Diabetes Care最新文献

The Effectiveness of Diabetes Prevention Programs Delivered in Primary Care for Individuals With Prediabetes or at Risk of Developing Type 2 Diabetes: A Systematic Review and Meta-analysis 糖尿病预防项目在糖尿病前期或2型糖尿病高危人群的初级保健中的有效性：一项系统回顾和荟萃分析

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-24 DOI: 10.2337/dc25-1877

Jinfan Qiang, Maduomethaa Pathmaraj, Tiffany Lo, Elizabeth M. Uleryk, Ella Huszti, Lusine Abrahamyan, Andrew D. Pinto

{"title":"The Effectiveness of Diabetes Prevention Programs Delivered in Primary Care for Individuals With Prediabetes or at Risk of Developing Type 2 Diabetes: A Systematic Review and Meta-analysis","authors":"Jinfan Qiang, Maduomethaa Pathmaraj, Tiffany Lo, Elizabeth M. Uleryk, Ella Huszti, Lusine Abrahamyan, Andrew D. Pinto","doi":"10.2337/dc25-1877","DOIUrl":"https://doi.org/10.2337/dc25-1877","url":null,"abstract":"BACKGROUND Prediabetes is a precursor of type 2 diabetes mellitus (T2DM), and lifestyle modifications are key preventive strategies. Primary care is central to prevention efforts, including screening, diagnosis, and follow-up. PURPOSE This systematic review and meta-analysis aimed to evaluate the effectiveness of lifestyle interventions delivered in primary care to patients at elevated risk of developing T2DM. DATA SOURCES We searched Medline and Embase from inception to 28 March 2024. STUDY SELECTION We screened 639 records and included 14 eligible studies of lifestyle-based diabetes prevention programs. Eligible participants had prediabetes or high diabetes risk scores, and interventions were delivered in primary care. DATA EXTRACTION Outcomes included diabetes incidence, glycemic and anthropometric indicators, physical activity, and diet. DATA SYNTHESIS Pooled mean differences (MD) were estimated using inverse variance methods; leave-one-out cross-validation (LOOCV) addressed heterogeneity (&gt;50%). Meta-analysis found no significant effects on diabetes incidence (relative risk 0.82; 95% CI 0.65–1.02), and pooled MD on HbA1c (MD −0.41, 95% CI −0.94 to 0.12), fasting glucose, 2-h glucose, body weight, BMI, waist circumference (MD −1.13, 95% CI −2.40 to 0.13), or systolic and diastolic blood pressure. LOOCV identified one study driving heterogeneity in several outcomes. LIMITATIONS English-only publications may reduce generalizability. CONCLUSIONS This review found no significant differences in diabetes incidence or other key indicators of T2DM, with certainty of evidence varying from moderate to low. Future studies should test integrated screening, referral, and social support strategies in routine care for high-risk groups.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"13 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147739352","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}

引用次数: 0

Life Course Cumulative BMI Burden From Childhood to Adulthood and Risk of Metabolic Multimorbidity: A 36-Year Prospective Cohort Study 从童年到成年的生命过程累积BMI负担和代谢多病的风险：一项36年的前瞻性队列研究

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-22 DOI: 10.2337/dc25-2889

Tongshuai Guo, Huimin Li, Ziqi Liu, Yanjie Yang, Jintang Xie, Jie Ren, Mingjun He, Chao Chu, Chao Li, Yu Yan, Yue Sun, Dan Wang, Guilin Hu, Mingfei Du, Hao Jia, Yinkun Yan, Min Zhao, Costan G. Magnussen, Bo Xi, Jianjun Mu

