Diabetes Care最新文献

{"title":"International Variation in Case Fatality After Major Coronary or Cerebrovascular Events in Individuals With Type 2 Diabetes: Evidence From ADVANCE, TECOS, and EXSCEL","authors":"Philip M. Clarke, Xinyang Hua, Ruth L. Coleman, John Chalmers, Mark Woodward, Jennifer B. Green, Darren K. McGuire, Lee-Ling Lim, Amanda I. Adler, Rury R. Holman","doi":"10.2337/dc25-0541","DOIUrl":"https://doi.org/10.2337/dc25-0541","url":null,"abstract":"OBJECTIVE To examine differences in case-fatality incidence among individuals with type 2 diabetes after major coronary or cerebrovascular events by geographic region and country income level. RESEARCH DESIGN AND METHODS We studied ADVANCE, TECOS, and EXSCEL participants who experienced within-trial major coronary (fatal or nonfatal myocardial infarction or sudden cardiac death) or cerebrovascular (fatal or nonfatal stroke) events. Case fatality was defined as death at the time or within 30 days of an event. We compared geographic regions with the reference category (Western Europe, North America, or Australia and New Zealand) and compared medium- and low-income countries, based on gross national income per capita by the World Bank, with the reference category (high). Unadjusted and adjusted analyses were performed for each trial using logistic regression for individual participant data, and the results were meta-analyzed. Adjustments were made for previous cardiovascular events and risk factors. RESULTS There were 2,574 major coronary and 1,247 cerebrovascular events among the 40,563 study participants. Postcoronary case-fatality adjusted odds ratios (95% CIs), compared with the reference group, were 3.31 (2.32–4.72), 2.78 (2.11–3.66), and 2.84 (1.71–4.73) for Asia, Central and Eastern Europe, and South America and Africa, respectively. The odds ratio for low- and middle-income versus high-income countries was 3.07 (2.41–3.92). Case fatality after a major cerebrovascular event did not differ by geographic region or income group. CONCLUSIONS Postcoronary case fatality was substantially higher in Asia, Central and Eastern Europe, and South America and Africa compared with Western countries and higher in low- and middle-income countries compared with high-income countries.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"10 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919054","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":"Plant-Based Dietary Patterns Associated With Reduced Risk of All-Cause Mortality in Diabetes Subgroups: A Prospective Cohort Study From the UK Biobank","authors":"Edyta Schaefer, Janett Barbaresko, Michael Roden, Oliver Kuss, Sabrina Schlesinger","doi":"10.2337/dc25-0344","DOIUrl":"https://doi.org/10.2337/dc25-0344","url":null,"abstract":"OBJECTIVE To investigate the association between adherence to a plant-based dietary index (PDI), healthy PDI, and unhealthy PDI with all-cause mortality in people with type 2 diabetes and to assess whether associations varied by diabetes subgroups. RESEARCH DESIGN AND METHODS We included 4,829 UK Biobank participants with type 2 diabetes and at least two 24-h dietary recalls. We generated overall, healthy, and unhealthy scores. Multivariable Cox regression estimated hazard ratios (HRs) and 95% CIs for all-cause mortality, comparing the highest tertile (T3) with the lowest T1 of adherence to PDI, a healthy PDI, and an unhealthy PDI. Interactions between PDI adherence and diabetes subgroups (HbA1c, waist circumference, age at diagnosis, diabetes duration) were assessed by two-dimensional B-splines and by including product terms into the model. RESULTS During a mean follow-up of 11.3 years, 679 deaths occurred. Individuals with the highest PDI adherence, compared with those with lowest, were at lower risk of all-cause mortality (T3 vs. T1: HR 0.79 [95% CI 0.63; 0.99]), and a similar direction was observed for those with a healthy PDI (0.82 [0.67; 1.02]) but the 95% CI included the null value. Unhealthy PDI was associated with increased mortality risk (1.24 [1.00; 1.54]). The associations of PDI, healthy PDI, and unhealthy PDI with all-cause mortality risk were more pronounced for those with poorer glycemic control, higher waist circumference, diagnosis earlier in life, and longer diabetes duration. CONCLUSIONS Higher PDI adherence was associated with decreased mortality risk and higher unhealthy PDI adherence with an increased mortality risk. There was an indication for differences in these association depending on diabetes subgroups.