Diabetes Care最新文献

{"title":"Erratum. Sodium–Glucose Cotransporter 2 Inhibitor Use and Risk of Liver-Related Events in Patients With Type 2 Diabetes: A Meta-analysis of Observational Cohort Studies. Diabetes Care 2025;48:1042–1052","authors":"Alessandro Mantovani, Riccardo Morandin, Maria Giovanna Lando, Veronica Fiorio, Grazia Pennisi, Salvatore Petta, Norbert Stefan, Herbert Tilg, Christopher D. Byrne, Giovanni Targher","doi":"10.2337/dc27-er01","DOIUrl":"https://doi.org/10.2337/dc27-er01","url":null,"abstract":"In the article cited above, funding information required by Piano Nazionale di Ripresa e Resilienza (PNRR) was inadvertently omitted. The following text has been added: “funded by the European Union - Next Generation EU - NRRP M6C2 - Investment 2.1 Enhancement and strengthening of biomedical research in the NHS. Project Cod. PNRR-MAD-2022-12375656, title ‘RATIONAL: Risk strAtificaTIon Of Nonalcoholic fAtty Liver’ – CUP: I75E22000540006.” The authors apologize for the omission. The online version of the article (https://doi.org/10.2337/dc25-0282) has been updated with the required funding information.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"30 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Sex-Specific Mortality Risk in Type 1 Diabetes During the Era of Advanced Therapeutic Care","authors":"Adi Vinograd, Shiraz Vered, Liat Lev-Shalem, Shany Or, Noah Levek, Neriya Levran, Boris Fishman, Uri Hamiel, Ofir Vinograd, Yuliya Bazdarska, Violeta Iotova, Gabriel Chodick, Hertzel C. Gerstein, Gilad Twig, Orit Pinhas-Hamiel","doi":"10.2337/dc26-1472","DOIUrl":"https://doi.org/10.2337/dc26-1472","url":null,"abstract":"OBJECTIVE Amid major advances in diabetes care technologies, this study aimed to assess all-cause mortality risk among individuals diagnosed with type 1 diabetes in recent decades compared with matched control individuals. RESEARCH DESIGN AND METHODS This retrospective cohort study included all patients with type 1 diabetes diagnosed before age 35 between 2000 and 2022, identified through a validated registry from Maccabi Healthcare Services (MHS), a large state-mandated health care provider network. A diabetes-free comparison cohort was constructed using 1:4 propensity score matching by sex and age. Follow-up continued until 2023, death, or transfer from MHS, whichever occurred first. Cox regression and sensitivity analyses were performed. RESULTS Mortality rates among 4,299 individuals with type 1 diabetes (mean ± SD age at diagnosis, 17.4 ± 9.1 years) and 17,196 matched control individuals (45.6% female overall) were 131.0 and 35.2 per 100,000 person-years, respectively, with 112 deaths over 204,102 person-years. Type 1 diabetes was associated with higher mortality (hazard ratio [HR] 3.66; 95% CI 2.53–5.31), with consistent estimates after adjustment and sensitivity analyses. Excess mortality was greater in females than males (adjusted HR 8.40 [3.71–19.04] vs. 2.90 [1.78–4.72]; P-interaction = 0.02), although absolute mortality rates were higher in males. Mortality risk was higher in those diagnosed in 2000–2010 than in 2011–2022 (adjusted HR 4.36 [1.22–15.57] vs. 2.94 [1.31–6.60]), with follow-up truncated for comparability. CONCLUSIONS Type 1 diabetes was associated with higher risk of mortality, particularly among females. This association was attenuated among individuals diagnosed in more recent years.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"471 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps in Diagnosis and Treatment of Patients With Laboratory-Confirmed Diabetes: A National Cohort Study","authors":"Jim P. Stimpson,Yixin Tang,Robin Pena Bojorges,Joshua M. Liao","doi":"10.2337/dc26-1318","DOIUrl":"https://doi.org/10.2337/dc26-1318","url":null,"abstract":"OBJECTIVE To characterize gaps in diagnostic coding and pharmacologic treatment among adults with laboratory-confirmed diabetes. RESEARCH DESIGN AND METHODS We conducted a retrospective cohort study using national commercial and Medicare claims (2017–2023) linked to laboratory results. Adults with laboratory-confirmed diabetes and no prior diabetes/prediabetes were observed for 1 year. Outcomes were type 2 diabetes diagnostic coding and pharmacologic treatment initiation. RESULTS Among 27,650 adults with laboratory-confirmed diabetes, 66.6% received both a diagnosis code and pharmacologic treatment within 1 year; 19.7% received a diagnosis only, 4.1% received treatment only, and 9.6% received neither. Compared with HbA1c 6.5–6.9%, higher HbA1c was associated with progressively higher probabilities of diagnostic coding and treatment initiation, whereas greater comorbidity burden was associated with lower probabilities of both outcomes. CONCLUSIONS One-third of adults with laboratory-confirmed diabetes lacked claims-documented diagnostic coding, treatment, or both, with patterns of care defined by glycemic severity and comorbidity burden.