Evidence map›Paper›PMID 31312579›Full record

ReviewJournal of general and family medicine2019

Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus.

Masayuki Ikeda, Rumiko Shimazawa

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of general and family medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing 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

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

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
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  6. Article
  7. Observational
  8. Article
  9. Randomized controlled trials of biomarker targets.Clinical trials (London, England) · 2023
    Article
  10. Article
  11. Review
  12. 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

2 authors.

Masayuki IkedaDepartment of Medical Informatics Kagawa University Hospital Kagawa Japan.ORCID https://orcid.org/0000-0001-5157-1362
Rumiko ShimazawaDepartment of Clinical Pharmacology Tokai University School of Medicine Kanagawa Japan.ORCID https://orcid.org/0000-0001-8326-8835

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Glycated hemoglobin (HbA1c) is widely accepted as the most reliable measure of long-term glycemia. However, there is disagreement among professional medical societies on a proper glycemic target for long-term benefits in type 2 diabetes (T2D). The use of some glucose-lowering drugs was associated with heart failure despite substantial lowering of HbA1c. The failure of intensive glycemic control to reduce cardiovascular risk in some trials again brought into question the usefulness of HbA1c as a therapeutic target in T2D. In large cardiovascular outcome trials, some newer glucose-lowering drugs were associated with higher risks of heart failure or amputation despite comparable glycemic control between the test and placebo groups. Here, we provide evidence that variation in hemoglobin glycation between individuals is responsible for these inconsistencies. We suggest that further research be conducted in this area and that the findings be applied to clinical trials and practice.

Indexed as

cardiovascular diseasesclinical trialsglycated hemoglobinhypoglycemic agentsoutcome assessmenttype 2 diabetes mellitus

Identifiers

PMID31312579
PMCPMC6612881

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Registered trials

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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.