Diabetes Care最新文献

{"title":"Making Modern Diabetes Medications Affordable and Accessible: Lessons From India for Other Countries","authors":"Viswanathan Mohan, Rayapati Samuel Sathweek, Ranjit Mohan Anjana, Ranjit Unnikrishnan","doi":"10.2337/dci26-0054","DOIUrl":"https://doi.org/10.2337/dci26-0054","url":null,"abstract":"Diabetes affects 589 million adults globally, 80% of whom live in low- and middle-income countries (LMICs). Although modern diabetes therapies such as sodium–glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) improve cardiovascular and renal outcomes and analog insulins help reduce risk of hypoglycemia, affordability remains a barrier to equitable access to these agents. This article analyzes how India has reduced the costs of modern diabetes therapies and improved affordability, pricing trends, regulatory frameworks, pharmaceutical manufacturing policies, and public distribution initiatives in India. India has achieved approximately 60%–90% price reductions for SGLT2i and GLP-1 RA following patent expiry, driven by strong generic competition, structured price regulation, and governmental support, leading to much greater access to these agents. Costs of insulin biosimilars of glargine are also much lower in India, making them more affordable. Cross-national price comparisons show 15- to 65-fold differences between Indian generic prices and U.S. list prices for selected agents. On the policy front, government initiatives like the Ayushman Bharat have considerably helped to increase accessibility for the poor and vulnerable sections of the society. Despite these advances, challenges remain, particularly in rural areas where modern therapies may still be unaffordable or unavailable. Moreover, due to multiple manufacturers providing generics, there could be differences in quality and pharmacokinetics, even between the branded generics. However, India’s experience demonstrates that affordable access to modern diabetes medicines is achievable through coordinated pharmaceutical policy, regulatory efficiency, and enhanced manufacturing capacity, offering lessons for LMICs and high-income countries facing high drug costs.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"2 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979377","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":"From Alert to Action: Electronic Practice Advisory Improves DSMES Referrals Over 18 Months","authors":"Katrina E. Donahue, Jacqueline R. Halladay, Ping Chen, Kathleen Mottus, Karen Goeke-Austin, Jennifer Rees, Maihan B. Vu, Aaron Thomas, Kelli Hammond, Alice Merritt, Laura A. Young","doi":"10.2337/dc26-1213","DOIUrl":"https://doi.org/10.2337/dc26-1213","url":null,"abstract":"OBJECTIVE Engagement in diabetes self-management education and support (DSMES) is suboptimal among people with type 2 diabetes (T2D). The PROMPT study examined whether referral rates to DSMES increased through a best practice advisory (BPA) deployed during clinic visits via the electronic health record. RESEARCH DESIGN AND METHODS In this cluster-randomized controlled trial in central North Carolina, we created a BPA within the electronic health record that deployed when eligible patients with T2D attended primary care visits. The BPA was active in four primary care practices over 18 months, with two control practices. After 12 months, standing orders were added so the BPA would additionally deploy for nurses or medical assistants before patients saw their clinician. We analyzed data using multilevel logistic regression modeling with patient data nested within clinics, using binary logit functions and maximum likelihood estimation to estimate the odds of DSMES referrals. RESULTS At 12 months, the BPA intervention achieved a 12.9% DSMES referral rate compared with 1.2% in control clinics (P < 0.001). At 18 months, the referral rate remained higher in the intervention clinics (13.7%) than in controls (1.6%; P < 0.001). After adjusting for patient and clinic characteristics, the odds of referral in BPA-exposed clinics were significantly greater than in control clinics at both time points: odds ratio (OR) 10.55 (95% CI 4.65–23.94) at 12 months and OR 9.44 (95% CI 4.91–18.17) at 18 months after implementation of standing orders. CONCLUSIONS Integrating BPA prompts into the electronic health record boosts DSMES referral rates, and adding standing orders helps sustain these gains.