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"74 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Type 2 Diabetes, 2026. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","authors":"Melanie J. Davies, Vanita R. Aroda, Mandeep Bajaj, Nuha A. ElSayed, Francesco Giorgino, Jennifer Green, Rita R. Kalyani, Nisa M. Maruthur, Chantal Mathieu, Sylvia E. Rosas, Peter Rossing, Tommy Slater, Tsvetalina Tankova, Pinar Topsever, Apostolos Tsapas, John B. Buse","doi":"10.2337/dci26-0141","DOIUrl":"https://doi.org/10.2337/dci26-0141","url":null,"abstract":"The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the consensus statement on the management of type 2 diabetes in nonpregnant adults, published since 2006 and last updated in 2022. The target audience is the multidisciplinary health care team providing diabetes care in the U.S. and Europe. A systematic examination of publications since 2022 informed new recommendations. This update has broadened the focus from the management of hyperglycemia to the holistic management of type 2 diabetes and its risk of associated multiple long-term conditions. Fundamental aspects of diabetes care include promoting healthy lifestyle behaviors (healthy eating, 24-h physical behaviors including sleep, and avoiding tobacco and substance use), alongside the provision of psychological support and weight management interventions. For the management of people living with type 2 diabetes, earlier use, potentially from diagnosis, of sodium–glucose cotransporter 2 (SGLT2) inhibitors and/or glucagon-like peptide 1 (GLP-1)-based therapies to offer organ protection and improve long-term outcomes in type 2 diabetes is advocated. Furthermore, earlier combination use of SGLT2 inhibitors and GLP-1–based therapies should be considered in people with concomitant cardiovascular disease, chronic kidney disease, and heart failure. Finally, the ability to transform outcomes for people living with type 2 diabetes is within our grasp through the consistent, equitable, and systematic implementation of strategies and therapies that are already available.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"218 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149085978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Susceptibility in Relative Maternal Protection From Type 1 Diabetes","authors":"Sarah D. Slack, Neha Venkatesh, Shane E. Ridoux, Kirk R. Hohsfield, Lauren A. Vanderlinden, Jill M. Norris, Randi K. Johnson","doi":"10.2337/dc26-1524","DOIUrl":"https://doi.org/10.2337/dc26-1524","url":null,"abstract":"OBJECTIVE Type 1 diabetes is half as common in offspring of mothers versus fathers with type 1 diabetes. We investigated whether selective loss of fetuses with high genetic risk during type 1 diabetes pregnancy explains this relative protection. RESEARCH DESIGN AND METHODS In 6,942 live births in The Environmental Determinants of Diabetes in the Young (TEDDY) cohort, we compared genetic susceptibility by family member with type 1 diabetes and tested whether it explained maternal protection from diabetes or its preclinical stages. RESULTS The type 1 diabetes Genetic Risk Score 2 extended (GRS2x) did not differ between children with mothers (P = 0.36) or siblings (P = 0.27) versus fathers with type 1 diabetes. Relative maternal protection from type 1 diabetes and islet autoimmunity (IA) was observed with GRS2x adjustment (diabetes: hazard ratio [HR] 0.50, P = 0.01; IA: HR 0.38, P = 0.006) and without adjustment but not during progression from IA to diabetes. This protection waned after age 6 years. CONCLUSIONS Intrauterine exposure to type 1 diabetes offers relative protection from IA during early childhood and is not explained by genetic susceptibility differences.