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"11 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915481","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":"Sight-Threatening Diabetic Retinopathy During and After Pregnancy—A Nationwide Matched-Cohort Study","authors":"Janni E. Larsson, Lonny Stokholm, Toke Bek, Nis Andersen, Jens Andresen, Javad Hajari, Steffen Heegaard, Kurt Højlund, Ryo Kawasaki, Sören Möller, Frederik N. Pedersen, Katja C. Schielke, Anne Thykjær Petersen, Jakob Grauslund, Elisabeth R. Mathiesen, Caroline S. Laugesen","doi":"10.2337/dc25-0758","DOIUrl":"https://doi.org/10.2337/dc25-0758","url":null,"abstract":"OBJECTIVE To evaluate the risk of treatment of sight-threatening diabetic retinopathy (DR) defined as panretinal photocoagulation for proliferative DR or anti–vascular endothelial growth factor injections for diabetic macular edema (DME) during and after pregnancy compared with nonpregnant control participants. RESEARCH DESIGN AND METHODS This was a matched cohort study of women with type 1 diabetes who gave birth in 2013–2022 and who had DR levels recorded in the national Danish Registry of Diabetic Retinopathy during and after pregnancy. Control participants consisted of nonpregnant women with type 1 diabetes, individually matched by baseline DR level. Data were collected from relevant national registers from 36 months before pregnancy until 36 months after. RESULTS We included 1,041 pregnant women and 1,041 matched control participants. At baseline, the median duration (interquartile range [IQR]) of diabetes was 13 (6, 19) and 10 (5, 17) years for cases and control participants. Median baseline HbA1c (IQR) was 57 (50, 67) compared with 64 (55, 79) mmol/mol (7.4% vs. 8%), and DR was present in 42.7% of both groups. During and after pregnancy, treatment of proliferative DR with panretinal photocoagulation occurred to a similar extent in both groups (pregnant women vs. control participants: during treatment: 1.2% vs. 1.1%, respectively, OR 1.18 [95% CI 0.53, 2.66]); and after treatment: 2.7% vs. 2.9%, respectively, OR 0.93 [95% CI 0.55, 1.57]). Treatment of DME was rare in both groups. Progression to proliferative DR was not higher in the pregnant group (adjusted hazard ratio 0.64 [95% CI 0.32, 1.31]). CONCLUSIONS In this nationwide register study of women with type 1 diabetes, pregnant women and retinopathy-matched, nonpregnant control participants had a similar risk of developing sight-threatening DR requiring treatment during and within 36 months after pregnancy.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"19 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906061","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":"Prediction of Sarcopenia Onset in Type 2 Diabetes Using Urinary Titin Levels: A Japanese Prospective Cohort Study","authors":"Hayato Tanabe, Yoshinori Takiguchi, Rie Tsutsumi, Kaori Shiroma, Mizusa Hyodo, Yuna Izumi-Mishima, Kazuhiro Nomura, Masafumi Matsuo, Hiroshi Sakaue, Michio Shimabukuro","doi":"10.2337/dc25-1067","DOIUrl":"https://doi.org/10.2337/dc25-1067","url":null,"abstract":"OBJECTIVE The predictive power of urinary titin for incident sarcopenia was studied in Japanese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Baseline urinary titin levels were measured, and sarcopenia was evaluated annually using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Kaplan-Meier curves, Cox models, and time-dependent receiver operating characteristic analyses were used to assess incident sarcopenia. RESULTS Among 444 participants (median follow-up, 1,078 days), 41 developed sarcopenia. The high titin tertile was associated with an elevated sarcopenia risk (log-rank P = 0.04). Cox models associated titin with sarcopenia (adjusted hazard ratio per SD 1.37, 95% CI 1.05–1.77, P = 0.019) and low muscle strength. Risk estimates were consistent across subgroups, including those aged ≥70 years, men, individuals with BMI <25 kg/m2, HbA1c ≥7%, and estimated glomerular filtration rate ≥60 mL/min/1.73 m2 (P for interaction > 0.05). CONCLUSIONS Elevated urinary titin levels predict sarcopenia and low muscle strength in individuals with type 2 diabetes, supporting its use as a noninvasive biomarker.