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"80 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979378","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":"Three-Year Glycemic Trajectories in Subgroups With Type 1 Diabetes at Risk for Suboptimal Glycemic Control: A Multicenter Continuous Glucose Monitoring Study","authors":"Jee Hee Yoo, Seohyun Kim, Yeonsoo Park, Soojin Park, Choon Hee Chung, Jae Hyeon Kim, Soo Heon Kwak, Gyuri Kim","doi":"10.2337/dc26-1039","DOIUrl":"https://doi.org/10.2337/dc26-1039","url":null,"abstract":"OBJECTIVE To examine 3-year longitudinal trajectories of continuous glucose monitoring (CGM) metrics across subgroups at risk for suboptimal glycemic control among adults with type 1 diabetes. RESEARCH DESIGN AND METHODS In this multicenter study, 1,028 individuals contributed 3,441 longitudinal CGM profiles. Participants were stratified on the basis of age, chronic kidney disease (CKD), β-cell function, BMI, and triglyceride-glucose (TyG) tertile. Linear mixed-effects models were used to estimate subgroup differences in longitudinal changes. RESULTS At baseline, there was more time spent with glucose above target range, >180 mg/dL, for the subgroups of older age, CKD, severe β-cell failure, higher BMI, and highest TyG tertile (all P < 0.05), while severe β-cell failure was additionally associated with more time spent with glucose below target range (TBR), <70 mg/dL, along with greater glycemic variability (all P < 0.001). In relation to younger individuals, for older adults improvement in time spent with glucose in target range (TIR), 70–180 mg/dL, was comparable (β = 0.110; P = 0.102) and lower TBR was maintained (3.5% vs. 1.7%, respectively; P < 0.001). Among the CKD group significant improvement in TIR was seen (β = 0.228; P = 0.002) without exacerbation of hypoglycemia. Severe β-cell failure attenuated TIR improvement (β = −0.119; P = 0.025) and TBR reduction (β = 0.046; P < 0.001). Lower absolute TIR was seen for those with higher BMI and those in the highest TyG tertile. Greater TIR improvement was observed for those in the highest TyG tertile (β = 0.083; P = 0.001). CGM metrics varied widely within these subgroups. CONCLUSIONS Older age and CKD were associated with longitudinal glycemic improvement without worsening of hypoglycemia, whereas severe β-cell failure limited glycemic gains; substantial within-group heterogeneity supports individualized glycemic targets informed by CGM trajectories in type 1 diabetes.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"233 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979379","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 Management of Type 1 Diabetes in Adults. The Updated 2026 Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","authors":"Richard I.G. Holt, J. Hans DeVries, Amy Hess-Fischl, Irl B. Hirsch, M. Sue Kirkman, Tomasz Klupa, Barbara Ludwig, Kirsten Nørgaard, Jeremy Pettus, Eric Renard, Jay S. Skyler, Frank J. Snoek, Ruth S. Weinstock, Anne L. Peters","doi":"10.2337/dci26-0122","DOIUrl":"https://doi.org/10.2337/dci26-0122","url":null,"abstract":"This 2026 consensus report from the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) builds on the 2021 consensus report to provide guidance for managing type 1 diabetes in adults. Reflecting the rapid advances in the field, this update places particular emphasis on the integration of new technologies, while all sections have been revised to incorporate new evidence, advances in clinical practice, and novel therapies, including interventions to delay the onset of stage 3 type 1 diabetes. It also broadens its scope to screening for long-term diabetes complications, and the management of obesity and cardiovascular risk factors. Psychosocial care and diabetes self-management education and support (DSMES) remain key elements.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"12 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964256","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":"All-Cause Mortality, Morbidity, and Reamputation Rates Following Below-Knee Amputation in 25,176 People With Diabetes: A 25-Year England Population Study","authors":"Conor Hennessy, Simon Abram, Rick Brown, Constantinos Loizou, Robert Sharp, Adrian Kendal","doi":"10.2337/dc26-1100","DOIUrl":"https://doi.org/10.2337/dc26-1100","url":null,"abstract":"OBJECTIVE Below-knee amputation (BKA) is the most common major amputation for advanced diabetic foot disease. Understanding the associated mortality, cause of death, and postoperative risks is important for patient counseling and improving care. This national population study described mortality and causes of death following BKA in people with diabetes, identifying those at greatest risk and whether