Diabetes Therapy最新文献

{"title":"Optimizing Continuous Glucose Monitoring Adoption in India: From Current Challenges to Future Solutions.","authors":"Jothydev Kesavadev, V Mohan, Shashank Joshi, Banshi Saboo, Manoj Chawla, A G Unnikrishnan, Om Lakhani, Amit Gupta, Rakesh Parikh, Abhijith Bhograj, Anuj Maheshwari, Ameya Joshi, Timor Glatzer, Sandeep Sewlikar, Abin Augustine","doi":"10.1007/s13300-026-01842-y","DOIUrl":"10.1007/s13300-026-01842-y","url":null,"abstract":"<p><p>Despite revolutionizing diabetes care globally, continuous glucose monitoring (CGM) adoption in India remains limited, as a result of several economic, infrastructural, clinical, and sociocultural concerns. This narrative review aims to map unmet needs and propose practical, context-specific solutions. Continuous use of CGM remains the preferred approach for optimal glucose management and achieving long-term metabolic advantages, providing insights for proactive, data-driven, and preventive diabetes care. However, main barriers to CGM uptake include limited awareness among people with diabetes and healthcare providers, high costs, lack of reimbursement, limited device availability beyond major cities, and economic, infrastructural, and sociocultural access inequities across urban and rural populations. The psychological burden from frequent alarms, data fatigue, and stigma with noticeable or intrusive devices add to these challenges. Addressing these barriers necessitates a multifaceted strategy involving affordable, climate-adapted devices, interoperable digital ecosystems, India-specific reimbursement models, and robust educational infrastructure. The emergence of cost-effective CGM devices with a range of advanced features, such as predictive glucose algorithms and personalized pattern identification, is pivotal to this effort. These innovations improve clinical outcomes and quality of life by simplifying the user experience, addressing challenges, such as alarm fatigue while translating complex data into actionable insights, facilitating widespread CGM adoption in India.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"357-372"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104263","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":"Rewriting Diabetes Therapy: How Incretin Modulation is Transforming Cardiovascular and Renal Outcomes.","authors":"José Pablo Miramontes-González, Álvaro Rodrigo-Alaíz, Miriam Gabella-Martín, David González-Calle, Juana Carretero-Gómez, Luis Corral-Gudino","doi":"10.1007/s13300-025-01829-1","DOIUrl":"10.1007/s13300-025-01829-1","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with type 2 diabetes mellitus (T2DM), cardiovascular (CV) disease and chronic kidney disease (CKD) drive excess morbidity and mortality. Beyond glucose-lowering, incretin-based therapies may provide organ protection across the cardiorenal axis.</p><p><strong>Methods: </strong>Narrative review of mechanistic pathways and randomized trials of GLP-1 receptor agonists (GLP-1RA), DPP-4 inhibitors, and newer dual/triple agonists, with targeted updates from recent pivotal programs (SELECT, FLOW, SOUL, SURPASS-CVOT) and emerging oral small-molecule GLP-1R agonists.</p><p><strong>Results: </strong>Long-acting GLP-1RA reduces major adverse CV events (MACE), all-cause and CV death, heart-failure hospitalization, and kidney composites across CV outcome trials and meta-analyses. A 2019 pooled analysis and a 2025 update confirm consistent reductions in MACE and hard kidney outcomes independent of baseline HbA1c. In obesity without diabetes, semaglutide 2.4 mg lowered MACE in SELECT, expanding prevention beyond glycemia. In CKD with T2DM, FLOW showed that semaglutide reduced major kidney disease events and death from CV/kidney causes. In T2DM with ASCVD and/or CKD, the SOUL cardiovascular outcome trial (CVOT) demonstrated that oral semaglutide reduced three-point MACE versus placebo. In head-to-head CVOT, tirzepatide was non-inferior to dulaglutide on MACE while achieving greater weight and HbA1c reductions. Mechanistically, GLP-1R signaling spans Gs-cAMP/PKA, β-arrestin-dependent pathways, and additional routes (including Gq contexts), aligning with anti-inflammatory, natriuretic, and antifibrotic effects observed preclinically and clinically. Oral non-peptide GLP-1R agonists (e.g., orforglipron) show phase 2 efficacy but lack long-term CV/renal outcome data.</p><p><strong>Conclusions: </strong>Incretin-based therapy has shifted care from glucose-centric targets to cardiorenal risk reduction. GLP-1RA are guideline-endorsed for patients with T2DM and high CV/renal risk irrespective of HbA1c; dual agonists and oral small-molecule agents may broaden indications pending definitive outcome evidence.