{"title":"Life Course Cumulative BMI Burden From Childhood to Adulthood and Risk of Metabolic Multimorbidity: A 36-Year Prospective Cohort Study","authors":"Tongshuai Guo, Huimin Li, Ziqi Liu, Yanjie Yang, Jintang Xie, Jie Ren, Mingjun He, Chao Chu, Chao Li, Yu Yan, Yue Sun, Dan Wang, Guilin Hu, Mingfei Du, Hao Jia, Yinkun Yan, Min Zhao, Costan G. Magnussen, Bo Xi, Jianjun Mu","doi":"10.2337/dc25-2889","DOIUrl":"https://doi.org/10.2337/dc25-2889","url":null,"abstract":"OBJECTIVE To examine the associations between cumulative BMI burden from childhood to adulthood and the risk of adult metabolic multimorbidity. RESEARCH DESIGN AND METHODS This prospective cohort study used data from the Hanzhong Adolescent Hypertension Study (1987–2023). A total of 2,446 participants with at least two BMI measurements in both childhood (6–18 years) and adulthood (19–52 years) were included. Cumulative BMI exposure was quantified using total and incremental area under the curve (AUC). Outcomes included metabolic multimorbidity, defined as the presence of two or more or three or more metabolic diseases, specifically hypertension, diabetes, dyslipidemia, elevated liver enzymes/bilirubin, and kidney damage. RESULTS Higher total and incremental BMI AUC during childhood, adulthood, and over the life course were consistently associated with an increased risk of adult metabolic multimorbidity (two or more diseases). For total AUC, odds ratios (ORs) ranged from 1.51 to 2.59 (all P &lt; 0.05); for incremental AUC, ORs ranged from 1.94 to 4.33 (all P &lt; 0.05). Compared with total AUC, incremental AUC showed a stronger association with metabolic multimorbidity in childhood (OR 4.33 [95% CI 2.93, 6.40] vs. 1.51 [1.17, 1.95], respectively). Conversely, total AUC exhibited a stronger association in adulthood than in childhood (OR 2.51 [2.08, 3.04] vs. 1.94 [1.62, 2.31]). Furthermore, the associations for adulthood and life course BMI AUC were significantly stronger in males than in females (P for interaction &lt; 0.05). CONCLUSIONS These findings highlight the importance of life stage–specific strategies: curbing rapid BMI gain in childhood and maintaining long-term weight control throughout adulthood.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"55 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731780","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}

引用次数: 0

Long-term Air Pollution and Overall and Regional Body Composition in Older Adults With Overweight or Obesity and Metabolic Syndrome 长期空气污染与超重或肥胖和代谢综合征老年人整体和局部身体成分的关系

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-21 DOI: 10.2337/dc25-2497

Ariadna Curto, Jadwiga Konieczna, Antoni Colom, Itziar Abete, Kees de Hoogh, Gerard Hoek, Jordi Salas-Salvadó, J. Vicente Martín-Sánchez, Ramón Estruch, Josep Vidal, Estefania Toledo, Jesús F. García-Gavilán, José Antonio de Paz, Rosa Casas, Nuria Goñi-Ruiz, Héctor Vázquez-Lorente, Montserrat Fitó, J. Alfredo Martínez, Dora Romaguera

{"title":"Long-term Air Pollution and Overall and Regional Body Composition in Older Adults With Overweight or Obesity and Metabolic Syndrome","authors":"Ariadna Curto, Jadwiga Konieczna, Antoni Colom, Itziar Abete, Kees de Hoogh, Gerard Hoek, Jordi Salas-Salvadó, J. Vicente Martín-Sánchez, Ramón Estruch, Josep Vidal, Estefania Toledo, Jesús F. García-Gavilán, José Antonio de Paz, Rosa Casas, Nuria Goñi-Ruiz, Héctor Vázquez-Lorente, Montserrat Fitó, J. Alfredo Martínez, Dora Romaguera","doi":"10.2337/dc25-2497","DOIUrl":"https://doi.org/10.2337/dc25-2497","url":null,"abstract":"OBJECTIVE To examine the relationship between long-term air pollution exposure, including black carbon (BC), fine particulate matter (PM2.5), and nitrogen dioxide (NO2), and total fat mass, visceral fat mass, and lean mass in older adults with overweight or obesity and metabolic syndrome. RESEARCH DESIGN AND METHODS We included 1,454 older adults (aged 54–75 years; 48% female) from the PREDIMED-Plus trial in Spain who underwent baseline DXA scans at recruitment (2013–2016) and at 1- and 3-year follow-up. Annual air pollution exposure was assigned at participants’ baseline residential address at 100 m resolution. We used linear mixed-effect regression models with interaction terms for exposure and time to examine longitudinal associations with body composition, also stratifying by sex, age, and physical activity. RESULTS At baseline, a 1× 10−5/m increase in BC was associated with 1.01% (95% CI 0.31–1.71) higher body fat percentage, –0.97% (95% CI –1.64 to –0.30) lower lean mass percentage, and –0.74 kg (95% CI –1.37 to –0.12) lower lean mass. PM2.5 and NO2 showed similar relationships with body fat and lean mass percentage at baseline. These associations persisted in years 1 and 3 for BC and PM2.5. In age-stratified analyses, associations with visceral fat mass were observed only in participants younger than 65 years. Associations did not meaningfully differ by sex or physical activity. CONCLUSIONS Long-term air pollution exposure was adversely associated with body composition over 3 years. Results indicate air pollution is associated with fat accumulation and lean mass loss in metabolically vulnerable older adults.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"16 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731781","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}