mortality has improved. It investigated perioperative complications, readmission, reoperation, and further limb amputation. RESEARCH DESIGN AND METHODS An England population study of people with diabetes undergoing BKA was performed using mortality-linked Hospital Episode Statistics. The primary outcome was Kaplan-Meier analysis of all-cause mortality. Cox proportional hazards modeling identified variables associated with high mortality. Secondary outcomes included causes of death, 90-day complications, readmission, and further amputation rates. RESULTS A total of 25,176 people with diabetes underwent 28,232 BKA procedures. Mortality was 23.5% at 1 year, 60.0% at 5 years, and 82.3% at 10 years, with no improvement since 2012. Female sex (hazard ratio [HR] 1.06 [95% CI 1.03–1.10]), older age (HR 1.62 [95% CI 1.56–1.69]), and increasing Charlson Comorbidity Index (HR 1.04 per point) were independently associated with increased mortality. Ninety-day complications included reoperation (6.24%), myocardial infarction (3.74%), and readmission (20.25%). The cumulative incidence of contralateral amputation was 6.43% (95% CI 6.14–6.73%) at 5 years. CONCLUSIONS The associated mortality of BKA in people with diabetes has not improved since 2012. One-year mortality was 23.5%, increasing to 82.3% at 10 years. Older age, female sex, and greater comorbidity burden identified people at greatest risk of death.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"28 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964257","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":"Evaluating Improvement in Pain and Sensory Function When Using High-Frequency (10-kHz) Spinal Cord Stimulation in Individuals With Painful Diabetic Neuropathy: A Multicenter Randomized Controlled Trial (PDN-Sensory)","authors":"Robert W. Hurley, Elias S. Siraj, Shawn Sills, Mitchell Engle, Curtis Johnson, Rodica Pop-Busui, David Armstrong, Andrew Boulton, Brian Levy, Solomon Tesfaye, George Grunberger, Erika Petersen, Rose Azalde, Deborah Edgar, Samer Nakhle, Cong Yu, Khurram Khan, Ioannis Skaribas, Kasra Amirdelfan, Quang Nguyen, Jessica Jameson, Maged Guirguis, Kerry Bradley, Janus S. Patel, Daniel J. Bintrim, David Caraway","doi":"10.2337/dc26-0758","DOIUrl":"https://doi.org/10.2337/dc26-0758","url":null,"abstract":"OBJECTIVE The PDN-Sensory randomized controlled trial (RCT) evaluated the effects of high-frequency 10-kHz spinal cord stimulation (10-kHz SCS) on pain and sensory function in individuals with painful diabetic neuropathy (PDN). RESEARCH DESIGN AND METHODS Participants were randomized 1:1 to conventional medical management (CMM) alone or 10-kHz SCS plus CMM. The primary and key secondary end points were the proportions of participants with pain response (≥50% lower limb pain relief) and sensory improvement (≥3-point reduction in modified Toronto Clinical Neuropathy Score [mTCNS]). Hierarchical secondary outcomes included intraepidermal nerve fiber density (IENFD), sleep, and health and neuropathy-related quality of life (QoL). IENFD and mTCNS assessments were allocation blinded. RESULTS A total of 91 participants were randomly assigned to CMM alone (n = 50) or 10-kHz SCS plus CMM (n = 41). In a modified intention-to-treat worst-case analysis, 27 of 34 participants in the 10-kHz SCS group who underwent a temporary trial achieved the primary outcome, versus 2 of 50 CMM-alone participants (P < 0.001). Among those with 6-month data, mTCNS sensory improvement was observed in 16 of 29 (55.2%) 10-kHz SCS participants versus 12 of 48 (25.0%) CMM-alone participants (P = 0.01). The mean change in lower-calf IENFD was 0.58 fibers/mm with 10-kHz SCS versus −0.07 with CMM alone (P = 0.03). Eight of 10 hierarchical secondary end points were met (including sleep and QoL). CONCLUSIONS The PDN-Sensory RCT replicated previous pain-reduction findings and showed prespecified, objective improvements in sensory function and IENFD. These 6-month findings support clinically meaningful benefit and are consistent with a potential disease-modifying effect that requires longer-term confirmation.