Diabetes Care最新文献_第5页

Sarcopenic Obesity and Risk of Incident Type 2 Diabetes: A Prospective Cohort Study and Landmark Analysis From the UK Biobank 肌肉减少型肥胖和2型糖尿病发生的风险：来自英国生物银行的前瞻性队列研究和里程碑式分析

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-07-13 DOI: 10.2337/dc26-0797

Zhongyang Guan, Blossom C.M. Stephan, Mario Siervo

引用次数: 0

Effects of the Omnipod 5 Hybrid Closed-Loop System in People With Type 1 Diabetes With Impaired Awareness of Hypoglycemia Omnipod 5混合闭环系统在1型糖尿病低血糖认知障碍患者中的作用

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-07-10 DOI: 10.2337/dc26-0422

Iona R. Goodman, Simon A. Berry, Eleanor H. McNally, Gilberte Martine-Edith, Jonah J. C. Thomas, Pratik Choudhary, Simon R. Heller, Jackie Elliott, Ahmed Iqbal

{"title":"Effects of the Omnipod 5 Hybrid Closed-Loop System in People With Type 1 Diabetes With Impaired Awareness of Hypoglycemia","authors":"Iona R. Goodman, Simon A. Berry, Eleanor H. McNally, Gilberte Martine-Edith, Jonah J. C. Thomas, Pratik Choudhary, Simon R. Heller, Jackie Elliott, Ahmed Iqbal","doi":"10.2337/dc26-0422","DOIUrl":"https://doi.org/10.2337/dc26-0422","url":null,"abstract":"OBJECTIVE To determine the real-world impact of initiating Omnipod 5 hybrid closed-loop System (OP5-HCL) on hypoglycemia frequency, duration, and awareness in people with type 1 diabetes and impaired awareness of hypoglycemia (IAH). RESEARCH DESIGN AND METHODS A single-center study of people with type 1 diabetes and IAH (Gold score ≥4) with outcomes compared at baseline and 12 months after OP5-HCL initiation. The 28-day CGM data were analyzed to provide weekly sensor-detected hypoglycemia (SDH) data and glycemic metrics at baseline and 12 months. Outcomes of those with IAH were compared with age- and sex-matched control participants with normal awareness of hypoglycemia (NAH) (Gold score ≤2). RESULTS The study included 68 individuals (73.5% female; mean ± SD age 38.0 ± 15.6 years; and diabetes duration 21.0 ± 13.5 years). At baseline, people with IAH (n = 32) experienced both significantly higher time below range (TBR) (&lt;3.9 mmol/L) and more episodes of SDH compared with those with NAH (n = 32). The IAH group also experienced a significantly longer median duration of hypoglycemia episodes below 3.9 mmol/L (SDH3.9) (33.5 vs. 24.5 min; P = 0.007). Initiation of OP5-HCL resulted in a decrease in TBR (from 2.8% to 1.7%; P = 0.024) and number of SDH3.9 episodes (from 5.4 to 4.0; P = 0.026). After 12 months of OP5-HCL use, the hypoglycemia burden experienced by those with IAH remained higher, including TBR (1.7% vs. 0.7%; P = 0.007) and number of SDH3.9 episodes (4.0 vs. 2.0; P = 0.013), but the difference in episode duration was no longer significant (29.8 vs. 28.0 min; P = 0.084). CONCLUSIONS Use of OP5-HCL by people with IAH reduced TBR and the number of episodes of SDH. However, the overall hypoglycemia burden remained significantly higher in those with IAH.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"20 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148416298","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

State Insulin Out-of-Pocket Cap Policies and Estimated Eligible Populations in the United States, 2019–2026 2019-2026年美国各州胰岛素自付上限政策和估计符合条件的人群

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-06-30 DOI: 10.2337/dc26-0300

Renhao Wang, Umailla Naeem, Alexander O. Everhart, Pinar Karaca Mandic, Stacie B. Dusetzina, Kasia J. Lipska, Rozalina G. McCoy

