Diabetes Care最新文献

{"title":"Hypercholesterolemia and Lipid-Lowering Therapy in Children and Adolescents With Type 1 Diabetes: Do We Implement Current Guidelines?","authors":"Jantje Weiskorn, Marianne Becker, Clemens Kamrath, Johanna Hammersen, Susanne Bechtold-Dalla Pozza, Elke Müller-Roßberg, Martin Holder, Marie-Anne Burckhardt, Reinhard Walter Holl","doi":"10.2337/dc25-2459","DOIUrl":"https://doi.org/10.2337/dc25-2459","url":null,"abstract":"OBJECTIVE We investigated the prevalence of elevated LDL cholesterol in youths with type 1 diabetes (T1D), contributing factors, the frequency of lipid-lowering medication (LLM), and the achievement of target values. RESEARCH DESIGN AND METHODS A cross-sectional analysis based on data from the Diabetes-Patienten-Verlaufsdokumentation registry (Diabetes Prospective Follow-up Registry) from 2013 to 2023. Inclusion criteria were T1D, age <18 years, and at least one documented LDL measurement. LDL cut offs of >2.6, >3.4, and >4.1 mmol/L were defined. Application of national and international treatment guidelines was examined. Descriptive analyses and linear and logistic regression models were implemented using SAS 9.4. RESULTS The study included 55,028 participants. Of these, 9.7% and 2.3% had LDL >3.4 mmol/L and >4.1 mmol/L, respectively. The parameters HbA1c (β = 1,142.7; P = 0.001), female sex (β = 861.5; P < 0.001), and BMI >70th percentile (β = 520.1; P < 0.001) had the strongest effect on LDL levels. Only 7.3% of the cohort with elevated LDL levels received LLM. The majority (92.7%) with LDL >3.4 mmol/L and 87.0% with LDL >4.1 mmol/L were not treated. Estimated odds ratios (95% CI) for the use of LLM were 19.13 (15.4–23.7) for LDL >4.1 mmol/L; 3.1 (1.82–5.41) for ages 12–18 years; 2.31 (1.9–2.1) for diabetes duration of 5–10 years; 1.8 (1.5–2.1) for BMI >70th percentile; 1.3 (1.0–1.6) for HbA1c >9%; and 1.18 (1.0–1.4) for female sex. However, only 15.7% of the treated patients (n = 707) reached the LDL target of <2.6 mmol/L, and LDL levels of 55% even remained at >3.4 mmol/L. CONCLUSIONS We found a high prevalence of LDL hypercholesterolemia. The use of LLM was low, despite treatment indication, and treatment targets were mostly not achieved either due to underdosing or nonadherence to LLM. These findings confirm that dyslipidemia remains an underestimated cardiovascular risk factor in pediatric diabetology.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"21 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470891","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":"Weight Regain Reverses Caloric Restriction–Induced Benefits on the Insulin–IGF-1 Nutrient-Sensing Pathway: Post Hoc Analysis From the CALERIE-2 Randomized Controlled Trial","authors":"Moritz V. Warmbrunn, Lin Yang, Raaj Kishore Biswas, Calen P. Ryan, Andrew Harper, Daniel W. Belsky, Giovanni Fiorito, Luigi Fontana","doi":"10.2337/dc25-1911","DOIUrl":"https://doi.org/10.2337/dc25-1911","url":null,"abstract":"OBJECTIVE To investigate the long-term metabolic and hormonal consequences of sustained weight loss versus weight regain after 1 year of caloric restriction (CR), with attention to insulin resistance and type 2 diabetes risk. RESEARCH DESIGN AND METHODS In the 2-year Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy 2 (CALERIE-2) trial (n = 220), participants were randomized to 25% CR or control diet. The intervention targeted weight loss over the first 6–12 months, followed by a 12-month maintenance phase. To assess weight-regain consequences, participants were stratified by weight trajectory regardless of randomization, and group differences were balanced by propensity score weighting. Cardiometabolic and hormonal markers of available participants (n = 190), as well as a biomarker-based estimate of biological age, were compared across weight trajectory groups. RESULTS At 12 months, weight loss ranged from 5.0 to 5.8 kg between groups. Between months 12 and 24, most participants either maintained weight (n = 112) or continued to lose weight (n = 58), whereas a smaller group regained >5% of baseline weight (n = 20). This group had the largest initial caloric reductions. Weight regain reversed improvements in insulin area under the curve and the ratio of insulin-like growth factor 1 (IGF-1) to insulin-like growth factor-binding protein 1, and sustained weight loss maintained metabolic benefits and was associated with greater reductions in biological age. CONCLUSIONS Substantial weight loss followed by weight regain can attenuate or reverse CR-induced benefits on key regulators of the insulin–IGF-1 nutrient-sensing pathway and markers of biological aging. Sustained, moderate weight loss more effectively improves insulin resistance and maintains favorable hormonal profiles linked to type 2 diabetes risk and aging biology.