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"5 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148909183","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":"Third-Trimester Energy-Restriction or Weight Loss and Maternal and Child Body Composition One Year Postnatally After a Pregnancy With Gestational Diabetes: Results From the DiGest Follow-up Study","authors":"Sarah Dib, Laura C. Kusinski, Richard Powell, Tim J. Cole, Danielle L. Jones, Suzanne Smith, Roy Taylor, Ken K. Ong, Mark L. Evans, Emanuella De Lucia Rolfe, Claire L. Meek","doi":"10.2337/dc26-0405","DOIUrl":"https://doi.org/10.2337/dc26-0405","url":null,"abstract":"OBJECTIVE Energy restriction and weight loss are evidence-based, safe, and well-tolerated methods for lowering glycemia in type 2 diabetes. We assessed if imposed energy restriction or natural weight loss in the third trimester in women with gestational diabetes was associated with maternal and offspring weight postnatally. RESEARCH DESIGN AND METHODS Women with gestational diabetes and BMI ≥25 kg/m2 were randomized to a standard- (2,000 kcal/day) or reduced-energy (1,200 kcal/day) diet from ∼29 to –36 weeks’ gestation, with follow-up to 12 months postnatally. We performed both trial and cohort analyses, using adjusted linear and logistic regression and a Super-Imposition by Translation and Rotation model. RESULTS Allocation to energy restriction did not alter antenatal or postnatal growth, with infants in both randomized groups having normal weight for age throughout the first year of life. In cohort analysis, women who lost weight in pregnancy (average loss of 3 kg) had lower adjusted weight at 3 but not 12 months. Infants exposed to pregnancy weight loss had lower risk of large-for-gestational age at birth and lower fat mass at 3 months, and no higher prevalence of low infant weight (<5% had weight for age < −2 SD). Infants exposed to weight loss in pregnancy showed no evidence of growth faltering or excessive catch-up or catch-down growth. CONCLUSIONS Among women with gestational diabetes and high BMI, energy restriction or weight loss in pregnancy were associated with no adverse effects on offspring weight or growth in the first year. Future work will assess associations with child obesity at 3 years.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"10 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148821096","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 Joint Effects of Life’s Essential 8 and Genetics on Mild Cognitive Impairment and Dementia Risk in People With Diabetes: Findings From the UK Biobank and All of Us","authors":"Xiu Wu, Yuanhao Zu, You Lu, Yue Zhao, David Crosslin, Vivian Fonseca, Demetrius Maraganore, Yilin Yoshida","doi":"10.2337/dc25-3126","DOIUrl":"https://doi.org/10.2337/dc25-3126","url":null,"abstract":"OBJECTIVE We examined how cardiovascular health (CVH), measured by Life’s Essential 8 (LE8), and genetic risk are jointly associated with risks of mild cognitive impairment (MCI), dementia, and related cognitive outcomes in people with diabetes. RESEARCH DESIGN AND METHODS We analyzed 41,374 participants without dementia from the UK Biobank (UKB) and 9,766 from All of Us (AoU). LE8, comprising diet, physical activity, nicotine exposure, sleep, body mass index, lipids, blood glucose, and blood pressure, was scored from 0 to 100 and categorized as low, moderate, or high. Genetic risk was assessed using APOE ε4 alleles and polygenic risk scores (PRS) for Alzheimer disease. We used Cox regression to examine associations of LE8 with MCI and dementia and linear regression to assess MRI-based brain functional measures and cognitive test outcomes, adjusting for covariates. Interactions between LE8 and genetic risk were tested on multiplicative and additive scales. RESULTS Over 15 years of follow-up (UKB), moderate or high CVH versus low CVH was associated with a lower risk of MCI (hazard ratio 0.82 [95% CI 0.71, 0.95], P < 0.05) but not with risk of all-cause dementia (0.97 [0.84, 1.11], P = 0.63). In participants at high genetic risk (high PRS), moderate or high CVH was associated with a lower risk of MCI (0.78 [0.62, 0.98], P for additive interaction < 0.05). AoU results were consistent. CONCLUSIONS Better CVH was significantly associated with a lower risk of MCI in people with diabetes, accounting for genetic risk. The association between CVH and MCI and dementia was stronger among individuals with low or moderate genetic risk and appeared attenuated among those with high genetic risk.