Evidence map›Paper›PMID 34369627›Full record

Trial reportPediatric diabetes2021

Increasing plasma glucose before the development of type 1 diabetes-the TRIGR study.

Johnny Ludvigsson, David Cuthbertson, Dorothy J Becker, Olga Kordonouri, Bärbel Aschemeier, Daniele Pacaud, Cheril Clarson, Jeffrey P Krischer, Mikael Knip, TRIGR Investigators

Open access · bronzeAbstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Pediatric diabetes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.2field-weighted citation impact, top 19% 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

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
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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

10 authors at 7 institutions in 5 countries.

Johnny LudvigssonCrown Princess Victoria Children's Hospital and Div of Pediatrics, Dept of Biomedical and Clinical Sciences, Linköping university, Linköping, Sweden.ORCID 0000-0003-1695-5234
David CuthbertsonHealth Informatics Institute, University of South Florida, Tampa, Florida, USA.
Dorothy J BeckerDepartment of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.ORCID 0000-0001-8632-3633
Olga KordonouriDiabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany.ORCID 0000-0001-9563-3537
Bärbel AschemeierDiabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany.
Daniele PacaudDepartment of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, USA.ORCID 0000-0001-6337-7241
Cheril ClarsonDepartment of Paediatrics, University of Western Ontario, London, ON, Canada.
Jeffrey P KrischerHealth Informatics Institute, University of South Florida, Tampa, Florida, USA.
Mikael KnipPediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0003-0474-0033
TRIGR Investigators
Kinderkrankenhaus auf der Bult · DEUniversity of South Florida · USAlberta Children's Hospital · CABoston Children's Hospital · USLinköping University Hospital · SEUniversity of Helsinki · FIWestern University · CA

Funding

Trial to Reduce IDDM in the Genetically at Risk StudyU01HD040364 · NICHD · UNIVERSITY OF HELSINKI · PI KNIP, MIKAEL · 2001 to 2015
$32.7M
Trial to Reduce IDDM in the Genetically at Risk: A Nutritional primary preventionU01HD042444 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BECKER, DOROTHY J · 2001 to 2015
$24.4M
Trial to Reduce IDDM in the Genetically at Risk (TRIGR) Data Management UnitU01HD051997 · NICHD · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2006 to 2015
$7.1M
Trial to Reduce IDDM in the Genetically at Risk (TRIGR) Data Management UnitR01HD051997 · NICHD · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2016 to 2018
$2.3M
NICHD NIH HHS R01 HD051997NICHD NIH HHS U01 HD040364NICHD NIH HHS U01 HD042444NICHD NIH HHS U01 HD051997
6 · The paper itself

Abstract

objectiveThe β-cell stress hypothesis suggests that increased insulin demand contributes to the development of type 1 diabetes. In the TRIGR trial we set out to assess the profile of plasma glucose and HbA1c before the diagnosis of clinical diabetes compared to nondiabetic children. RESEARCH DESIGN AND

methodsA cohort of children (N = 2159) with an affected first-degree relative and increased HLA risk were recruited 2002-2007 and followed until 2017. To study the relationship between plasma glucose/HbA1c and the development of autoantibodies or clinical disease Kaplan-Meir curves were developed. Mixed models were constructed for plasma glucose and HbA1c separately.

resultsA family history of type 2 diabetes was related to an increase in plasma glucose (p < 0.001). An increase in glucose from the previous sample predicted clinical diabetes (p < 0.001) but not autoantibodies. An increase of HbA1c of 20% or 30% from the previous sample predicted the development of any autoantibody (p < 0.003 resp <0.001) and the development of diabetes (p < 0.002 resp <0.001. Participants without autoantibodies had lower HbA1c (mean 5.18%, STD 0.24; mean 33.08 mmol/mol, STD 2.85) than those who progressed to clinical disease (5.31%, 0.42; 34.46 mmol/mol, 4.68; p < 0.001) but higher than those who developed any autoantibody (5.10%, 0.30; 32.21 mmol/mol, 3.49; p < 0.001), or multiple autoantibodies (5.11%, 0.35; 32.26 mmol/mol, 3.92; p < 0.003).

conclusionsA pronounced increase in plasma glucose and HbA1c precedes development of clinical diabetes, while the association between plasma glucose or HbA1c and development of autoantibodies is complex. Increased insulin demand may contribute to development of type 1 diabetes.

Indexed as

AutoantibodiesBlood GlucoseCohort StudiesDiabetes Mellitus, Type 1Double-Blind MethodFemaleFollow-Up StudiesGenetic Predisposition to DiseaseGlycated HemoglobinHLA AntigensHumansInfantInsulinInsulin ResistanceInsulin-Secreting CellsMaleAutoantibodiesBlood GlucoseGlycated HemoglobinHLA AntigensInsulinaccelerator hypothesisautoantibodiesHbA1cplasma glucosetype 1 diabetesβ-cell stress

Identifiers

PMID34369627
PMCPMC8530903
OpenAlexW3188841440

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.