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"317-330"},"PeriodicalIF":4.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899272","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":"Cost-effectiveness of Freestyle Libre Systems for People with Type 2 Diabetes Mellitus on Basal Insulin Therapy in the Netherlands: An Economic Evaluation from a Societal Perspective Within a Publicly Funded Healthcare System.","authors":"Peter van Dijk, Chris Chesters, Jack Timmons, Kirk Szafranski, Julia Bakker, Fleur Levrat-Guillen","doi":"10.1007/s13300-025-01821-9","DOIUrl":"10.1007/s13300-025-01821-9","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare expenditure for the treatment of type 2 diabetes mellitus (T2DM) in the Netherlands is high, mainly due to the cost of treating diabetes-related complications. Guidelines recommend sensor-based glucose monitoring systems for people living with T2DM and using insulin, but these are not reimbursed in the Netherlands for those using basal insulin only. The objective of this study was to assess the cost-effectiveness of glucose monitoring with FreeStyle Libre systems (FSL), compared with capillary-based self-monitoring of blood glucose (SMBG), for people living with T2DM on basal insulin, from the perspective of the Dutch publicly funded healthcare system.</p><p><strong>Methods: </strong>The patient-level microsimulation model DEDUCE (DEtermination of Diabetes Utilities, Costs, and Effects) was used to estimate the incidence of complications and acute diabetes events (ADEs; hypoglycemia and diabetic ketoacidosis). The effect of FSL was modeled as a 0.5% reduction in glycated hemoglobin level, which DEDUCE translates to a lower rate of complications, and as reductions in ADEs and absenteeism. Costs (in 2024 euros) and utilities were discounted at 3% and 1.5%, respectively. Outcomes were assessed as quality-adjusted life years (QALYs).</p><p><strong>Results: </strong>FSL was associated with 0.53 more QALYs than SMBG (12.77 vs. 12.24), at an additional cost of €8021. The resulting incremental cost-effectiveness ratio (ICER) for FSL versus SMBG was €15,181/QALY. The increased acquisition cost of FSL (€19,738) was partially offset by reductions in costs associated with complications, ADEs, and absenteeism. Probabilistic sensitivity analysis showed that FSL was 52% likely to be cost-effective at a willingness-to-pay threshold of €20,000/QALY, and > 99% likely at thresholds ≥ €40,000/QALY. FSL had an ICER of below €50,000/QALY in all scenarios investigated.</p><p><strong>Conclusion: </strong>From a Dutch publicly funded healthcare system perspective, FSL can be considered to be cost-effective compared with SMBG for people living with T2DM on basal insulin therapy.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"217-229"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631161","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":"Correction to: Quantifying Patient Preferences for Basal Insulin Treatments in Adults Living with Type 2 Diabetes: A Discrete Choice Experiment in Canada, Spain, France, and Japan.","authors":"Amy M Jones, Pam Hallworth, Sophi Tatlock, Morten Sall Jensen, Helen Kendal, Sophie Wallace, Elisabeth de Laguiche","doi":"10.1007/s13300-025-01820-w","DOIUrl":"10.1007/s13300-025-01820-w","url":null,"abstract":"","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"301-311"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631150","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":"Performance of a New Continuous Glucose Monitoring System in German Adults Living with Diabetes.","authors":"Nina Jendrike, Manuela Link, Sükrü Öter, Jiangfeng Fei, Jiyun Zheng, Fei Gao, Ao Gao, Siting Zhu, Leon Shi, Poul Strange, Frank Flacke, Manuel Eichenlaub, Guido Freckmann","doi":"10.1007/s13300-025-01832-6","DOIUrl":"10.1007/s13300-025-01832-6","url":null,"abstract":"<p><strong>Introduction: </strong>The True Vie I3 continuous glucose monitoring system (i3 CGM, Sinocare Meditech Inc., also approved in Europe as GlucoMen® iCan or iCan CGM system) is a new real-time continuous glucose monitoring system (CGM) intended for the management of diabetes mellitus. This pivotal study evaluated the performance of the factory-calibrated CGM system.