Diabetologia最新文献

{"title":"Perceived blood glucose regulation after menopause: a cross-sectional survey in women with type 1 diabetes in the Netherlands.","authors":"Esther M Speksnijder,Suat Simsek,Peter H Bisschop,Dirk Jan Stenvers,Sarah E Siegelaar, ","doi":"10.1007/s00125-025-06518-z","DOIUrl":"https://doi.org/10.1007/s00125-025-06518-z","url":null,"abstract":"AIMS/HYPOTHESISWomen with type 1 diabetes experience changes in insulin requirements in pregnancy and throughout the menstrual cycle. It remains to be explored whether women with type 1 diabetes perceive changes in glucose regulation during and after the menopausal transition, another period of marked hormonal change in a woman's life.METHODSWe conducted a cross-sectional survey to investigate whether women with type 1 diabetes perceive changes in glucose regulation after their final menstrual period. The online questionnaires were distributed through advertisements in hospitals and through online platforms for people living with type 1 diabetes in the Netherlands. Postmenopausal women (≥1 year of amenorrhoea) with type 1 diabetes, aged 45-65 years, were included. Participants with primary amenorrhoea, premenopausal hysterectomy or a postmenopausal diabetes diagnosis were excluded from the study. The primary outcome was the extent to which participants perceived changes in their glucose regulation following their final menstrual period, assessed using a five-point Likert scale. Menopausal symptom severity was estimated using the Greene climacteric scale (GCS).RESULTSQuestionnaires from a total of 159 women were eligible for inclusion. Participants had a mean age of 54.9 years (SD 3.8), a mean diabetes duration of 30.3 years (SD 12.8), and had their final menstrual period at a mean age of 50.1 years (SD 5.0). Overall, 67.4% of participants reported moderate to severe postmenopausal changes in glucose regulation. Increased blood glucose levels were perceived by 41.9% of participants, 19.6% perceived lower glucose levels and 38.5% perceived no change in blood glucose levels. For fluctuations in glucose levels, 55.0% experienced more fluctuations and 18.1% experienced less fluctuation. More hyperglycaemic events were experienced by 61.6% of participants, while 38.5% experienced more hypoglycaemic events and 28.0% experienced fewer hypoglycaemic events. Reported menopausal symptoms were more severe after the final menstrual period compared with before the final menstrual period (mean GCS score ± SD: 18.8±9.9 vs 11.7±8.3, p<0.001). An increase in postmenopausal symptom severity score was associated with an increase in the odds of perceiving postmenopausal changes in glucose regulation, with an adjusted OR of 1.04 (95% CI 1.01, 1.08; p=0.014). A total of 57.2% of participants had a global Pittsburgh sleep quality index (PSQI) score >5, indicating poor sleep quality. Poor sleep quality was not associated with perceived glycaemic changes after menopause (global PSQI >5) (adjusted OR 1.10; 95% CI 0.58, 2.08; p=0.731).CONCLUSIONS/INTERPRETATIONApproximately two-thirds of women with type 1 diabetes perceive changes in their glucose regulation after menopause, including subjective changes in the number of hyperglycaemic and hypoglycaemic events. Changes in perceived glucose regulation were associated with the severity of reported menopausal symptoms. These re","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"17 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857713","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":"Scavenging acrolein with 2-HDP preserves neurovascular integrity in a rat model of diabetic retinal disease.","authors":"Josy Augustine,Evan P Troendle,Thomas Friedel,Caolan Baldwin,Eimear M Byrne,Sadaf Ashraf,Paul Canning,Corey A McAleese,Adam G Rollo,Peter Barabas,Timothy J Lyons,Martin B Ulmschneider,Alan W Stitt,Tim M Curtis","doi":"10.1007/s00125-025-06515-2","DOIUrl":"https://doi.org/10.1007/s00125-025-06515-2","url":null,"abstract":"AIMS/HYPOTHESISDiabetic retinal disease (DRD) is characterised by progressive neurovascular unit (NVU) dysfunction, often occurring before visible microvascular damage. Our previous studies suggested that the accumulation of acrolein (ACR)-derived protein adducts on retinal Müller cells and neuronal proteins may contribute to NVU dysfunction in diabetes, although this has yet to be directly tested. In this study, we evaluated the effects of the novel ACR-scavenging drug 2-hydrazino-4,6-dimethylpyrimidine (2-HDP) on retinal NVU dysfunction in experimental diabetes and explored its potential for systemic delivery in humans.METHODSSprague Dawley rats were divided into three groups: non-diabetic rats; streptozocin (STZ)-induced diabetic rats; and STZ-induced diabetic rats treated with 2-HDP in their drinking water throughout the duration of diabetes. Endpoint measures were taken at varying time points, ranging from 1 to 6 months post-diabetes induction. Retinal function and structure were evaluated using electroretinography (ERG) and spectral-domain optical coherence tomography (SD-OCT). Retinal vessel calibre, BP and vasopermeability (assessed