引用次数: 0

Seasonal BMI Amplitude and Risk of Kidney Function Decline in Japanese Adults With Type 2 Diabetes (JDDM 82) 日本成人2型糖尿病患者的季节性BMI振幅与肾功能下降的风险（jddm82）

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-14 DOI: 10.2337/dc26-0082

Ryota Toki, Masaya Sakamoto, Masahiro Yuki, Miho Iida, Michiko Yamazaki, Seiichi Ichikawa, Ryuzo Horiuchi, Hiroshi Maegawa, Tomonori Okamura, Toru Takebayashi

{"title":"Seasonal BMI Amplitude and Risk of Kidney Function Decline in Japanese Adults With Type 2 Diabetes (JDDM 82)","authors":"Ryota Toki, Masaya Sakamoto, Masahiro Yuki, Miho Iida, Michiko Yamazaki, Seiichi Ichikawa, Ryuzo Horiuchi, Hiroshi Maegawa, Tomonori Okamura, Toru Takebayashi","doi":"10.2337/dc26-0082","DOIUrl":"https://doi.org/10.2337/dc26-0082","url":null,"abstract":"OBJECTIVE Body weight variability is linked to cardiometabolic outcomes, but its renal impact in type 2 diabetes remains uncertain. We tested whether the magnitude of seasonal BMI fluctuation is independently associated with kidney function decline. RESEARCH DESIGN AND METHODS We analyzed a nationwide, multicenter Japanese cohort (2014–2020). Monthly BMI was modeled using seasonal-trend locally estimated scatterplot smoothing to quantify each participant’s within-year peak-to-trough difference. The primary outcome was ≥40% decline in estimated glomerular filtration rate (eGFR). Secondary outcomes were ≥30% eGFR decline, creatinine doubling, incident chronic kidney disease (CKD) stage ≥3, and kidney failure. Associations were estimated using multivariable Cox models with clinic as a random effect. RESULTS Among 6,700 outpatients (median follow-up: 6.8 years), 779 reached the primary end point. Each 1-SD increase in BMI fluctuation was associated with higher risk of ≥40% eGFR decline (hazard ratio [HR] 1.23, 95% CI 1.16–1.31). The highest versus lowest tertile showed a 1.7-fold increased risk (HR 1.72, 95% CI 1.42–2.09). Patterns were consistent for ≥30% eGFR decline (HR 1.18, 95% CI 1.13–1.23), creatinine doubling (HR 1.30, 95% CI 1.17–1.45), and incident CKD stage ≥3 (HR 1.11, 95% CI 1.07–1.16). Longitudinal analyses showed steeper eGFR decline in the highest-fluctuation group. Results were robust across sensitivity analyses, including models for time-varying medication exposure. CONCLUSIONS In type 2 diabetes, larger intra-annual BMI fluctuations were independently and dose-dependently associated with kidney function decline. Seasonal BMI amplitude may identify higher-risk individuals; whether reducing seasonal BMI fluctuations improves kidney outcomes warrants prospective evaluation.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"33 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147684645","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}

