Diabetes Therapy最新文献

{"title":"The Therapeutic Potential of Dipeptidyl Peptidase 4 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists in Diabetic Peripheral Neuropathy.","authors":"Theodoros Panou, Evanthia Gouveri, Djordje S Popovic, Dimitrios Papazoglou, Nikolaos Papanas","doi":"10.1007/s13300-025-01712-z","DOIUrl":"10.1007/s13300-025-01712-z","url":null,"abstract":"<p><p>Diabetic peripheral neuropathy (DPN) is one of the commonest complications of diabetes mellitus (DM). Current therapeutic approaches largely focus on pain management. However, less evidence is available on the clinical potential of two widely prescribed drug categories in DM management: dipeptidyl peptidase 4 inhibitors (DPP-4is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs). In this review, we discuss evidence from both experimental and clinical studies on the potential utility of these drugs in the management of DPN. Immunohistochemical data indicate that agents in both categories promote neurite outgrowth, ion conduction, neuronal survival and Schwann cell function. Furthermore, intra-epidermal nerve fibre density has been reported to increase with DPP-4is or GLP-1RAs treatment. Moreover, electrophysiological studies have indicated a diverse, but mostly beneficial, effect on motor or sensory nerve conduction velocity. Clinical tests, such as the muscular grip or paw jumping control resembling neuropathic symptoms, have also confirmed the advantageous effect of DPP-4is and GLP-1RAs. Finally, limited but promising clinical data have shown improved somatosensory-evoked potentials and vibration perception threshold, as well as restored excitability and nerve size parameters. Nevertheless, further clinical studies are required to elucidate the exact role of DPP-4is and GLP-1RAs in DPN.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1077-1105"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Serum SERPINE2 Levels are Linked to Impaired Renal Function in Patients with Type 2 Diabetes Mellitus.","authors":"Shudan Cao, Qing Tan, Lijuan Yang","doi":"10.1007/s13300-025-01742-7","DOIUrl":"10.1007/s13300-025-01742-7","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic nephropathy (DN) is the primary complication associated with diabetes mellitus and is increasingly acknowledged as the leading cause of end-stage renal disease worldwide, placing a significant economic burden on society. This study determined how blood serpin peptidase inhibitor clade E member 2 (SERPINE2) levels affect DN in individuals with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>We recruited 292 individuals diagnosed with T2DM and 120 healthy controls for this study. We employed comprehensive and systematic data collection methodologies to gather relevant biomarkers and information on biochemical parameters. We measured serum levels of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1), transforming growth factor-β1 (TGFβ1), connective tissue growth factor (CTGF), and SERPINE2 by the enzyme-linked immunosorbent assay in control subjects and patients with T2DM. We calculated generalized odds ratios (OR) to estimate the risk of developing DN.</p><p><strong>Results: </strong>Patients with diabetes had significantly higher levels of SERPINE2 (285.64 ± 56.58 pg/mL) than healthy controls (184.84 ± 23.54 pg/mL). Additionally, the multivariate logistic regression analysis indicated that patients with diabetes with DN possessed higher levels of serum SERPINE2 (OR 1.033, 95% confidence interval [CI] 1.013-1.053; P = 0.001), along with an increased body mass index (BMI), duration of diabetes, serum creatinine (Scr), NGAL, KIM-1, TGFβ1, and CTGF. Receiver operating characteristic (ROC) curve analysis indicated that patients with T2DM and serum SERPINE2 levels exceeding 278.94 pg/mL had a significantly higher risk of developing DN.</p><p><strong>Conclusion: </strong>The results showed that patients with diabetes with DN have higher levels of serum SERPINE2. A more extensive population-based prospective study is needed to validate our findings.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1313-1326"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative Review: Continuous Glucose Monitoring (CGM) in Older Adults with Diabetes.","authors":"Abbie Wilson, Deborah Morrison, Christopher Sainsbury, Gregory Jones","doi":"10.1007/s13300-025-01720-z","DOIUrl":"10.1007/s13300-025-01720-z","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous glucose monitoring (CGM) has revolutionised diabetes care, with proven effect on glycaemic control, adverse diabetic events (such as hypoglycaemia and diabetic ketoacidosis) and hospitalisations in the general population. However, the evidence for CGM in older people is less robust.