Diabetes Care最新文献_第3页

One-Hour Oral Glucose Tolerance Test for the Postpartum Reclassification of Women With Hyperglycemia in Pregnancy

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-03-03 DOI: 10.2337/dc24-1848

Ravi Retnakaran, Chang Ye, Caroline K. Kramer, Anthony J. Hanley, Philip W. Connelly, Mathew Sermer, Bernard Zinman

{"title":"One-Hour Oral Glucose Tolerance Test for the Postpartum Reclassification of Women With Hyperglycemia in Pregnancy","authors":"Ravi Retnakaran, Chang Ye, Caroline K. Kramer, Anthony J. Hanley, Philip W. Connelly, Mathew Sermer, Bernard Zinman","doi":"10.2337/dc24-1848","DOIUrl":"https://doi.org/10.2337/dc24-1848","url":null,"abstract":"OBJECTIVE The International Diabetes Federation recently endorsed a 1-h oral glucose tolerance test (OGTT) as more convenient than the conventional 2-h OGTT. In practice, women with hyperglycemia in pregnancy are advised to undergo a 2-h OGTT within 6 months after delivery, but this test is often not completed, partly owing to its inconvenience for busy mothers. Recognizing the potential advantage of the 1-h OGTT in this setting, we sought to compare 1-h and 2-h OGTT glucose measurements at 3 months postpartum as predictors of dysglycemia (prediabetes/diabetes) over the first 5 years postpartum. RESEARCH DESIGN AND METHODS A total of 369 women across a range of glucose tolerance in pregnancy (from normoglycemia to gestational diabetes [GDM]) underwent multisample 2-h 75-g OGTTs at 3 months, 1 year, 3 years, and 5 years postpartum. Glucose measurements from the 3-month OGTT were ranked as predictors of dysglycemia (both criteria) by change in concordance index (CCI) of Cox proportional hazard regression models. RESULTS At the 3-month OGTT, 1-h glucose identified all but 10 of 70 women concurrently diagnosed with dysglycemia by 2-h glucose, while diagnosing an additional 96 women. The cumulative incidence of dysglycemia progressively increased over 5 years by tertile of 1-h glucose on the 3-month OGTT (P &lt; 0.0001). On regression analyses, the strongest predictor of dysglycemia was 1-h glucose (change in CCI: 16.1%), followed by 2-h glucose (14.9%). In women with GDM, 1-h glucose again emerged as strongest predictor of dysglycemia (13.0%), followed by 2-h glucose (12.8%). CONCLUSIONS The 1-h OGTT may offer a strategy for increasing rates of postpartum reclassification following hyperglycemia in pregnancy.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"35 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539206","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

Isolated Glucosuria in Adolescence and Early-Onset Diabetes: A Nationwide Cohort Study of 1.6 Million Adolescents

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-26 DOI: 10.2337/dc24-2402

Adi Vinograd, Tsahi T. Lerman, Orit Pinhas-Hamiel, Aya Bardugo, Cole D. Bendor, Estela Derazne, Josef Coresh, Ofir Vinograd, Miri Lutski, Inbar Zucker, Michal Bromberg, Tamar Fishman, Gabriel Chodick, Hertzel C. Gerstein, Tali Cukierman-Yaffe, Asaf Vivante, Adi Leiba, Arnon Afek, Amir Tirosh, Boris Fishman, Gilad Twig

