Diabetes Care最新文献

{"title":"Capillary Ketone Level and Future Ketoacidosis Risk in Patients With Type 1 Diabetes Using Sodium–Glucose Cotransporter Inhibitors","authors":"Priya Bapat, Sharon Dhaliwal, Cimon Song, Yucheng Zhang, Daniel Scarr, Abdulmohsen Bakhsh, Dalton Budhram, Natasha J. Verhoeff, Alanna Weisman, Michael Fralick, Noah M. Ivers, David Z.I. Cherney, George Tomlinson, Doug Mumford, Leif Erik Lovblom, Bruce A. Perkins","doi":"10.2337/dc25-0125","DOIUrl":"https://doi.org/10.2337/dc25-0125","url":null,"abstract":"OBJECTIVE We aimed to determine if routine capillary blood ketone testing on well days predicts future diabetic ketoacidosis (DKA) in type 1 diabetes (T1D) using sodium–glucose cotransporter inhibitors (SGLTi). RESEARCH DESIGN AND METHODS We examined previously collected data from empagliflozin-assigned participants in a T1D trial that included weekly fasted ketone levels. Over 6–12 months, ketone levels were subdivided into 28-day periods, and the outcome was subsequent adjudicated DKA or severe ketosis. RESULTS Among 1,194 participants, 325 had 49 DKA and 568 severe ketosis events. On-treatment maximum ketone levels were higher in the 28 days before an outcome compared with levels in those without an outcome, with area under receiver operating characteristic curve of 0.76 (95% CI 0.71–0.82). Maximum ketone level ≥0.8 mmol/L had sensitivity of 66.0%, specificity of 79.6%, and diagnostic odds ratio of 7.6. CONCLUSIONS Routine surveillance of capillary ketone levels in T1D using SGLTi may represent a DKA mitigation strategy and implies a potential threshold for continuous ketone monitoring.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"4 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920105","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":"Cellular Versus Acellular Matrix Products for Diabetic Foot Ulcer Treatment: The Dermagraft and Oasis Longitudinal Comparative Efficacy Study (DOLCE)—A Randomized Clinical Trial","authors":"Harrison Shawa, Ramanjot Kaur, Catherine Tchanque-Fossuo, Hadar Lev-Tov, Kaitlyn West, Pallas Sulgi Lim, Nuen Tsang Yang, Mirabel Dafinone, Rawlings Everett Lyle, Chin-Shang Li, David Rocke, Sara Dahle, Roslyn Rivkah Isseroff","doi":"10.2337/dc24-1233","DOIUrl":"https://doi.org/10.2337/dc24-1233","url":null,"abstract":"OBJECTIVE To determine whether cellular matrix (CM) products result in better healing rates than acellular matrix (ACM) products for nonhealing diabetic foot ulcers. RESEARCH DESIGN AND METHODS The Dermagraft and Oasis Longitudinal Comparative Efficacy Study (DOLCE) was a randomized, single-blinded, three-arm controlled trial. Patients (aged ≥18 years) with a full-thickness nonhealing diabetic foot ulcer who met inclusion/exclusion criteria were enrolled. RESULTS Of 169 eligible patients, 138 were enrolled and 117 randomly assigned. For 12 weeks, patients received standard of care (SOC), CM, or ACM. The primary outcome was the percentage of wounds healed by 12 weeks. Of the 117 participants, 41 were in the CM group, 48 in the ACM group, and 28 in the SOC group. There were 21 withdrawals, but seven had reached the first primary end point. Complete re-epithelialization of the ulcer by 12 weeks occurred in 59% of the 117 total participants: 49% in the CM group, 69% in the ACM group, and 57% in the SOC group (P = 0.16 by χ2 test). At 28 weeks, 25 participants (61%) in the CM group, 27 (56%) in the ACM group, and 18 (64%) in the SOC group had healed (P = 0.78). No differences were found in wound recidivism or adverse event occurrence between groups. CONCLUSIONS No difference in efficacy was found between SOC, ACM, and CM, suggesting that SOC can reduce the economic burden of diabetic foot ulcer treatment.