Diabetes Care最新文献

Glucose Abnormalities Detected by Continuous Glucose Monitoring in Very Old Adults With and Without Diabetes

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-20 DOI: 10.2337/dc24-1990

Natalie R. Daya, Michael Fang, Dan Wang, Arielle Valint, B. Gwen Windham, Josef Coresh, Justin B. Echouffo-Tcheugui, Elizabeth Selvin

{"title":"Glucose Abnormalities Detected by Continuous Glucose Monitoring in Very Old Adults With and Without Diabetes","authors":"Natalie R. Daya, Michael Fang, Dan Wang, Arielle Valint, B. Gwen Windham, Josef Coresh, Justin B. Echouffo-Tcheugui, Elizabeth Selvin","doi":"10.2337/dc24-1990","DOIUrl":"https://doi.org/10.2337/dc24-1990","url":null,"abstract":"OBJECTIVE To characterize the prevalence of continuous glucose monitoring (CGM)-defined glucose abnormalities in a large, community-based population of very old adults (&gt;75 years). RESEARCH DESIGN AND METHODS A cross-sectional analysis of 1,150 older adults with and without diabetes who attended the Atherosclerosis Risk in Communities Study (2021–2022). Diabetes was based on a self-reported diagnosis of diabetes by a health care provider, use of diabetes medication, or a hemoglobin A1c (HbA1c) ≥6.5%. Prediabetes was defined as an HbA1c of 5.7% to &lt;6.5% and normoglycemia as an HbA1c of &lt;5.7%. We analyzed CGM metrics, including mean glucose, measures of hyperglycemia, and the coefficient of variation, by diabetes status. RESULTS Of the 1,150 participants (mean age 83 years, 59% women, 26% who are Black), 35.1% had normoglycemia, 34.5% had prediabetes, and 30.4% had diabetes. The summary 24-h ambulatory glucose profile for participants with prediabetes was very similar to those with normoglycemia. No participants with normoglycemia or prediabetes had a CGM mean glucose &gt;140 mg/dL, while 32.7% of participants with diabetes had a CGM mean glucose &gt;140 mg/dL. CONCLUSIONS In very old adults with normal or prediabetes HbA1c, hyperglycemia detected by CGM was rare. This suggests that HbA1c adequately captures the burden of hyperglycemia for most people in this population.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"48 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142867317","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

Limitations in Achieving Glycemic Targets From CGM Data and Persistence of Severe Hypoglycemia in Adults With Type 1 Diabetes Regardless of Insulin Delivery Method

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-19 DOI: 10.2337/dc24-1474

Lori M. Laffel, Jennifer L. Sherr, Jingwen Liu, Wendy A. Wolf, Jeoffrey Bispham, Katherine S. Chapman, Daniel Finan, Lina Titievsky, Tina Liu, Kaitlin Hagan, Jason Gaglia, Keval Chandarana, Jeremy Pettus, Richard Bergenstal

{"title":"Limitations in Achieving Glycemic Targets From CGM Data and Persistence of Severe Hypoglycemia in Adults With Type 1 Diabetes Regardless of Insulin Delivery Method","authors":"Lori M. Laffel, Jennifer L. Sherr, Jingwen Liu, Wendy A. Wolf, Jeoffrey Bispham, Katherine S. Chapman, Daniel Finan, Lina Titievsky, Tina Liu, Kaitlin Hagan, Jason Gaglia, Keval Chandarana, Jeremy Pettus, Richard Bergenstal","doi":"10.2337/dc24-1474","DOIUrl":"https://doi.org/10.2337/dc24-1474","url":null,"abstract":"OBJECTIVE We captured continuous glucose monitoring (CGM) metrics from a large online survey of adults with type 1 diabetes to determine how glycemic outcomes varied by insulin delivery form. RESEARCH DESIGN AND METHODS Adults with type 1 diabetes from the T1D Exchange Registry/online communities completed the survey and contributed retrospective CGM data for up to 1 year. Self-reported glycemic outcomes and CGM measures were described overall and by insulin delivery method. RESULTS The 926 participants completed the survey and provided CGM data. Mean ± SD age was 41.9 ± 15.7 years, and 50.8% reported using automated insulin delivery (AID). While AID users spent more time in range, 27.9% did not achieve time in range targets, 15.5% reported severe hypoglycemic events (SHEs), and 16.0% had CGM-detected level 2 hypoglycemic events. CONCLUSIONS Despite use of diabetes technologies, many individuals are unable to achieve glycemic targets and experience severe hypoglycemia, highlighting the need for novel treatments.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"11 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142858453","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