{"title":"Isolated Glucosuria in Adolescence and Early-Onset Diabetes: A Nationwide Cohort Study of 1.6 Million Adolescents","authors":"Adi Vinograd, Tsahi T. Lerman, Orit Pinhas-Hamiel, Aya Bardugo, Cole D. Bendor, Estela Derazne, Josef Coresh, Ofir Vinograd, Miri Lutski, Inbar Zucker, Michal Bromberg, Tamar Fishman, Gabriel Chodick, Hertzel C. Gerstein, Tali Cukierman-Yaffe, Asaf Vivante, Adi Leiba, Arnon Afek, Amir Tirosh, Boris Fishman, Gilad Twig","doi":"10.2337/dc24-2402","DOIUrl":"https://doi.org/10.2337/dc24-2402","url":null,"abstract":"OBJECTIVE We assess diabetes risk in adulthood among adolescents with isolated glucosuria. RESEARCH DESIGN AND METHODS Included were adolescents (16–19 years) examined before military service between 1993 and 2015. Data were linked with the Israeli National Diabetes Registry. Glucosuria was confirmed following normal renal function and glucose tolerance tests. Cox models were applied. RESULTS The study included 1,611,467 adolescents, of whom 755 (0.05%) had glucosuria. The latter group had a higher proportion of males (75% vs. 57%) and a lower proportion of BMI ≥ 85th percentile (10.4% vs. 16.3%) compared with nonglucosuric (all P &lt; 0.001). During follow-up, 10,328 diabetes cases were recorded with an incidence rate of 87.5 and 43.3 per 100,000 person-years for those with versus without glucosuria, respectively. Individuals with glucosuria had an adjusted hazard ratio of 2.17 (95% CI, 1.17–4.04) for diabetes. CONCLUSIONS Glucosuria in adolescents is associated with an increased risk of early-onset diabetes.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"27 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507121","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

Early Continuous Glucose Monitor Use in Children and Adolescents With Type 1 Diabetes: Rates of Initiation and Impact on Glycemic Outcomes

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-26 DOI: 10.2337/dc25-0076

Elizabeth A. Mann, Saketh Rompicherla, Brian Miyazaki, Nicole Rioles, Holly Hardison, Lauren Golden, Jennifer Sarhis, Halis K. Akturk, Joyce Lee, Daniel J. DeSalvo, Patricia Gomez, Osagie Ebekozien, Priya Prahalad

{"title":"Early Continuous Glucose Monitor Use in Children and Adolescents With Type 1 Diabetes: Rates of Initiation and Impact on Glycemic Outcomes","authors":"Elizabeth A. Mann, Saketh Rompicherla, Brian Miyazaki, Nicole Rioles, Holly Hardison, Lauren Golden, Jennifer Sarhis, Halis K. Akturk, Joyce Lee, Daniel J. DeSalvo, Patricia Gomez, Osagie Ebekozien, Priya Prahalad","doi":"10.2337/dc25-0076","DOIUrl":"https://doi.org/10.2337/dc25-0076","url":null,"abstract":"OBJECTIVE Early initiation of continuous glucose monitor (CGM) after type 1 diabetes (T1D) diagnosis has been associated with lower hemoglobin A1C (HbA1c) in single-institution studies. This multicenter study evaluated the association between the timing of CGM initiation and HbA1c at 3 years postdiagnosis. RESEARCH DESIGN AND METHODS Data were obtained from the T1D Exchange Quality Improvement Collaborative (T1DX-QI) electronic health record database from 25 pediatric centers and included children and adolescents ≤18 years old diagnosed with T1D in 2019 and 2020. CGM initiation and glycemic outcomes were followed for 3 years after diagnosis. Locally estimated scatterplot smoothing plots evaluated the relationship between timing of CGM initiation and HbA1c over time, and logistic regression models were used to adjust for potential confounders. RESULTS There were 4,164 people included in this analysis, mean age was 12.6 (SD 3.5) years, and 37% had public health insurance. Of the 93% (n = 3,877) who initiated CGM within 3 years of T1D diagnosis, 21% did so at 0–3 months, 14% at 3–6 months, 14% at 6–12 months, and 51% after 12 months. Median HbA1c at 3 years postdiagnosis was lower for the 0–3 and 3–6 months groups compared with the 6–12 months and non-CGM user groups (7.9%, 7.9%, 8.4%, and 9.5%, respectively). Adjusted odds of HbA1c &gt;9% were lowest for the 0–3 months group followed by the 3–6 months group. CONCLUSIONS In summary, early initiation of CGM within the first 6 months of diagnosis is associated with improved HbA1c outcomes at 3 years postdiagnosis.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"69 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507120","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