by Evans Blue leakage) were also monitored. Immunohistochemistry was employed to assess retinal neurodegenerative and vasodegenerative changes, while cytokine arrays were used to investigate the effect of 2-HDP on diabetes-induced retinal inflammation. The accumulation of the ACR-protein adduct Nε-(3-formyl-3,4-dehydropiperidino)lysine (FDP-Lys) in human diabetic retinas was analysed. Computational chemistry simulations were performed to predict 2-HDP's passive permeability properties and its potential for systemic delivery.RESULTS2-HDP treatment had no effect on blood glucose, body weight, water intake, HbA1c levels or BP in diabetic rats (p&gt;0.05). However, it protected against retinal FDP-Lys accumulation (p&lt;0.05) and neurophysiological dysfunction, preserving ERG waveforms at 3 and 6 months post-diabetes induction (p&lt;0.05 to p&lt;0.001 for scotopic for a-wave, b-wave and summed oscillatory potentials). SD-OCT imaging revealed that 2-HDP prevented retinal thinning at 3 months (p&lt;0.01) and protected against synaptic dysfunction, as evidenced by preserved synaptophysin expression (p&lt;0.01 and p&lt;0.001 for inner and outer plexiform layers, respectively). It also prevented neurodegeneration by maintaining retinal ganglion cells, amacrine cells, bipolar cells, and photoreceptors (p&lt;0.05 to p&lt;0.01). In addition, 2-HDP prevented retinal arteriolar dilation (p&lt;0.01), reduced microvascular permeability (p&lt;0.05) and attenuated microvascular damage, as indicated by preserved pericyte numbers and reduced acellular capillary formation (p&lt;0.05). Mechanistically, 2-HDP inhibited microglial activation (p&lt;0.05), suppressed the upregulation of proinflammatory molecules associated with NVU dysfunction in the diabetic retina (p&lt;0.05 to p&lt;0.001) and preserved the expression of the Müller cell glutamate-handling proteins, glutamate as","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"13 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850929","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":"The moral equivalent: 60 years of publishing a scientific journal.","authors":"Edwin Gale,George Alberti,Ele Ferrannini,Sally Marshall,Juleen R Zierath,Hindrik Mulder","doi":"10.1007/s00125-025-06507-2","DOIUrl":"https://doi.org/10.1007/s00125-025-06507-2","url":null,"abstract":"","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"79 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819804","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 prevention and treatment: a global perspective.","authors":"Christian Herder,Cheryl Pritlove,Nishi Chaturvedi,Hindrik Mulder","doi":"10.1007/s00125-025-06511-6","DOIUrl":"https://doi.org/10.1007/s00125-025-06511-6","url":null,"abstract":"","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"26 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825461","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 in four dialects: a global call for equity across lived, loved, learned and laboured experiences.","authors":"Linxi Mytkolli,Asra Ahmed,Sana Ajmal,Ana Alvarez Pagola,Justin Binko,Paula Chinchilla,Sumeet Dhagia,Emma Doble,Eman El-Menshawy,Frank Fol,Nupur Lalvani,Chelcie Rice,Mohammed Seyam,Kaajal Vaghela,Zhuo Xing","doi":"10.1007/s00125-025-06506-3","DOIUrl":"https://doi.org/10.1007/s00125-025-06506-3","url":null,"abstract":"","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"35 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802502","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":"The impact of child type 1 diabetes on parental incomes in a welfare state context: quasi-experimental evidence from Swedish national registers.","authors":"Beatrice Kennedy,Mona-Lisa Wernroth,Sophie Langenskiöld,Carl Bonander,Liisa Byberg,Erik Grönqvist,Tove Fall","doi":"10.1007/s00125-025-06492-6","DOIUrl":"https://doi.org/10.1007/s00125-025-06492-6","url":null,"abstract":"AIMS/HYPOTHESISThe aim of this study was to quantify the impact of childhood-onset type 1 diabetes on parental incomes in a Nordic welfare state.METHODSIn this register-based quasi-experimental study, we included the parents of 13,358 children diagnosed with type 1 diabetes in Sweden from 1993 to 2014 together with 506,516 population-based matched control parents. A difference-in-differences approach was used to compare income trajectories between exposed parents and control parents. Work-related and pension-qualifying incomes (including parental benefits) were assessed during the first 7 years after diagnosis. The long-term incomes of parents of children diagnosed with type 1 diabetes in 1993-2004 were also investigated.RESULTSA sharp decline in work-related income was observed in both mothers and fathers of children diagnosed with type 1 diabetes. In the year after diagnosis, the mean yearly income difference (expressed in €100) was -15.4 for mothers (95% CI -17.2, -13.6) and -6.0 for fathers (95% CI -8.9, -3.2), representing a relative decrease of 6.6% and 1.6%, respectively. The effects on income were similar across sociodemographic groups and calendar periods. The pension-qualifying income of mothers