Glycemic Management and Individualized Diabetes Care in Dialysis-Dependent Kidney Failure

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-18 DOI: 10.2337/dci24-0081

Klara R. Klein, Ildiko Lingvay, Katherine R. Tuttle, Jennifer E. Flythe

{"title":"Glycemic Management and Individualized Diabetes Care in Dialysis-Dependent Kidney Failure","authors":"Klara R. Klein, Ildiko Lingvay, Katherine R. Tuttle, Jennifer E. Flythe","doi":"10.2337/dci24-0081","DOIUrl":"https://doi.org/10.2337/dci24-0081","url":null,"abstract":"Of the nearly 600,000 people in the U.S. who receive dialysis for chronic kidney failure, &gt;60% have diabetes. People receiving dialysis who have diabetes have worse overall and cardiovascular survival rates than those without diabetes. Diabetes care in the dialysis setting is complicated by kidney failure–related factors that render extrapolation of glycated hemoglobin (HbA1c) targets to the dialysis population unreliable and may change the risk-benefit profiles of glucose-lowering and disease-modifying therapies. No prospective studies have established the optimal glycemic targets in the dialysis population, and few randomized clinical trials of glucose-lowering medications included individuals receiving dialysis. Observational data suggest that both lower and higher HbA1c are associated with mortality in the dialysis population. Existing data suggest the potential for safety and effectiveness of some glucose-lowering medications in the dialysis population, but firm conclusions are hindered by limitations in study design and sample size. While population-specific knowledge gaps about optimal glycemic targets and diabetes medication safety and effectiveness preclude the extension of all general population diabetes guidelines to the dialysis-dependent diabetes population, these uncertainties should not detract from the importance of providing person-centered diabetes care to people receiving dialysis. Diabetes care for individuals with and without dialysis-dependent kidney failure should be holistic, based on individual preferences and prognoses, and tailored to integrate established treatment approaches with proven benefits for glycemic control and cardiovascular risk reduction. Additional research is needed to inform how recent pharmacologic and technological advances can be applied to support such individualized care for people receiving maintenance dialysis.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"47 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142849177","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

Effect of Community-Based Integrated Care for Patients With Diabetes and Depression (CIC-PDD) in China: A Pragmatic Cluster-Randomized Trial 中国糖尿病和抑郁症患者社区综合治疗（CIC-PDD）的效果：务实的分组随机试验

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-16 DOI: 10.2337/dc24-1593

Yanshang Wang, Dan Guo, Yiqi Xia, Mingzheng Hu, Ming Wang, Qianqian Yu, Zhansheng Li, Xiaoyi Zhang, Ruoxi Ding, Miaomiao Zhao, Zhenyu Shi, Dawei Zhu, Ping He