{"title":"State Insulin Out-of-Pocket Cap Policies and Estimated Eligible Populations in the United States, 2019–2026","authors":"Renhao Wang, Umailla Naeem, Alexander O. Everhart, Pinar Karaca Mandic, Stacie B. Dusetzina, Kasia J. Lipska, Rozalina G. McCoy","doi":"10.2337/dc26-0300","DOIUrl":"https://doi.org/10.2337/dc26-0300","url":null,"abstract":"OBJECTIVE High insulin prices are a major barrier to diabetes management in the U.S. Since 2019, several states have implemented legislation to mitigate high out-of-pocket (OOP) costs for commercially insured individuals by setting caps on monthly OOP payments for insulin. In this study, we examine the reach of these policies. RESEARCH DESIGN AND METHODS We identified insulin OOP cap legislation enacted through 2026 for each state and Washington, DC. Using public data on diabetes prevalence and health insurance coverage, we identified the population eligible and exposed to OOP caps legislation: adults aged 18–64 years with diabetes, using insulin, enrolled in state-regulated commercial plans, and residing in states that enacted OOP caps legislation. We then estimated the number of commercially insured individuals using insulin still left unprotected due to 1) enrolled in federally regulated plans, regardless of state of residence; or 2) enrolled in state-regulated plans but living in states without OOP cap legislation. RESULTS By 2026, 29 states and Washington, DC, had enacted OOP caps on insulin, covering an estimated 0.99 million individuals with diabetes, using insulin, and enrolled in state-regulated commercial plans. Despite these gains, policy reach remains uneven: 0.67 million adults with diabetes using insulin and insured by state-regulated plans live in states without an insulin OOP cap, and 2.2 million more are insured by federally regulated commercial plans that fall outside of state jurisdiction. CONCLUSIONS State OOP caps have the potential to reduce OOP insulin costs for many commercial plan enrollees but have limited reach. Legislative efforts to contain costs at the federal level are therefore needed to decrease the financial burden of insulin therapy.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"36 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355679","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

Real-Time Continuous Glucose Monitoring Among People With Type 2 Diabetes and End-Stage Kidney Failure Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial 进行维持性血液透析的2型糖尿病终末期肾衰竭患者的实时连续血糖监测：一项随机临床试验

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-06-26 DOI: 10.2337/dc26-0404

Rodolfo J. Galindo, Bobak Moazzami, Amany Gerges, Ina Flores, Giuliana Arevalo, Limin Peng, Ian H. de Boer, Katherine R. Tuttle, Guillermo E. Umpierrez

{"title":"Real-Time Continuous Glucose Monitoring Among People With Type 2 Diabetes and End-Stage Kidney Failure Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial","authors":"Rodolfo J. Galindo, Bobak Moazzami, Amany Gerges, Ina Flores, Giuliana Arevalo, Limin Peng, Ian H. de Boer, Katherine R. Tuttle, Guillermo E. Umpierrez","doi":"10.2337/dc26-0404","DOIUrl":"https://doi.org/10.2337/dc26-0404","url":null,"abstract":"OBJECTIVE There is a need for improved glycemia monitoring tools for people with type 2 diabetes (T2D) and end-stage kidney failure (ESKF). RESEARCH DESIGN AND METHODS This prospective, randomized, crossover trial compared the efficacy of real-time continuous glucose monitoring (rtCGM) with capillary blood glucose (CBG) testing in adults with T2D and ESKF undergoing hemodialysis. The primary outcome was percentage of time below range (%TBR) &lt;70 mg/dL. RESULTS The %TBR &lt;70 mg/dL was not significantly different between groups (mean 1.17% ± 1.8 vs. 1.29% ± 2.7; P = 0.28). Compared with CBG testing, percentage time in range (%TIR) was higher (63.4% ± 24 vs. 54.5% ± 23) and mean glucose lower (173.6 ± 37 vs. 187.7 ± 38 mg/dL) after the rtCGM intervention, while percentage time above range (%TAR) &gt;180 mg/dL (35.3% ± 25 vs. 44.3% ± 23) and &gt;250 mg/dL decreased (12.3% ± 15 vs. 18.8% ± 19) (all P ≤ 0.01). CONCLUSIONS In adults with T2D and ESKF undergoing hemodialysis, TBR was minimal and not influenced by rtCGM use. Compared with CBG testing, %TIR and %TAR improved during the rtCGM intervention. Future studies are needed to confirm the benefits of rtCGM in this population.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"59 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148322671","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 Effectiveness of Diabetes Prevention Programs Delivered in Primary Care for Individuals With Prediabetes or at Risk of Developing Type 2 Diabetes: A Systematic Review and Meta-analysis 糖尿病预防项目在糖尿病前期或2型糖尿病高危人群的初级保健中的有效性：一项系统回顾和荟萃分析

