Diabetes Therapy最新文献

{"title":"Advancing Cardiovascular, Kidney, and Metabolic Medicine: A Narrative Review of Insights and Innovations for the Future.","authors":"Kevin Fernando, Derek Connolly, Eimear Darcy, Marc Evans, William Hinchliffe, Patrick Holmes, W David Strain","doi":"10.1007/s13300-025-01738-3","DOIUrl":"10.1007/s13300-025-01738-3","url":null,"abstract":"<p><p>Cardiovascular, kidney and metabolic (CKM) conditions are interrelated, significantly contributing to morbidity, mortality and healthcare burden. Despite therapeutic advances, traditional disease-specific approaches often fail to address their complex interplay. Key therapeutic agents-including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dual GLP-1/glucose-dependent insulinotropic polypeptide RAs, sodium glucose co-transporter inhibitors and the nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenone-offer multi-organ benefits. Emerging therapies, such as triple receptor agonists and second-generation MRAs, target new pathways further expanding treatment options for CKM conditions. A holistic CKM management approach must address and recognise that conditions such as metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction-associated steatohepatitis, obstructive sleep apnoea and obesity are part of the CKM spectrum. Frailty assessment is also important alongside CKM conditions, warranting comprehensive geriatric assessment and deprescribing when appropriate. Multidisciplinary care-including lifestyle interventions, pathway redesign, pharmacological advances and novel technologies-is essential for improving outcomes. As the CKM landscape evolves, future strategies should prioritise early intervention, personalised treatment and addressing unmet needs in high-risk populations. This review advocates for an integrated CKM framework, exploring treatment strategies, emerging therapies and technological innovations. It also examines the role of artificial intelligence and digital health tools in risk stratification, early diagnosis and long-term condition management, alongside ethical and regulatory considerations.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1155-1176"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988944","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":"Association of Blood Heavy Metals with Diabetic Foot Ulcers in U.S. Adults with Diabetes: Insights from the 1999-2004 NHANES Data.","authors":"Jia-Hao Xing, Yang Yu, Lin Teng, Xue-Ying Hui, Wei-Guang Guo","doi":"10.1007/s13300-025-01730-x","DOIUrl":"10.1007/s13300-025-01730-x","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic foot ulcers (DFU) are serious complications of diabetes. These ulcers significantly increase the risk of amputations. Many studies have examined how blood heavy metals affect insulin secretion in diabetes. However, research linking blood heavy metal exposure to DFU is limited. This study aims to explore the connection between blood heavy metal exposure and DFU in people with diabetes.</p><p><strong>Methods: </strong>This cross-sectional study used data from the 1999-2004 cycle of the National Health and Nutrition Examination Survey (NHANES). Researchers measured blood levels of lead (Pb) and cadmium (Cd) using inductively coupled plasma mass spectrometry (ICP-MS). Four logistic regression models assessed the relationship between blood heavy metals and the prevalence of DFU. The models adjusted for potential confounding factors. Additionally, smooth curve fitting and piecewise regression analyses were conducted to investigate the correlation further. Subgroup analyses and interaction tests helped evaluate consistency across the general population.</p><p><strong>Results: </strong>A total of 1664 participants aged 40 years or older with diabetes were included in the final analysis. The average age is 64.66 ± 11.79 years, with 52.52% being male and 47.48% being female. Among these individuals, 135 (8.11%) were diagnosed with DFU. Statistical modeling revealed a significant positive correlation between blood cadmium (Cd) levels and the prevalence of DFU. Specifically, model 4, which was the fully adjusted model, indicated that for each unit increase in blood Cd level, there was a corresponding 64% increase in DFU prevalence [OR = 1.64; 95% CI (1.42-1.89), p = 0.004]. Further analysis through smooth curve fitting demonstrated a significant linear relationship between blood Cd levels and DFU prevalence.</p><p><strong>Conclusions: </strong>This study identified a positive correlation between blood cadmium (Cd) levels and the prevalence of DFU. These results suggest that monitoring blood Cd levels in patients with diabetes during follow-up may be important for preventing the development of DFU. However, further prospective studies are necessary to provide additional evidence.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1255-1266"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735769","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":"Preferences, Expectations and Attitudes on Basal Insulin from Patient-Physician-Payer Perspective: A Multi-stakeholder Survey by the Italian Diabetes Society (ITA4P Study).","authors":"Gian Paolo Fadini, Stefano Ciardullo, Gianluca Perseghin, Carla Giordano, Ernesto Maddaloni, Raffaella Buzzetti, Mariangela Ghiani, Angelo Avogaro","doi":"10.1007/s13300-025-01729-4","DOIUrl":"10.1007/s13300-025-01729-4","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes management often involves complex insulin regimens, posing significant challenges for patients and healthcare systems. Weekly basal insulin formulations aim to simplify treatment, reduce injection frequency, and improve adherence and quality of life. This study explored the beliefs, preferences and attitudes of patients, physicians and payers regarding current basal insulin therapy and weekly insulin formulations.