Diabetes Care最新文献

{"title":"Health-Related Quality of Life and Health Utility After Metabolic/Bariatric Surgery Versus Medical/Lifestyle Intervention in Individuals With Type 2 Diabetes and Obesity: The ARMMS-T2D Study","authors":"Donald C. Simonson, William F. Gourash, David E. Arterburn, Bo Hu, Sangeeta R. Kashyap, David E. Cummings, Mary-Elizabeth Patti, Anita P. Courcoulas, Ashley H. Vernon, John M. Jakicic, Sarah Kirschling, Ali Aminian, Philip R. Schauer, John P. Kirwan","doi":"10.2337/dc24-2046","DOIUrl":"https://doi.org/10.2337/dc24-2046","url":null,"abstract":"OBJECTIVE Type 2 diabetes and obesity are associated with reduced health-related quality of life (HRQoL) and health utility (HU), but long-term effects of metabolic/bariatric surgery (MBS) compared with those of medical/lifestyle intervention (MLI) on these outcomes are unclear. RESEARCH DESIGN AND METHODS We studied 228 individuals with type 2 diabetes and obesity randomly assigned to MBS (Roux-en-Y gastric bypass, sleeve gastrectomy, or gastric band; n = 152) or MLI (n = 76) in the ARMMS-T2D study. HRQoL (36-Item Short-Form Health Survey [SF-36], including Physical Component Score [PCS] and Mental Component Score [MCS]) and HU (Short Form 6 Dimensions [SF-6D]) were measured annually up to 12 years. RESULTS At baseline, participants’ mean ± SD age was 49.2 ± 8.0 years, 68.4% were female, BMI was 36.3 ± 3.4 kg/m2, and HbA1c was 8.7 ± 1.6%. PCS improved significantly more in the MBS versus MLI group over 12 years (+2.37 ± 0.53 vs. −0.95 ± 0.73; difference 3.32 ± 0.85; P < 0.001). MBS was associated with better general health (P < 0.001), physical functioning (P = 0.001), and vitality (P = 0.003). Reduction in BMI was greater after MBS versus MLI (P < 0.001) and correlated with improved PCS (r = −0.43; P < 0.001). Change in PCS was not associated with change in HbA1c. MCS changed minimally from baseline and was similar between MBS and MLI groups during follow-up (−0.21 ± 0.61 vs. −0.89 ± 0.84; difference 0.68 ± 0.97; P = 0.48). Improvements in HU were greater in the MBS versus MLI group over 12 years (+0.02 ± 0.01 vs. −0.01 ± 0.01; difference 0.03 ± 0.01; P = 0.003). CONCLUSIONS Metabolic surgery produces sustained weight loss and improves PCS, general health, physical functioning, vitality, and HU in individuals with type 2 diabetes and obesity compared with medical therapy up to 12 years after intervention.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"164 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125403","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":"Short-Term Metformin Protects Against Glucocorticoid-Induced Toxicity in Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial","authors":"Susanne Thierry, Caspar Joyce Peterson, Stéphanie Pfammatter, Patricia Arroyo Tardio, Christian Meier, Tarik Delko, Vasco Iten, Christine S. Zuern, Michael Kühne, Michael Epstein, Alaa Othman, Nicola Zamboni, Isabel Reinisch, Adhideb Ghosh, Christian Wolfrum, Eleonora Seelig","doi":"10.2337/dc24-2039","DOIUrl":"https://doi.org/10.2337/dc24-2039","url":null,"abstract":"OBJECTIVE Glucocorticoids (GCs) are potent anti-inflammatory drugs, but strategies to prevent side effects are lacking. We investigated whether metformin could prevent GC-related toxicity and explored the underlying mechanisms. RESEARCH DESIGN AND METHODS This single-center, randomized, placebo-controlled, double-blind, crossover trial compared metformin with placebo during high-dose GC treatment in 18 lean, healthy, male study participants. The trial was conducted at the University Hospital Basel, Switzerland. Participants received prednisone 30 mg/d in combination with metformin or placebo for two 7-day periods (1:1 randomization). The primary outcome, change in insulin sensitivity, was assessed using a two-sided paired t test. Before and after each study period, we conducted a mixed-meal tolerance test, blood metabolomics, and RNA sequencing of subcutaneous adipose tissue biopsy specimens. RESULTS Metformin improved insulin sensitivity as assessed by the Matsuda index (n = 17; mean change: −2.73 ± 3.55 SD for placebo, 2.21 ± 3.95 for metformin; mean difference of change −4.94 [95% CI, −7.24, −2.65)]; P < 0.001). Metabolomic and transcriptomic analyses revealed that metformin altered fatty acid flux in the blood and downregulated genes involved in fatty acid synthesis in adipose tissue. Metformin reduced markers of protein breakdown and bone resorption. Furthermore, metformin downregulated genes responsible for AMPK inhibition and affected GLP1 and bile acid metabolism. CONCLUSIONS Metformin prevents GC-induced insulin resistance and reduces markers of dyslipidemia, myopathy, and, possibly, bone resorption through AMPK-dependent and -independent pathways.