{"title":"Effect of Community-Based Integrated Care for Patients With Diabetes and Depression (CIC-PDD) in China: A Pragmatic Cluster-Randomized Trial","authors":"Yanshang Wang, Dan Guo, Yiqi Xia, Mingzheng Hu, Ming Wang, Qianqian Yu, Zhansheng Li, Xiaoyi Zhang, Ruoxi Ding, Miaomiao Zhao, Zhenyu Shi, Dawei Zhu, Ping He","doi":"10.2337/dc24-1593","DOIUrl":"https://doi.org/10.2337/dc24-1593","url":null,"abstract":"OBJECTIVE To develop a care model for patients with both diabetes and depression and assess the model’s effectiveness. RESEARCH DESIGN AND METHODS In this pragmatic cluster randomized trial, we allocated eight community health centers into two groups: the enhanced usual care group and the intervention group. A comprehensive care plan was developed for the intervention group based on the integrated care model. We recruited individuals aged ≥18 years with type 2 diabetes and depression (Patient Health Questionnaire-9 score ≥10). The primary outcome was the between-group difference in the percentage of patients who had at least a 50% reduction in depressive symptoms and a reduction of at least 0.5 percentage points in HbA1c. The outcome analysis was conducted within the intention-to-treat population; missing data were multiply imputed. RESULTS We enrolled 630 participants, with 275 in the intervention group and 355 in the control group. A significantly greater percentage of patients in the intervention group met the primary outcome at 12 months (for depressive symptoms: risk difference [RD] 31.03% [62.06% vs. 31.02%, respectively; 95% CI 21.85–40.21]; for HbA1c: RD 19.16% [32.41% vs. 13.25%, respectively; 95% CI 11.35–26.97]). The patients in the intervention group showed significant enhancements in mental quality of life (mean difference [MD] 6.74 [46.57 vs. 39.83, respectively; 95% CI 3.75–9.74]), diabetes self-care activities (MD 0.69 [3.46 vs. 2.78, respectively; 95% CI 0.52–0.86]), medication adherence (MD 0.72 [6.49 vs. 5.78, respectively; 95% CI 0.37–1.07]), and experience of care (MD 0.89 [3.84 vs. 2.95, respectively; 95% CI 0.65–1.12]) at 12 months. Rural participants benefited more from the intervention. CONCLUSIONS The implementation strategy can serve as a valuable blueprint for the identification and treatment of patients with physical and mental multimorbidity in primary health care settings.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"76 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831963","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

Risk of Nephrolithiasis Associated With SGLT2 Inhibitors Versus DPP4 Inhibitors Among Patients With Type 2 Diabetes: A Target Trial Emulation Study

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-12 DOI: 10.2337/dc24-1652

Anna Shin, Ju-Young Shin, Eun Ha Kang

{"title":"Risk of Nephrolithiasis Associated With SGLT2 Inhibitors Versus DPP4 Inhibitors Among Patients With Type 2 Diabetes: A Target Trial Emulation Study","authors":"Anna Shin, Ju-Young Shin, Eun Ha Kang","doi":"10.2337/dc24-1652","DOIUrl":"https://doi.org/10.2337/dc24-1652","url":null,"abstract":"OBJECTIVE We aim to compare the risk of nephrolithiasis among type 2 diabetes patients who initiated sodium-glucose cotransporter-2 inhibitors (SGLT2is) versus dipeptidyl-peptidase-4 inhibitors (DPP4is), individually within stone never- and ever-formers. RESEARCH DESIGN AND METHODS Using the 2010–2021 Korea National Health Insurance Service database, we conducted a population-based cohort study, comparing initiators of SGLT2is versus DPP4is. The primary outcome was incident nephrolithiasis. Osteoarthritis encounters served as a negative control outcome. After 1:1 propensity score (PS) matching in stone never- and ever-formers, pooled and individual hazard ratios (HRs), incidence rate difference (IRD), and 95% CIs were reported. Subgroup analyses by sex, age, thiazide co-use, and baseline cardiovascular risk were done. RESULTS The 17,006 PS-matched pairs of SGLT2i and DPP4i initiators were pooled from stone never- (105,378 pairs) and ever-formers (11,628 pairs). Over a mean of 654 days, the risk of nephrolithiasis was lower in SGLT2i initiators than in DPP4i: 0.65 vs. 1.12 events per 100 person-years, HR 0.54 (95% CI, 0.50–0.57), IRD −0.46 (95% CI,−0.21 to −0.52). Among never-formers, the HR was 0.43 (95% CI, 0.39–0.48) and IRD was −0.32 (95% CI,−0.27 to −0.36). Among ever-formers, the HR was 0.64 (95% CI, 0.59–0.69) and IRD was −2.26 (95% CI,−1.77 to −2.76). Near-null associations were found for osteoarthritis encounters. Results were consistent across subgroups. CONCLUSIONS We found a lower risk of nephrolithiasis associated with SGLT2is versus DPP4is in stone never- and ever-formers. Despite a greater relative risk reduction in the former, the absolute risk reduction was greater in the latter.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"92 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815500","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