Development and Validation of the Patient-Level Chinese Diabetes Outcome Model on Long-term Complications in Type 2 Diabetes: An Application of the Hong Kong Diabetes Register

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-25 DOI: 10.2337/dca24-0069

Eric S.H. Lau, Andrea O.Y. Luk, Lee-Ling Lim, Hongjiang Wu, Aimin Yang, Alice P.S. Kong, Ronald C.W. Ma, Risa Ozaki, Elaine Y.K. Chow, Chiu-Chi Tsang, Chun-Kwun O, Amy Fu, Edward W. Gregg, Philip Clarke, Wing-Yee So, Juliana N.M. Lui, Juliana C.N. Chan

{"title":"Development and Validation of the Patient-Level Chinese Diabetes Outcome Model on Long-term Complications in Type 2 Diabetes: An Application of the Hong Kong Diabetes Register","authors":"Eric S.H. Lau, Andrea O.Y. Luk, Lee-Ling Lim, Hongjiang Wu, Aimin Yang, Alice P.S. Kong, Ronald C.W. Ma, Risa Ozaki, Elaine Y.K. Chow, Chiu-Chi Tsang, Chun-Kwun O, Amy Fu, Edward W. Gregg, Philip Clarke, Wing-Yee So, Juliana N.M. Lui, Juliana C.N. Chan","doi":"10.2337/dca24-0069","DOIUrl":"https://doi.org/10.2337/dca24-0069","url":null,"abstract":"OBJECTIVE Patient-level simulation models, mainly developed in Western populations, capture complex interactions between risk factors and complications to predict the long-term effectiveness and cost-effectiveness of novel treatments and identify high-risk subgroups for personalized care. However, incidence of outcomes varies significantly by ethnicity and region. We used high-quality, patient-level register data to develop the Chinese Diabetes Outcomes Model (CDOM) for predicting incident and recurrent events in type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS The CDOM was developed using the prospective Hong Kong Diabetes Register (HKDR) cohort (n = 21,453; median follow-up duration, 7.9 years; 166,433 patient-years). It was externally validated with a retrospective territory-wide cohort of Chinese patients with T2D attending Hong Kong publicly funded diabetes centers and community clinics (n = 176,120; follow-up duration, 7.2 years; 953,523 patient-years). RESULTS The CDOM predicted first and recurrent events with satisfactory performance during internal (C-statistic = 0.740–0.941) and external (C-statistic = 0.758–0.932) validation after calibration. The respective C-statistic values for cancer were 0.664 and 0.661. Subgroup analysis showed consistent performance during internal (C-statistic = 0.632–0.953) and external (C-statistic = 0.598–0.953) validation after calibration. CONCLUSIONS The CDOM, developed using comprehensive register data with long-term follow-up, is a robust tool for predicting long-term outcomes in Chinese patients with T2D. The model enables the identification of patient subgroups to augment study design and develop tailored novel treatment strategies, inform policy, and guide practice to improve cost-effectiveness of diabetes care.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"230 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495378","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

Comparative Efficacy of Glucagon-Like Peptide 1 Receptor Agonists for Cardiovascular Outcomes in Asian Versus White Populations: Systematic Review and Meta-analysis of Randomized Trials of Populations With or Without Type 2 Diabetes and/or Overweight or Obesity

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-20 DOI: 10.2337/dc24-1533

Matthew M.Y. Lee, Nazim Ghouri, Anoop Misra, Yu Mi Kang, Martin K. Rutter, Hertzel C. Gerstein, Darren K. McGuire, Naveed Sattar

