Current Diabetes Reports最新文献

{"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":"https://doi.org/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":"","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":"","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":"https://doi.org/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":"","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":"","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}

{"title":"Applications of Continuous Glucose Monitoring in Cognitive Research in Diabetes: a Scoping Review.","authors":"Jeeyeon Kim, Jayeong Kim, Heather Cuevas, Anna Kratz","doi":"10.1007/s11892-026-01638-1","DOIUrl":"10.1007/s11892-026-01638-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Continuous glucose monitoring (CGM) has increasingly been incorporated into studies examining cognitive function in people with diabetes. This scoping review systematically maps how CGM has been applied in cognitive research among individuals with diabetes to characterize current methodological approaches, identify key knowledge gaps, and inform future research.</p><p><strong>Recent findings: </strong>A scoping review was conducted following Arksey and O'Malley's framework. A systematic search of five electronic databases (PubMed, CINAHL, Cochrane Library, EMBASE, PsycINFO) was performed. Cognitive outcomes were extracted and mapped to the International Classification of Functioning, Disability and Health framework. Twenty-one studies met the inclusion criteria. CGM data completeness was consistently high, with 84-100% of expected CGM data captured, supporting the feasibility of intensive glucose monitoring in cognitive research in diabetes. Considerable heterogeneity was observed in cognitive domains and assessment tools. Most studies evaluated executive function, memory, and attention, whereas psychomotor, language, and perceived cognitive functions were less frequently assessed. More than 10 distinct instruments were used to assess memory and executive function. Across studies, similar cognitive domains were examined regardless of the specific CGM metrics employed. Research examining CGM and cognitive function in diabetes is characterized by substantial methodological variability in both CGM metrics and cognitive assessments. These findings underscore the need for greater standardization to improve cross-study comparability and to advance CGM-informed cognitive research, including the development of personalized interventions to support cognitive health through optimized glucose management in people with diabetes.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677443","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":"Insulin-Related Disordered Eating Behaviour: A Scoping Review of Evidence.","authors":"Amy Shelford, Paul E Jenkins, Kate Harvey","doi":"10.1007/s11892-026-01637-2","DOIUrl":"10.1007/s11892-026-01637-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Current understanding of insulin-related disordered eating behaviour is limited by inconsistencies in terminology and measurement. Prevalence of the behaviour and characteristics of individuals are unclear. How best to intervene and with whom is therefore unknown. This scoping review summarises existing knowledge as a first step to addressing the problem. Eligible sources investigated individuals with T1D restricting or inflating insulin with disordered eating motivations. Charted data included study aims, sample characteristics, measures, and key findings.</p><p><strong>Recent findings: </strong>Samples converged on adolescent females in USA, Canada and western Europe. Numerous measures were used, few had received extensive validation. Prevalence estimates, and models of development and maintenance were inconsistent. The validity and generalisability of measures should be improved, particularly so that diverse perspectives (e.g., males, non-Western cultures), so far overlooked, are captured. Identity and social relationships appeared particularly important in the development and maintenance of insulin-related disordered eating behaviour and recovery, and could be a potential target for interventions.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600154","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":"Alternative Payment Models and Diabetes Outcomes.","authors":"Marshall H Chin","doi":"10.1007/s11892-026-01636-3","DOIUrl":"10.1007/s11892-026-01636-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Determine whether and how alternative payment models (APMs) impact diabetes care and outcomes. Explain what APMs are and highlight key principles of effective APMs. Provide a conceptual model for how APMs can support transformation to evidence-based population health delivery models that improve diabetes outcomes.</p><p><strong>Recent findings: </strong>Advanced APMs with shared savings or global budgets, along with quality incentives, tended to improve diabetes and composite chronic condition outcomes, and can reduce Medicare Part A hospital and Part B outpatient costs. Advanced APMs, particularly models with global budgets that hold health care organizations accountable for total cost of care and quality of care, can improve diabetes outcomes and reduce costs. Careful design and implementation of APMs are essential to provide the appropriate mix of incentives, support, and risk for participants to succeed in APMs and develop effective population health management models.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535475","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":"Plasticizing Diabetes Care: The Metabolic Threat of Plastic-Associated Endocrine Disruptors and Micro-/Nanoplastics in Clinical Medicine.","authors":"Robert M Sargis, Sirimon Reutrakul, Leonardo Trasande, Angel Nadal","doi":"10.1007/s11892-026-01635-4","DOIUrl":"10.1007/s11892-026-01635-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Diabetes care is characterized by the widespread use of plastics. With plastic-associated endocrine-disrupting chemicals (EDCs) implicated in diabetes pathogenesis, this review examines how medical plastics relate to diabetes and related disorders and proposes interventions to improve the situation.