引用次数: 0

Diabetic Retinopathy in Parous Women With and Without Previous Gestational Diabetes Mellitus: A Nationwide Register-Based Cohort Study 有或没有妊娠期糖尿病的分娩妇女的糖尿病视网膜病变：一项基于全国登记的队列研究

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-03 DOI: 10.2337/dc25-3074

Maria Hornstrup Christensen, Christina Anne Vinter, Maria Houborg Petersen, Marianne Skovsager Andersen, Jakob Grauslund, Dorte Moeller Jensen

{"title":"Diabetic Retinopathy in Parous Women With and Without Previous Gestational Diabetes Mellitus: A Nationwide Register-Based Cohort Study","authors":"Maria Hornstrup Christensen, Christina Anne Vinter, Maria Houborg Petersen, Marianne Skovsager Andersen, Jakob Grauslund, Dorte Moeller Jensen","doi":"10.2337/dc25-3074","DOIUrl":"https://doi.org/10.2337/dc25-3074","url":null,"abstract":"OBJECTIVE To investigate previous gestational diabetes mellitus (GDM) as a potential risk factor for diabetic retinopathy (DR) in women with diabetes, including the potential role of GDM severity and hypertension after pregnancy. RESEARCH DESIGN AND METHODS A nationwide, register-based cohort study including all women giving birth in Denmark in 1997–2018. We defined GDM and DR using ICD-10 codes. GDM severity was a proxy based on insulin treatment during GDM pregnancy. Subsequent diabetes and hypertension were based on ICD-10 codes and/or medication postpregnancy. Statistical analyses included Cox regression. RESULTS The complete study population comprised 708,250 women. The GDM prevalence was 3.4%, and the overall median follow-up was 12 years. Diabetes developed subsequently in 18,556 women, and DR occurred in 655 of these. In the women who developed diabetes, previous GDM was associated with a threefold higher risk of DR (adjusted hazard ratio [aHR] 3.0 [95% CI 2.6–3.6]). The risk increased with increasing GDM severity (aHRs 5.6 [95% CI 4.5–6.9] and 2.4 [95% CI 2.0–2.9]) in women with previous GDM with and without insulin treatment, respectively, compared with women without previous GDM [reference group]). In women with subsequent hypertension, GDM exposure was associated with a 2.7-fold higher DR risk (aHR 2.7 [95% CI 2.1–3.5]). CONCLUSIONS This large population-based study identified GDM as significant risk factor for DR in parous women with diabetes, a risk that increased with increasing GDM severity and postpregnancy hypertension development. On the basis of this study, planning of DR screening strategies should include awareness of GDM history.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"60 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599189","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}

引用次数: 0

Intake of Fiber From Different Food Sources and Type 2 Diabetes Risk: An Integrated Analysis of Epidemiological and Multiomic Data 从不同食物来源摄入纤维与2型糖尿病风险：流行病学和多组学数据的综合分析

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-01 DOI: 10.2337/dc25-2957

Yi Wan, Hala B. Alessa, Marta Guasch-Ferré, Deirdre K. Tobias, Kyu Ha Lee, JoAnn E. Manson, Walter C. Willett, Qi Sun, Frank B. Hu