</p><p><strong>Methods: </strong>An online survey with structured questionnaires was developed for multiple stakeholders: patients with type 1 or type 2 diabetes, physicians and payers. Participants provided self-reported insights into basal insulin therapy and perceptions of weekly formulations. Results are presented in a descriptive non-analytical way.</p><p><strong>Results: </strong>A total of 1094 patients, 468 physicians and 100 payers participated. Patients reported moderate satisfaction with current insulin therapy, with lower satisfaction in type 2 diabetes (T2D). The major burdens identified were daily injections and fear of hypoglycaemia, with weekly insulin seen as a promising alternative. Physicians prioritized glycaemic control goals, while patients emphasized independence and quality of life. Payers valued adherence and hypoglycaemia avoidance but raised concerns about costs and education needs.</p><p><strong>Conclusions: </strong>According to this multi-stakeholder survey, weekly basal insulin offers a promising approach to reduce treatment burden and improve adherence and quality of life. Addressing concerns about safety, efficacy and cost will be critical to its successful adoption in clinical practice.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1241-1254"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735780","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":"Amylin: From Mode of Action to Future Clinical Potential in Diabetes and Obesity.","authors":"Špela Volčanšek, Andrijana Koceva, Mojca Jensterle, Andrej Janež, Emir Muzurović","doi":"10.1007/s13300-025-01733-8","DOIUrl":"10.1007/s13300-025-01733-8","url":null,"abstract":"<p><p>Precision diabetology is increasingly becoming diabetes phenotype-driven, whereby the specific hormonal imbalances involved are taken into consideration. Concomitantly, body weight-favorable therapeutic approaches are being dictated by the obesity pandemic, which extends to all diabetes subpopulations. Amylin, an anorexic neuroendocrine hormone co-secreted with insulin, is deficient in individuals with diabetes and plays an important role in postprandial glucose homeostasis, with additional potential cardiovascular and neuroprotective functions. Its actions include suppressing glucagon secretion, delaying gastric emptying, increasing energy expenditure and promoting satiety. While amylin holds promise as a therapeutic agent, its translation into clinical practice is hampered by complex receptor biology, the limitations of animal models, its amyloidogenic properties and pharmacokinetic challenges. In individuals with advanced β-cell dysfunction, supplementing insulin therapy with pramlintide, the first and currently only approved injectable short-acting selective analog of amylin, has demonstrated efficacy in enhancing both postprandial and overall glycemic control in both type 2 diabetes (T2D) and type 1 diabetes (T1D) without increasing the risk of hypoglycemia or weight gain. Current research focuses on several key strategies, from enhancing amylin stability by attaching polyethylene glycol or carbohydrate molecules to amylin, to developing oral amylin formulations to improve patients' convenience, as well as developing various combination therapies to enhance weight loss and glucose regulation by targeting multiple receptors in metabolic pathways. The novel synergistically acting glucagon-like peptide-1 (GLP-1) receptor agonist combined with the amylin agonist, CagriSema, shows promising results in both glucose regulation and weight management. As such, amylin agonists (combined with other members of the incretin class) could represent the elusive drug candidate to address the multi-hormonal dysregulations of diabetes subtypes and qualify as a precision medicine approach that surpasses the long overdue division into T1DM and T2DM. Further development of amylin-based therapies or delivery systems is crucial to fully unlock the therapeutic potential of this intriguing hormone.Graphical abstract available for this article.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1207-1227"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958172","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":"Association Between Diabetes Management Behaviors and State-Level Social Vulnerability: A Cross-sectional Study.","authors":"Debra Winberg, Nicolas Marchi, Tiange Tang, Lizheng Shi","doi":"10.1007/s13300-025-01754-3","DOIUrl":"https://doi.org/10.1007/s13300-025-01754-3","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus remains a major public health concern in the United States. Previous research demonstrates that social determinants of health, including inequities in living conditions, directly affect the biological and behavioral outcomes associated with diabetes control and prevention. New tools such as the social vulnerability index (SVI) can be used to assess these inequities. This paper aims to assess the impact of state-level social vulnerability on diabetes management behaviors.