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"11 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147465233","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":"Improving the Algorithm: The Inclusion of a Socioeconomic Status Measure in Predicting Type 2 Diabetes Development in Youth With Prediabetes","authors":"Subin Jang, Yinzhao Wang, Sisi Ma, Daniel S. Hsia, Kristina Cossen, David Haynes, Megan O. Bensignor","doi":"10.2337/dc25-3060","DOIUrl":"https://doi.org/10.2337/dc25-3060","url":null,"abstract":"OBJECTIVE To evaluate whether the Area Deprivation Index (ADI) contributes to predicting type 2 diabetes development in youth with prediabetes compared with a machine learning (ML) model built with other data elements. RESEARCH DESIGN AND METHODS Patient encounters (n = 665) from an electronic medical record were used to build supervised ML models to predict type 2 diabetes development within 1 year of prediabetes diagnosis. The ADI was constructed using patients’ census block data. Two models, trained on data with and without ADI, were built. The model selection resulted in logistic regressions with 1) HbA1c only and 2) HbA1c + ADI as the best models from each data set. RESULTS A total of 181 patient encounters (27.2%) developed type 2 diabetes. The area under the receiver operating characteristic curve of the HbA1c-only model was 0.68 and of the HbA1c + ADI model, 0.73. CONCLUSIONS The addition of ADI to the model resulted in the best performance in predicting youth-onset type 2 diabetes development.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"20 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A U-Shaped Association Between Blood mtDNA Copy Number and Risk of Type 2 Diabetes","authors":"Xinhao Huang, Zijian Tian, Ying Pan, Jia Zhang, Benrui Wu, Shiteng Gao, Yao Cheng, Qi Hu, Jinxiang Ma, Qi Pan, Jian Shao, Kaixin Zhou","doi":"10.2337/dc25-2198","DOIUrl":"https://doi.org/10.2337/dc25-2198","url":null,"abstract":"OBJECTIVE mtDNA copy number (CN) reflects mitochondrial function, but prior studies have reported inconsistent associations with type 2 diabetes risk, ranging from inverse to positive or null findings. We hypothesized that mtDNA-CN is nonlinearly associated with incident type 2 diabetes. RESEARCH DESIGN AND METHODS We included 34,835 adults without diabetes from the Kunshan Aging Research With E-Health (KARE) cohort and 289,338 from the UK Biobank (UKB). Associations between blood mtDNA-CN and incident type 2 diabetes were evaluated using Cox proportional hazards and restricted cubic spline models stratified by age. RESULTS A U-shaped association was observed in the KARE cohort (P < 0.001), in which the hazard ratios (95% CIs) across increasing mtDNA-CN quartiles were 1.00 (reference), 0.94 (0.88–1.00), 0.85 (0.79–0.91), and 0.93 (0.87–1.00). In contrast, the UKB cohort exhibited a predominantly inverse linear trend. Age-stratified analyses revealed that this U-shaped association was particularly evident in younger participants (aged <65 years in KARE and <50 years in UKB), indicating elevated diabetes risk at both low and high mtDNA-CN levels. Additionally, mtDNA-CN declined with age in both cohorts, with an accelerated decrease beyond ∼65 years in KARE and ∼50 years in UKB. CONCLUSIONS Blood mtDNA-CN showed a U-shaped association with incident type 2 diabetes in younger individuals.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"13 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462178","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":"Accuracy, Variability, and Bias of Glycemic Biomarkers in Patients Treated With Maintenance Dialysis","authors":"Leila R. Zelnick, Subbulaxmi Trikudanathan, Yoshio N. Hall, Ernest Ayers, Lisa Anderson, Nathaniel Ashford, Evelin Jones, Andrea C. Rivas-Nieto, Simon Hsu, Kuanysh Kabytaev, Zhuo Wang, Andrew N. Hoofnagle, Irl B. Hirsch, Ian H. de Boer","doi":"10.2337/dc25-2952","DOIUrl":"https://doi.org/10.2337/dc25-2952","url":null,"abstract":"OBJECTIVE Accurate assessment of glycemia in patients treated with maintenance