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"37 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920102","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":"Type 1 Diabetes TrialNet: Leading the Charge in Disease Prediction, Prevention, and Immunotherapeutic Mechanistic Understanding","authors":"Laura M. Jacobsen, Jamie L. Felton, Brandon M. Nathan, Cate Speake, Jeffrey Krischer, Kevan C. Herold","doi":"10.2337/dc24-2908","DOIUrl":"https://doi.org/10.2337/dc24-2908","url":null,"abstract":"Established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in 2001, Type 1 Diabetes TrialNet (TrialNet) is an international consortium of clinical research centers that studies the development of type 1 diabetes and performs clinical studies aimed at delaying or preventing the disease. In recognition of NIDDK’s 75th anniversary, this review will summarize the major findings, accomplishments, and future opportunities of its long-running program TrialNet. More than 20 intervention, observational, and mechanism-directed clinical studies have been conducted in collaboration with thousands of people living with type 1 diabetes and their families. New and repurposed immunotherapies have been successful in stages 2 and 3 of type 1 diabetes, contributing to the U.S. Food and Drug Administration approval of the first disease-modifying therapy to delay the onset of type 1 diabetes. Mechanistic findings continue to drive ongoing and future trial designs including novel combination therapies. TrialNet has several ongoing trials, with several for early stages of type 1 diabetes in development. There are new initiatives within TrialNet for community engagement, increasing clinical trial representation, personalizing treatments, and training the next generation of translational investigators.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"44 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920103","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":"Comparison of Insulin Titration Strategies for Glycemic Control in Type 2 Diabetes: A Systematic Review and Network Meta-analysis","authors":"Kansak Boonpattharatthiti, Kirana Wechkunanukul, Noramon Mayang, E Lyn Lee, Anjana Fuangchan, Alice Y.Y. Cheng, Nathorn Chaiyakunapruk, Teerapon Dhippayom","doi":"10.2337/dc24-2661","DOIUrl":"https://doi.org/10.2337/dc24-2661","url":null,"abstract":"BACKGROUND Adjusting basal insulin doses is essential for lowering blood glucose while minimizing the risk of hypoglycemia. Despite various basal insulin titration strategies being available, their comparative effectiveness remains unclear. PURPOSE To compare the effectiveness of different basal insulin titration strategies on glycemic control in patients with type 2 diabetes. DATA SOURCES PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and EBSCO Open Dissertations were searched from inception to January 2024. STUDY SELECTION We included published trials with evaluation of basal insulin titration strategies for glycemic control in type 2 diabetes. DATA EXTRACTION Data on HbA1c and severe hypoglycemia were extracted. DATA SYNTHESIS Studies were categorized with the theme, intensity, and provider/platform (TIP) framework. “Theme” referred to conventional titration (Conv) or self-titration (ST), “intensity” was categorized as high (Conv, >1/month; ST, ≥2/week) or low (Conv, ≤1/month; ST, <2/week), and for “provider/platform” categories included supported by health care provider (HCP for Conv or S-HCP for ST), patient led (Pt), and supported by application (S-App). The ST/High/S-HCP strategy resulted in the greatest HbA1c reduction in comparison with all others (e.g., ST/High/S-App, mean difference −0.75 [95% CI −1.26, −0.25], and Conv/Low/HCP, −1.19 [95% CI −1.67, −0.72]). Severe hypoglycemia risk did not differ significantly across strategies. LIMITATIONS The number of studies per network meta-analysis was limited, and not all TIP combinations were evaluated. CONCLUSIONS Self-titration at least twice a week with health care provider support leads to superior HbA1c reduction in comparison with other strategies, without increasing the risk of severe hypoglycemia. This approach should be considered for clinical practice, where appropriate, to achieve optimal glycemic control in patients with type 2 diabetes.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"25 1","pages":"837-845"},"PeriodicalIF":16.