{"title":"Comparative Efficacy of Glucagon-Like Peptide 1 Receptor Agonists for Cardiovascular Outcomes in Asian Versus White Populations: Systematic Review and Meta-analysis of Randomized Trials of Populations With or Without Type 2 Diabetes and/or Overweight or Obesity","authors":"Matthew M.Y. Lee, Nazim Ghouri, Anoop Misra, Yu Mi Kang, Martin K. Rutter, Hertzel C. Gerstein, Darren K. McGuire, Naveed Sattar","doi":"10.2337/dc24-1533","DOIUrl":"https://doi.org/10.2337/dc24-1533","url":null,"abstract":"BACKGROUND Cardiovascular outcome trials (CVOTs) suggest glucagon-like peptide 1 receptor agonists (GLP-1RAs) provide greater cardiovascular (CV) benefits in Asian compared with White individuals. PURPOSE Compare CV efficacy of GLP-1RAs between Asian and White individuals. DATA SOURCES Systematic review of PubMed and ClinicalTrials.gov (1 January 2015 to 1 November 2024). STUDY SELECTION Randomized placebo-controlled CVOTs of GLP-1RAs. Risk of bias was assessed (RoB 2). DATA EXTRACTION Ethnicity-specific hazard ratios (HRs) for major adverse cardiovascular events (MACE). DATA SYNTHESIS Random-effects meta-analyses per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included eight trials (5,909 Asian individuals, 55,855 White individuals). GLP-1RA–associated MACE HR was 0.69 (95% CI 0.58, 0.83) in Asian people and 0.85 (95% CI 0.79, 0.91) in White people (Pinteraction = 0.045). Absolute MACE risk reduction was 2.9% (95% CI 1.5, 4.2) in Asian people versus 1.4% (0.9, 1.9) in White people. LIMITATIONS Lack of individual patient-level data precluded detailed subclassification of the Asian group. CONCLUSIONS GLP-1RAs may offer greater MACE reductions in Asian compared with White individuals.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"22 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143462799","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

Alcohol Intake, Drinking Pattern, and Risk of Type 2 Diabetes in Three Prospective Cohorts of U.S. Women and Men

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-18 DOI: 10.2337/dc24-1902

Xinyi Li, Jinhee Hur, Stephanie A. Smith-Warner, Mingyang Song, Liming Liang, Kenneth J. Mukamal, Eric B. Rimm, Edward L. Giovannucci

{"title":"Alcohol Intake, Drinking Pattern, and Risk of Type 2 Diabetes in Three Prospective Cohorts of U.S. Women and Men","authors":"Xinyi Li, Jinhee Hur, Stephanie A. Smith-Warner, Mingyang Song, Liming Liang, Kenneth J. Mukamal, Eric B. Rimm, Edward L. Giovannucci","doi":"10.2337/dc24-1902","DOIUrl":"https://doi.org/10.2337/dc24-1902","url":null,"abstract":"OBJECTIVE Although the adverse effects of excessive alcohol consumption are well established, the association between light to moderate alcohol consumption (≤30 g ethanol per day) and risk of type 2 diabetes (T2D) remains controversial and holds substantial public health implications. We aimed to examine the association of total alcohol intake and drinking pattern with T2D among three cohorts, Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII), and Health Professionals Follow-up Study (HPFS). RESEARCH DESIGN AND METHODS Former regular drinkers were excluded from baseline nondrinkers. Hazard ratios (HRs) and 95% CIs were estimated by Cox models. RESULTS Over 3 decades of follow-up, 20,551 T2D cases were documented among 200,969 participants. Total alcohol intake was associated with a lower risk of T2D, either using nondrinkers or 0.1–4.9 g/day as the reference. The association was robust to extended latency periods and alternative modeling of exposure. Drinking frequency was associated with a lower T2D risk. For example, compared with drinking 1–2 days per week, the HRs (95% CIs) for drinking 5–6 days were 0.73 (0.65, 0.83), 0.73 (0.62, 0.86), and 0.76 (0.67, 0.86) in the NHS, NHSII, and HPFS cohorts, respectively. When modeled jointly, the lower risk of T2D among drinkers was primarily driven by the drinking frequency. The inverse association began at drinking 1–2 days per week in women and 3–4 days per week in men and was strongest for ≥5 days per week, regardless of drinking &lt;10 g or ≥30 g per drinking day. CONCLUSIONS Light to moderate alcohol consumption, especially regular light drinking, was associated with a lower risk of T2D in both men and women.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"1 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443202","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

