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Hypoglycemia: a review of definitions used in clinical trials evaluating antihyperglycemic drugs for diabetes

Overview of attention for article published in Clinical Epidemiology, May 2017
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (53rd percentile)

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68 Mendeley
Title
Hypoglycemia: a review of definitions used in clinical trials evaluating antihyperglycemic drugs for diabetes
Published in
Clinical Epidemiology, May 2017
DOI 10.2147/clep.s129268
Pubmed ID
Authors

Chakrapani Balijepalli, Eric Druyts, Gaye Siliman, Michel Joffres, Kristian Thorlund, Edward J Mills

Abstract

To understand the severity and potential impact of heterogeneity in definitions of hypoglycemia used in diabetes research, we aimed to review the hypoglycemia definitions adopted in randomized controlled trials (RCTs). We reviewed 109 RCTs included in the Canadian Agency for Drugs and Technologies in Health reports for the second- and third-line therapy for the patients with type 2 diabetes (T2D). Nearly 60% (n=66) of the studies reviewed presented the definitions for overall hypoglycemia, and another 20% (n=22) of the studies reported the results for hypoglycemia but did not report a definition. Among these 66 studies, only 9 (14%) followed the American Diabetes Association/European Medicines Agency specified guidelines to define hypoglycemia, with an exact threshold of plasma glucose ≤3.9 mmol/L. Fifty-two of the 66 studies (79%) used a threshold considerably lower than the recommended ≤3.9 mmol/L, and 16 studies used a threshold between 3.8 and 4.0 mmol/L. The proportion of the trials that used a cutoff value of <3.1 mmol/L appeared to be slightly similar among the more commonly used non-insulin treatments, GLP-1s (7 of 18 [39%]), thiazolidinediones (TZDs; 6 of 11 [55%]), DPP-4s (12 of 19 [64%]), and sulfonylureas (11 of 20 [55%]). Among trials with intermediate-long-acting insulins (neutral protamine Hagedorn insulin, detemir, glargine), 7 of 26 trials (27%) used a cutoff of <3.1 mmol/L. The definition of severe hypoglycemia was also subject to substantial heterogeneity, in both the utilized threshold and accompanying soft definitions. This review demonstrates that substantial heterogeneity exists in the definition of overall, severe/major, and nocturnal hypoglycemia across RCTs investigating T2D interventions.

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The data shown below were collected from the profiles of 3 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 68 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 68 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 15%
Student > Bachelor 8 12%
Other 7 10%
Student > Master 7 10%
Student > Ph. D. Student 7 10%
Other 10 15%
Unknown 19 28%
Readers by discipline Count As %
Medicine and Dentistry 29 43%
Pharmacology, Toxicology and Pharmaceutical Science 3 4%
Biochemistry, Genetics and Molecular Biology 3 4%
Agricultural and Biological Sciences 3 4%
Nursing and Health Professions 3 4%
Other 7 10%
Unknown 20 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. 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 09 February 2019.
All research outputs
#7,528,244
of 22,973,051 outputs
Outputs from Clinical Epidemiology
#300
of 723 outputs
Outputs of similar age
#119,404
of 310,769 outputs
Outputs of similar age from Clinical Epidemiology
#10
of 13 outputs
Altmetric has tracked 22,973,051 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 723 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.4. This one has gotten more attention than average, scoring higher than 53% 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 310,769 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 53% of its contemporaries.
We're also able to compare this research output to 13 others from the same source and published within six weeks on either side of this one. This one is in the 23rd percentile – i.e., 23% of its contemporaries scored the same or lower than it.