Current Diabetes Reports最新文献

{"title":"Body Mass Index Variability and Cardiovascular Risk: Contemporary Evidence and Clinical Implications for Diabetes Care.","authors":"Arnaud D Kaze, Justin B Echouffo-Tcheugui","doi":"10.1007/s11892-026-01648-z","DOIUrl":"https://doi.org/10.1007/s11892-026-01648-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>To synthesize contemporary evidence on body mass index (BMI) variability as a determinant of cardiovascular risk, integrate mechanistic insights, and clarify its clinical relevance in individuals with and without diabetes.</p><p><strong>Recent findings: </strong>Large cohort studies demonstrate that greater BMI or weight variability is associated with increased risks of all-cause mortality, atherosclerotic cardiovascular disease, heart failure and atrial fibrillation, independent of mean BMI. Mechanistic evidence to explain the observed association implicates adipose tissue dysfunction, ectopic fat deposition, metabolic instability, systemic inflammation, and autonomic imbalance. Diabetes may amplify these pathways through impaired metabolic flexibility and treatment-related weight fluctuations. Evidence from diabetes-specific cohorts suggests that structured, intentional weight loss may attenuate the adverse associations seen with unstructured weight cycling. BMI variability is an emerging marker of cardiometabolic instability with implications for cardiovascular risk, particularly in diabetes. Defining actionable thresholds and determining whether stabilizing weight improves outcomes are key future research priorities.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Caregivers Behind Youth with T1D: A Systematic Review of Psychosocial Interventions and Youth Glycemic Outcomes.","authors":"Vasco Costa, Bárbara Pereira, Nadia de Maio, Susana R Patton, Sónia do Vale, Lurdes Sampaio, Catarina Limbert, Tânia Brandão","doi":"10.1007/s11892-026-01646-1","DOIUrl":"10.1007/s11892-026-01646-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>This systematic review sought to synthetize recent studies on psychological interventions aiming to address parental psychosocial factors in families of children and adolescents with Type 1 Diabetes (T1D). Particularly, its purpose was to characterize intervention designs, frameworks, and delivery modalities, as well as to examine their findings on both parental psychosocial and youth glycemic outcomes.</p><p><strong>Recent findings: </strong>Twenty-six manuscripts from 2019 to 2025 were selected, including randomized controlled trials, quasi-experimental designs, pilot, feasibility, and protocol studies. Most interventions were grounded in cognitive-behavioral frameworks and implemented through a range of diverse delivery formats. Overall, the available evidence indicates that the interventions are associated with improvements across a range of parental psychosocial factors (e.g., diabetes distress, depressive and anxiety symptoms, fear of hypoglycemia, and quality of life), while findings regarding glycemic outcomes were heterogeneous across studies. Interventions targeting parents of youth with T1D appear effective in enhancing psychosocial adjustment. The diversity of study designs, theoretical frameworks, and intervention approaches reflects both heterogeneity and a robust scientific evidence base, with potential for adaptation and replication across different contexts.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes and Suicide Risk Among Black Males, Including Sexual Minority Males: A Narrative Review With Primary Care Implications.","authors":"Donte T Boyd, Jaclynn Hawkins, Jamie Mitchell","doi":"10.1007/s11892-026-01647-0","DOIUrl":"10.1007/s11892-026-01647-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Diabetes and suicide are intersecting public health concerns, yet evidence at this intersection remains sparse for Black males and especially Black sexual minority males (SMM). This focused narrative review synthesizes direct and adjacent evidence, with emphasis on diabetes-specific disparities, intersectional stress processes, and primary care implications.</p><p><strong>Recent findings: </strong>The diabetes-suicide literature is heterogeneous, but consistently identifies depression, diabetes distress, treatment burden, complications, and access to insulin or other medications as clinically relevant pathways. For Black males, structural racism, economic inequity, health care discrimination, and constrained access to high-quality diabetes and mental health care may intensify these burdens. The most directly relevant study identified found more lifetime suicide attempts among African American adults with type 1 diabetes than controls, but did not report male-specific estimates. We identified no study estimating diabetes-related suicidal thoughts or behaviors specifically among Black SMM. Common tools such as the Patient Health Questionnaire-9, Diabetes Distress