Association of Diabetic Ketoacidosis at Onset, Diabetes Technology Uptake, and Clinical Outcomes After 1 and 2 Years of Follow-up: A Collaborative Analysis of Pediatric Registries Involving 9,269 Children With Type 1 Diabetes From Nine Countries

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-18 DOI: 10.2337/dc24-2483

Klemen Dovc, Vit Neuman, Gemulla Gita, Valentino Cherubini, G. Todd Alonso, Maria Fritsch, Claudia Boettcher, Carine de Beaufort, Reinhard W. Holl, Martin de Bock

{"title":"Association of Diabetic Ketoacidosis at Onset, Diabetes Technology Uptake, and Clinical Outcomes After 1 and 2 Years of Follow-up: A Collaborative Analysis of Pediatric Registries Involving 9,269 Children With Type 1 Diabetes From Nine Countries","authors":"Klemen Dovc, Vit Neuman, Gemulla Gita, Valentino Cherubini, G. Todd Alonso, Maria Fritsch, Claudia Boettcher, Carine de Beaufort, Reinhard W. Holl, Martin de Bock","doi":"10.2337/dc24-2483","DOIUrl":"https://doi.org/10.2337/dc24-2483","url":null,"abstract":"OBJECTIVE This study examined the association between diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis and long-term glycemic outcomes, insulin requirements, BMI SDS, and diabetes technology uptake in youth. RESEARCH DESIGN AND METHODS Data were from nine countries (Austria, Czechia, Germany, Italy, Luxembourg, New Zealand, Slovenia, Switzerland, and U.S. [Colorado]), including youth (0.5–15.9 years) diagnosed with type 1 diabetes in 2019–2020 and followed for 2 years thereafter. Participants were divided into three groups: no DKA, nonsevere, and severe DKA at diagnosis. HbA1c, insulin requirements, BMI SDS, and use of technology, including automated insulin delivery (AID), were assessed. RESULTS The analysis included 9,269 individuals (54.8% males, mean age 9.0 years). DKA at diagnosis was observed in 34.2% of participants and severe DKA in 12.8%. After 1 year, adjusted mean HbA1c was higher in the severe DKA group (7.41%) compared with nonsevere DKA (7.23%, P = 0.001) and no DKA groups (7.14, P &lt; 0.001), and this difference persisted after 2 years (7.58% vs. 7.38% [P &lt; 0.001] and vs. 7.32% [P &lt; 0.001]). Higher BMI SDS was observed in both DKA groups compared with no DKA. The use of AID was associated with lower HbA1c levels compared with other treatment modalities and moderated differences between DKA groups after 2 years of follow-up (P = 0.072). CONCLUSIONS Severe and nonsevere DKA at type 1 diabetes diagnosis were both associated with persistently higher HbA1c and higher BMI SDS. AID use diminishes the association of DKA at diagnosis and higher HbA1c over time.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"13 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443358","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

Lung Function Impairment and Risks of Incident Cardiovascular Diseases and Mortality Among People With Type 2 Diabetes: A Prospective Cohort Study