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-24 DOI: 10.2337/dc25-1877

Jinfan Qiang, Maduomethaa Pathmaraj, Tiffany Lo, Elizabeth M. Uleryk, Ella Huszti, Lusine Abrahamyan, Andrew D. Pinto

{"title":"The Effectiveness of Diabetes Prevention Programs Delivered in Primary Care for Individuals With Prediabetes or at Risk of Developing Type 2 Diabetes: A Systematic Review and Meta-analysis","authors":"Jinfan Qiang, Maduomethaa Pathmaraj, Tiffany Lo, Elizabeth M. Uleryk, Ella Huszti, Lusine Abrahamyan, Andrew D. Pinto","doi":"10.2337/dc25-1877","DOIUrl":"https://doi.org/10.2337/dc25-1877","url":null,"abstract":"BACKGROUND Prediabetes is a precursor of type 2 diabetes mellitus (T2DM), and lifestyle modifications are key preventive strategies. Primary care is central to prevention efforts, including screening, diagnosis, and follow-up. PURPOSE This systematic review and meta-analysis aimed to evaluate the effectiveness of lifestyle interventions delivered in primary care to patients at elevated risk of developing T2DM. DATA SOURCES We searched Medline and Embase from inception to 28 March 2024. STUDY SELECTION We screened 639 records and included 14 eligible studies of lifestyle-based diabetes prevention programs. Eligible participants had prediabetes or high diabetes risk scores, and interventions were delivered in primary care. DATA EXTRACTION Outcomes included diabetes incidence, glycemic and anthropometric indicators, physical activity, and diet. DATA SYNTHESIS Pooled mean differences (MD) were estimated using inverse variance methods; leave-one-out cross-validation (LOOCV) addressed heterogeneity (&gt;50%). Meta-analysis found no significant effects on diabetes incidence (relative risk 0.82; 95% CI 0.65–1.02), and pooled MD on HbA1c (MD −0.41, 95% CI −0.94 to 0.12), fasting glucose, 2-h glucose, body weight, BMI, waist circumference (MD −1.13, 95% CI −2.40 to 0.13), or systolic and diastolic blood pressure. LOOCV identified one study driving heterogeneity in several outcomes. LIMITATIONS English-only publications may reduce generalizability. CONCLUSIONS This review found no significant differences in diabetes incidence or other key indicators of T2DM, with certainty of evidence varying from moderate to low. Future studies should test integrated screening, referral, and social support strategies in routine care for high-risk groups.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"13 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147739352","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

Life Course Cumulative BMI Burden From Childhood to Adulthood and Risk of Metabolic Multimorbidity: A 36-Year Prospective Cohort Study 从童年到成年的生命过程累积BMI负担和代谢多病的风险：一项36年的前瞻性队列研究

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-22 DOI: 10.2337/dc25-2889

Tongshuai Guo, Huimin Li, Ziqi Liu, Yanjie Yang, Jintang Xie, Jie Ren, Mingjun He, Chao Chu, Chao Li, Yu Yan, Yue Sun, Dan Wang, Guilin Hu, Mingfei Du, Hao Jia, Yinkun Yan, Min Zhao, Costan G. Magnussen, Bo Xi, Jianjun Mu