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"20 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083439","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 Autoantibody Screening Throughout Australia Using In-Home Blood Spot Sampling: 2-Year Outcomes of Type1Screen","authors":"John M. Wentworth, Anna B. E. Sing, Gaetano Naselli, Dexing Huang, Elizabeth Azidis-Yates, Batsho Mandlebe, James D. Brown, Kelly McGorm, Candice Hall, Leanne Redl, Renee Kludas, Aniruddh Haldar, Felicity Healy, Abbey Gilbert, Kelly Watson, Cherie Chiang, Jennifer J. Couper, Tony Huynh, Elizabeth A. Davis, Maria E. Craig, Fergus J. Cameron, Thomas W. Kay, Leonard C. Harrison, Peter G. Colman","doi":"10.2337/dc24-2443","DOIUrl":"https://doi.org/10.2337/dc24-2443","url":null,"abstract":"OBJECTIVE Type1Screen offers islet autoantibody testing to Australians with a family history of type 1 diabetes (T1D) with the dual aims of preventing diabetic ketoacidosis (DKA) and enabling use of disease-modifying therapy. We describe screening and monitoring outcomes 2 years after implementing in-home capillary blood spot sampling. RESEARCH DESIGN AND METHODS Data from 2,064 participants who registered between July 2022 and June 2024 were analyzed: 1,507 and 557 chose blood spot and venipuncture screening respectively. We compared baseline characteristics and outcomes for 1,243 participants (967 blood spot and 276 venipuncture) whose samples were tested by June 2024. RESULTS One blood spot and five venous participants reported unsuccessful sample collections. The median (quartile 1, quartile 3) age of blood spot registrants was lower (12.1 [7.1, 27.1] vs. 17.2 [9, 38.4] years; P < 0.0001), and a higher proportion lived in regional Australia (39% vs. 29%; P = 0.0037). Among 72 participants (5.9%) with a positive screening test, 5 screened by blood spot and 2 by venipuncture had no autoantibodies on confirmatory testing. Blood spot screening identified the expected 2.1% prevalence of multiple autoantibodies and a 2.5% prevalence of a single autoantibody compared with 1.5% and 4.1%, respectively, for venipuncture screening. Clinical diabetes developed in 12 participants. All had screened positive and none had DKA. CONCLUSIONS Type1Screen has national reach. In-home blood spot screening is feasible, particularly for younger participants living regionally, and identifies the expected prevalence of preclinical T1D. The lower cost, increased convenience, and greater reach of blood spot screening could help meet increasing demand for early T1D diagnosis.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"74 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056321","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":"Diabetes Risk After Treatment for Childhood and Young Adult Cancer","authors":"Kirsten J. Cromie, Robert D. Murray, Ramzi A. Ajjan, Nicola F. Hughes, Richard G. Feltbower, Adam W. Glaser","doi":"10.2337/dc24-2171","DOIUrl":"https://doi.org/10.2337/dc24-2171","url":null,"abstract":"OBJECTIVE Diabetes is a potential late consequence of childhood and young adult cancer (CYAC) treatment. Causative treatments associated with diabetes have been identified in retrospective cohort studies but have not been validated in population-based cohorts. Our aim was to define the extent of diabetes risk and explore contributory factors for its development in survivors of CYAC in the United Kingdom. RESEARCH DESIGN AND METHODS Cancer registration data (n = 4,238) were linked to electronic health care databases to identify cases of diabetes through clinical coding or HbA1c values. Total effect of prespecified treatment exposures on diabetes risk was estimated using flexible parametric modeling and standardized cause-specific cumulative incidence functions (CIFs). RESULTS After median follow-up of 14.4 years, 163 individuals (3.8%) were identified with diabetes. Total body irradiation (TBI) increases diabetes risk over time, with a 40-year CIF reaching 21.0% (95% CI 13.8–31.9) compared with 8.4% (95% CI 6.1–11.5) without TBI. Survivors treated with corticosteroids had a 7.7% increased risk at 40 years after cancer diagnosis. Hematopoietic stem cell transplant (HSCT) survivors had markedly higher risk, with a 40-year CIF of 19.6% (95% CI 13.4–28.6) versus 8.2% (95% CI 6.0–11.3) for patients who had not undergone HSCT. Among patients who received allogeneic HSCT, the 40-year CIF of diabetes was 25.7% (95% CI 17.4–38.0), compared with 7.9% (95% CI 3.3–19.1) in patients who received autologous transplants. CONCLUSIONS This evaluation of a hospital-based cohort of patients with CYAC identifies these patients’ increased long-term risk of developing diabetes and how this varies temporally according to treatment modalities. Notable contrasts in risk by treatment were detected as early as 10 years after cancer diagnosis. Findings should inform the development of risk-stratified evidence-based screening.