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"12 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898086","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":"Low-Dose Glucagon to Prevent and Treat Exercise-Associated Hypoglycemia in Individuals With Type 1 Diabetes: A Systematic Review and Meta-analysis","authors":"Sissel Banner Lundemose, Ajenthen Gayathri Ranjan, Ole Nørgaard, Tommi Suvitaival, Kirsten Nørgaard","doi":"10.2337/dc25-0702","DOIUrl":"https://doi.org/10.2337/dc25-0702","url":null,"abstract":"OBJECTIVE People with type 1 diabetes (T1D) struggle to manage exercise because of hypoglycemia risk. RESEARCH DESIGN AND METHODS This systematic review and meta-analysis evaluated low-dose glucagon's efficacy for preventing and treating exercise-induced hypoglycemia in T1D. Medline, Embase, and Cochrane CENTRAL were searched for randomized controlled trials and crossover studies until September 2024. The analysis included T1D adolescents and adults treated with low-dose glucagon versus nonglucagon treatments. Studies with glucagon-like peptides, noninsulin combinations, or uncontrolled exercise settings were excluded. Two authors extracted the data. The methodological quality was assessed with the Risk of Bias-2 tool and Grading of Recommendations Assessment, Development and Evaluations framework. Risk of Bias 2 informed a sensitivity analysis. The meta-analysis employed a random effects model to estimate the pooled treatment effects on hypoglycemia and time below range (TBR) (glucose <3.9 mmol/L), as well as secondary outcomes and adverse effects. RESULTS Of 6,792 records, 12 studies involving 248 individuals (mean age: 36 ± 10.5 years) met inclusion criteria. The meta-analysis showed significant reductions in hypoglycemia risk (risk ratio 0.54; 95% CI 0.35, 0.84) and TBR (−3.91 percentage points; 95% CI −6.27, 1.54) with low-dose glucagon. Sensitivity analysis yielded a slightly more confident effect size for hypoglycemia and TBR. However, overall adverse events increased with low-dose glucagon (risk ratio 2.75; 95% CI 1.07, 7.08). The included studies were few and heterogeneous, which may have influenced the overall outcomes. CONCLUSIONS Low-dose glucagon reduces exercise-induced hypoglycemia and TBR in T1D individuals. Future research should optimize glucagon dosage and timing for various exercise types and durations to confirm real-world effectiveness.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"46 1","pages":"1637-1645"},"PeriodicalIF":16.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901568","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":"Risk of Phimosis Associated With SGLT2i Versus GLP-1RA: A Danish Cohort Study","authors":"Christine Ljungberg, Mette Nørgaard, Christina Vandenbroucke-Grauls, Jakob Kristian Jakobsen, Morten Haaning Charles, Anton Pottegård, Michael Dalager-Pedersen, Henrik Toft Sørensen, Reimar Wernich Thomsen","doi":"10.2337/dc25-0693","DOIUrl":"https://doi.org/10.2337/dc25-0693","url":null,"abstract":"OBJECTIVE Sodium-glucose cotransporter 2 inhibitors (SGLT2i) induce glucosuria, potentially leading to infection and inflammation in the preputial microenvironment, subsequently increasing the risk of phimosis. We aimed to investigate the risks of phimosis in males with type 2 diabetes initiating SGLT2i or glucagon-like peptide-1 receptor agonists (GLP-1RA). RESEARCH DESIGN AND METHODS In this population-based active-comparator new-user cohort study emulating a target trial, we included all adult male metformin users in Denmark initiating SGLT2i or GLP-1RA between 2016 and 2021. We used inverse probability of treatment weighting to balance the distribution of potential confounders. We estimated weighted intention-to-treat risk and risk ratios of phimosis identified from population-based medical databases. RESULTS In this study, we included 32,486 SGLT2i initiators and 14,793 GLP-1RA initiators with a median follow-up of 4 years (maximum 8 years). The risk of phimosis was elevated among SGLT2i users. The 1-year risk of phimosis was 0.9% among new SGLT2i users and 0.5% among new GLP-1RA users, corresponding to a 1-year risk ratio of 1.88 (95% CI, 1.43 to 2.47). During 8 years of follow-up, the risk of phimosis accumulated up to 4.8% in SGLT2i users and 3.6% in GLP-1RA users, with an 8-year risk ratio of 1.36 (95% CI, 1.14 to 1.61). CONCLUSIONS SGLT2i use was associated with a nearly twofold increased phimosis risk 1 year after treatment initiation in men with type 2 diabetes, compared with GLP-1RA use. Over 8 years of follow-up, the risk remained elevated, indicating a persistently higher risk associated with SGLT2i use.