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920212","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":"Premeal Whey Protein Lowers Postprandial Blood Glucose in Women With Gestational Diabetes Mellitus: A Randomized, Crossover Clinical Trial","authors":"Stine Smedegaard, Ulla Kampmann, Per G. Ovesen, Louise B. Suder, Janni H. Knudsen, Gregers Wegener, Lise H. Brunsgaard, Nikolaj Rittig","doi":"10.2337/dc24-2831","DOIUrl":"https://doi.org/10.2337/dc24-2831","url":null,"abstract":"OBJECTIVE To examine how whey protein served as a premeal affects postprandial glucose excursions in women with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS A placebo-controlled, single-blinded, crossover, randomized trial including women with and without GDM (20–36 weeks’ gestation) was performed. Participants were studied in the laboratory and at home. In the laboratory, women were randomized to consume 20 g of whey or placebo 30 min before undergoing, 7–14 days later, a 75-g oral glucose tolerance test (OGTT). Blood was sampled consecutively 3 hours following the OGTT. The primary end point was the incremental area under the curve (iAUC) for glucose. At home, participants wore continuous glucose monitors and, on subsequent days, randomly consumed 0, 10, 15, 20, and 30 g of whey 30 min before breakfast. RESULTS Twelve women with GDM and 12 pregnant women with normal glucose tolerance (NGT) to part in the trials. Intake of premeal whey resulted in lowered peak glucose by −1.0 mmol/L (95% CI −1.6 to −0.4) in women with GDM and −0.7 mmol/L (95% CI −1.3 to −0.1) in women without GDM compared with placebo. Insulin, glucose-dependent insulinotropic polypeptide, and glucagon-like peptide-1 levels increased rapidly after whey consumption in both groups. At home, a premeal of 30 g of whey dose-dependently reduced incremental glucose peaks with a maximum of −2.0 mmol/L (95% CI −2.5 to −1.5) in women with GDM compared with placebo. CONCLUSIONS Premeal whey consumption acutely lowers postprandial blood glucose in women with GDM and those with NGT, with 15–30 g lowering the glucose iAUC of women with GDM. These findings emphasize the need for long-term studies to assess the impact of whey premeals in pregnancies affected by GDM.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"12 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920106","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":"Energy Restriction, Weight Loss, Glycemia, and Breastfeeding Outcomes in Gestational Diabetes: A DiGest Trial Secondary Analysis","authors":"Sarah Dib, Laura C. Kusinski, Danielle L. Jones, Nooria Atta, Suzanne Smith, Emanuella De Lucia Rolfe, Helen R. Murphy, Roy Taylor, Claire L. Meek","doi":"10.2337/dc24-2625","DOIUrl":"https://doi.org/10.2337/dc24-2625","url":null,"abstract":"OBJECTIVE We aimed to assess whether energy restriction, weight loss, or maternal glycemia in late pregnancy were associated with breastfeeding outcomes. RESEARCH DESIGN AND METHODS This is a secondary analysis of the Dietary Intervention in Gestational Diabetes (DiGest) randomized controlled trial, which included 425 participants with gestational diabetes who were randomly assigned to receive a standard-energy (2,000 kcal/day) or reduced-energy (1,200 kcal/day) diet box from 29 weeks until delivery, with masked continuous glucose monitoring. Breastfeeding intentions and outcomes were documented (n = 304 of 425) and analyzed using regression models. RESULTS Energy restriction in late pregnancy did not affect breastfeeding outcomes. Achieving ≥90% time in range (3.5–6.7 mmol/L; 63–120 mg/dL) with a low glycemic variability (coefficient of variation and SD), but not weight loss, were associated with any breastfeeding at 3 months postnatally. CONCLUSIONS Improved late pregnancy glycemia and decreased glucose variability, but not weight loss or energy restriction, were associated with breastfeeding after gestational diabetes.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"228 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920113","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":"Lipidomic Markers of Processed Meat and Unprocessed Red Meat Intake and Risk of Diabetes in American Indians","authors":"Xiaoxiao Wen, Guanhong Miao, Amanda M. Fretts, Mingjing Chen, Ying Zhang, Jason G. Umans, Shelley A. Cole, Lyle G. Best, Oliver Fiehn, Jinying Zhao","doi":"10.2337/dc24-2828","DOIUrl":"https://doi.org/10.2337/dc24-2828","url":null,"abstract":"OBJECTIVE To identify lipidomic markers of habitual unprocessed red meat and processed meat intake and evaluate their associations with