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"35 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031087","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":"Additive Value of Polygenic Risk Score to Family History for Type 2 Diabetes Prediction: Results From the All of Us Research Database","authors":"Emily Drzymalla, Laura Raffield, Katherine Kolor, Alain Koyama, Ramal Moonesinghe, Meda E. Pavkov, Cassandra N. Spracklen, Muin J. Khoury","doi":"10.2337/dc24-1537","DOIUrl":"https://doi.org/10.2337/dc24-1537","url":null,"abstract":"OBJECTIVE The goal of this study was to assess the additive value of considering type 2 diabetes (T2D) polygenic risk score (PRS) in addition to family history for T2D prediction. RESEARCH DESIGN AND METHODS Data were obtained from the All of Us (AoU) research database. First-degree T2D family history was self-reported on the personal family history health questionnaire. A PRS was constructed from 1,289 variants identified from a large multiancestry genome-wide association study meta-analysis for T2D. Logistic regression models were run to generate odds ratios (ORs) and 95% CIs for T2D. All models were adjusted for age, sex, and BMI. RESULTS A total of 109,958 AoU research participants were included in the analysis. The odds of T2D increased with 1 SD PRS (OR 1.75; 95% CI 1.71–1.79) and positive T2D family history (OR 2.32; 95% CI 2.20–2.43). In the joint model, both 1 SD PRS (OR 1.69; 95% CI 1.65–1.72) and family history (OR 2.06; 95% CI 1.98–2.15) were significantly associated with T2D, although the ORs were slightly attenuated. Predictive models that included both the PRS and family history (area under the curve [AUC] 0.794) performed better than models including only family history (AUC 0.763) or the PRS (AUC 0.785). CONCLUSIONS In predicting T2D, inclusion of a T2D PRS in addition to family history of T2D (first-degree relatives) added statistical value. Further study is needed to determine whether consideration of both family history and a PRS would be useful for clinical T2D prediction.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"27 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020557","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":"Lessons Learned From Epidemiology of Type 2 Diabetes in South Asians: Kelly West Award Lecture 2024","authors":"Viswanathan Mohan","doi":"10.2337/dci24-0046","DOIUrl":"https://doi.org/10.2337/dci24-0046","url":null,"abstract":"South Asia has high prevalence rates of type 2 diabetes (T2D). Until the 1990s, the prevalence of T2D within South Asia was low but much higher in the South Asian diaspora living abroad. Today, high prevalence rates of T2D are reported among those living in South Asia. T2D in South Asians presents with unique clinical features described as the “South Asian phenotype” that include younger age at onset of diabetes than in White Europeans, much lower BMI, hyperinsulinemia and greater insulin resistance, rapid decline in β-cell function resulting in low insulin reserve, low muscle mass, and greater ectopic fat deposition, especially in the liver. Also, prevalence of impaired fasting glucose is higher among South Asians than prevalence of impaired glucose tolerance. Genetic predisposition combined with intrauterine fetal programming (low vitamin B12 intake and high folate intake) increases susceptibility to T2D, from birth. In later life, overnutrition, especially a high carbohydrate intake with refined grains of higher glycemic index, coupled with low physical activity likely triggers the T2D epidemic in South Asians. Additionally, there are emerging risk factors like air pollution. Preventing T2D in South Asians requires a multifactorial approach, including improvements in maternal and fetal nutrition with special reference to vitamin B12 and folate intake, decreasing refined carbohydrate and increasing protein and fiber intake in the diet, increasing physical activity, and control of air pollution. Lessons learned from epidemiology of T2D in South Asians could be useful to other developing countries that are in earlier stages of epidemiological transition.