</p><p><strong>Methods: </strong>In this center-specific dataset, 35 adults with type 1 diabetes (T1D) and type 2 diabetes (T2D) wore sensors on the abdomen and arm for 15 days. Four in-clinic visits were scheduled, during which frequent comparator sampling of venous blood was performed every 5-15 min for up to 10 h, and a glucose manipulation was performed. CGM performance compared to Yellow Springs Instrument 2300 Stat Plus Glucose and Lactate Analyzer (Yellow Springs, OH) glucose analyzer was evaluated for abdomen and arm sensors separately, regarding mean absolute relative difference (MARD) and agreement rates (AR) stratified by glucose range and rate of change (RoC). Additionally, clinical accuracy, sensor attachment rate, pain, and safety were assessed. This single-center analysis was developed with the intention to provide European-and particularly German-data. The presented site was the highest-enrolling center in the study and, as such, can be considered representative of the overall study population-an assumption that the analysis confirmed.</p><p><strong>Results: </strong>20/20 AR and MARD were 95.5% and 9.4% for abdomen sensors, and 95.3% and 9.8% for arm sensors, respectively. Consensus error grid (CEG) analyses revealed that 100% of CGM-comparator pairs fell in zones A and B for abdomen and arm sensors. Accuracy of sensors remained stable throughout the wearing time. Adhesion rate was 100% for abdomen sensors and 97.1% for arm-worn sensors, without the use of any over-tape during the 15-day study period. Pain during insertion and removal was reported as minimal, and no unexpected safety issues were identified.</p><p><strong>Conclusions: </strong>Data from a single study center showed that the performance of the i3 CGM is comparable to that published for other established CGM devices, and accuracy results were within limits specified for integrated continuous glucose monitoring systems (iCGM). The i3 CGM showed reliability, and its safety was validated during the 15 study days.</p><p><strong>Trial registration: </strong>The study was registered under ClinicalTrials.gov (ID: NCT05806554).</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"287-299"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145854766","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":"Use of Fixed Ratio Combinations to Improve Glycemic Control in Individuals with Type 2 Diabetes: Experts' Opinion from the Gulf Region.","authors":"Mohamed Hassanein, Thamer Alessa, Khadija A Hafidh, Lamya Alzubaidi, Mahir Jallo, Fatma Al Slail, Hussein Elbadawi, Rayaz A Malik","doi":"10.1007/s13300-025-01824-6","DOIUrl":"10.1007/s13300-025-01824-6","url":null,"abstract":"<p><p>Sequential addition of oral glucose-lowering therapies, insulin or incretin-based therapy is often required to attain optimal glycemic control and reduce the risk of diabetes-associated complications. Despite advances in treatment, a large proportion of people with type 2 diabetes fail to achieve optimal glycemic control. Recent guidelines emphasize the need to commence injectable options in individuals unable to attain glycemic targets, despite maximal oral therapy. In individuals already on basal insulin, an improvement in glycemic control requires stepwise addition of prandial insulin, full basal-bolus insulin regimen, or additional injectable incretin-based therapy. However, concerns around weight gain and hypoglycemia often limit addition or increase in insulin to improve glycemic control. Treatment simplification i.e. a decrease in treatment complexity, particularly insulin therapy, seeks to alleviate treatment burden without compromising therapeutic efficacy and safety. However, currently there is a lack of guidance on simplifying treatment, particularly for individuals unable to attain glycemic targets. We now provide evidence-based treatment simplification strategies for people with diabetes in the Gulf Cooperation Council region.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"185-200"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145721518","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 Expanding Role of Continuous Glucose Monitoring in the Management and Prevention of Type 2 Diabetes.","authors":"Heejun Son, Sun-Joon Moon, Young Min Cho","doi":"10.1007/s13300-025-01830-8","DOIUrl":"10.1007/s13300-025-01830-8","url":null,"abstract":"<p><p>Continuous glucose monitoring (CGM) has transformed diabetes management by providing continuous, high-resolution insight into glucose dynamics. Initially developed for type 1 diabetes, CGM now demonstrates substantial clinical and behavioral benefits for individuals with type 2 diabetes across diverse therapeutic settings. This narrative review synthesizes current evidence on the expanding role of CGM in optimizing glycemic control and promoting patient-driven lifestyle modification.Across randomized and real-world studies, CGM consistently improves glycosylated hemoglobin, increases