</p><p><strong>Method: </strong>We conducted a narrative review of trials reporting data comparing standard blood glucose monitoring (SBGM) and CGM in adults over 65 with type 1 or type 2 diabetes who were treated with insulin published between 1999 and 2024.</p><p><strong>Results: </strong>Seventeen studies were identified, including eight retrospective cohort studies and five randomised controlled trials (RCTs). Sixteen of the 17 papers were based in Europe or North America. The studies were highly heterogeneous; however, they provided clear evidence supporting the use of CGM in reducing hypoglycemia in older adults, with potential benefits for overall wellbeing and quality of life..</p><p><strong>Conclusions: </strong>Current approaches to diabetes care in older adults may over-rely on HbA1c (haemoglobin A1c) as a measurement of control given accuracy may be reduced in older adults and propensity for hypoglycaemia. Although goals should be personalised, avoidance of hypoglycaemia is a key goal for many older people with diabetes. There is good evidence that CGM can improve time-in-range and reduce hypoglycaemia and glucose variability in older adults. CGM should be considered for older adults as a means of reducing hypoglycaemia and associated potential harm.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1139-1154"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Urgent Need for Breakthrough Therapies and a World Without Type 1 Diabetes.","authors":"Lynn Starr, Sanjoy Dutta, Thomas Danne, Stephen R Karpen, Campbell Hutton, Aaron Kowalski","doi":"10.1007/s13300-025-01735-6","DOIUrl":"10.1007/s13300-025-01735-6","url":null,"abstract":"<p><p>Despite significant progress, type 1 diabetes (T1D) still results in premature death, significant complications, and a substantial daily burden for those affected. T1D remains a lifelong condition that demands constant vigilance and resilience and has a significant social and economic impact. Individuals with T1D must walk a tightrope to minimize disease-related complications that result from insufficient insulin while also avoiding adverse effects from too much insulin. Achieving this balance is challenging, as diet, activity, medications, physiology, the environment, stress, and many other aspects of daily living all affect glucose levels, often differently from day to day. Persistent challenges of T1D go beyond maintaining glycemic control and include managing long-term complications and preventing potentially life-threating adverse reactions from insulin therapy, and the emotional and cognitive burdens that often lead to diabetes distress and burnout. The T1D community-researchers, sponsors, clinicians, those living with T1D, and advocates-must look beyond managing symptoms of T1D and aim for better treatments and to bring cures. Emerging therapies need clear and efficient regulatory pathways, and new solutions are needed to address ongoing regulatory challenges. The perspectives of people with T1D must be front and center in research and regulatory decision-making. Through the collective efforts of the T1D community, the urgent needs of those with T1D can be met, and T1D can be made a thing of the past.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1063-1076"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary L-FABP: A Novel Biomarker for Evaluating Diabetic Nephropathy Onset and Progression. A Narrative Review.","authors":"Ersilia Satta, Felice Strollo, Luisa Borgia, Giuseppina Guarino, Carmine Romano, Mario Masarone, Raffaele Marfella, Sandro Gentile","doi":"10.1007/s13300-025-01731-w","DOIUrl":"10.1007/s13300-025-01731-w","url":null,"abstract":"<p><p>Patients with diabetes mellitus (DM) are at risk of developing diabetic nephropathy (DN), a condition whose onset and progression are linked to increased morbidity and mortality. Therefore, early recognition is crucial. Presently, this relies on the albumin excretion rate (AER) and glomerular filtration rate (GFR). Nevertheless, DN eventually affects patients with normal AER and GFR. Thus, further easy-to-handle biomarkers of DN onset/worsening are needed. Liver-type fatty acid-binding protein (L-FABP) has been associated with renal damage and could help predict/diagnose DN. We performed a literature selection