Use of SGLT2i Versus DPP-4i as an Add-On Therapy and the Risk of PAD-Related Surgical Events (Amputation, Stent Placement, or Vascular Surgery): A Cohort Study in Veterans With Diabetes

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-09 DOI: 10.2337/dc24-1546

Katherine E. Griffin, Kathryn Snyder, Amir H. Javid, Amber Hackstadt, Robert Greevy, Carlos G. Grijalva, Christianne L. Roumie

{"title":"Use of SGLT2i Versus DPP-4i as an Add-On Therapy and the Risk of PAD-Related Surgical Events (Amputation, Stent Placement, or Vascular Surgery): A Cohort Study in Veterans With Diabetes","authors":"Katherine E. Griffin, Kathryn Snyder, Amir H. Javid, Amber Hackstadt, Robert Greevy, Carlos G. Grijalva, Christianne L. Roumie","doi":"10.2337/dc24-1546","DOIUrl":"https://doi.org/10.2337/dc24-1546","url":null,"abstract":"OBJECTIVE To compare the risk of composite peripheral artery disease (PAD) surgical outcome, including peripheral revascularization and amputation procedures, between new users of sodium–glucose cotransporter 2 inhibitors (SGLT2is) and dipeptidyl peptidase 4 inhibitors (DPP-4is). RESEARCH DESIGN AND METHODS This retrospective cohort study of U.S. veterans age ≥18 years with diabetes who received care from the Veterans Health Administration was performed from 1 October 2000 to 31 December 2021. Data were linked to Medicare, Medicaid, and the National Death Index. New use of SGLT2i or DPP-4i medications as an add-on to metformin, sulfonylurea, or insulin treatment alone or in combination was evaluated for an association with PAD surgical procedure for peripheral revascularization and amputation. A Cox proportional hazards model for time-to-PAD event analysis compared the risk of a PAD event between SGLT2is and DPP-4is in a propensity score–weighted cohort with a competing risk of death and allowance for events to occur up to 90 days or 360 days after stopping SGLT2is. RESULTS The weighted cohort included 76,072 SGLT2i vs. 75,833 DPP-4i use episodes. The median age was 69 years, HbA1c was 8.4% (interquartile range [IQR] 7.5–9.4%), and the median diabetes duration was 10.1 (IQR 6.6–14.6) years. There were 874 and 780 PAD events among SGLT2i and DPP-4i users, respectively, for an event rate of 11.2 (95% CI 10.5–11.9) and 10.0 (9.4–10.6) per 1,000 person-years (adjusted hazard ratio [aHR] 1.18 [95% CI 1.08–1.29]). When PAD events were allowed for 360 days after SGLT2i use ended, the aHR was 1.16 (95% CI 1.06–1.26). CONCLUSIONS SGLT2i as an add-on diabetes therapy was associated with an increased cause-specific hazard of PAD surgeries compared with DPP-4i.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"10 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142797019","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 Discovery and Risk Prediction for Type 1 Diabetes in Individuals Without High-Risk HLA-DR3/DR4 Haplotypes

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-03 DOI: 10.2337/dc24-1251

Carolyn McGrail, Joshua Chiou, Ruth Egamal, Amber M. Luckett, Richard A. Oram, Paola Benaglio, Kyle J. Gaulton