{"title":"Life Course Cumulative BMI Burden From Childhood to Adulthood and Risk of Metabolic Multimorbidity: A 36-Year Prospective Cohort Study","authors":"Tongshuai Guo, Huimin Li, Ziqi Liu, Yanjie Yang, Jintang Xie, Jie Ren, Mingjun He, Chao Chu, Chao Li, Yu Yan, Yue Sun, Dan Wang, Guilin Hu, Mingfei Du, Hao Jia, Yinkun Yan, Min Zhao, Costan G. Magnussen, Bo Xi, Jianjun Mu","doi":"10.2337/dc25-2889","DOIUrl":"https://doi.org/10.2337/dc25-2889","url":null,"abstract":"OBJECTIVE To examine the associations between cumulative BMI burden from childhood to adulthood and the risk of adult metabolic multimorbidity. RESEARCH DESIGN AND METHODS This prospective cohort study used data from the Hanzhong Adolescent Hypertension Study (1987–2023). A total of 2,446 participants with at least two BMI measurements in both childhood (6–18 years) and adulthood (19–52 years) were included. Cumulative BMI exposure was quantified using total and incremental area under the curve (AUC). Outcomes included metabolic multimorbidity, defined as the presence of two or more or three or more metabolic diseases, specifically hypertension, diabetes, dyslipidemia, elevated liver enzymes/bilirubin, and kidney damage. RESULTS Higher total and incremental BMI AUC during childhood, adulthood, and over the life course were consistently associated with an increased risk of adult metabolic multimorbidity (two or more diseases). For total AUC, odds ratios (ORs) ranged from 1.51 to 2.59 (all P &lt; 0.05); for incremental AUC, ORs ranged from 1.94 to 4.33 (all P &lt; 0.05). Compared with total AUC, incremental AUC showed a stronger association with metabolic multimorbidity in childhood (OR 4.33 [95% CI 2.93, 6.40] vs. 1.51 [1.17, 1.95], respectively). Conversely, total AUC exhibited a stronger association in adulthood than in childhood (OR 2.51 [2.08, 3.04] vs. 1.94 [1.62, 2.31]). Furthermore, the associations for adulthood and life course BMI AUC were significantly stronger in males than in females (P for interaction &lt; 0.05). CONCLUSIONS These findings highlight the importance of life stage–specific strategies: curbing rapid BMI gain in childhood and maintaining long-term weight control throughout adulthood.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"55 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731780","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

Long-term Air Pollution and Overall and Regional Body Composition in Older Adults With Overweight or Obesity and Metabolic Syndrome 长期空气污染与超重或肥胖和代谢综合征老年人整体和局部身体成分的关系

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-21 DOI: 10.2337/dc25-2497

Ariadna Curto, Jadwiga Konieczna, Antoni Colom, Itziar Abete, Kees de Hoogh, Gerard Hoek, Jordi Salas-Salvadó, J. Vicente Martín-Sánchez, Ramón Estruch, Josep Vidal, Estefania Toledo, Jesús F. García-Gavilán, José Antonio de Paz, Rosa Casas, Nuria Goñi-Ruiz, Héctor Vázquez-Lorente, Montserrat Fitó, J. Alfredo Martínez, Dora Romaguera

{"title":"Long-term Air Pollution and Overall and Regional Body Composition in Older Adults With Overweight or Obesity and Metabolic Syndrome","authors":"Ariadna Curto, Jadwiga Konieczna, Antoni Colom, Itziar Abete, Kees de Hoogh, Gerard Hoek, Jordi Salas-Salvadó, J. Vicente Martín-Sánchez, Ramón Estruch, Josep Vidal, Estefania Toledo, Jesús F. García-Gavilán, José Antonio de Paz, Rosa Casas, Nuria Goñi-Ruiz, Héctor Vázquez-Lorente, Montserrat Fitó, J. Alfredo Martínez, Dora Romaguera","doi":"10.2337/dc25-2497","DOIUrl":"https://doi.org/10.2337/dc25-2497","url":null,"abstract":"OBJECTIVE To examine the relationship between long-term air pollution exposure, including black carbon (BC), fine particulate matter (PM2.5), and nitrogen dioxide (NO2), and total fat mass, visceral fat mass, and lean mass in older adults with overweight or obesity and metabolic syndrome. RESEARCH DESIGN AND METHODS We included 1,454 older adults (aged 54–75 years; 48% female) from the PREDIMED-Plus trial in Spain who underwent baseline DXA scans at recruitment (2013–2016) and at 1- and 3-year follow-up. Annual air pollution exposure was assigned at participants’ baseline residential address at 100 m resolution. We used linear mixed-effect regression models with interaction terms for exposure and time to examine longitudinal associations with body composition, also stratifying by sex, age, and physical activity. RESULTS At baseline, a 1× 10−5/m increase in BC was associated with 1.01% (95% CI 0.31–1.71) higher body fat percentage, –0.97% (95% CI –1.64 to –0.30) lower lean mass percentage, and –0.74 kg (95% CI –1.37 to –0.12) lower lean mass. PM2.5 and NO2 showed similar relationships with body fat and lean mass percentage at baseline. These associations persisted in years 1 and 3 for BC and PM2.5. In age-stratified analyses, associations with visceral fat mass were observed only in participants younger than 65 years. Associations did not meaningfully differ by sex or physical activity. CONCLUSIONS Long-term air pollution exposure was adversely associated with body composition over 3 years. Results indicate air pollution is associated with fat accumulation and lean mass loss in metabolically vulnerable older adults.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"16 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731781","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