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"13 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149085979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Resistance in the 21st Century: New Takes on an Old Problem—2025 Diabetes , Diabetes Care , and Diabetologia Expert Forum","authors":"Amalia Gastaldelli, Eunhee Choi, Karin Conde-Knape, Olga Göransson, Anna Krook, Sanna Lehtonen, Michael Roden, Patrick Schrauwen, Lauren M. Sparks, Martin Heni","doi":"10.2337/dci26-0142","DOIUrl":"https://doi.org/10.2337/dci26-0142","url":null,"abstract":"Insulin resistance is a hallmark of type 2 diabetes and several other metabolic diseases. However, efforts to improve insulin resistance are hindered by the biological complexity inherent to insulin action, as well as conceptual and methodological limitations to date. In September 2025, the editors of Diabetes, Diabetes Care, and Diabetologia convened an Expert Forum in advance of the 61st Annual Meeting of the European Association for the Study of Diabetes (EASD). Participants reviewed the latest research, clarified key concepts, and recommended future research priorities. Their insights were presented at a symposium during the EASD meeting and are offered in more detail here. The authors challenge the historical view of insulin resistance as a single, uniform pathophysiological condition, describing it instead as a diverse and highly plastic set of adaptive, maladaptive, acute, and chronic responses that manifest differently throughout the body, in numerous biological processes, within and among individuals, and under various physiological and environmental conditions. They describe existing methods of measuring whole-body and tissue-specific insulin resistance and offer a primer on the two main insulin signaling networks. Next, they review current therapeutic options, which offer mostly indirect effects on insulin resistance, and highlight promising strategies to inform the eventual development of true insulin-sensitizing agents. The authors call for continued investigation of the complex factors accounting for variability in insulin resistance, as well as pathway-specific defects, with the ultimate goal of developing targeted and more effective therapies for type 2 diabetes and the broader spectrum of cardiometabolic complications and related comorbidities.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"57 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Insulin Resistance Mosaic: Defect, Defense, or Both? A Perspective on What Insulin Resistance Means and Whether It Should be Treated","authors":"David E. James","doi":"10.2337/dci26-0146","DOIUrl":"https://doi.org/10.2337/dci26-0146","url":null,"abstract":"Insulin resistance is conventionally framed as a pathological defect in insulin action that contributes to type 2 diabetes and related metabolic disease and should therefore be identified and reversed. The comprehensive review by Gastaldelli and colleagues highlights a more complicated reality: insulin resistance is heterogeneous between individuals, tissues, pathways, and physiological states. I argue that this heterogeneity exposes a fundamental issue—insulin resistance is a phenotype, not a mechanism. It can arise through many molecular routes, occur in both disease and normal physiology, originate in different tissues, and long precede overt disease. I propose an “insulin resistance mosaic” in which its clinical significance depends on why and where insulin resistance develops, physiological compensation, environmental exposure, and end-organ vulnerability. Similar degrees of insulin resistance could therefore lead to very different clinical outcomes, remain compensated for decades, or even, in some contexts, be protective. This framework challenges the assumption that insulin resistance represents a single disease process that should invariably be overcome. Instead, we should determine why it has developed, where it resides, what it predicts, and whether modifying it improves clinical outcomes.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"63 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Peak Body Weight Loss With Semaglutide in the SELECT Trial","authors":"Ildiko Lingvay, Robert F. Kushner, Upendra Kaul, Alexander Kokkinos, A. Michael Lincoff, Denes Pall, Mikko Pietilä, Jorge Plutzky, Signe Stensen, Paweł Bogdański, Paul Brown, Cintia Cercato, Selcuk Dagdelen, John Deanfield, G. Kees Hovingh, Steven E. Kahn, Donna H. Ryan","doi":"10.2337/dc26-0784","DOIUrl":"https://doi.org/10.2337/dc26-0784","url":null,"abstract":"OBJECTIVE To evaluate whether clinically available baseline characteristics predict peak percentage body weight loss (%BWL) achieved with chronic use of semaglutide. RESEARCH DESIGN AND METHODS SELECT (Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity Trial) evaluated the cardiovascular benefits of semaglutide in