</p><p><strong>Recent findings: </strong>Plastic-associated EDCs and micro-/nanoplastics (MNPs) are linked to metabolic dysfunction. Medical care exposes patients to these agents; however, the precise contribution of diabetes care to these exposures and their associated adverse health effects remains poorly defined. Diabetes care is an increasingly important contributor to plastic pollution and climate change, yet inadequate systems exist to mitigate its environmental impact. Plastic-associated EDCs and MNPs remain an underappreciated metabolic health threat. Mitigating the deleterious impacts of plastics on human and planetary health requires concerted actions from manufacturers, scientists, policymakers, professional organizations, healthcare providers, and patients. Doing so has the potential to improve metabolic health and promote health equity.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430027","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":"Digital Management of Early-Onset Type 2 Diabetes: Empowerment, Challenges, and Future Outlook.","authors":"Li-Jun Guo, Kah-Seng Low, Sok-Kun Tae, Lee-Ling Lim","doi":"10.1007/s11892-026-01633-6","DOIUrl":"10.1007/s11892-026-01633-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Early-onset type 2 diabetes (EOT2D), defined as a diabetes diagnosis before 40 years of age, is rising globally and associated with an aggressive disease course and early complications. This review examines the role of digital health technologies (DHT) in addressing the unique clinical and life-course challenges of EOT2D.</p><p><strong>Recent findings: </strong>DHT, including continuous glucose monitoring, mobile health applications, digital therapeutics, telemedicine, remote patient monitoring, wearable devices, and artificial intelligence-based analytics, have demonstrated modest improvements in glycemic control, weight management, and patient engagement in people with type 2 diabetes. However, evidence in adults with EOT2D remains limited. Compared with usual-onset T2D, people with EOT2D may derive particular benefits due to higher digital literacy, greater lifestyle variability, and longer anticipated disease duration. Although DHT shows promise for improving empowerment and care integration in EOT2D, important gaps persist, including a lack of EOT2D-specific trials, digital divide-related inequities, interoperability challenges, and reimbursement barriers. Future research should prioritize tailored interventions and hybrid care models to optimize long-term outcomes in this high-risk population.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419577","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":"Continuous Glucose Monitoring in Type 2 Diabetes: Clinical Outcomes, Disparities in Access, and Cost-effectiveness.","authors":"Giuliana Perini Villanueva, Walter M Solorzano, Estelle Everett","doi":"10.1007/s11892-026-01631-8","DOIUrl":"10.1007/s11892-026-01631-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes recent evidence on continuous glucose monitoring (CGM) in adults with type 2 diabetes mellitus (T2D), focusing on clinical effectiveness, patient-reported outcomes, disparities in use, and policy and economic considerations.</p><p><strong>Recent findings: </strong>Studies from 2020 to 2025 show that CGM use in T2D is associated with consistent improvements in glycosylated hemoglobin (HbA1c), time in range, and diabetes self-management across insulin and non-insulin treatment regimens. Emerging observational data suggest reductions in mortality and health care utilization, and cost-effectiveness analyses consistently demonstrate that CGM represents a high-value intervention across payer settings. Despite these benefits, CGM uptake remains variable, with persistent disparities by age, race, and ethnicity, insurance coverage, and care setting. CGM is an effective and cost-effective tool for T2D management, but inequities in access limit its impact. Future research should address implementation in safety-net and primary care settings, evaluate over-the-counter CGM, and assess long-term clinical and health system outcomes.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293035","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":"Beyond Inflammation - A Multidisciplinary Approach to Managing Obesity and Cardiometabolic Risk in Inflammatory Bowel Disease.","authors":"Samantha L Plush, Peter Litwin, Sangwoo Han, Robert V Bryant, Saravana Kumar, Patricia Kaazan, Alice S Day","doi":"10.1007/s11892-026-01627-4","DOIUrl":"10.1007/s11892-026-01627-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Adults with inflammatory bowel disease (IBD) demonstrate a high prevalence of obesity, metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiometabolic comorbidities. Cardiovascular disease (CVD) is a leading cause of mortality in IBD. This review examines cardiometabolic and obesity screening, and management within IBD models of care to optimise chronic disease management.</p><p><strong>Recent findings: </strong>Obesity prevalence in IBD has increased to 40%. Chronic systemic inflammation driven by visceral adiposity, proinflammatory cytokine production, insulin resistance and vascular endothelial dysfunction represent a unifying mechanism linking IBD, MASLD and CVD. Proactive management of cardiometabolic risk is not prioritised within traditional IBD service models. Therapeutic approaches to manage obesity and lower CVD risk in this cohort with concurrent optimisation of IBD control include dietary and lifestyle intervention through to anti-obesity pharmacotherapy and bariatric procedures. Integrated multidisciplinary models of care that leverage existing infrastructure and shared-care partnerships with primary care, proactive risk identification and management strategies should be adopted within specialist IBD services. As obesity, MASLD and CVD emerge as major contributors of morbidity and mortality in IBD, failure to systematically address cardiometabolic risk represents a critical gap in contemporary IBD care. Embedding proactive screening and multidisciplinary management within existing IBD infrastructure offers immediate actionable opportunity to improve long-term outcomes beyond inflammatory control.</p>","PeriodicalId":10898,"journal":{"name":"Current Diabetes Reports","volume":"26 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13279483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270594","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}