time in range, and reduces glycemic variability, regardless of insulin use. Beyond metabolic outcomes, CGM enhances treatment satisfaction, psychological well-being, and self-efficacy, particularly when combined with structured education and feedback. By enabling individuals to visualize real-time glucose responses to daily behaviors, CGM serves as a powerful catalyst for sustained behavioral change and personalized self-management.In addition to its therapeutic applications, CGM also provides diagnostic insight by revealing unrecognized glucose excursions that conventional monitoring may miss, facilitating earlier identification of dysglycemia in at-risk individuals. Yet significant barriers persist, including device costs, limited insurance coverage, and the difficulty of translating raw data into actionable insights for patients and clinicians.In conclusion, CGM has evolved from a glucose-monitoring device to a comprehensive platform that supports both clinical decision-making and behavioral empowerment, bridging the continuum from diabetes prevention to long-term management.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"201-216"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780384","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":"Developing a Comprehensive Approach for Managing Cardiorenal Metabolic Diseases (CRMD) in Saudi Arabia: Thinking beyond Single Disease-Literature Review and Multidisciplinary Consensus Report.","authors":"Abdulrahman Alshaikh, Ali Alshehri, Lamya Alzubaidi, Hussein Elbadawi, Abdulghani Alsaeed, Mohammed Almehthel, Raed Aldahash, Fahad Alsabaan, Metib Alotaibi, Khalid Alghamdi, Hussein Alamri, Abdulmohsen Bakhsh, Marc Evans, Emad R Issak, Saud Alsifri","doi":"10.1007/s13300-025-01826-4","DOIUrl":"10.1007/s13300-025-01826-4","url":null,"abstract":"<p><p>Cardiorenal metabolic disease (CRMD) encompasses a cluster of interrelated conditions-including obesity, type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic dysfunction-associated steatotic liver disease (MASLD)-that share common pathophysiologic pathways and amplify morbidity and mortality risks. Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated robust evidence across randomized controlled trials and real-world studies in improving glycemic control (mean glycated hemoglobin [HbA1c] reduction of 1.0-1.5%), inducing sustained weight loss (average 10-15%), and reducing major adverse cardiovascular events (by 26% in SUSTAIN-6 and 20% in SELECT). Its potential renal and hepatic benefits, including slower estimated glomerular filtration rate (eGFR) decline and reduction in liver fat content, highlight its suitability for integrated CRMD management. This consensus report was developed through a structured, multiphase Delphi process involving endocrinologists, cardiologists, nephrologists, hepatologists, and public health experts from across Saudi Arabia. A comprehensive literature search (PubMed, Scopus, and Saudi Digital Library [2016-2024]) prioritized high-quality evidence from randomized controlled trials (RCTs), systematic reviews, and regional data. The panel reached consensus on key recommendations: (1) early identification and holistic management are critical for effective CRMD control; (2) adults at risk should undergo systematic screening for metabolic, cardiovascular, renal, hepatic, and cognitive complications; and (3) semaglutide should be positioned as a cornerstone therapy given its multiorgan benefits and favorable safety profile. Implementation strategies emphasize the careful selection of patients, individualized dosing, patient education, and integration into national pathways. In alignment with Saudi Vision 2030, incorporating semaglutide into CRMD management, supported by provider training, multidisciplinary care models, and cost-effectiveness analyses, can significantly reduce the national burden of metabolic disease and CVD.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"165-183"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631103","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":"Temporal Changes in SGLT2 Inhibitor and GLP-1 Receptor Agonist Use in Patients with Chronic Kidney Disease and Type 2 Diabetes, 2012-2023: A US Cohort Study.","authors":"Catherine B Johannes, Craig I Coleman, Csaba P Kovesdy, Anam M Khan, Ryan Ziemiecki, J Bradley Layton, David Vizcaya, Fangfang Liu, Nikolaus G Oberprieler","doi":"10.1007/s13300-025-01825-5","DOIUrl":"10.1007/s13300-025-01825-5","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes is a leading cause of chronic kidney disease (CKD). Individuals with both conditions have increased risk of poor cardiorenal outcomes and mortality. The rapidly evolving landscape for CKD-protective therapies in type 2 diabetes currently includes sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA), both of which demonstrate cardiorenal outcome benefits. As part of the FOUNTAIN platform (ClinicalTrials.gov ID: NCT05526157; EUPAS ID: EUPAS48148), this study aimed to better understand changes in patient characteristics and treatment patterns corresponding with updates to clinical guideline recommendations and drug labeling and the emergence of new CKD-protective therapies such as finerenone in the US in 2021-2022.