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"14 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020558","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":"Efficacy of GLP-1 Receptor Agonists on Weight Loss, BMI, and Waist Circumference for Patients With Obesity or Overweight: A Systematic Review, Meta-analysis, and Meta-regression of 47 Randomized Controlled Trials","authors":"Hon Jen Wong, Bryan Sim, Yao Hao Teo, Yao Neng Teo, Mark Y. Chan, Leonard L.L. Yeo, Pei Chia Eng, Benjamin Y.Q. Tan, Naveed Sattar, Mayank Dalakoti, Ching-Hui Sia","doi":"10.2337/dc24-1678","DOIUrl":"https://doi.org/10.2337/dc24-1678","url":null,"abstract":"OBJECTIVE To provide an updated synthesis on effects of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) on weight, BMI, and waist circumference incorporating newer randomized controlled trials (RCTs), particularly in individuals with overweight or obesity. RESEARCH DESIGN AND METHODS We systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) for RCTs published from inception to 4 October 2024. The search was limited to RCTs evaluating the use of GLP-1 RAs for mean differences from baseline in weight, BMI, and waist circumference in adults with obesity or overweight with or without diabetes. Two independent reviewers performed the literature search and data extraction, resolving disagreements via consensus or third-reviewer consultation. RESULTS Forty-seven RCTs were included, with a combined cohort of 23,244 patients. GLP-1 RAs demonstrated a mean weight reduction of −4.57 kg (95% CI −5.35 to −3.78), mean BMI reduction of −2.07 kg/m2 (95% CI −2.53 to −1.62), and mean waist circumference reduction of −4.55 cm (95% CI −5.72 to −3.38) compared with placebo. This effect was consistent across diabetes status, GLP-1 RA used, and route of administration. The greatest treatment benefit appeared to favor patients who were younger, female, without diabetes, with higher baseline weight and BMI but lower baseline HbA1c, and treated over a longer duration. Limitations include substantial statistical heterogeneity, in part due to broad inclusion criteria. However, this heterogeneity may improve generalizability by reflecting a wide range of study designs and patient populations. CONCLUSIONS GLP-1 RAs demonstrated significant weight, BMI, and waist circumference reduction benefits in this meta-analysis.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"12 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020559","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":"Derivation and Validation of D-RISK: An Electronic Health Record–Driven Risk Score to Detect Undiagnosed Dysglycemia in Clinical Practice","authors":"Michael E. Bowen, Ildiko Lingvay, Luigi Meneghini, Brett Moran, Noel O. Santini, Song Zhang, Ethan A. Halm","doi":"10.2337/dc24-1624","DOIUrl":"https://doi.org/10.2337/dc24-1624","url":null,"abstract":"OBJECTIVE We derive and validate D-RISK, an electronic health record (EHR)-driven risk score to optimize and facilitate screening for undiagnosed dysglycemia (prediabetes + diabetes) in clinical practice. RESEARCH DESIGN AND METHODS We used retrospective EHR data (derivation sample) and a prospective diabetes screening study (validation sample) to develop D-RISK. Logistic regression with backward selection was used to predict dysglycemia (HbA1c ≥5.7%) using diabetes risk factors consistently captured in structured EHR data. Model coefficients were converted to a points-based risk score. We report discrimination, sensitivity, and specificity and compare D-RISK to the American Diabetes Association (ADA) risk test and the ADA and United States Preventive Services Task Force (USPSTF) screening guidelines. RESULTS The derivation cohort included 11,387 patients (mean age 48 years; 65% female; 42% Hispanic; 32% non-Hispanic Black; mean BMI 32; 29% with hypertension). D-RISK included age, race, BMI, hypertension, and random glucose. The area under curve (AUC) for the risk score was 0.75 (95% CI 0.74–0.76). In the validation screening study (n = 519), the AUC was 0.71 (95% CI 0.66–0.75) which was better than the ADA and USPSTF diabetes screening guidelines (AUC = 0.52 and AUC = 0.58, respectively; P < 0.001 for both). Discrimination was similar to the ADA risk test (AUC = 0.67) using patient-reported data to supplement EHR data, although D-RISK was more sensitive (75% vs. 61%) at the recommended screening thresholds. CONCLUSIONS Designed for use in EHR, D-RISK performs better than commonly used screening guidelines and risk scores and may help detect undiagnosed cases of dysglycemia in clinical practice.