to evaluate the performance of urinary excretion of such biomarker (urinary-L-FABP:uL-FABP) in predicting/diagnosing DN and its progression in diabetes. We evaluated 635 publications, 21 of which were included. Of these, 14 have cross-sectional design/arms and ten longitudinal design/arms. Cross-sectional studies showed uL-FABP to correlate with DN onset and severity in type-1 DM and type-2 DM, besides being higher than in healthy controls in the case of normoalbuminuria. Longitudinal studies showed baseline uL-FABP to predict DN onset in normoalbuminuric patients with T1DM and DN progression independently of diabetes type. The results suggest that uL-FABP is a marker of tubular damage detectable before increased albumin excretion and can represent the earliest sign of DN. Indeed, it discloses its onset and often predicts its severity in T2DM and patients with T1DM. Currently, uL-FABP can be routinely assessed and, being available as a point-of-care fast-test kit, may also become an easy-to-handle diagnostic tool for outpatients. In conclusion, uL-FABP represents a user-friendly biomarker of DN and can even predict DN progression in T2DM and T1DM over time.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1107-1124"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell Therapy for T1D Beyond BLA: Gearing Up Toward Clinical Practice.","authors":"Yong Wang, YingYing Chen, James McGarrigle, Jenny Cook, Peter D Rios, Giovanna La Monica, Wei Wei, Jose Oberholzer","doi":"10.1007/s13300-025-01732-9","DOIUrl":"10.1007/s13300-025-01732-9","url":null,"abstract":"<p><p>Type 1 diabetes (T1D) remains a significant global health challenge and patients with T1D need lifelong insulin therapy. Islet transplantation holds transformative potential by replacing autoimmune-mediated destruction of insulin-producing beta cells. This review examines the trajectory of islet transplantation for T1D, focusing on the process and benefits of obtaining biologics license application (BLA) approval for cell-based therapies. Following US Food and Drug Administration (FDA) approval, the authors identify key steps urgently needed to foster islet transplantation as a viable treatment for a broader population of patients with T1D. Furthermore, the authors highlight recent advances in encapsulation technologies, stem cell-derived islets, xenogeneic islets, and gene editing as strategies to overcome challenges such as immune rejection and limited islet sources. These innovations are pivotal in enhancing the safety and efficacy of islet transplantation. Ultimately, this review emphasizes that while BLA approval represents a critical milestone, realizing the full potential of cell therapy for T1D requires addressing the scientific, clinical, and logistical challenges of its real-world implementation. By fostering innovation, collaboration, and strategic partnerships, the field can transform T1D care, offering patients a durable, life-changing alternative to traditional insulin therapy.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1125-1138"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lights and Shadows of Bariatric Surgery: Insights from a Nationwide Administrative Database of People Living with Type 1 Diabetes and Obesity.","authors":"Claire Carette, Claire Rives-Lange, Nicholas Shoung, Aurélie Phan, Elodie Torreton, Anne Dutour, Bruno Detournay, Sébastien Czernichow","doi":"10.1007/s13300-025-01709-8","DOIUrl":"10.1007/s13300-025-01709-8","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to describe the population of patients living with type 1 diabetes who had access to bariatric surgery (BS) in France, analyzing the changes in healthcare resource use and associated costs in the 3 years following this surgery.</p><p><strong>Methods: </strong>An observational longitudinal study based on the French national health insurance database was conducted on all adult patients that underwent a first BS from 2015 to 2020. Cost analyses were conducted on a sub-population who underwent BS from 2016 to 2017 for sufficient observation time using a pre-post methodology.