adults (mean age 62, 72% men) with obesity and preexisting atherosclerotic disease without diabetes. This prespecified analysis evaluated participants randomized to semaglutide who continued treatment for a minimum of 1 year. Baseline demographics, medical history, laboratory variables, and clinical measurements were candidate predictors of peak %BWL evaluated in a general linear model estimated with ordinary least squares. RESULTS Among the 7,594 SELECT participants continuously treated with semaglutide for ≥1 year (representing 86.3% of those randomized to semaglutide), median peak %BWL was 12.5% (interquartile range [IQR] 7.9–17.9), achieved after a median of 19 months (IQR 10–30) of treatment. The full model predicted <10% of the variability in peak %BWL; female sex accounted for 85.3% of this model (explaining ≈8% of the variability). Semaglutide dose was associated with peak %BWL (median 6.0% [IQR 1.9–10.9] vs. 13.3% [IQR 9.0–18.4] for those with a maximum dose of 0.24 mg vs. 2.4 mg). The highest median peak %BWL was achieved by women (16.6% [IQR 10.9–23.4]) versus men (12.4% [IQR 8.4–16.9]). CONCLUSIONS The peak amount of weight loss expected following initiation of semaglutide cannot be predicted based on clinically available baseline characteristics; unmeasured biological, behavioral, or genetic differences are likely responsible for variability in individual response. Women treated with the highest dose of semaglutide experienced the largest %BWL.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"40 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Sulfonylurea-Sparing First-Line HNF4A-MODY Therapy With Sodium-Dependent Glucose Cotransporter 2 Inhibitors","authors":"Christopher Philbey","doi":"10.2337/dc26-1631","DOIUrl":"https://doi.org/10.2337/dc26-1631","url":null,"abstract":"","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"17 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Traditional Glycemic Measures: CGM Glycemic Profiles Reveal Associations With Cardiometabolic Risk in Individuals Without Diabetes","authors":"Bahar Bakhshi, Honghuang Lin, Naznin Sultana, Elizabeth Healey, Havelah Queen, Ge Gao, Sophie E. Claudel, Erika T. Minetti, Gary F. Mitchell, Joanne M. Murabito, Donald M. Lloyd-Jones, Michael C. Cheney, Devin W. Steenkamp, Matthew Nayor, Vanessa Xanthakis, Maura E. Walker, Nicole L. Spartano","doi":"10.2337/dc26-1197","DOIUrl":"https://doi.org/10.2337/dc26-1197","url":null,"abstract":"OBJECTIVE Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) may not fully capture the heterogeneity underlying dysglycemia or its associations with cardiometabolic risk factors (CMRFs). We cross-sectionally investigated whether continuous glucose monitoring (CGM) measures and glycemic profiles could reveal 10-year cardiovascular disease (CVD) risk and individual CMRFs among individuals without diabetes. RESEARCH DESIGN AND METHODS We included 1,356 participants without prevalent diabetes or CVD from the Framingham Heart Study, who wore a blinded Dexcom G6 Pro CGM for up to 10 days. CGM glycemic profiles were characterized using 1) binary classification of glycemic burden and variability and 2) unsupervised clustering of CGM measures. We performed multivariable-adjusted linear and logistic regression models to examine associations of CGM measures and profiles with 10-year CVD risk estimates (PREVENT equations) and individual CMRFs. RESULTS Participants’ mean was age 59.3 years; 55.8% were women, and 92.6% were non-Hispanic White. CGM measures were positively associated with 10-year CVD risk estimates and CMRFs. For example, 1 SD higher percentage of time spent at glucose levels >140 mg/dL (15.4%) was associated with 2% higher 10-year CVD risk estimates and 21–26% higher odds of hypertension and dyslipidemia, even after adjusting for FPG. Glycemic profiles representing higher CGM dysglycemia revealed discordance with traditionally defined glycemic status (FPG and HbA1c). Although 48.1–84.2% of individuals with traditionally defined prediabetes were included in CGM profiles representing higher dysglycemia, such profiles were associated with 6–7% higher 10-year CVD risk estimates, in addition to worse CMRFs. CONCLUSIONS Glycemic measures reflective of continuous glucose dynamics may provide additional insights into cardiometabolic risk beyond traditional measures.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"16 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148985098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}