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"11 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988461","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":"Financial Incentives, Income Supplementation, Cash Transfer, and Universal Basic Income Interventions in Diabetes: Understanding Differences and Effectiveness: A Scoping Review","authors":"Leonard E. Egede, Jennifer A. Campbell, Sebastian Linde, Rebekah J. Walker","doi":"10.2337/dci24-0072","DOIUrl":"https://doi.org/10.2337/dci24-0072","url":null,"abstract":"The objective of this review is to evaluate and summarize the evidence base for the effects of monetary intervention approaches (the use of positive monetary reinforcers and gains) on diabetes outcomes. A reproducible search using OVID Medline, PubMed, Scopus, and CINAHL was conducted. Articles published from database creation up to July 2024 were searched. Outcomes included hemoglobin A1c (HbA1c), LDL, BMI, blood pressure, quality of life (QOL), psychosocial factors, self-care behaviors, and diabetes complications. A total of 13 articles met inclusion criteria and were included for final synthesis. Looking at the monetary approach across each study, eight used financial incentives, three used a form of income supplementation, one used cash transfers, and one used a combination of income supplementation and financial incentives. Ten of the 13 studies found statistically significant and clinically meaningful changes in HbA1c. For participants receiving interventions, change in HbA1c ranged from 0.19% to 1.74% for interventions incorporating financial incentives, 0.7% to 1.3% for interventions incorporating income supplementation, and 0.2% to 0.7% for the study incorporating cash transfers. Overall, evidence supports the relationship between monetary approaches, diabetes-related outcomes, and self-care behaviors across monetary approaches. Future studies should consider comparison between different monetary approaches using designs that will allow identification of effective strategies. As these approaches are theoretically and structurally different, pathways identifying the underlying mechanisms of change are greatly needed to advance the field.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"52 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981448","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 Follow-up After Antiviral Treatment in New-Onset Type 1 Diabetes: Results From the Diabetes Virus Detection and Intervention Trial","authors":"Ida M. Mynarek, Lars Krogvold, Freja B. Mørk, Trine W. H. Lawaetz, Trine Roald, Morten W. Fagerland, Nina Lindblom, Jacob Westman, Peter Barker, Heikki Hyöty, Johnny Ludvigsson, Kristian F. Hanssen, Jesper Johannesen, Knut Dahl-Jørgensen","doi":"10.2337/dc24-2121","DOIUrl":"https://doi.org/10.2337/dc24-2121","url":null,"abstract":"OBJECTIVE In the Diabetes Virus Detection and Intervention trial, antiviral treatment with pleconaril and ribavirin decreased the decline, compared with placebo, in endogenous C-peptide 1 year after diagnosis of type 1 diabetes (T1D) in children and adolescents. This article reports the results 2 and 3 years after diagnosis. RESEARCH DESIGN AND METHODS This was a multicenter, randomized, placebo-controlled (1:1) trial of 96 children and adolescents aged 6–15.9 years newly diagnosed with T1D. Antiviral treatment (pleconaril and ribavirin) or placebo was given for 6 months from diagnosis, and participants were followed for 3 years. The primary outcome was residual C-peptide secretion, reported as the area under the curve (AUC), assessed by 2-h mixed-meal tolerance test. Secondary outcomes included insulin doses and HbA1c. RESULTS At the 3-year follow-up, 75 participants attended. At 2 years, the mean ± SD AUC for C-peptide in the placebo group was 0.27 ± 0.33 compared with 0.34 ± 0.37 in the pleconaril and ribavirin group. After 3 years, the AUC had decreased to 0.17 ± 0.23 and 0.25 ± 0.34, respectively. There was no statistically significant difference between the groups. The groups were also comparable with regard to secondary end points. CONCLUSIONS The decreased reduction in C-peptide levels after antiviral treatment is no longer present after 2 or 3 years. Further investigations are needed to explore options to use antiviral treatment in the prevention and treatment of T1D.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"43 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974557","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}