{"title":"Genetic Discovery and Risk Prediction for Type 1 Diabetes in Individuals Without High-Risk HLA-DR3/DR4 Haplotypes","authors":"Carolyn McGrail, Joshua Chiou, Ruth Egamal, Amber M. Luckett, Richard A. Oram, Paola Benaglio, Kyle J. Gaulton","doi":"10.2337/dc24-1251","DOIUrl":"https://doi.org/10.2337/dc24-1251","url":null,"abstract":"OBJECTIVE More than 10% of patients with type 1 diabetes (T1D) do not have high-risk HLA-DR3 or -DR4 haplotypes with distinct clinical features, such as later onset and reduced insulin dependence. We aimed to identify genetic drivers of T1D in the absence of DR3/DR4 and improve prediction of T1D risk in these individuals. RESEARCH DESIGN AND METHODS We performed T1D association and fine-mapping analyses in 12,316 non-DR3/DR4 samples. Next, we performed heterogeneity tests to examine differences in T1D risk variants in individuals without versus those with DR3/DR4 haplotypes. We further assessed genome-wide differences in gene regulatory element and biological pathway enrichments between the non-DR3/DR4 and DR3/DR4 cohorts. Finally, we developed a genetic risk score (GRS) to predict T1D in individuals without DR3/DR4 and compared with an existing T1D GRS. RESULTS A total of 18 T1D risk variants in non-DR3/DR4 samples were identified. Risk variants at the MHC and multiple other loci genome wide had heterogeneity in effects on T1D dependent on DR3/DR4 status, and non-DR3/DR4 T1D had evidence for a greater polygenic burden. T1D-assocated variants in non-DR3/DR4 were more enriched for regulatory elements and pathways involved in antigen presentation, innate immunity, and β-cells and depleted in T cells compared with DR3/DR4. A non-DR3/DR4 GRS outperformed an existing risk score GRS2 in discriminating non-DR3/DR4 T1D from no diabetes (area under the curve 0.867; P = 7.48 × 10−32) and type 2 diabetes (0.907; P = 4.94 × 10−44). CONCLUSIONS In total, we identified heterogeneity in T1D genetic risk dependent on high-risk HLA-DR3/DR4 haplotype, which uncovers disease mechanisms and enables more accurate prediction of T1D across the HLA background.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"14 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142763244","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

Compounded GLP 1 and Dual GIP/GLP 1 Receptor Agonists: A Statement from the American Diabetes Association

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-02 DOI: 10.2337/dci24-0091

Joshua J. Neumiller, Mandeep Bajaj, Raveendhara R. Bannuru, Rozalina G. McCoy, Elizabeth J. Pekas, Alissa R. Segal, Nuha A. ElSayed

引用次数: 0

Continuous Glucose Monitor Accuracy for Diabetes Management in Hospitalized Children

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-12-02 DOI: 10.2337/dc24-1562

