Evidence map›Paper›PMID 36321737›Full record

Trial reportDiabetes care2022

Optimal Frequency of Urinary Albumin Screening in Type 1 Diabetes.

Bruce A Perkins, Ionut Bebu, Ian H de Boer, Mark Molitch, Bernard Zinman, John Bantle, Gayle M Lorenzi, David M Nathan, John M Lachin

Open access · bronzeAbstract readClinical Trial
In one paragraph

Trial report in Diabetes care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 27% 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, 7 citations in OpenAlex.

  1. Review
  2. Article
  3. 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

9 authors at 7 institutions in 2 countries.

Bruce A PerkinsLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada.ORCID 0000-0002-5885-0046
Ionut BebuThe Biostatistics Center, The George Washington University, Rockville, MD.ORCID 0000-0002-4944-7968
Ian H de BoerDivision of Nephrology, University of Washington, Seattle, WA.
Mark MolitchDivision of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Bernard ZinmanLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada.
John BantleDepartment of Medicine, University of Minnesota, Minneapolis, MN.
Gayle M LorenziDepartment of Medicine, University of California, San Diego, San Diego, CA.
David M NathanDiabetes Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
John M LachinThe Biostatistics Center, The George Washington University, Rockville, MD.ORCID 0000-0001-9838-2841
George Washington University · USMount Sinai Hospital · CAHarvard University · USNorthwestern University · USUniversity of California San Diego · USUniversity of Minnesota · USUniversity of Washington · US

Funding

Limited Competition for the Continuation of Epidemiology of Diabetes Interventions and Complications (EDIC) Study Clinical Research Center (Collaborative U01)U01DK094157 · NIDDK · CASE WESTERN RESERVE UNIVERSITY · PI Ionut Bebu, Barbara Halina Braffett · 2011 to 2026
$97.6M
Epidemiology of Diabetes Interventions and Complications Data Coordinating CenterU01DK094176 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI BEBU, IONUT, BRAFFETT, BARBARA HALINA · 2012 to 2022
$30.8M
PILOT STUDY--CLINICAL NUTRITION RESEARCHP30DK035816 · NIDDK · UNIVERSITY OF WASHINGTON · PI Ellen A Schur · 1986 to 2026
$30.4M
NIDDK NIH HHS P30 DK035816NIDDK NIH HHS U01 DK094157NIDDK NIH HHS U01 DK094176
6 · The paper itself

Abstract

objectiveKidney disease screening recommendations include annual urine testing for albuminuria after 5 years' duration of type 1 diabetes. We aimed to determine a simple, risk factor-based screening schedule that optimizes early detection and testing frequency. RESEARCH DESIGN AND

methodsUrinary albumin excretion measurements from 1,343 participants in the Diabetes Control and Complications Trial and its long-term follow-up were used to create piecewise-exponential incidence models assuming 6-month constant hazards. Likelihood of the onset of moderately or severely elevated albuminuria (confirmed albumin excretion rate AER ≥30 or ≥300 mg/24 h, respectively) and its risk factors were used to identify individualized screening schedules. Time with undetected albuminuria and number of tests were compared with annual screening.

resultsThe 3-year cumulative incidence of elevated albuminuria following normoalbuminuria at any time during the study was 3.2%, which was strongly associated with higher glycated hemoglobin (HbA1c) and AER. Personalized screening in 2 years for those with current AER ≤10 mg/24 h and HbA1c ≤8% (low risk [0.6% three-year cumulative incidence]), in 6 months for those with AER 21-30 mg/24 h or HbA1c ≥9% (high risk [8.9% three-year cumulative incidence]), and in 1 year for all others (average risk [2.4% three-year cumulative incidence]) was associated with 34.9% reduction in time with undetected albuminuria and 20.4% reduction in testing frequency as compared with annual screening. Stratification by categories of HbA1c or AER alone was associated with reductions of lesser magnitude.

conclusionsA personalized alternative to annual screening in type 1 diabetes can substantially reduce both the time with undetected kidney disease and the frequency of urine testing. ARTICLE HIGHLIGHTS: Kidney disease screening recommendations include annual urine testing for albuminuria after 5 years' duration of type 1 diabetes. We investigated simple screening schedules that optimize early detection and testing frequency. Personalized screening in 2 years for those with current AER ≤10 mg/24 h and HbA1c ≤8%, in 6 months for those with AER 21-30 mg/24 h or HbA1c ≥9%, and in 1 year for all others yielded 34.9% reduction in time with undetected albuminuria and 20.4% fewer evaluations compared with annual screening. A personalized alternative to annual screening in type 1 diabetes can substantially reduce both the time with undetected kidney disease and the frequency of urine testing.

Indexed as

Diabetes Mellitus, Type 1Diabetic NephropathiesAlbuminsAlbuminuriaGlycated HemoglobinHumansIncidenceAlbuminsGlycated Hemoglobin

Identifiers

PMID36321737
PMCPMC9763027
OpenAlexW4307968332

What OpenQuestion holds

Textmetadata
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.