Seasonal BMI Amplitude and Risk of Kidney Function Decline in Japanese Adults With Type 2 Diabetes (JDDM 82) 日本成人2型糖尿病患者的季节性BMI振幅与肾功能下降的风险（jddm82）

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-14 DOI: 10.2337/dc26-0082

Ryota Toki, Masaya Sakamoto, Masahiro Yuki, Miho Iida, Michiko Yamazaki, Seiichi Ichikawa, Ryuzo Horiuchi, Hiroshi Maegawa, Tomonori Okamura, Toru Takebayashi

{"title":"Seasonal BMI Amplitude and Risk of Kidney Function Decline in Japanese Adults With Type 2 Diabetes (JDDM 82)","authors":"Ryota Toki, Masaya Sakamoto, Masahiro Yuki, Miho Iida, Michiko Yamazaki, Seiichi Ichikawa, Ryuzo Horiuchi, Hiroshi Maegawa, Tomonori Okamura, Toru Takebayashi","doi":"10.2337/dc26-0082","DOIUrl":"https://doi.org/10.2337/dc26-0082","url":null,"abstract":"OBJECTIVE Body weight variability is linked to cardiometabolic outcomes, but its renal impact in type 2 diabetes remains uncertain. We tested whether the magnitude of seasonal BMI fluctuation is independently associated with kidney function decline. RESEARCH DESIGN AND METHODS We analyzed a nationwide, multicenter Japanese cohort (2014–2020). Monthly BMI was modeled using seasonal-trend locally estimated scatterplot smoothing to quantify each participant’s within-year peak-to-trough difference. The primary outcome was ≥40% decline in estimated glomerular filtration rate (eGFR). Secondary outcomes were ≥30% eGFR decline, creatinine doubling, incident chronic kidney disease (CKD) stage ≥3, and kidney failure. Associations were estimated using multivariable Cox models with clinic as a random effect. RESULTS Among 6,700 outpatients (median follow-up: 6.8 years), 779 reached the primary end point. Each 1-SD increase in BMI fluctuation was associated with higher risk of ≥40% eGFR decline (hazard ratio [HR] 1.23, 95% CI 1.16–1.31). The highest versus lowest tertile showed a 1.7-fold increased risk (HR 1.72, 95% CI 1.42–2.09). Patterns were consistent for ≥30% eGFR decline (HR 1.18, 95% CI 1.13–1.23), creatinine doubling (HR 1.30, 95% CI 1.17–1.45), and incident CKD stage ≥3 (HR 1.11, 95% CI 1.07–1.16). Longitudinal analyses showed steeper eGFR decline in the highest-fluctuation group. Results were robust across sensitivity analyses, including models for time-varying medication exposure. CONCLUSIONS In type 2 diabetes, larger intra-annual BMI fluctuations were independently and dose-dependently associated with kidney function decline. Seasonal BMI amplitude may identify higher-risk individuals; whether reducing seasonal BMI fluctuations improves kidney outcomes warrants prospective evaluation.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"33 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147684645","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

Diabetic Retinopathy in Parous Women With and Without Previous Gestational Diabetes Mellitus: A Nationwide Register-Based Cohort Study 有或没有妊娠期糖尿病的分娩妇女的糖尿病视网膜病变：一项基于全国登记的队列研究

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-03 DOI: 10.2337/dc25-3074

Maria Hornstrup Christensen, Christina Anne Vinter, Maria Houborg Petersen, Marianne Skovsager Andersen, Jakob Grauslund, Dorte Moeller Jensen