{"title":"Intake of Fiber From Different Food Sources and Type 2 Diabetes Risk: An Integrated Analysis of Epidemiological and Multiomic Data","authors":"Yi Wan, Hala B. Alessa, Marta Guasch-Ferré, Deirdre K. Tobias, Kyu Ha Lee, JoAnn E. Manson, Walter C. Willett, Qi Sun, Frank B. Hu","doi":"10.2337/dc25-2957","DOIUrl":"https://doi.org/10.2337/dc25-2957","url":null,"abstract":"OBJECTIVE To examine the association between fiber from various food sources and type 2 diabetes (T2D) risk, as well as the molecular profiles involved. RESEARCH DESIGN AND METHODS Using data from three large prospective U.S. cohorts comprising 195,222 participants observed for up to 34 years, we evaluated the association between fiber from various food sources and T2D risk. We also assessed the association between fiber intake, plasma metabolic biomarkers, and a metabolomic profile indicative of T2D risk. Additionally, we examined gut microbial features related to fiber intake and the T2D metabolomic profile. RESULTS During follow-up, we documented 18,369 incident T2D cases. Higher intakes of total fiber (hazard ratio [HR] comparing extreme quintiles 0.88; 95% CI 0.82, 0.94), cereal fiber (HR 0.77; 95% CI 0.73, 0.82), and fruit fiber (HR 0.82; 95% CI 0.78, 0.87) were each associated with a lower T2D risk. Greater intakes of total fiber, cereal fiber, and fruit fiber, but not vegetable fiber, were linked to more favorable plasma profiles of insulinemic, lipid, and inflammatory biomarkers and a metabolomic profile indicative of a lower T2D risk. We also identified multiple gut microbial species, such as Faecalibacterium prausnitzii, Ruminococcus lactaris, and Gemmiger formicilis, along with relevant butyric acid–producing enzymes, all of which were associated with higher fruit fiber intake and a metabolomic profile indicating a lower likelihood of T2D development. CONCLUSIONS Higher intakes of total, cereal, and fruit fiber are associated with a lower risk of T2D and a more favorable metabolic profile, with the gut microbiome potentially contributing to the beneficial association of fruit fiber.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"149 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147587118","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}

引用次数: 0

Impact of Body Size on Preclinical Type 1 Diabetes Development and Progression 体型对临床前1型糖尿病发生和进展的影响

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-03-31 DOI: 10.2337/dci25-0134

Raquel M. Gupta, Heba M. Ismail, Alejandro F. Siller, Jonah Pesikoff, Sridevi Devaraj, Ashok Balasubramanyam, Maria J. Redondo

{"title":"Impact of Body Size on Preclinical Type 1 Diabetes Development and Progression","authors":"Raquel M. Gupta, Heba M. Ismail, Alejandro F. Siller, Jonah Pesikoff, Sridevi Devaraj, Ashok Balasubramanyam, Maria J. Redondo","doi":"10.2337/dci25-0134","DOIUrl":"https://doi.org/10.2337/dci25-0134","url":null,"abstract":"Type 1 diabetes arises from the interplay of genetic susceptibility and environmental exposures, leading to autoimmune β-cell destruction. Although disease-modifying therapies (DMTs) can delay progression to clinical (stage 3) type 1 diabetes, treatment responses remain inconsistent and transient. The marked heterogeneity of type 1 diabetes, shaped by age, sex, race/ethnicity, and genetic background, underscores the need to elucidate distinct mechanistic pathways. Among environmental contributors, obesity stands out as a compelling modifiable target. Data from The Environmental Determinants of Diabetes in the Young (TEDDY), Type 1 Diabetes TrialNet, and other longitudinal cohorts link BMI and adiposity to the onset of islet autoimmunity, progression through preclinical stages, and development of stage 3 type 1 diabetes. These associations are not uniform; heightened susceptibility to adiposity-related risk is seen among younger children, Hispanic populations, and individuals with specific HLA genotypes. Despite robust epidemiologic evidence, the biological pathways connecting elevated BMI to autoimmune β-cell destruction remain incompletely defined. Emerging data implicate a network of immunologic and metabolic disturbances, including insulin resistance, β-cell stress, chronic adipose tissue inflammation, altered adipokine signaling, and gut microbiome changes, that collectively heighten β-cell vulnerability, amplify autoreactive immune responses, and drive metabolic decompensation toward clinical disease. Elucidating these mechanisms and identifying related biomarkers are critical to advancing precision prevention. In future studies, investigators should evaluate whether modifying elevated BMI or targeting obesity-associated immunologic and metabolic pathways can alter the preclinical trajectory of type 1 diabetes. Such mechanistic understanding may help curb type 1 diabetes incidence and improve outcomes for populations most vulnerable to obesity-related risk.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"5 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147586655","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}

