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Effect of Insulin Glargine Up-titration vs Insulin Degludec/Liraglutide on Glycated Hemoglobin Levels in Patients With Uncontrolled Type 2 Diabetes: The DUAL V Randomized Clinical Trial

Overview of attention for article published in JAMA: Journal of the American Medical Association, March 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (83rd percentile)

Mentioned by

news
18 news outlets
blogs
2 blogs
policy
2 policy sources
twitter
28 X users
patent
11 patents
peer_reviews
1 peer review site
facebook
1 Facebook page
googleplus
1 Google+ user

Citations

dimensions_citation
192 Dimensions

Readers on

mendeley
188 Mendeley
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Title
Effect of Insulin Glargine Up-titration vs Insulin Degludec/Liraglutide on Glycated Hemoglobin Levels in Patients With Uncontrolled Type 2 Diabetes: The DUAL V Randomized Clinical Trial
Published in
JAMA: Journal of the American Medical Association, March 2016
DOI 10.1001/jama.2016.1252
Pubmed ID
Authors

Ildiko Lingvay, Federico Pérez Manghi, Pedro García-Hernández, Paul Norwood, Lucine Lehmann, Mads Jeppe Tarp-Johansen, John B. Buse

Abstract

Achieving glycemic control remains a challenge for patients with type 2 diabetes, even with insulin therapy. To assess whether a fixed ratio of insulin degludec/liraglutide was noninferior to continued titration of insulin glargine in patients with uncontrolled type 2 diabetes treated with insulin glargine and metformin. Phase 3, multinational, multicenter, 26-week, randomized, open-label, 2-group, treat-to-target trial conducted at 75 centers in 10 countries from September 2013 to November 2014 among 557 patients with uncontrolled diabetes treated with glargine (20-50 U) and metformin (≥1500 mg/d) with glycated hemoglobin (HbA1c) levels of 7% to 10% and a body mass index of 40 or lower. 1:1 randomization to degludec/liraglutide (n = 278; maximum dose, 50 U of degludec/1.8 mg of liraglutide) or glargine (n = 279; no maximum dose), with twice-weekly titration to a glucose target of 72 to 90 mg/dL. Primary outcome measure was change in HbA1c level after 26 weeks, with a noninferiority margin of 0.3% (upper bound of 95% CI, <0.3%). If noninferiority of degludec/liraglutide was achieved, secondary end points were tested for statistical superiority and included change in HbA1c level, change in body weight, and rate of confirmed hypoglycemic episodes. Among 557 randomized patients (mean: age, 58.8 years; women, 49.7%), 92.5% of patients completed the trial and provided data at 26 weeks. Baseline HbA1c level was 8.4% for the degludec/liraglutide group and 8.2% for the glargine group. HbA1c level reduction was greater with degludec/liraglutide vs glargine (-1.81% for the degludec/liraglutide group vs -1.13% for the glargine group; estimated treatment difference [ETD], -0.59% [95% CI, -0.74% to -0.45%]), meeting criteria for noninferiority (P < .001), and also meeting criteria for statistical superiority (P < .001). Treatment with degludec/liraglutide was also associated with weight loss compared with weight gain with glargine (-1.4 kg for degludec/liraglutide vs 1.8 kg for glargine; ETD, -3.20 kg [95% CI, -3.77 to -2.64],P < .001) and fewer confirmed hypoglycemic episodes (episodes/patient-year exposure, 2.23 for degludec/liraglutide vs 5.05 for glargine; estimated rate ratio, 0.43 [95% CI, 0.30 to 0.61],P < .001). Overall and serious adverse event rates were similar in the 2 groups, except for more nonserious gastrointestinal adverse events reported with degludec/liraglutide (adverse events, 79 for degludec/liraglutide vs 18 for glargine). Among patients with uncontrolled type 2 diabetes taking glargine and metformin, treatment with degludec/liraglutide compared with up-titration of glargine resulted in noninferior HbA1c levels, with secondary analyses indicating greater HbA1c level reduction after 26 weeks of treatment. Further studies are needed to assess longer-term efficacy and safety. clinicaltrials.gov Identifier: NCT01952145.

X Demographics

X Demographics

The data shown below were collected from the profiles of 28 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 188 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 <1%
United States 1 <1%
Italy 1 <1%
Brazil 1 <1%
Unknown 184 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 33 18%
Student > Bachelor 24 13%
Other 16 9%
Student > Ph. D. Student 12 6%
Student > Master 12 6%
Other 41 22%
Unknown 50 27%
Readers by discipline Count As %
Medicine and Dentistry 84 45%
Pharmacology, Toxicology and Pharmaceutical Science 14 7%
Nursing and Health Professions 9 5%
Biochemistry, Genetics and Molecular Biology 7 4%
Agricultural and Biological Sciences 6 3%
Other 14 7%
Unknown 54 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 163. 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 20 December 2022.
All research outputs
#250,297
of 25,374,647 outputs
Outputs from JAMA: Journal of the American Medical Association
#3,283
of 36,428 outputs
Outputs of similar age
#4,441
of 312,602 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#66
of 396 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 36,428 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 72.5. This one has done particularly well, scoring higher than 90% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 312,602 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 396 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 83% of its contemporaries.