Neha Garg, Kamryn Lewis, Perrin C. White, Soumya Adhikari

{"title":"Continuous Glucose Monitor Accuracy for Diabetes Management in Hospitalized Children","authors":"Neha Garg, Kamryn Lewis, Perrin C. White, Soumya Adhikari","doi":"10.2337/dc24-1562","DOIUrl":"https://doi.org/10.2337/dc24-1562","url":null,"abstract":"OBJECTIVE The adoption of continuous glucose monitors (CGMs) in inpatient settings in the pediatric population has been slow because of a scarcity of data on their reliability in hospitalized children. RESEARCH DESIGN AND METHODS We retrospectively reviewed the accuracy of the Dexcom G6 CGM system in pediatric patients with diabetes admitted to our academic children’s hospital from March 2018 to September 2023. We cross-referenced the Dexcom Clarity database against an internal database of inpatient admissions to identify all children with CGM data admitted to the hospital. We recorded sensor glucose readings from Clarity and values for point-of-care (POC) glucose, blood urea nitrogen (BUN), and pH from the electronic medical record. CGM accuracy and clinical reliability were measured by mean absolute relative difference (MARD) and Clarke error grid (CEG) analyses. RESULTS There were 3,200 admissions of children with diabetes in this period, of which 277 (from 202 patients age 2–18 years) had associated CGM data. Paired CGM and POC measurements (n = 2,904) were compared, resulting in an MARD of 15.9%, with 96.6% of the values in zones A and B of the CEG analysis. Approximately 62% of paired values fell within a 15% or 15 mg/dL difference, whichever was larger (15%/15 mg/dL range), 74% within 20%/20, and 88% within 30%/30. Serum pH, sodium, and BUN had no impact on CGM values or absolute relative difference in linear regression analysis. CONCLUSIONS CGMs demonstrated acceptable accuracy in hospitalized children with diabetes. CGM data should be integrated into hospital electronic records to optimize management.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"204 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142760506","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

Cutaneous Carbonyl Stress Is Associated With Nerve Dysfunction in Recent-Onset Type 2 Diabetes 皮肤羰基应激与新发 2 型糖尿病患者的神经功能障碍有关

IF 16.2 1区医学

Diabetes Care Pub Date : 2024-11-25 DOI: 10.2337/dc24-1799

Gidon J. Bönhof, Alexander Strom, Tobias Jung, Kálmán B. Bódis, Julia Szendroedi, Robert Wagner, Tilman Grune, Michael Roden, Dan Ziegler

{"title":"Cutaneous Carbonyl Stress Is Associated With Nerve Dysfunction in Recent-Onset Type 2 Diabetes","authors":"Gidon J. Bönhof, Alexander Strom, Tobias Jung, Kálmán B. Bódis, Julia Szendroedi, Robert Wagner, Tilman Grune, Michael Roden, Dan Ziegler","doi":"10.2337/dc24-1799","DOIUrl":"https://doi.org/10.2337/dc24-1799","url":null,"abstract":"OBJECTIVE Endogenous carbonyl stress leads to the formation of advanced glycation end products (AGEs). AGEs represent a potential target to prevent or treat diabetic sensorimotor polyneuropathy (DSPN). The current study aimed to characterize cutaneous carbonyl stress, oxidative stress, immune cells, and endothelial cell damage in early type 2 diabetes compared with normal glucose tolerance (NGT) using novel cutaneous biomarkers. RESEARCH DESIGN AND METHODS Included were 160 individuals recently (≤12 months) diagnosed with type 2 diabetes and 144 with NGT from the German Diabetes Study baseline cohort. Nerve function was assessed using electrophysiological, quantitative sensory, and clinical testing. Skin biopsies were obtained to analyze intraepidermal nerve fiber density, AGEs autofluorescence, argpyrimidine area, and endothelial cell area. In addition, skin autofluorescence was measured noninvasively using the AGE reader. A subgroup with type 2 diabetes (n = 80) was reassessed 5 years later. RESULTS After adjustment for sex, age, HbA1c, LDL cholesterol, and BMI, argpyrimidine area (17.5 ± 18.8 vs. 11.7 ± 12.7%) was higher in recent-onset type 2 diabetes than in NGT (P &lt; 0.05). AGEs autofluorescence was inversely correlated with nerve conduction (e.g., peroneal motor nerve conduction velocity: r = −0.346) and positively with AGE reader measurements in type 2 diabetes (r = 0.358, all P &lt; 0.05), but not in NGT. Higher baseline AGEs autofluorescence and lower endothelial cell area predicted the deterioration of clinical and neurophysiological measures after 5 years. CONCLUSIONS Cutaneous AGEs markers were associated with neurophysiological deficits in recent-onset type 2 diabetes and predicted their progression after 5 years, substantiating the role of carbonyl stress in the development of early DSPN.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"33 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712532","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