{"title":"Diabetic Retinopathy in Parous Women With and Without Previous Gestational Diabetes Mellitus: A Nationwide Register-Based Cohort Study","authors":"Maria Hornstrup Christensen, Christina Anne Vinter, Maria Houborg Petersen, Marianne Skovsager Andersen, Jakob Grauslund, Dorte Moeller Jensen","doi":"10.2337/dc25-3074","DOIUrl":"https://doi.org/10.2337/dc25-3074","url":null,"abstract":"OBJECTIVE To investigate previous gestational diabetes mellitus (GDM) as a potential risk factor for diabetic retinopathy (DR) in women with diabetes, including the potential role of GDM severity and hypertension after pregnancy. RESEARCH DESIGN AND METHODS A nationwide, register-based cohort study including all women giving birth in Denmark in 1997–2018. We defined GDM and DR using ICD-10 codes. GDM severity was a proxy based on insulin treatment during GDM pregnancy. Subsequent diabetes and hypertension were based on ICD-10 codes and/or medication postpregnancy. Statistical analyses included Cox regression. RESULTS The complete study population comprised 708,250 women. The GDM prevalence was 3.4%, and the overall median follow-up was 12 years. Diabetes developed subsequently in 18,556 women, and DR occurred in 655 of these. In the women who developed diabetes, previous GDM was associated with a threefold higher risk of DR (adjusted hazard ratio [aHR] 3.0 [95% CI 2.6–3.6]). The risk increased with increasing GDM severity (aHRs 5.6 [95% CI 4.5–6.9] and 2.4 [95% CI 2.0–2.9]) in women with previous GDM with and without insulin treatment, respectively, compared with women without previous GDM [reference group]). In women with subsequent hypertension, GDM exposure was associated with a 2.7-fold higher DR risk (aHR 2.7 [95% CI 2.1–3.5]). CONCLUSIONS This large population-based study identified GDM as significant risk factor for DR in parous women with diabetes, a risk that increased with increasing GDM severity and postpregnancy hypertension development. On the basis of this study, planning of DR screening strategies should include awareness of GDM history.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"60 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599189","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

Intake of Fiber From Different Food Sources and Type 2 Diabetes Risk: An Integrated Analysis of Epidemiological and Multiomic Data 从不同食物来源摄入纤维与2型糖尿病风险：流行病学和多组学数据的综合分析

IF 16.2 1区医学

Diabetes Care Pub Date : 2026-04-01 DOI: 10.2337/dc25-2957

Yi Wan, Hala B. Alessa, Marta Guasch-Ferré, Deirdre K. Tobias, Kyu Ha Lee, JoAnn E. Manson, Walter C. Willett, Qi Sun, Frank B. Hu

{"title":"Intake of Fiber From Different Food Sources and Type 2 Diabetes Risk: An Integrated Analysis of Epidemiological and Multiomic Data","authors":"Yi Wan, Hala B. Alessa, Marta Guasch-Ferré, Deirdre K. Tobias, Kyu Ha Lee, JoAnn E. Manson, Walter C. Willett, Qi Sun, Frank B. Hu","doi":"10.2337/dc25-2957","DOIUrl":"https://doi.org/10.2337/dc25-2957","url":null,"abstract":"OBJECTIVE To examine the association between fiber from various food sources and type 2 diabetes (T2D) risk, as well as the molecular profiles involved. RESEARCH DESIGN AND METHODS Using data from three large prospective U.S. cohorts comprising 195,222 participants observed for up to 34 years, we evaluated the association between fiber from various food sources and T2D risk. We also assessed the association between fiber intake, plasma metabolic biomarkers, and a metabolomic profile indicative of T2D risk. Additionally, we examined gut microbial features related to fiber intake and the T2D metabolomic profile. RESULTS During follow-up, we documented 18,369 incident T2D cases. Higher intakes of total fiber (hazard ratio [HR] comparing extreme quintiles 0.88; 95% CI 0.82, 0.94), cereal fiber (HR 0.77; 95% CI 0.73, 0.82), and fruit fiber (HR 0.82; 95% CI 0.78, 0.87) were each associated with a lower T2D risk. Greater intakes of total fiber, cereal fiber, and fruit fiber, but not vegetable fiber, were linked to more favorable plasma profiles of insulinemic, lipid, and inflammatory biomarkers and a metabolomic profile indicative of a lower T2D risk. We also identified multiple gut microbial species, such as Faecalibacterium prausnitzii, Ruminococcus lactaris, and Gemmiger formicilis, along with relevant butyric acid–producing enzymes, all of which were associated with higher fruit fiber intake and a metabolomic profile indicating a lower likelihood of T2D development. CONCLUSIONS Higher intakes of total, cereal, and fruit fiber are associated with a lower risk of T2D and a more favorable metabolic profile, with the gut microbiome potentially contributing to the beneficial association of fruit fiber.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"149 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147587118","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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