increased in the first year after diagnosis by 28.7 (95% CI 27.1, 30.3), attributable to the parental care allowance, but gradually decreased during long-term follow-up (-10.9, 95% CI -16.6, -5.1, after 17 years).CONCLUSIONS/INTERPRETATIONThis study highlights the enduring financial consequences for parents caring for a child with type 1 diabetes in Sweden. While parental benefits in Sweden mitigated the short-term loss of maternal income, the current welfare system does not adequately address long-term consequences.","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"16 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802661","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":"Adverse pregnancy outcomes in women with type 1 diabetes are associated with multiple alterations in the vaginal microbiome.","authors":"Alexandra J Roth-Schulze,Esther Bandala-Sanchez,Katrina M Ngui,Gaetano Naselli,Helena Oakey,Patricia Ashwood,Guinevere Martin,James D Brown,Enrique Zozaya-Valdés,Rebecca L Thomson,Peter G Colman,John M Wentworth,Peter J Vuillermin,Tony Hunyh,Georgia Soldatos,Jennifer J Couper,Megan A S Penno,Leonard C Harrison, ","doi":"10.1007/s00125-025-06509-0","DOIUrl":"https://doi.org/10.1007/s00125-025-06509-0","url":null,"abstract":"AIMS/HYPOTHESISThe vaginal microbiome has been linked to adverse pregnancy outcomes, which are markedly increased in women with type 1 diabetes. To investigate this relationship, we profiled the vaginal microbiome in pregnant women with and without type 1 diabetes, and in relation to pre-term birth (PTB) and pre-eclampsia (PE) in women with type 1 diabetes.METHODSBacterial and fungal microbiomes were analysed by 16S rRNA gene and internal transcribed spacer 1 sequencing, respectively, in the third trimester of 310 pregnancies (160 with type 1 diabetes) for bacteria, and 147 pregnancies (70 with type 1 diabetes) for fungi.RESULTSThe vaginal microbiome was altered by type 1 diabetes in pregnancy, with an increase in the bacterial species Lactobacillus iners and Lactobacillus jensenii, and in the anaerobic genera Gardnerella, Anaerococcus, Prevotella, Dialister, Peptoniphilus and others that are associated with vaginal dysbiosis. In addition, the abundance of the fungal species Malassezia restricta was increased in women with type 1 diabetes. These changes were associated with increased risks of PTB and PE. PTB was associated with higher bacterial alpha diversity, decreased abundance of Lactobacillus reuteri, and increased abundance of Malassezia fungal genus, family Malasseziaceae and order Malasseziales. PE was associated with higher bacterial alpha diversity, increased abundance of Gardnerella vaginalis and decreased abundance of Candida albicans.CONCLUSIONS/INTERPRETATIONAdverse pregnancy outcomes in women with type 1 diabetes are reflected by distinct changes in the vaginal microbiome. This highlights the importance of monitoring and managing the vaginal microbiome in high-risk pregnancies, particularly those complicated by type 1 diabetes. Early detection and treatment of risk-associated taxa, e.g. G. vaginalis in the case of PE, could potentially improve vaginal health and pregnancy outcomes in women with type 1 diabetes.","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"98 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796783","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":"Ethnic diversity in precision medicine: a reality or an aspiration?","authors":"Shivani Misra","doi":"10.1007/s00125-025-06513-4","DOIUrl":"https://doi.org/10.1007/s00125-025-06513-4","url":null,"abstract":"Precision medicine seeks to tailor prevention, diagnosis and treatment strategies to the biological and contextual characteristics of individuals. In diabetes, where there is substantial heterogeneity in risk, progression and treatment response, this approach holds particular promise. However, the majority of precision medicine research has been conducted in populations of White European ancestry, limiting its relevance and equity across ethnically diverse groups. This review examines the role of ethnicity in precision diabetes medicine, highlighting its potential value and limitations. It summarises evidence for ethnic variation in both type 1 and type 2 diabetes, including differences in susceptibility, phenotypes and complications, and demonstrates how under-representation in research has led to diagnostic and therapeutic blind spots. Three conceptual models for incorporating ethnicity into precision approaches are described: ancestry-anchored discovery, ethnicity-adapted translation and trait-based individualisation. Each model presents distinct opportunities for and challenges to equitable implementation. The review also outlines key barriers, such as limited diversity in discovery science, inconsistent data infrastructure, and resource constraints, and proposes practical strategies to overcome them. It concludes by identifying critical research gaps and emphasises the need for inclusive and context-sensitive models of precision medicine that account for both inter- and intra-ethnic diversity. Realising