diabetes risk in American Indians. RESEARCH DESIGN AND METHODS We studied 1,816 participants from the Strong Heart Family Study. Using untargeted liquid chromatography-mass spectrometry, we quantified 1,542 lipids (518 known) in fasting plasma at baseline and follow-up (∼5 years apart). Meat intake was assessed via Food Frequency Questionnaires. Mixed-effects linear regression was used to identify lipids associated with meat consumption. Mixed-effects logistic regression was used to examine whether these lipids were associated with incident diabetes, independent of conventional risk factors, or with longitudinal glucose/insulin metrics. RESULTS Diabetes developed in 66 of 1,076 participants with normal baseline glucose. After multiple testing correction, 15 known lipids, primarily plasmalogens, were associated with unprocessed red meat intake. Three plasmalogens were linked to incident diabetes (odds ratio [OR] 1.32 [95% CI 1.02–1.70] to 1.39 [1.08–1.78] per SD increase in baseline levels) and higher red meat intake. Eight lipids, mainly sphingomyelins, were associated with processed meat intake. Two sphingomyelins were linked to incident diabetes (OR 1.33 [95% CI 1.02–1.75] and 1.36 [1.04–1.80]) and higher processed meat intake. Of 23 meat-related lipids, 20 were associated with altered glucose/insulin metrics, and 11 mediated positive associations between red or processed meat intake and fasting glucose. CONCLUSIONS We identified lipidomic markers of unprocessed red and processed meat consumption. Several lipids were independently associated with increased diabetes risk, potentially by mediating the association between meat intake and glucose metabolism.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"22 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920111","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":"Empagliflozin in Patients With Type 2 Diabetes Undergoing On-Pump CABG: The POST-CABGDM Randomized Clinical Trial","authors":"Fabio Grunspun Pitta, Eduardo Gomes Lima, Caio Assis Moura Tavares, Eduardo Bello Martins, Fabiana Hanna Rached, Eduardo Martelli Moreira, Bruno Mahler Mioto, Simão Augusto Lottenberg, Paula Mathias Paulino Bolta, Larissa Gonçalves Justino, Desiderio Favarato, Letícia Neves Solon Carvalho, Henrique Trombini Pinesi, Camila Talita Machado Barbosa, Luís Alberto Oliveira Dallan, Luís Roberto Palma Dallan, Marcelo Henrique Moreira Barbosa, Roberto Kalil Filho, James A. de Lemos, Carlos Vicente Serrano","doi":"10.2337/dc24-2807","DOIUrl":"https://doi.org/10.2337/dc24-2807","url":null,"abstract":"OBJECTIVE To evaluate the efficacy and safety of empagliflozin in patients with type 2 diabetes mellitus (T2DM) undergoing elective on-pump coronary artery bypass grafting (CABG). RESEARCH DESIGN AND METHODS Investigator-initiated, pragmatic, single-center, randomized, open-label trial with blinded outcome adjudication conducted in Brazil. A total of 145 patients with T2DM scheduled for elective on-pump CABG were randomized to receive empagliflozin 25 mg daily plus standard care (n = 71) for at least 3 months, which was discontinued 72 h before surgery, or to received standard care alone (n = 74). The primary outcome was postoperative acute kidney injury (AKI) within 7 days of surgery, defined by creatinine-based criteria (namely, Acute Kidney Injury Network; Risk, Injury, Failure, Loss of Kidney Function, and End-Stage Kidney Disease; or Kidney Disease: Improving Global Outcomes). Secondary outcomes included 30-day postoperative atrial fibrillation and type 5 myocardial infarction (MI). Safety outcomes were ketoacidosis, urinary tract infection, hospital-acquired pneumonia, and wound infection within 30 days after CABG. RESULTS AKI occurred in 22.5% of the empagliflozin group vs. 39.1% in the control group (relative risk [RR] 0.57 [95% CI 0.34–0.96]; P = 0.03). Rates of atrial fibrillation (15.4% vs. 13.5%; RR 1.15 [95% CI 0.52–2.53]; P = 0.73) and type 5 MI (1.4% vs. 4.1%; RR 0.35 [95% CI 0.04–3.26]; P = 0.62) were similar between groups. No statistically significant differences between groups were observed for safety events. Three deaths occurred, all in the control group. CONCLUSIONS Empagliflozin use before on-pump CABG in patients with T2DM was associated with a reduced incidence of postoperative AKI without an increase in safety events. These findings warrant confirmation in larger clinical trials.