引用次数: 0

The Association Between Ambient Temperature and Hypoglycemia in People Living With Type 1 Diabetes: A Case Time Series Analysis Using Real-Time Continuous Glucose Monitoring 1型糖尿病患者环境温度与低血糖之间的关系：使用实时连续血糖监测的病例时间序列分析

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-03-31 DOI: 10.2337/dc25-2383

Harriet E. Daultrey, Nick S. Oliver, Ali J. Chakera, Arturo de la Cruz Libardi, Collins C. Iwuji, Antonio Gasparrini

{"title":"The Association Between Ambient Temperature and Hypoglycemia in People Living With Type 1 Diabetes: A Case Time Series Analysis Using Real-Time Continuous Glucose Monitoring","authors":"Harriet E. Daultrey, Nick S. Oliver, Ali J. Chakera, Arturo de la Cruz Libardi, Collins C. Iwuji, Antonio Gasparrini","doi":"10.2337/dc25-2383","DOIUrl":"https://doi.org/10.2337/dc25-2383","url":null,"abstract":"OBJECTIVE To investigate the short-term association between ambient temperature and risk of hypoglycemia in adults with type 1 diabetes mellitus (T1DM). We hypothesized that higher ambient temperature would increase the odds of hypoglycemia developing. RESEARCH DESIGN AND METHODS We applied a case time series design to assess the longitudinal association between ambient temperature and hypoglycemia measured using routine continuous glucose monitoring data from individuals with T1DM. A quasi-binomial fixed-effect regression with distributed lag nonlinear models was used to estimate potentially nonlinear and lagged risks of nonoptimal temperature on hypoglycemic episodes, defined as ≥15 min of glucose concentration &lt;3.9 mmol/L. The model was adjusted for long-term trends, seasonality, day of the week, and public holidays. A secondary outcome was change in daily mean glucose concentration. RESULTS We analyzed 32,966,282 glucose readings from 679 adults with T1DM attending two National Health Service clinics in Sussex, England, between 2017 and 2024. Higher ambient temperatures were associated with an increased risk of hypoglycemia. The risk increased nonlinearly for temperatures above 13°C, with the odds ratio reaching 1.26 (95% CI 1.13–1.26) at 25°C. The strongest effect was observed on the same day of the exposure, and it diminished over subsequent days. In the secondary analysis, higher temperatures were associated with lower mean glucose levels. CONCLUSIONS Elevated ambient temperature significantly increases the short-term risk of hypoglycemia in adults with T1DM. These findings are specific to the U.K. population and climate, which may limit generalizability. Our results support anticipatory insulin adjustments during hot weather and consideration of ambient temperature in hybrid closed-loop insulin algorithms.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"102 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147586640","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}

引用次数: 0

Accuracy of Continuous Glucose Monitoring in Adults With Postbariatric Hypoglycemia After Roux-en-Y Gastric Bypass Surgery Under Stable and Dynamic Glucose Conditions 在稳定和动态血糖条件下Roux-en-Y胃旁路手术后持续血糖监测的准确性

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-03-31 DOI: 10.2337/dc25-2724

Aritz Lizoain, Martina Vettoretti, Antonio Ferreira, Katja A. Schönenberger, Olivia Streicher, Eva Rolfes, Vincent Braunack-Mayer, Andrea Facchinetti, David Herzig, Martina Rothenbühler, Lia Bally