</p><p><strong>Methods: </strong>An observational real-world data study assessed patient characteristics and drug utilization in separate SGLT2i and GLP-1 RA new-user cohorts of adults with CKD and type 2 diabetes in an earlier (1 January 2012-30 June 2021) and a later (9 July 2021-30 September 2023) period using Optum's de-identified Clinformatics^® Data Mart Database (Optum^® CDM).</p><p><strong>Results: </strong>Compared with the earlier period new users, later period new users in both cohorts were older, had more severe CKD, used less intensive type 2 diabetes medication, and had better metabolic control; SGLT2i new users more frequently had no type 2 diabetes therapy before the index date and greater congestive heart failure prevalence; and GLP-1 RA new users had increased SGLT2i use and decreased insulin use.</p><p><strong>Conclusions: </strong>These findings inform and contextualize future studies assessing cardiorenal outcomes for these and additional treatments, including finerenone, for individuals with CKD and type 2 diabetes.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"231-250"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707809","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":"Risk of Microvascular and Macrovascular Complications in Patients with Type 2 Diabetes and Metabolic Dysfunction-Associated Steatohepatitis: A Retrospective Cohort Study.","authors":"Semiu O Gbadamosi, David Shi, Abdalla Aly, Caichen K Zhong, Husam Albarmawi, Aidan McGovern, Anthony Hoovler, Carlos Campos","doi":"10.1007/s13300-025-01831-7","DOIUrl":"10.1007/s13300-025-01831-7","url":null,"abstract":"<p><strong>Introduction: </strong>Although there is a recognized negative interplay between metabolic dysfunction-associated steatohepatitis (MASH) and type 2 diabetes (T2D), the extent to which comorbid MASH exacerbates T2D complications is not well understood. This real-world cohort study evaluated whether the coexistence of these diseases is associated with increased risk of microvascular and macrovascular complications.</p><p><strong>Methods: </strong>We identified eligible adults with T2D from the Optum^® Clinformatics^® Data Mart Database (2016-2024). Presence of MASH was determined using International Classification of Diseases, Tenth Revision, Clinical Modification coding, requiring ≥ 1 primary inpatient or outpatient diagnosis code. Patients with T2D and MASH were matched 1:1 with patients with T2D without MASH using propensity score matching to balance baseline characteristics. Fine-Gray models were used to estimate subdistribution hazard ratios (sHR) comparing the risk of microvascular and macrovascular T2D complications between both groups, while accounting for death as a competing risk. Stratified analyses were performed by glycemic control (glycated hemoglobin < 7% and ≥ 7%) and age (< 65 and ≥ 65 years).</p><p><strong>Results: </strong>The study comprised 7396 and 6207 matched pairs in the microvascular and macrovascular complications cohorts, respectively. In this T2D population, mean (standard deviation) follow-up was 2.8 (2.0) years for patients with MASH and 2.4 (1.8) years for patients without MASH in both cohorts. Compared with patients with T2D without MASH, those with T2D and MASH had increased hazards of microvascular (sHR 1.19 [95% confidence interval (CI) 1.12-1.26]) and macrovascular complications (sHR 1.15 [95% CI 1.08-1.23]). A similar trend was observed for the stratified subgroup analyses.</p><p><strong>Conclusion: </strong>Patients with T2D and MASH had higher hazards of microvascular and macrovascular complications versus those with T2D without MASH. These findings suggest that the presence of MASH accelerates T2D-related complications, creating a clinical imperative for integrated screening and management approaches to identify this high-risk population among patients with T2D.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"251-269"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817951","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}