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"16 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837061","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":"Islet Autoantibodies and Their Association With β-Cell Function and Diabetes Measures in Children With Acute Recurrent and Chronic Pancreatitis","authors":"Gila Ginzburg, Lindsey Hornung, Lee Denson, Amy S. Shah, Sarah Swauger, Jonathan Tatum, Siobhan Tellez, Deborah Elder, Melena D. Bellin, Maisam Abu-El-Haija","doi":"10.2337/dc24-2672","DOIUrl":"https://doi.org/10.2337/dc24-2672","url":null,"abstract":"OBJECTIVE In children with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP), circulating islet autoantibodies (auto-Ab) may influence β-cell function. This study reports Ab prevalence in youth with ARP/CP, and investigates effects on indices of insulin secretion during mixed meal tolerance testing (MMTT) and diabetes status. RESEARCH DESIGN AND METHODS This was a retrospective cross-sectional analysis of 234 youth with ARP/CP who had islet Ab testing. Ab+ group n = 28 (12%), and Ab− group n = 206 (88%). Fasting glucose and HbA1c were collected. MMTT was performed in 78% (183 of 234). MMTT-derived indices were calculated and compared between groups. RESULTS The Ab+ and Ab− groups did not differ in age, sex, race, ethnicity, BMI percentile, or fasting glucose. Of Ab+ patients, 54% had one Ab+ and 46% had multiple Ab+. Comparing the Ab+ to Ab− groups, HbA1c was higher (median 5.7 vs. 5.2%, P < 0.01), and C-peptide was lower (median 2.4 vs. 3.7 ng/mL, P = 0.01) in the Ab+ group. The Ab+ compared with the Ab− group had a higher proportion of prediabetes/diabetes (57% vs. 32%, P < 0.001). In survival analysis, the Ab+ group had significantly shorter time from first acute pancreatitis episode to diabetes development (P = 0.02). CONCLUSIONS In children with ARP/CP, Ab+ was associated with higher risk of diabetes/diabetes development, and shorter time to diabetes development, suggesting that islet Ab+ is associated with β-cell dysfunction in this patient cohort. Islet Ab+ was also associated with higher HbA1c and lower C-peptide levels. Future studies are needed to validate the role of islet Ab positivity in pancreatitis.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"21 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837064","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":"Influence of Maternal Glycemia on Breast Milk Composition and Volume Ingested by Infants of Mothers With Type 1 Diabetes","authors":"Lois E. Donovan, Rhonda C. Bell, Jennifer M. Yamamoto, Patricia Lemieux, Josephine Ho, Denice S. Feig, Heidi Virtanen, Susan Crawford, Raylene A. Reimer","doi":"10.2337/dc25-0096","DOIUrl":"https://doi.org/10.2337/dc25-0096","url":null,"abstract":"OBJECTIVE To examine relationships between maternal glucose and breast milk composition and volume ingested by infants of mothers with type 1 diabetes (T1D), and to compare breast milk composition in women with and without T1D. RESEARCH DESIGN AND METHODS Midfeed breast milk samples were collected from 11 mothers with T1D. Maternal continuous glucose monitoring data were correlated with breast milk composition and volume ingested. Breast milk composition was compared between the women with T1D and five without T1D. RESULTS Forty-seven breast milk samples from mothers with T1D were analyzed. Maternal glucose 90–120 min before breastfeeding correlated with breast milk glucose and fructose but not with lactose, protein, fatty acids, leptin, or volume consumed. Breast milk leptin correlated with volume of breast milk consumed (r = 0.394; P = 0.008). Higher breast milk glucose (1.0 ± 0.3 vs. 0.7 ± 0.3 mg/mL) and leptin (463.6 ± 480.0 vs. 114.4 ± 68.6 pg/mL) were found in women with versus without T1D. CONCLUSIONS Maternal glucose is associated with breast milk glucose and fructose in women with T1D but not with volume of breast milk consumed.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"108 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837060","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}