Scale, and Columbia-Suicide Severity Rating Scale have broad clinical support but have not been specifically validated in Black males with diabetes or Black SMM. Common tools such as the Patient Health Questionnaire-9, Diabetes Distress Scale, and Columbia-Suicide Severity Rating Scale have broad clinical support, but the literature identified in this review did not establish their population-specific validity among Black males with diabetes, including Black SMM. The central finding is an evidence gap, not proof of a multiplicative risk effect. Primary care clinicians should use culturally responsive psychosocial inquiry, direct suicide assessment when indicated, collaborative safety planning, and integrated behavioral health care while avoiding assumptions that screening tools perform equivalently across populations. Prospective, disaggregated research and population-specific measurement studies are urgently needed.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile Health Interventions to Support Self-Management in Youth with Type 1 Diabetes.","authors":"Isa Granados, David A Fedele, Susana R Patton","doi":"10.1007/s11892-026-01645-2","DOIUrl":"10.1007/s11892-026-01645-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Youth with type 1 diabetes face demanding daily self-management requirements. Mobile health interventions are a promising approach for supporting diabetes self-management both within clinical care and in everyday contexts. This review synthesizes recent evidence published between 2018 and 2024 on mobile health interventions designed to support self-management in children and adolescents with type 1 diabetes.</p><p><strong>Recent findings: </strong>Forty-four studies met inclusion criteria. Most were early-phase evaluations emphasizing feasibility, usability, and engagement. Across modalities, mHealth interventions were most successful at lowering hemoglobin A1c when they provided real-time, actionable support during insulin dosing or carbohydrate estimation. Engagement trajectory emerged as an important determinant of clinical benefit, suggesting that initial usability alone are insufficient to produce meaningful clinical impact. Mobile health interventions for youth with type 1 diabetes are feasible, acceptable, and effective for improving self-management processes and psychosocial outcomes. Glycemic improvements occur selectively when interventions provide point-of-need decision support and when engagement is sustained. Future research should prioritize mechanisms of action, strategies to support long-term engagement, and rigorous effectiveness-implementation trials to support scalable clinical impact.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Oxytocin in Obesity.","authors":"Amber L Williams, James E Blevins","doi":"10.1007/s11892-026-01640-7","DOIUrl":"10.1007/s11892-026-01640-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review will summarize the role of the hormone, oxytocin (OT), in the control of energy balance and glucose homeostasis in pre-clinical and clinical models and the role of sex in contributing to these effects.</p><p><strong>Recent findings: </strong>OT reduces intake of chow and highly palatable foods, including sucrose, high fat diet, and chocolate cookies, suggesting that it suppresses homeostatic and hedonic feeding. Chronic administration reduces body weight in diet-induced obese (DIO) rodent models. These effects occur through a selective reduction of fat mass while sparing lean mass. While OT has been found to elicit modest weight loss in a translational nonhuman primate (NHP) model, the effects of intranasal treatment of OT in humans with obesity have been mixed, highlighting the need to optimize dose, dose frequency and duration of administration and the need to develop longer-lasting OT analogs to increase compliance and to minimize off-target effects.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omega-3 and Omega-6 Fatty Acids and Cardiovascular Outcomes in Diabetes - A Review of Current Evidence.","authors":"Rachel A Wattick, Tara B McNabb, Alana G Hudson","doi":"10.1007/s11892-026-01644-3","DOIUrl":"10.1007/s11892-026-01644-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardiovascular disease remains the leading cause of morbidity and mortality among individuals with diabetes. This review examines recent evidence on the effects of omega-3 and omega-6 fatty acids on cardiovascular outcomes in diabetes.