dialysis is imperative and hampered by known biases of glycated hemoglobin (HbA1c) in kidney failure (KF). This study evaluated the accuracy, variability, and covariate bias of three glycemic biomarkers compared with glycemia measured by continuous glucose monitor (CGM) among people with and without diabetes treated with maintenance dialysis. RESEARCH DESIGN AND METHODS In a prospective community-based cohort study, 251 participants treated with maintenance dialysis wore a Dexcom G6 Pro CGM for 10 days. We compared correlations of HbA1c, glycated albumin (GA), and fructosamine with CGM-derived mean glycemia and examined sources of bias. RESULTS Participants (43% women; 63% with diabetes) had a median of 9.3 (interquartile range 8.5–9.4) valid days of CGM data. Mean (SD) HbA1c, GA, fructosamine, and mean CGM glucose were 6.2% (1.4%), 19.6% (6.3%), 351 (99) µmol/L, and 170 (63) mg/dL, respectively. HbA1c, GA, and fructosamine all strongly correlated with mean CGM blood glucose, with HbA1c and GA more correlated than fructosamine (overall, r = 0.85, r = 0.87, and r = 0.70, respectively; in diabetes, r = 0.84, r = 0.84, and r = 0.64, respectively). Compared with mean CGM glucose, HbA1c was significantly biased by erythropoiesis-stimulating agent dose, BMI, hemoglobin, and serum albumin; GA and fructosamine were biased by dialysis modality and vintage, residual kidney function, and BMI. CONCLUSIONS HbA1c and GA were strongly correlated with mean CGM blood glucose, but all biomarkers had substantial bias by relevant clinical characteristics. HbA1c and GA may be useful assessments of average glycemia in patients treated with maintenance dialysis, if bias can be adequately addressed.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"80 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147383341","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":"Comparative Effectiveness of Tirzepatide Versus Dulaglutide or Semaglutide on Major Cardiovascular Events in Type 2 Diabetes and Cardiovascular Disease: Insights From Two Target-Trial Emulations","authors":"John W. Ostrominski, Janinne Ortega-Montiel, Deborah J. Wexler, Brendan M. Everett, Sara J. Cromer, Caroline F. Byrne, Robert J. Glynn, Julie M. Paik, Elisabetta Patorno","doi":"10.2337/dc25-3063","DOIUrl":"https://doi.org/10.2337/dc25-3063","url":null,"abstract":"OBJECTIVE To evaluate the comparative effectiveness of dulaglutide or semaglutide versus tirzepatide on cardiovascular outcomes in adults with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD). RESEARCH DESIGN AND METHODS Two target trial emulations included commercially insured adults (June 2022–December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide. The primary outcome was modified major adverse cardiovascular events (MACE), defined as a composite of nonfatal myocardial infarction, nonfatal stroke, and all-cause death. First, new users of tirzepatide and dulaglutide were propensity score (PS) matched one to one. Second, new users of tirzepatide and semaglutide were PS matched one to one. Incidence rates (IRs) per 1,000 person-years and hazard ratios (HRs) were estimated. RESULTS After PS matching, 9,233 pairs of tirzepatide or dulaglutide initiators and 25,266 pairs of tirzepatide or semaglutide initiators were identified. Tirzepatide initiators experienced a lower rate of modified MACE versus dulaglutide initiators (IR 31.3 vs. 39.4, respectively; HR 0.80 [95% CI 0.65–0.99]), which seemed to be driven by lower all-cause mortality among tirzepatide versus dulaglutide initiators (HR 0.60 [95% CI 0.43–0.83]). In post hoc analyses, tirzepatide was associated with lower rates of pneumonia-related hospitalization when compared with dulaglutide. Rates of modified MACE were similar among tirzepatide and semaglutide initiators (IR 23.7 vs. 23.2, respectively; HR 1.03 [95% CI 0.90–1.17]). CONCLUSIONS Among adults with T2D and ASCVD in routine care, tirzepatide was associated with a lower risk of modified MACE when compared with dulaglutide, driven by reduction in all-cause mortality. Risks of modified MACE seemed similar with tirzepatide and semaglutide.