{"title":"Accuracy of Continuous Glucose Monitoring in Adults With Postbariatric Hypoglycemia After Roux-en-Y Gastric Bypass Surgery Under Stable and Dynamic Glucose Conditions","authors":"Aritz Lizoain, Martina Vettoretti, Antonio Ferreira, Katja A. Schönenberger, Olivia Streicher, Eva Rolfes, Vincent Braunack-Mayer, Andrea Facchinetti, David Herzig, Martina Rothenbühler, Lia Bally","doi":"10.2337/dc25-2724","DOIUrl":"https://doi.org/10.2337/dc25-2724","url":null,"abstract":"OBJECTIVE Although continuous glucose monitors (CGMs) are increasingly used to detect and manage postbariatric hypoglycemia (PBH) and associated glucose variability, data on their accuracy in this population remain scarce. RESEARCH DESIGN AND METHODS We retrospectively assessed the accuracy of the Dexcom G6 CGM system in adults with PBH after Roux-en-Y gastric bypass (RYGB) surgery (n = 70). Glucose excursions were induced using a standardized solid mixed-meal test, and reference blood glucose (BG) values were obtained through repeated venous whole-blood sampling. CGM accuracy was analyzed separately during stable and dynamic postmeal glucose periods, with dynamic phases stratified according to magnitude and direction of the rate of change (RoC). We further estimated the lag time for each sensor and examined predictive factors affecting CGM accuracy. RESULTS A total of 1,822 CGM-BG pairs obtained with 70 individuals were included in the analysis. Mean absolute relative differences at stable and dynamic levels were 9.6% and 16.4%, respectively. After the meal test, 67.6% of pairs had CGM values within 15%, or 15 mg/dL of the reference BG; 78.0% within 20%, or 20 mg/dL; and 90.8% within 30%, or 30 mg/dL. Performance was worse at rapid plasma glucose decline (&gt;1.5 mg/dL/min), and CGM values at the time of plasma glucose nadir were systematically higher (bias, 8.2 mg/dL). Plasma-interstitium time delay was estimated at 9.8 min. No participant or sensor characteristic had a significant impact on CGM accuracy. CONCLUSIONS Meal-induced glucose dynamics, particularly rapid declines, challenge CGM accuracy in people with PBH and must be carefully considered when diagnosing or managing the condition.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"12 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147586639","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}

引用次数: 0

Genetic Susceptibility to Diabetes Subtypes and Risk of Developing Coronary Artery Disease 糖尿病亚型的遗传易感性和发生冠状动脉疾病的风险

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-03-31 DOI: 10.2337/dc25-1711

Mengyu Pan, Dania Al-Sharify, Gunnar Engström, Emma Ahlqvist, Luca Lotta, Jan Nilsson, Isabel Goncalves, Jiangming Sun, Andreas Edsfeldt

{"title":"Genetic Susceptibility to Diabetes Subtypes and Risk of Developing Coronary Artery Disease","authors":"Mengyu Pan, Dania Al-Sharify, Gunnar Engström, Emma Ahlqvist, Luca Lotta, Jan Nilsson, Isabel Goncalves, Jiangming Sun, Andreas Edsfeldt","doi":"10.2337/dc25-1711","DOIUrl":"https://doi.org/10.2337/dc25-1711","url":null,"abstract":"OBJECTIVE Diabetes significantly increases the risk for atherosclerotic complications, including coronary artery disease (CAD). Previous studies have suggested that adult-onset diabetes can be classified into five different clinical subtypes, including moderate obesity-related diabetes (MOD). The aim of this study was to investigate the genetic associations between the five diabetes subtypes and the risk of developing CAD and diabetes in the general population. RESEARCH DESIGN AND METHODS The Malmö Diet and Cancer cohort (N = 24,025) was used to assess whether polygenic risk scores (PRSs) for the five diabetes subtypes could predict future diabetes and CAD. Genetic correlations and causal effects of the MOD subtype on CAD were investigated using data from large genome-wide association studies of the MOD subtype (N = 4,116) and CAD (N = 296,525). RESULTS During follow-up, 4,105 participants (17.1%) developed diabetes (median follow-up 24.0 years) and 3,841 (16.0%) developed CAD (median follow-up 24.6 years). PRS for MOD (PRSMOD) was associated with incident diabetes and CAD. In addition, participants in the third tertile of PRSMOD had a 1.10-fold higher risk of developing CAD compared with those in the first tertile. A positive genetic correlation between MOD and CAD was observed, and Mendelian randomization analyses suggested a causal effect of MOD on CAD. CONCLUSIONS The current study showed that the genetic susceptibilities for all five diabetes subtypes were associated with incident diabetes. However, only the MOD subtype was associated with incident CAD. These findings underscore the significance of a high genetic risk for MOD as an early marker for CAD.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"103 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577899","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}

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