| Title |
Long-term follow-up of intensive glycaemic control on renal outcomes in the Veterans Affairs Diabetes Trial (VADT)
|
|---|---|
| Published in |
Diabetologia, November 2017
|
| DOI | 10.1007/s00125-017-4473-2 |
| Pubmed ID | |
| Authors |
Lily Agrawal, Nasrin Azad, Gideon D. Bahn, Ling Ge, Peter D. Reaven, Rodney A. Hayward, Domenic J. Reda, Nicholas V. Emanuele, for the VADT Study Group |
| Abstract |
We conducted an analysis of data collected during the Veterans Affairs Diabetes Trial (VADT) and the follow-up study (VADT-F) to determine whether intensive (INT) compared with standard (STD) glycaemic control during the VADT resulted in better long-term kidney outcomes. VADT randomly assigned 1791 veterans from 20 Veterans Affairs (VA) medical centres who had type 2 diabetes mellitus and a mean HbA1c of 9.4 ± 2% (79.2 mmol/mol) at baseline to receive either INT or STD glucose control for a median of 5.6 years (randomisation December 2000 to May 2003; intervention ending in May 2008). After the trial, participants received routine care through their own physicians within the VA. This is an interim analysis of the VADT-F (June 2008 to December 2013). We collected data using VA and National databases and report renal outcomes based on serum creatinine, eGFR and urine albumin to creatinine ratio (ACR) in 1033 people who provided informed consent to participate in the VADT-F. By the end of the VADT-F, significantly more people who received INT treatment during the VADT maintained an eGFR >60 ml min(-1) 1.73 m(-2) (OR 1.34 [95% CI 1.05, 1.71], p = 0.02). This benefit was most evident in those who were classified as at moderate risk (INT vs STD, RR 1.3, p = 0.03) or high risk (RR 2.3, p = 0.04) of chronic kidney disease on the Kidney Disease Improving Global Outcomes (KDIGO-CKD) at the beginning of VADT. At the end of VADT-F, significantly more people from the INT group improved to a low KDIGO risk category (RR 6.1, p = 0.002). During the VADT-F there were no significant differences between INT and STD for average HbA1c, blood pressure or lipid levels. After just over 11 years of follow-up, there was a 34% greater odds of maintaining an eGFR of >60 ml min(-1) 1.73 m(-2) and of improving the KDIGO category in individuals with type 2 diabetes who had received INT for a median of 5.6 years. VADT clinical trials.gov number: NCT 00032487. |
X Demographics
The data shown below were collected from the profiles of 62 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 6 | 10% |
| Canada | 6 | 10% |
| United Kingdom | 5 | 8% |
| India | 4 | 6% |
| Australia | 4 | 6% |
| United States | 2 | 3% |
| France | 2 | 3% |
| Denmark | 1 | 2% |
| Germany | 1 | 2% |
| Other | 6 | 10% |
| Unknown | 25 | 40% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 38 | 61% |
| Scientists | 13 | 21% |
| Practitioners (doctors, other healthcare professionals) | 11 | 18% |
Mendeley readers
The data shown below were compiled from readership statistics for 89 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 89 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 10 | 11% |
| Student > Master | 10 | 11% |
| Student > Postgraduate | 7 | 8% |
| Student > Bachelor | 6 | 7% |
| Student > Doctoral Student | 5 | 6% |
| Other | 18 | 20% |
| Unknown | 33 | 37% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 34 | 38% |
| Nursing and Health Professions | 5 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 3% |
| Business, Management and Accounting | 1 | 1% |
| Biochemistry, Genetics and Molecular Biology | 1 | 1% |
| Other | 5 | 6% |
| Unknown | 40 | 45% |
Attention Score in Context
This research output has an Altmetric Attention Score of 35. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 March 2018.
All research outputs
#1,060,778
of 24,041,016 outputs
Outputs from Diabetologia
#580
of 5,207 outputs
Outputs of similar age
#23,079
of 332,953 outputs
Outputs of similar age from Diabetologia
#19
of 75 outputs
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