this vision will be essential to delivering effective and equitable diabetes care globally.","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"30 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792071","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":"Race, ethnicity and ancestry in global diabetes research: grappling with complexity to advance equity and scientific integrity - a narrative review and viewpoint.","authors":"Nish Chaturvedi,Benjamin F Voight,Jonathan C Wells,Cheryl Pritlove","doi":"10.1007/s00125-025-06516-1","DOIUrl":"https://doi.org/10.1007/s00125-025-06516-1","url":null,"abstract":"The global burden of diabetes-across major forms such as type 2 diabetes, type 1 diabetes and gestational diabetes mellitus-disproportionately affects people of non-European ancestry, the majority of whom live in low- and middle-income countries. The heterogeneity of diabetes risks and phenotypes indicates that knowledge derived principally from European-origin populations may not be readily transferable to other groups. In this review our aim is to enhance the quality of diabetes research by championing the inclusion of diverse populations, ensuring clarity of population definition and encouraging exploration of population differences. We review the terminology used to define populations and make recommendations on the use of these terms. We argue that population membership by itself does not determine risks or response to intervention; rather, it is the confluence of genetic, environmental, sociocultural and policy factors that are causal and should be identified. We note that, while common diabetes forms are polygenic and populations are unlikely to harbour single genes that account for significant risk, environmental change that impacts lifestyle and biology demonstrably alters diabetes risk and provides opportunities for effective intervention. Similarly, while genetic variants are associated with adverse events, population group membership may sometimes not be a valid proxy for such variants, which has implications for healthcare equity. For most drugs used in diabetes there is little evidence that drug responsiveness materially differs by population grouping, although it is only recently that well-designed studies have been performed. In contrast, other population characteristics, such as sex, age and obesity, appear to alter glucose-lowering drug effectiveness and should be considered when prescribing. Inclusion of diverse populations in diabetes research, combined with a multidisciplinary approach, is essential if we are to combat the global burden of diabetes.","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"4 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792141","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":"Ethnic differences in beta cell function and pancreatic fat in Black African and White European men across a spectrum of glucose tolerance.","authors":"Gráinne Whelehan,Olah Hakim,Meera Ladwa,Oluwatoyosi Bello,Danielle H Bodicoat,A Margot Umpleby,Stephanie A Amiel,Louise M Goff","doi":"10.1007/s00125-025-06514-3","DOIUrl":"https://doi.org/10.1007/s00125-025-06514-3","url":null,"abstract":"AIMS/HYPOTHESISPeople of Black African (BA) ancestry are disproportionately affected by type 2 diabetes when compared with people of White European (WE) descent, despite lower levels of ectopic fat. Impaired beta cell function is a key pathophysiological feature of type 2 diabetes. It remains to be determined whether an associative relationship exists between intrapancreatic lipid (IPL) accumulation and beta cell function, and whether this differs by ethnicity.METHODSFifty-three BA (23 normal glucose tolerance, 11 impaired glucose tolerance and 19 type 2 diabetes) and 51 WE (23/13/15) men underwent a hyperglycaemic clamp and mixed-meal tolerance test to assess insulin secretion and beta cell function, a hyperinsulinaemic-euglycaemic clamp to measure insulin sensitivity and Dixon MRI to determine IPL. Associations between IPL and beta cell function were assessed using linear regression.RESULTSIPL was lower in BA compared with WE men (mean ± SD; 7.6 ± 2.6% vs 8.8 ± 3.7%, p=0.038), but after adjustment for waist circumference this ethnic difference no longer occurred (p=0.278). BA men with type 2 diabetes had lower total insulin secretion response to the mixed-meal (p=0.001) and hyperglycaemic clamp (p=0.002), but no ethnic differences were observed in the disposition index within glucose tolerance groups. IPL was inversely associated with beta cell function in the WE but not the BA men, but after adjustment for confounders these associations were not significant.CONCLUSIONS/INTERPRETATIONEthnic differences were apparent as beta cell function was inversely associated with IPL in the WE, but not BA, men. However, in both ethnic groups, this relationship appears secondary to other factors, such as adiposity, in the pathogenesis of type 2 diabetes.","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"15 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787147","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}