia WaldhäuslDepartment of Radiotherapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria.
Edith HartmannRehabilitation Clinic for Diabetes and Metabolic Diseases, Moorbad Neydharting, Neydharting 4, Bad Wimsbach-Neydharting, Austria.
Oswald F WagnerDepartment of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria.
Werner WaldhäuslRehabilitation Clinic for Diabetes and Metabolic Diseases, Moorbad Neydharting, Neydharting 4, Bad Wimsbach-Neydharting, Austria.
Medical University of Vienna · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundT1D treatment requires informed self-responsible patients, who, however, frequently miss their therapeutic goals, providing considerable potential for improvement.

methodsThis observational report evaluates T1D patients [N = 109], aged ≥18 years (range 22-82), poorly controlled at home, at and 3 weeks after their admission to our diabetes rehabilitation clinic [DRC], where they were offered standardized, but unmonitored life-style modification.

resultsAt admission, patients displayed elevated HbA1c values (66 mmol/mol [57; 81]), a high prevalence of co-morbidities (88%), lipodystrophies due to monolocal insulin injections (42%), a low rate of influenza (16%) and pneumococcal (7%) immunization, and underuse of lipid-lowering drugs (-38%). Standardization of life-style improved glucose (p<0.0001) and lipid metabolism (LDL/HDL ratio p<0.01) permitting reduction of insulin dose and reduction of add-on glucose-lowering drugs (GLDs) other than metformin. Outcome was independent of the mode of insulin treatment strategy and more marked at initially high HbA1c, with DRC-costs/d less than 25% of those encountered at standard hospitals.

conclusionType 1 diabetes care requires i) insulin treatment, food intake and life style to be handled in concert, ii) this need cannot be replaced by arbitrary addition of add-on GLDs, and iii) training to this end is 75% cheaper at a DRC than in standard hospitals.

Indexed as

AdultBlood GlucoseDiabetes Mellitus, Type 1FemaleGlycated HemoglobinHumansHypoglycemic AgentsInsulinLife StyleLipid MetabolismMaleMetforminMiddle AgedBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulinMetformin

Identifiers

PMID29529063
PMCPMC5847233
OpenAlexW2791331980

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.