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-11 DOI: 10.2337/dc24-2188

Chaolei Chen, Zehan Huang, Lin Liu, Bingbing Su, Yingqing Feng, Yuqing Huang

{"title":"Lung Function Impairment and Risks of Incident Cardiovascular Diseases and Mortality Among People With Type 2 Diabetes: A Prospective Cohort Study","authors":"Chaolei Chen, Zehan Huang, Lin Liu, Bingbing Su, Yingqing Feng, Yuqing Huang","doi":"10.2337/dc24-2188","DOIUrl":"https://doi.org/10.2337/dc24-2188","url":null,"abstract":"OBJECTIVE Individuals with type 2 diabetes (T2D) frequently exhibit impaired lung function, potentially accelerating the onset of cardiovascular disease (CVD), although prospective studies remain limited. We aimed to explore the relationship between lung function impairment and risk of CVD and mortality within this high-risk population. RESEARCH DESIGN AND METHODS This prospective study included 16,242 participants with T2D and free of CVD from the UK Biobank. Obstructive physiology (OP), restrictive physiology (RP), and preserved ratio impaired spirometry (PRISm) were defined using spirometry, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Fine-Gray subdistribution hazards models and Cox proportional hazards models were used to estimate risks of CVD and all-cause mortality, respectively. RESULTS During a median follow-up of 13.9 years, 2,825 incident cases of CVD and 2,811 deaths were documented. Lower FEV1, FVC, FEV1/FVC ratio, FEV1 percent predicted, and FVC percent predicted were related to higher risks of CVD and all-cause mortality. Compared with preserved lung function, the adjusted subdistribution hazard ratios (HRs) for CVD were 1.19 (95% CI 1.05–1.35) for OP and 1.47 (95% CI 1.33–1.65) for RP. Compared with the control group, the subdistribution HRs for CVD were 1.20 (95% CI 1.06–1.36) for OP and 1.43 (95% CI 1.29–1.59) for PRISm. These associations were consistent across subgroups and sensitivity analyses. Adding lung function measurements significantly enhanced the performance of CVD prediction beyond the SCORE2-Diabetes model. CONCLUSIONS Lung function impairment was associated with increased risks of CVD and all-cause mortality among individuals with T2D.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"15 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143393333","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 Burden of Diabetes Mortality by County, Race, and Ethnicity in the U.S., 2000–2019

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-10 DOI: 10.2337/dc24-2259

Hasan Nassereldine, Zhuochen Li, Kelly Compton, Parkes Kendrick, Ethan Kahn, Yekaterina O. Kelly, Mathew M. Baumann, Chris A. Schmidt, Dillon O. Sylte, Kanyin Liane Ong, Wichada La Motte-Kerr, Farah Daoud, Susan A. McLaughlin, Simon I. Hay, Erik J. Rodriquez, Anna M. Nápoles, George A. Mensah, Eliseo J. Pérez-Stable, Ali H. Mokdad, Laura Dwyer-Lindgren

{"title":"The Burden of Diabetes Mortality by County, Race, and Ethnicity in the U.S., 2000–2019","authors":"Hasan Nassereldine, Zhuochen Li, Kelly Compton, Parkes Kendrick, Ethan Kahn, Yekaterina O. Kelly, Mathew M. Baumann, Chris A. Schmidt, Dillon O. Sylte, Kanyin Liane Ong, Wichada La Motte-Kerr, Farah Daoud, Susan A. McLaughlin, Simon I. Hay, Erik J. Rodriquez, Anna M. Nápoles, George A. Mensah, Eliseo J. Pérez-Stable, Ali H. Mokdad, Laura Dwyer-Lindgren","doi":"10.2337/dc24-2259","DOIUrl":"https://doi.org/10.2337/dc24-2259","url":null,"abstract":"OBJECTIVE Diabetes is a leading cause of death in the U.S. Previous studies have found substantial racial, ethnic, and geographical disparities in diabetes mortality; however, research considering racial, ethnic, and geographical disparities simultaneously has been limited. To fill this gap, we estimated trends in diabetes mortality rates from 2000 to 2019 at the county level for five racial and ethnic populations. RESEARCH DESIGN AND METHODS We applied small-area estimation methods to death registration data from the U.S. National Vital Statistics System and population data from the U.S. National Center for Health Statistics and corrected for misclassification of race and ethnicity on death certificates. RESULTS Age-standardized diabetes mortality rates decreased in the U.S. from 28.1 deaths per 100,000 (95% uncertainty interval 27.9–28.2) in 2000 to 19.1 deaths per 100,000 (19.0–19.2) in 2019. In 2019, national-level rates were highest for the American Indian or Alaska Native (AIAN) population (35.6 [32.1–39.4]), followed by the Black (31.9 [31.5–32.3]), Latino (19.7 [19.3–20.2]), White (17.6 [17.5–17.8]), and Asian (12.6 [12.1–13.1]) populations. There was substantial heterogeneity in diabetes mortality rates across counties within each racial and ethnic population, with the AIAN population experiencing the greatest heterogeneity in 2019 (interquartile range 18.7–50.3 [median 31.9]). For each racial and ethnic population, mortality rates declined in most counties from 2000 to 2019. CONCLUSIONS Since 2000, progress has been made in reducing diabetes mortality rates. Nonetheless, diabetes mortality remains too high for many Americans. Interventions focusing on communities at highest risk are vital to resolving persistent health inequities.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"16 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385125","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 Incident Diabetes Related to Lipoprotein(a), LDL Cholesterol, and Their Changes With Alirocumab: Post Hoc Analyses of the ODYSSEY OUTCOMES Randomized Trial