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"19 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747070","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":"A Metabolomics Study of Cardiac Dysfunction in Hyperglycemia—Findings From the Atherosclerosis Risk in Communities (ARIC) Study and the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)","authors":"Yilin Yoshida, Ngoc Quynh Nguyen, Eun Hye Moon, Casey Rebholz, Hicham Skali, Victoria Arthur, Justin B. Echouffo-Tcheugui, Christie Ballantyne, Elizabeth Selvin, Amil Shah, Robert Kaplan, Carlos J. Rodriguez, Qibin Qi, Susan Cheng, Bing Yu","doi":"10.2337/dc25-0730","DOIUrl":"https://doi.org/10.2337/dc25-0730","url":null,"abstract":"OBJECTIVE Hyperglycemic states (prediabetes and diabetes) are associated with heart failure (HF) risk. We aimed to identify distinct metabolites for subclinical cardiac dysfunction, a precursor of HF, in hyperglycemic or euglycemic individuals. RESEARCH DESIGN AND METHODS We conducted cross-sectional and prospective analyses of 2,492 HF-free participants from the Atherosclerosis Risk in Communities (ARIC) study visit 5, 2011–2013. A total of 1,297 participants were hyperglycemic (assessed on the basis of hemoglobin A1c >5.7%, fasting glucose >100 mg/dL, use of diabetes medication, or diagnosis), and 1,195 were euglycemic. We used logistic regression for analysis of association between 790 metabolites and cardiac dysfunction, defined according to echocardiographic abnormalities (left ventricular hypertrophy, systolic or diastolic dysfunction) or elevated NT-proBNP or troponin T, in two glycemic groups separately. We used Cox regression for prospective association between cardiac dysfunction–related metabolites identified in the prior step and HF risk, adjusting for clinical risk factors. Analyses were replicated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (n = 5,167). RESULTS Microvascular disease–related metabolites (e.g., pseudouridine, N6-carbamoylthreonyladenosine, N6-acetyllysine, N2,N5-diacetylornithine) were associated with cardiac dysfunction in hyperglycemic individuals. Carbohydrate and cofactor-derived metabolites (e.g., gulonate, erythrocyte) were associated with cardiac dysfunction in euglycemic individuals. These cardiac dysfunction–related metabolites were prospectively associated with HF risk in the two glycemic groups (follow-up 7.5 years, 137 and 94 HF cases, per-SD increase hazards ratios range 1–1.9 and 1.1–2.9), respectively. HCHS/SOL results were consistent with those from ARIC. CONCLUSIONS Metabolites known for microvascular complications were associated with cardiac dysfunction in hyperglycemic individuals but not among their euglycemic counterparts, supporting the premise that microvascular dysfunction contributes to HF pathogenesis in diabetes.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"50 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737176","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":"DNA Methylation Smoking Scores and Risk of Islet Autoimmunity and Type 1 Diabetes","authors":"Lauren A. Vanderlinden, Ellen Wong, Randi K. Johnson, Patrick Carry, Fran Dong, Katerina Kechris, Marian Rewers, Jill M. Norris","doi":"10.2337/dc25-0330","DOIUrl":"https://doi.org/10.2337/dc25-0330","url":null,"abstract":"OBJECTIVE Multiple studies have reported an inverse association between self-reported smoking during pregnancy and offspring type 1 diabetes (T1D) risk. We investigated the association between DNA methylation (DNAm) smoke exposure scores, parental self-reported smoking, and islet autoimmunity (IA) and T1D risk in children at high risk of T1D. RESEARCH DESIGN AND METHODS We used longitudinal data from the Diabetes Autoimmunity Study in the Young cohort, including 205 IA case and 206 control participants (87 and 88 were T1D case and control participants, respectively), matched by age, race/ethnicity, and sample availability. DNAm profiles were obtained from cord or peripheral blood using the Infinium Human Methylation 450K or EPIC BeadChip. Three published DNAm smoking scores were calculated at every time point. To estimate in utero smoke exposure, participant-specific intercepts were derived from mixed-effects models of longitudinal DNAm scores. These intercepts strongly correlated with cord blood scores (r = 0.85–0.95; n = 179), indicating their utility as proxies for in utero smoke exposure. Associations with IA/T1D were evaluated using logistic regression, adjusting for HLA-DR3/4, first-degree relative status, and sex. RESULTS Multivariable models showed both maternally reported smoking during pregnancy and higher DNAm smoking scores to be associated with lower risk of IA and T1D. Maternal smoking showed a strong inverse association with IA (odds ratio [OR] 0.24; 95% CI 0.10–0.54). Rauschert and McCartney DNAm scores showed consistent inverse associations with both outcomes (OR 0.65–0.83 for SD increase). CONCLUSIONS Our study supports existing literature indicating in utero smoke exposure is associated with reduced IA and T1D risk. Further research is essential to uncover the underlying mechanisms.