</p><p><strong>Results: </strong>A total of 437 patients were identified as living with type 1 diabetes among the 234,077 patients who had undergone surgery over 6 years (2015-2020). The most frequently performed interventions were sleeve gastrectomy (n = 272; 62.2%) and gastric bypass (n = 154; 35.2%), with the majority of patients being women (77.8%) and an average age of 42.3 (± 12.0) years, consistent with the general population undergoing BS in France. While no significant differences were found in the overall healthcare costs when comparing the 3 years before and after BS, there was an increase in the frequency of biological measurements. Expenditures related to antidiabetic medications and insulin decreased significantly (p < 0.0001). The number of hospitalizations for severe hypoglycemia, coma, and ketoacidosis more than doubled in the 3 years following surgery compared with the period before (p = 0.04).</p><p><strong>Conclusions: </strong>The risks of severe hypoglycemia or ketoacidosis in patients with type 1 diabetes undergoing BS remains a real concern and emphasizes the importance of involving the diabetologist in the operative decision with joint follow-up with the nutritionist.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1267-1277"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Tirzepatide Compared with GLP-1 RAs in Patients with Type 2 Diabetes Treated with Basal Insulin: A Network Meta-analysis.","authors":"Beatrice Osumili, Hélène Sapin, Zhengyu Yang, Kari Ranta, Jim S Paik, Matthias Blüher","doi":"10.1007/s13300-025-01728-5","DOIUrl":"10.1007/s13300-025-01728-5","url":null,"abstract":"<p><strong>Introduction: </strong>The relative efficacy and safety of tirzepatide was compared with glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes mellitus (T2DM) treated with basal insulin using a network meta-analysis (NMA).</p><p><strong>Methods: </strong>A systematic literature review was performed to identify randomized controlled trials of GLP-1 RAs in patients with T2DM treated with insulin and an antihyperglycaemic drug. For the NMA, studies included trials with 100% of patients treated with basal insulin background therapy with a titration scheme comparable to the SURPASS-5 trial. The following data were extracted for efficacy and safety assessment at the primary endpoint of each study: changes from baseline in glycated haemoglobin (HbA1c) and body weight and the incidence of nausea, vomiting or diarrhoea, hypoglycaemia, and patients discontinuing treatment because of adverse events. In this study, a comparative analysis of tirzepatide was performed with the GLP-1 RAs dulaglutide, exenatide, and lixisenatide in addition to placebo.</p><p><strong>Results: </strong>A total of six studies were included across the analyses. Tirzepatide 5, 10, and 15 mg showed statistically significant, greater reductions in HbA1c and body weight at the primary endpoint versus all GLP-1 RA comparators and placebo. Tirzepatide 5, 10, and 15 mg showed a statistically significant, higher likelihood of experiencing nausea compared with those who received placebo or exenatide 2 mg; no statistically significant differences were observed when compared with all other GLP-1 RA comparators. No statistically significant differences were observed in the proportions of patients who discontinued treatment because of adverse events when tirzepatide 5, 10, and 15 mg were compared with GLP-1 RA comparators, apart from tirzepatide 10 and 15 mg versus placebo.</p><p><strong>Conclusion: </strong>Tirzepatide demonstrated statistically significantly greater reductions in HbA1c and body weight when compared with selected GLP-1 RAs and placebo in patients with T2DM treated with basal insulin. Overall, the safety profile of tirzepatide was similar to that of GLP-1RAs.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1279-1311"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehending the Epidemiology and Aetiology of Childhood Obesity: Integrating Life Course Approaches for Prevention and Intervention.","authors":"Madhur Verma, Nitin Kapoor, Sabyasachi Senapati, Omna Singh, Ajeet Singh Bhadoria, Preeti Khetarpal, Shashank Kumar, Kanika Bansal, Rakhsha Ranjan, Rakesh Kakkar, Sanjay Kalra","doi":"10.1007/s13300-025-01734-7","DOIUrl":"10.1007/s13300-025-01734-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Childhood obesity is defined as a medical condition characterised by abnormally high amounts of body fat relative to lean body mass, which increases the risk of adverse health outcomes among children and adolescents from birth to 18 years. The prevalence of childhood obesity, which has serious healthcare implications, is surging, together with its healthcare burden. In this review we explore the intricate interplay of hereditary, environmental, behavioural, cultural and metabolic factors contributing to the global increase in childhood obesity rates. We examine the