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"10 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148821098","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":"Cardiometabolic Effects of Dual GLP-1 and Glucagon Receptor Agonists: A Systematic Review and Meta-analysis of Randomized Controlled Trials","authors":"Johann Roessler, Michael A. Nauck, Arash Haghikia","doi":"10.2337/dc26-1127","DOIUrl":"https://doi.org/10.2337/dc26-1127","url":null,"abstract":"OBJECTIVE Selective glucagon-like protein 1 receptor (GLP-1R) agonists reduce body weight and improve cardiometabolic risk factors. However, whether dual GLP-1R and glucagon receptor (GCGR) agonism modifies these cardiometabolic effects remains unclear. Here, we assessed the effects of dual GLP-1R/GCGR agonists on cardiometabolic risk factors across randomized controlled trials. RESEARCH DESIGN AND METHODS In this random-effects meta-analysis, Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, and Cochran Central Register of Controlled Trials (CENTRAL) were searched from database inception to 21 June 2026 for randomized controlled trials evaluating clinical efficacy of dual GLP-1R/GCGR agonists in adults with cardiometabolic disease with a treatment duration ≥12 weeks. The primary outcome was placebo-corrected change in body weight from baseline to end of treatment. Secondary outcomes were changes in waist circumference, atherogenic lipids (total cholesterol, LDL cholesterol, and triglycerides), glycated hemoglobin, and hemodynamic outcomes. Prespecified subgroup analyses evaluated effect modification by dose, treatment indication, and the use of an active comparator (selective GLP-1R agonists). RESULTS A total of 6,593 records were identified, and 16 trials comprising 6,611 participants (47.3% male) were included. Dual GLP-1R/GCGR agonists significantly reduced body weight compared with placebo (−7.44% [95% CI −9.44, −5.43]; −7.27 kg [95% CI −9.28, −5.27]). Weight loss was accompanied by improvements across all cardiometabolic risk factors. Compared with selective GLP-1R agonists, dual GLP-1R/GCGR agonists were associated with a greater reduction in triglycerides (−0.28 mmol/L [95% CI −0.50, −0.06]). CONCLUSIONS Dual GLP-1R/GCGR agonists consistently improved cardiometabolic risk factors across randomized clinical trials and may provide metabolic benefits beyond selective GLP-1R agonists. These findings support further evaluation in large-scale outcome studies.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"7 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148768693","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":"Recent Advances in Diabetes Therapies in Asia","authors":"Lei Qian, Filip Surmont, Linong Ji","doi":"10.2337/dci26-0057","DOIUrl":"https://doi.org/10.2337/dci26-0057","url":null,"abstract":"Asia confronts a disproportionately high diabetes burden, characterized by aggressive pathophysiology and early-onset complications. For addressing this crisis, established therapeutic agents are actively leveraged across Asia via multifaceted approaches, e.g., developing fixed-dose combinations to improve adherence or optimizing drug structures to enhance therapeutic profiles. Concurrently, Asian innovators are advancing emerging target-based agent classes into clinical use, including glucagon-like peptide 1 multiagonists, glucokinase activators, pan–peroxisome proliferator–activated receptor modulators, AMP-activated protein kinase/NOD-like receptor family pyrin domain–containing 3 dual targeted compound, glimins-class oral small molecule, and G-protein–coupled receptor 119 receptor agonist, etc. Technologies such as antisense oligonucleotide (ASO) inhibitors targeting glucagon receptor, stem cell therapy, and microbiome-based glycemic management are also being clinically validated in Asia. Meanwhile, devices such as continuous glucose monitoring, automated insulin delivery systems, and noninvasive glucose monitors are advancing toward broader clinical adoption. This review critically synthesizes Asia’s contemporary strategies against diabetes, spanning from the optimization of established target-based agents to the breakthroughs of novel therapeutics and the advancement of maturing technologies and devices. This evolution reflects Asia’s accelerating transition from a major clinical trial hub and product consumer to a global driver and leader in innovative glucose-lowering drug development. Propelled by pioneering drug innovators, surging research and development investment, and robust multistakeholder collaboration across industry, academia, and health care, the region is fostering a dynamic innovation ecosystem. Through synergistically advancing the research and application of glucose-lowering therapeutics alongside context-adapted implementation, Asia’s practical experience delivers a referable approach for diabetes management across the globe and promotes sustained innovation within diabetology.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"19 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148768695","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}