</p><p><strong>Recent findings: </strong>Cardiovascular outcomes trials demonstrate heterogeneous effects of omega-3 supplementation. High-dose purified eicosapentaenoic acid (EPA) has reduced cardiovascular events in selected high-risk populations, whereas low-dose combined EPA and docosahexaenoic acid (EPA + DHA) formulations have generally shown limited benefit. Omega-6 fatty acid evidence remains more limited, with most studies evaluating lipid markers rather than clinical cardiovascular outcomes. More investigation is needed into the potential benefits and optimal formulation of omega-3 fatty acids for cardiovascular outcomes in diabetes. Omega-6 fatty acids appear neutral or beneficial when replacing saturated fats, but their effects on clinical cardiovascular outcomes among individuals with diabetes remain uncertain. Future research should prioritize diabetes-specific trials examining patient characteristics, background diet, fatty acid formulation, dose, and long-term safety.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate Change and Cardiovascular Complications of Diabetes.","authors":"Corina Nava Suarez, Heranmaye Prasad, Andrew P Demidowich, Camille F Stanback, Qudsia Hussain, Mihail Zilbermint","doi":"10.1007/s11892-026-01641-6","DOIUrl":"10.1007/s11892-026-01641-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Climate change is emerging as a clinically relevant driver of cardiometabolic risk, particularly among individuals with diabetes. Increasing frequency and severity of extreme weather events, including heat waves, cold exposure, and air pollution, can disrupt physiological homeostasis and access to essential healthcare resources. People with diabetes are uniquely vulnerable due to impaired thermoregulation, increased risk of dehydration, and high prevalence of cardiovascular and kidney disease.</p><p><strong>Recent findings: </strong>Temperature extremes impose significant cardiovascular stress. Heat exposure promotes dehydration, hemoconcentration, and increased cardiac workload, contributing to ischemia, arrhythmia, and heart failure. Cold exposure increases vascular resistance and blood pressure, further elevating cardiovascular risk. In parallel, air pollution and wildfire smoke amplify systemic inflammation, oxidative stress, and endothelial dysfunction, accelerating atherosclerosis and increasing the likelihood of acute cardiovascular events. Clinical risk is further modified by age, comorbidities, socioeconomic factors, and access to healthcare infrastructure. Clinically, these findings support anticipatory management strategies, including patient education on heat and cold exposure, proactive medication adjustment, and closer monitoring during periods of environmental stress. Effective mitigation requires a multilevel approach, including patient education, medication management, disaster preparedness, and climate-resilient health systems. Integrating environmental data into clinical care and the use of predictive tools may enable proactive risk reduction. Climate change should be recognized as an emerging cardiovascular risk multiplier in diabetes, requiring coordinated action across clinical care, public health, and policy.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Digital Behavioral Approaches to Improve Medication Adherence in Type 2 Diabetes.","authors":"Yen-Ming Huang, Pin-Heng Tiao, Olayinka Shiyanbola","doi":"10.1007/s11892-026-01642-5","DOIUrl":"10.1007/s11892-026-01642-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Consistent medication adherence is fundamental for achieving favorable health outcomes in diabetes care; however, attaining optimal adherence remains a challenge. This review summarized recent evidence on digital behavioral interventions designed to improve medication adherence in type 2 diabetes (T2D) and identified key components commonly incorporated in these interventions.</p><p><strong>Recent findings: </strong>Thirty-two studies evaluating digital strategies to support medication adherence were identified. Interventions were delivered through a range of digital platforms, including mobile apps, short message service messaging, telemedicine systems, conversational artificial intelligence, and remote monitoring technologies. Medication adherence was assessed using a variety of measures, including self-reported adherence questionnaires, medication-taking records, and refill-based measures. Most studies reported improvements in medication adherence, and several also observed improvements in glycemic outcomes, most commonly A1C. Effective interventions frequently combined reminders, educational content, self-monitoring tools, and patient-provider communication. Digital behavioral interventions represent increasingly utilized strategies to promote medication adherence among individuals with T2D. Multifaceted digital approaches that integrate behavioral support, monitoring, and communication may enhance long-term diabetes self-management and treatment engagement. Recent advances have focused on improving personalization, integration across digital platforms, and interactive patient support rather than introducing entirely new digital modalities.