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"100 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350728","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":"Semaglutide Effects on Insulin Sensitivity and β-Cell Function in Patients With Schizophrenia, Prediabetes, and Obesity Treated With Second-Generation Antipsychotics: Findings From the HISTORI Trial, a 30-Week Randomized, Placebo-Controlled Trial With Semaglutide 1.0 mg Weekly","authors":"Ashok A. Ganeshalingam, Nicolai Uhrenholt, Sidse Arnfred, Peter Gæde, Andreas K. Pedersen, Niels Bilenberg, Jan Frystyk","doi":"10.2337/dc25-2041","DOIUrl":"https://doi.org/10.2337/dc25-2041","url":null,"abstract":"OBJECTIVE To examine the effects of semaglutide on insulin sensitivity, insulin resistance, and β-cell function and explore whether these changes were mediated by weight loss in overweight or obese individuals with schizophrenia and prediabetes receiving second-generation antipsychotics. RESEARCH DESIGN AND METHODS In this 30-week, double-blind trial, 154 participants were randomized to semaglutide (n = 77) or placebo (n = 77); 141 (91.5%) completed the study. Baseline and end-of-study assessments included fasting glucose, insulin, C-peptide, HOMA2 of β-cell function, HOMA2 of insulin sensitivity, HOMA of insulin resistance, and body weight. RESULTS Participants (56% women, mean age 38.3 years) provided complete insulin data in 131 cases. Compared with placebo, semaglutide significantly reduced fasting glucose (−0.87 mmol/L [95% CI −1.15, −0.59]; P < 0.001), improved insulin sensitivity (8.60 [5.82, 13.65]; P = 0.001), and lowered insulin resistance (−0.69 [−1.00, −0.20]; P = 0.006). Mean weight loss was 9.2 kg and mediated improvements in insulin sensitivity (estimate 7.82; P = 0.01) and insulin resistance (estimate −0.75; P = 0.01). Nonsignificant trends were observed toward reduced fasting insulin (−52.3 pmol/L; P = 0.11) and C-peptide (−182.9 pmol/L; P = 0.096), with a modest, nonsignificant increase in β-cell function (8.10; P = 0.19). CONCLUSIONS Semaglutide significantly improved insulin sensitivity, reduced insulin resistance, lowered fasting glucose, and promoted substantial weight loss in patients with antipsychotic-induced metabolic disturbances. Weight loss partly mediated the metabolic improvements, while β-cell function remained largely unchanged. These findings support semaglutide as a potential strategy for mitigating metabolic dysfunction in this high-risk population.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"227 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350690","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":"Gestational Diabetes, Glycemic Management Trajectories, and Offspring Growth Patterns and Obesity Risk","authors":"Rana F. Chehab, Mara B. Greenberg, Catherine Lee, Amanda L. Ngo, Juanran Feng, Yeyi Zhu, Assiamira Ferrara","doi":"10.2337/dc25-1643","DOIUrl":"https://doi.org/10.2337/dc25-1643","url":null,"abstract":"OBJECTIVE Children exposed to gestational diabetes mellitus (GDM) face an increased risk of obesity. We examined whether offspring obesity risk varied by maternal glycemic management trajectories during pregnancy compared with offspring unexposed to GDM. RESEARCH DESIGN AND METHODS This population-based prospective cohort included individuals who delivered at Kaiser Permanente Northern California (2011–2017) and their offspring with BMI measured at ages 2–10 through 2022. Glycemic management trajectories (optimal ≥80% of glucose values meeting American Diabetes Association targets) were identified from GDM diagnosis to delivery. Associations with offspring BMI and obesity risk were estimated using adjusted generalized estimating equations. RESULTS Among 206,464 pregnant individuals, 14,870 (7.2%) had GDM; among whom four glycemic management trajectories were identified: stably optimal (T1), rapidly improving to optimal (T2), slowly improving to near optimal (T3), and slowly improving to suboptimal (T4). Associations showed a dose-response pattern across T1–T4. By age 10, offspring in T1 had BMI (β = 0.27 [95% CI −0.13, 0.66]) and obesity risk (risk ratios 1.07 [0.91, 1.26]) similar to those unexposed to GDM. In contrast, offspring in T2, T3, and T4 had progressively higher BMI (1.00 [0.55, 1.46], 1.22 [0.67, 1.76], and 2.15 [1.48, 2.49]) and obesity risk (1.37 [1.18, 1.59], 1.53 [1.29, 1.81], and 1.62 [1.33, 1.98]). Associations were attenuated but persisted after adjustment for prepregnancy BMI. CONCLUSIONS Early and sustained glycemic management after GDM diagnosis was associated with lower childhood obesity risk comparable to that in offspring unexposed to GDM. These findings suggest an opportunity for prenatal risk stratification and prevention for children at higher obesity risk.