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"27 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712321","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":"Contrasting Adult and Pediatric Populations in a Cohort of At-Risk Relatives in The T1D TrialNet Pathway to Prevention Study","authors":"Erin L. Templeman, Lauric A. Ferrat, Nicholas Thomas, Cate Speake, Diane K. Wherrett, Jennifer Sherr, John M. Wentworth, Maria J. Redondo, Hemang M. Parik, Jamie L. Felton, Carmella Evans-Molina, Jay Sosenko, Lu You, Richard A. Oram, Emily K. Sims","doi":"10.2337/dc25-0192","DOIUrl":"https://doi.org/10.2337/dc25-0192","url":null,"abstract":"OBJECTIVE More than half of incident type 1 diabetes (T1D) occurs in adults, yet research on disease progression predominantly focuses on at-risk children. We compared autoantibody screening outcomes and T1D progression in adults versus children. RESEARCH DESIGN AND METHODS We studied 135,914 children (aged <18 years) and 99,795 adult relatives of individuals with T1D screened in the TrialNet Pathway to Prevention study. In autoantibody positive participants, we compared progression rates, associations with risk factors, and performance of metabolic risk scores. RESULTS Adults were more likely than children to screen positive for a single autoantibody (4.0% vs. 2.6%) but less likely for multiple autoantibodies (0.83% vs. 2.8%; P < 0.001). Progression to stage 3 disease was lower in adults with single autoantibody positivity or stage 1 T1D than in children (5-year risks: single autoantibody, adults 8.2% vs. children 22%, P < 0.001; stage 1, adults 17% vs. children 47%, P < 0.001). However, adults with stage 2 T1D at initial staging oral glucose tolerance test had comparable 5-year progression risks to children (78% for both groups). A higher proportion of adults progressing to clinical diabetes were single autoantibody positive (40% vs. 15%; P < 0.0001); these individuals commonly had single glutamic acid decarboxylase positivity and had lower type 1 but higher type 2 genetic risk scores compared with multiple autoantibody positive adults. HbA1c and established risk indices more effectively identified progressors in adults compared with children. CONCLUSIONS Autoantibody positive adult relatives have distinct autoantibody trajectories and progression risks compared with children, suggesting the need for tailored monitoring and intervention strategies.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"11 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684725","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":"Tirzepatide Treatment and Associated Changes in β-Cell Function and Insulin Sensitivity in People With Obesity or Overweight With Prediabetes or Normoglycemia: A Post Hoc Analysis From the SURMOUNT-1 Trial","authors":"Andrea Mari, Adam Stefanski, Daniel H. van Raalte, Xiaosu Ma, Elizabeth S. LaBell, Ludi Fan, Clare J. Lee, Melissa K. Thomas, Mathijs C. Bunck, Ele Ferrannini","doi":"10.2337/dc25-0763","DOIUrl":"https://doi.org/10.2337/dc25-0763","url":null,"abstract":"OBJECTIVE We assessed insulin sensitivity and β-cell function in adults with obesity/overweight, without diabetes, treated with tirzepatide for 72 weeks. RESEARCH DESIGN AND METHODS This post hoc analysis from the Study of Tirzepatide (LY3298176) in Participants With Obesity or Overweight (SURMOUNT-1) trial investigated tirzepatide versus placebo in 2,539 participants with BMI ≥27 kg/m2 and either prediabetes or normoglycemia at baseline. Model-derived parameters of β-cell function and insulin sensitivity were assessed from oral glucose tolerance tests. RESULTS At week 72, tirzepatide treatment was associated with body weight reduction and improvements in insulin sensitivity and β-cell function measures overall and in participants with prediabetes or normoglycemia. In multivariate regression models, improvements in insulin sensitivity were associated mostly with weight reduction and partly with tirzepatide treatment, whereas enhancement in β-cell function was mostly associated with tirzepatide treatment. CONCLUSIONS In adults with obesity/overweight without type 2 diabetes, tirzepatide treatment was associated with improved β-cell function and insulin sensitivity, partly independent of weight reduction.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"52 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684732","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}