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hidden Everyday-Life Burden of Pediatric Type 1 Diabetes: A Household Implementation Framework for Modern Diabetes Technology and Family Care.","authors":"Zsanett Tesch, Norbert Buzás","doi":"10.1007/s11892-026-01643-4","DOIUrl":"10.1007/s11892-026-01643-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Frameworks that classify the financial burdens of managing pediatric type 1 diabetes (T1D) primarily focus on measurable material hardship, affordability, and cost-related distress and therefore do not sufficiently detail the household-level resources that care requires from families. This study is a conceptual narrative review that aims to integrate the missing elements into a new three-level burden model, thereby linking the costs visible in clinical care, the household implementation burden borne by families, and the lived everyday experience of the child-parent-family triad. The proposed contribution of the model is to interpret the sustainability of modern T1D care not exclusively in terms of technology access, reimbursement, or clinical effectiveness, but also as a function of families' temporal, digital, organizational, and decision-making capacity in relation to everyday self-management, educational-setting coordination, caregiver time investment, digital health literacy, and the digital divide.</p><p><strong>Recent findings: </strong>The literature documents direct healthcare costs, out-of-pocket expenses, informal care, dietary adaptation, technology-related costs, parental distress, and time burden well when considered separately. However, these elements often do not appear as an integrated, cumulative household implementation burden. In pediatric T1D, the actual usability and sustainability of technology depend not only on device availability and reimbursement but also on the family's organizational, digital, temporal, and decision-making capacity. The T1D-ELB-P framework interprets the burdens placed on families as an organizing principle: it does not merely list domains but shows how financial, digital, temporal, decision-making, and institutional requirements can accumulate as household implementation burdens. The proposed Type 1 Diabetes Everyday-Life Burden-Pediatric framework (T1D-ELB-P) conceptualizes the everyday-life economic burden of pediatric type 1 diabetes as a complementary dimension interpretable at the household and caregiver levels. It highlights five interrelated domains: lifestyle and dietary adaptation; non-reimbursed or partially reimbursed consumables and accessories; digital infrastructure and digital health literacy; time, attention, and decision burden; and educational, extracurricular, and workplace coordination. In this model, technology is not a separate focus but a cross-cutting factor that makes the implementation work borne by families visible across several domains. The clinical and health-policy significance of the framework lies in its highlighting of how the real-world use of modern T1D care is embedded in the everyday functioning of the child-parent-family triad. Future cost-of-illness, health technology assessment, and patient-centered studies would benefit from explicitly measuring family implementation costs and capacities.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence in GLP-1-Based Therapy Among Adults with Obesity and Type 2 Diabetes: A Narrative Review of Definitions, Real-World Outcomes, and Determinants.","authors":"Tzu Wang, Olayinka O Shiyanbola","doi":"10.1007/s11892-026-01639-0","DOIUrl":"10.1007/s11892-026-01639-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Persistence with glucagon-like peptide-1 (GLP-1)-based therapies is important for sustained weight loss and glycemic control in adults with coexisting obesity and type 2 diabetes. This narrative review examined how persistence has been defined and measured, real-world patterns of continuation and discontinuation, factors associated with persistence, reasons for discontinuation, and supportive strategies in this population.</p><p><strong>Recent findings: </strong>Seven studies met the inclusion criteria, with follow-up ranging from 6 months to 2 years. Persistence generally declined over time and often fell below 60% by 12 to 24 months, although estimates varied by refill-gap definitions and analytic approaches. Discontinuation reached 64.1% at 2 years in one large cohort, and treatment interruption with reinitiation was common. Persistence varied by age, income, gastrointestinal adverse events, weight reduction, body mass index-related measures, GLP-1 agent, formulation, and dosing schedule. Only two studies reported patient-level reasons for discontinuation, most commonly adverse effects, and none described structured behavioral or supportive strategies. Persistence with GLP-1-based therapies among adults with obesity and type 2 diabetes is variable and often declines within the first one to two years. More consistent definitions, closer attention to patient experiences, and routine-care support strategies are needed to improve long-term continuation.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}