Evidence map›Paper›PMID 38741266›Full record

Trial reportDiabetic medicine : a journal of the British Diabetic Association2024

Diabetic autonomic neuropathy does not impede improvement in hypoglycaemia awareness in adults: Sub-study results from the HypoCOMPaSS trial.

Muhammad Fahad Arshad, Emma Walkinshaw, Alexandra Lubina Solomon, Alan Bernjak, Ines Rombach, Lala Leelarathna, Stuart A Little, Mark Evans, James A M Shaw, Simon R Heller and 1 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetic medicine : a journal of the British Diabetic Association, 2024. 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
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Autonomic neuropathy in diabetes.Archives of endocrinology and metabolism · 2025
    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

11 authors.

Muhammad Fahad ArshadUniversity of Sheffield, Sheffield, UK.ORCID https://orcid.org/0000-0001-9932-0941
Emma WalkinshawUniversity of Sheffield, Sheffield, UK.
Alexandra Lubina SolomonRussells Hall Hospital, Dudley Group Hospitals, Dudley, UK.
Alan BernjakUniversity of Sheffield, Sheffield, UK.
Ines RombachUniversity of Sheffield, Sheffield, UK.
Lala LeelarathnaDepartment of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London.
Stuart A LittleInstitute of Cellular Medicine, Newcastle University, Newcastle, UK.
Mark EvansMRC Institute of Metabolic Science, University of Cambridge, Cambridge, London.
James A M ShawInstitute of Cellular Medicine, Newcastle University, Newcastle, UK.
Simon R HellerUniversity of Sheffield, Sheffield, UK.ORCID https://orcid.org/0000-0002-2425-9565
Ahmed IqbalUniversity of Sheffield, Sheffield, UK.ORCID https://orcid.org/0000-0002-5648-0539

Funding

Diabetes UK 07/0003556
6 · The paper itself

Abstract

aimsImpaired awareness of hypoglycaemia (IAH) increases the risk of severe hypoglycaemia in people with type 1 diabetes mellitus (T1DM). IAH can be reversed through meticulous avoidance of hypoglycaemia. Diabetic autonomic neuropathy (DAN) has been proposed as an underlying mechanism contributing to IAH; however, data are inconsistent. The aim of this study was to examine the effects of cardiac autonomic neuropathy (CAN) on IAH reversibility inT1DM.

methodsParticipants with T1DM and IAH (Gold score ≥4) recruited to the HypoCOMPaSS (24-week 2 × 2 factorial randomised controlled) trial were included. All underwent screening for cardiac autonomic function testing at baseline and received comparable education and support aimed at avoiding hypoglycaemia and improving hypoglycaemia awareness. Definite CAN was defined as the presence of ≥2 abnormal cardiac reflex tests. Participants were grouped according to their CAN status, and changes in Gold score were compared.

resultsEighty-three participants (52 women [62.7%]) were included with mean age (SD) of 48 (12) years and mean HbA1c of 66 (13) mmol/mol (8.2 [3.3] %). The mean duration of T1DM was 29 (13) years. The prevalence of CAN was low with 5/83 (6%) participants having definite autonomic neuropathy with 11 (13%) classified with possible/early neuropathy. All participants, regardless of the autonomic function status, showed a mean improvement in Gold score of ≥1 (mean improvement -1.2 [95% CI -0.8, -1.6]; p < 0.001).

conclusionsIAH can be improved in people with T1DM, and a long duration of disease, with and without cardiac autonomic dysfunction. These data suggest that CAN is not a prime driver for modulating IAH reversibility.

Indexed as

Diabetes Mellitus, Type 1Diabetic NeuropathiesHypoglycemiaAdultAwarenessFemaleHumansHypoglycemic AgentsMaleMiddle AgedHypoglycemic Agentscardiac autonomic neuropathydiabetic autonomic neuropathyimpaired awareness of hypoglycaemia

Identifiers

PMID38741266
PMCPMC7617341

What OpenQuestion holds

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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.