influence of prenatal factors, genetic predispositions and epigenetic mechanisms on obesity susceptibility and treatment strategies, emphasising the importance of a multilevel life course framework to understand the multifactorial causes of obesity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This narrative review examines the epidemiology, burden, aetiology and impact of childhood obesity by focusing on published literature and the efficacy of multilevel interventions. Comprehensive algorithms are provided to illustrate the causes of childhood obesity through the lens of a multilevel life course framework, taking into consideration individual, family, community and societal factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Genetic predispositions, including inherited tendencies towards emotional eating, metabolic variations and body fat distribution, significantly influence a child's obesity risk. Environmental factors, such as limited access to nutritious food, sedentary behaviour, insufficient opportunities for physical activity and obesogenic environments, contribute to the increasing prevalence of childhood obesity. Prenatal influences, including maternal hyperglycaemia and nutritional exposures, lead to epigenetic alterations that predispose children to obesity and metabolic disorders. The social environment, including parental influences, cultural norms and peer dynamics, shapes children's dietary habits and physical activity levels. Additionally, the review highlights the importance of early detection of metabolic alterations associated with paediatric obesity and insulin resistance and the potential for epigenetic mechanisms as therapeutic targets. Recommendations are made for tailored medical nutrition therapy, screening for syndromic obesity and multilevel interventions targeting individual and societal factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This review underscores the necessity of a comprehensive, multilevel approach that integrates genetic, environmental, behavioural and cultural factors along with lifestyle modifications and public health initiatives to address the complex and multifaceted issue of childhood obesity effectively. Targeted interventions across the life course, policy reforms, community engagement and technological innovations are recommended to mitigate obesity risks and promote long-term health. An infographic is available for this artic","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1177-1206"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between HbA1c Levels and the Risk of Myocardial Infarction and Stroke in People with Type 2 Diabetes: A Post Hoc Analysis of the REPRESENT Study.","authors":"Irene Cristina Romera, Jennifer Redondo-Antón, Miriam Rubio-de Santos, Silvia Díaz-Cerezo, Esther Artime, Albert Rafels-Ybern, Emilio Ortega, Ignacio Conget","doi":"10.1007/s13300-025-01727-6","DOIUrl":"10.1007/s13300-025-01727-6","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this work was to analyze the association between baseline glycated hemoglobin (HbA1c) levels and other factors on the risk of first myocardial infarction (MI) and on the risk of first stroke in people with type 2 diabetes (T2D) in Spain.</p><p><strong>Methods: </strong>This post hoc analysis of the REPRESENT study used the IQVIA electronic medical records database. Cumulative incidences were estimated using the Kaplan-Meier method, and Cox regression models were used to identify associated risk factors, including gender, age, HbA1c, or prior cardiovascular disease (other than MI/stroke).</p><p><strong>Results: </strong>Median follow-up was 7 years. In people without prior MI/stroke, the incidence (95% confidence interval [CI]) of first MI/stroke was 0.31 (0.28-0.34) and 0.18 (0.15-0.20) events per 100 patient-years, respectively. Baseline HbA1c levels < 6.5% were independently associated with lower risk of first MI (hazard ratio [HR] 0.76 [95% CI 0.61-0.94]) and of first stroke (HR 0.74 [95% CI 0.56-0.98]). Male sex, age ≥ 50 years, and previous cardiovascular disease were independently associated with a higher risk of MI/stroke.</p><p><strong>Conclusions: </strong>This analysis found an association between baseline HbA1c levels < 6.5% and lower risk of a first MI or stroke in a T2D cohort in Spain, suggesting a role of stringent glycemic control in the prevention of cardiovascular complications.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1229-1239"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}