IF 16.2 1区医学

Diabetes Care Pub Date : 2025-02-06 DOI: 10.2337/dc24-2110

Gregory G. Schwartz, Michael Szarek, J. Wouter Jukema, Christa M. Cobbaert, Esther Reijnders, Vera A. Bittner, Markus Schwertfeger, Deepak L. Bhatt, Sergio Fazio, Genevieve Garon, Shaun G. Goodman, Robert A. Harrington, Harvey D. White, Philippe Gabriel Steg

{"title":"Risk of Incident Diabetes Related to Lipoprotein(a), LDL Cholesterol, and Their Changes With Alirocumab: Post Hoc Analyses of the ODYSSEY OUTCOMES Randomized Trial","authors":"Gregory G. Schwartz, Michael Szarek, J. Wouter Jukema, Christa M. Cobbaert, Esther Reijnders, Vera A. Bittner, Markus Schwertfeger, Deepak L. Bhatt, Sergio Fazio, Genevieve Garon, Shaun G. Goodman, Robert A. Harrington, Harvey D. White, Philippe Gabriel Steg","doi":"10.2337/dc24-2110","DOIUrl":"https://doi.org/10.2337/dc24-2110","url":null,"abstract":"OBJECTIVE Previous genetic and clinical analyses have associated lower lipoprotein(a) and LDL cholesterol (LDL-C) with greater risk of new-onset type 2 diabetes (NOD). However, PCSK9 inhibitors such as alirocumab lower both lipoprotein(a) and LDL-C without effect on NOD. RESEARCH DESIGN AND METHODS In a post hoc analysis of the ODYSSEY OUTCOMES trial (NCT01663402), we examined the joint prediction of NOD by baseline lipoprotein(a), LDL-C, and insulin (or HOMA–insulin resistance [HOMA-IR]) and their changes with alirocumab treatment. Analyses included 8,107 patients with recent acute coronary syndrome on optimized statin therapy, without diabetes at baseline, assigned to alirocumab or placebo with median follow-up 2.4 years. Splines were estimated from logistic regression models. RESULTS Lower baseline lipoprotein(a) and higher baseline insulin or HOMA-IR independently predicted 782 cases of NOD; baseline LDL-C did not predict NOD. Alirocumab reduced lipoprotein(a) and LDL-C without affecting insulin or NOD risk (odds ratio [OR] vs. placebo 0.998; 95% CI 0.860–1.158). However, in logistic regression, decreased lipoprotein(a) and LDL-C on alirocumab were independent, opposite predictors of NOD. OR for NOD for 25% and 50% lipoprotein(a) reductions on alirocumab were 1.12 (95% CI 1.01–1.23) and 1.24 (1.02–1.52). OR for NOD for 25% and 50% LDL-C reductions on alirocumab were 0.88 (95% CI 0.80–0.97) and 0.77 (0.64–0.94). CONCLUSIONS Baseline lipoprotein(a) was inversely associated with risk of NOD. Alirocumab-induced reductions of lipoprotein(a) and LDL-C were associated with increased and decreased risk of NOD, respectively, without net effect on NOD. Ongoing trials will determine the impact of larger and longer lipoprotein(a) reductions on NOD.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"85 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258593","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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