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"61 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350696","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":"Persistent Burden of Severe Hypoglycemia and Impaired Awareness of Hypoglycemia Among People With Type 1 Diabetes Despite Technology Use: A Follow-up Survey","authors":"Jennifer L. Sherr, Rebecca L. Molinsky, Tathabbai Pakalapati, Jordan S. Sherwood, Megan E. Peter, Emilee M. Cornelius, Jeremy Pettus","doi":"10.2337/dc25-2345","DOIUrl":"https://doi.org/10.2337/dc25-2345","url":null,"abstract":"OBJECTIVE To assess longitudinal trends in glycemic metrics, prevalence of severe hypoglycemic events (SHEs), impaired awareness of hypoglycemia (IAH), and technology use (continuous glucose monitoring [CGM], automated insulin delivery [AID]) in a real-world U.S. cohort of adults with type 1 diabetes. RESEARCH DESIGN AND METHODS This was a cross-sectional study of adults with type 1 diabetes conducted ∼2 years after participants enrolled in the original retrospective observational study. Participants self-reported technology use, insulin delivery method, glycated hemoglobin (HbA1c), IAH, and SHEs. Change was assessed among these variables from the initial and follow-up study. RESULTS Approximately 2 years after the original survey, 1,056 adults responded to the follow-up survey and were eligible for analysis (53% response rate; mean [SD] age: 46 [16] years; mean [SD] type 1 diabetes duration: 29 [16] years; 71% female; 97% White). Most reported using CGMs in the original study (91.8%) and at follow-up (94.4%), while the use of AID increased 17.7%. In the original study, 61.7% reported HbA1c <7% vs. 67.4% at follow-up. Proportions of individuals with IAH and SHEs remained high at ∼30% and ∼20%, respectively, in both studies. CONCLUSIONS Although most participants used CGM and the use of AID increased, approximately one-third of respondents did not achieve HbA1c targets, ∼20% continued to have SHEs in the last year, and ∼30% had IAH. This highlights that while CGM and AID systems are a significant advancement, their use alone has not mitigated the risk of severe hypoglycemia, and glucose management still remains suboptimal.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"2 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147292665","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":"Impact of Metabolic Bariatric Surgery on Weight Loss and Glycemic Control in Adults With Type 1 Diabetes: A Multicenter Retrospective Cohort Study","authors":"Rieneke van der Meer, Sofia Pazmino, Nele Steenackers, Amar van Laar, Maarten Sluis, Luna Tolenaars, Jonathan Rosen, Carmen Hurtado del Pozo, Carel W. le Roux, Jumana Al Kandari, Mohammad Irshad, Matthias Lannoo, Ellen Deleus, Bruno Dillemans, Yves Van Nieuwenhove, Arianne van Bon, Eric Hazebroek, Ebaa Al Ozairi, Roel Hoogma, Chantal Mathieu, Ronald Liem, Bart Van der Schueren","doi":"10.2337/dc25-2295","DOIUrl":"https://doi.org/10.2337/dc25-2295","url":null,"abstract":"OBJECTIVE To assess the effect of metabolic bariatric surgery (MBS) in people living with type 1 diabetes (T1D) and obesity. RESEARCH DESIGN AND METHODS From retrospective multicenter data, total weight loss, daily insulin requirement, HbA1c, and cardiometabolic parameters were assessed before and after surgery. Longitudinal models were used to identify response determinants. RESULTS This study included 162 people living with T1D and obesity. One year after surgery, mean total weight loss percentage was 29.7% (interquartile range (IQR) = 29.4, 30.3). Insulin requirements dropped from 0.75 (IQR = 0.58, 1.00) units/kg/day to 0.32 (IQR = 0.23, 0.43) units/kg/day (P < 0.001), and HbA1c from 64.0 (IQR = 57.0, 74.0) mmol/mol to 60.0 (IQR = 53.4, 68.0) mmol/mol (P < 0.001). LDL, HDL, total cholesterol, and triglyceride levels significantly improved after surgery (P < 0.001). Greater total weight loss was associated with reduced insulin requirements, and higher baseline HbA1c was associated with poorer postsurgery glycemic control. CONCLUSIONS MBS was associated with substantial metabolic improvement in people with T1D and obesity, in particular in those with high HbA1c and insulin need at baseline.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"180 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215706","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}