</p><p><strong>Methods: </strong>We used data from the Centers for Disease Control/Agency for Toxic Substances and Disease Registry's Social Vulnerability Index (SVI) and the Behavioral Risk Factor Surveillance System (BRFFS) Survey. The final sample included data from 2016 to 2021 and 89,643 people diagnosed with type 2 diabetes. We averaged the SVI and its component indices for each state and categorized them into terciles. The outcome measures included whether the respondents received diabetes education, conducted self-monitoring of blood glucose levels, and received medical care for diabetes. We ran logistic regressions to test the impact of the SVI on the outcomes, adjusting for state and fixed time-fixed effects and covariates. We weighted according to BRFFS guidelines.</p><p><strong>Results: </strong>Individuals in states with moderate social vulnerability were 1.87 times more likely to receive diabetes education than those in states with the lowest vulnerability (p < 0.01). Conversely, those in states with the highest vulnerability were 1.48 times more likely to see a doctor for diabetes care than those in the least vulnerable states (p =  < 0.01). However, individuals in states with moderate vulnerability are less likely to self-monitor their blood sugar levels (OR = 0.74, p = 0.03).</p><p><strong>Conclusions: </strong>People in states with different levels of social vulnerability exhibit differences in behaviors affecting diabetes management, particularly in activities not captured by standard diabetes quality measures. Differences are more apparent in activities that are not part of diabetes quality measures.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and Attitudes Toward Oral Semaglutide Among Japanese Physicians and Individuals with Type 2 Diabetes: A Web-Based Survey.","authors":"Ryo Suzuki, Krishant Chand, Yuu Taguchi","doi":"10.1007/s13300-025-01739-2","DOIUrl":"https://doi.org/10.1007/s13300-025-01739-2","url":null,"abstract":"<p><strong>Introduction: </strong>The oral formulation of the glucagon-like peptide-1 receptor agonist semaglutide has dosing requirements that could impact adherence. We compared perceptions of physicians and individuals with type 2 diabetes (T2D) in Japan, before and after initiating oral semaglutide, with respect to adherence to dosing requirements.</p><p><strong>Methods: </strong>In this observational study, online questionnaires were completed by treating physicians and adults with T2D who had received either oral semaglutide or other oral antidiabetic medications for ≥ 6 months. Physicians reported the expected adherence of their patients to oral semaglutide and expected patient difficulties around the dosing requirements prior to (baseline) and after (time of survey) initiating oral semaglutide. Patient-reported adherence and difficulties experienced with the dosing requirements were assessed after oral semaglutide was initiated.</p><p><strong>Results: </strong>Overall, 330 physicians and 412 individuals with T2D responded. There was a statistically significant difference (P < 0.001) between baseline and time of survey in the distribution of physicians who expected that ≥ 80% or < 80% of their patients would adhere to oral semaglutide, with 17.2% of physicians expecting ≥ 80% of their patients to be adherent before treatment initiation versus 44.6% reporting ≥ 80% of their patients to be adherent after treatment initiation. There was also a statistically significant difference (P < 0.001) in the distribution of expected versus reported adherence among individuals who received oral semaglutide. After semaglutide initiation, 95.2% of patients reported missing ≤ 1 dose/week. Before prescribing oral semaglutide, 186 (56.4%) physicians were resistant to it, due to the dosing requirements. After prescribing oral semaglutide, 146 (44.2%) reported their resistance had decreased, whereas only 28 (8.5%) reported increased resistance.</p><p><strong>Conclusions: </strong>We identified an improvement in physician perceptions of oral semaglutide adherence due to dosing requirements following semaglutide initiation. Our findings suggest that individuals with T2D in Japan are capable of adhering to the dosing requirements of oral semaglutide.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Treatment Intensification with Glucagon-Like Peptide-1 Receptor Agonists Versus Comparators in People with Type 2 Diabetes Treated with Metformin.","authors":"John W Ostrominski, Vanita R Aroda, Uffe C Braae, Christian Kruse, Kabirdev Mandavya, John B Buse","doi":"10.1007/s13300-025-01751-6","DOIUrl":"https://doi.org/10.1007/s13300-025-01751-6","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment intensification is often required to attain glycemic targets in people living with type 2 diabetes (T2D) but can introduce regimen complexity and increase medication burden. Whether rates of treatment intensification differ by glucose-lowering medication class is unclear. This study investigated comparative treatment durability of glucagon-like peptide-1 receptor agonists (GLP-1RAs) versus standard T2D treatments, with implications for longitudinal risk mitigation and the need for treatment intensification.</p><p><strong>Methods: </strong>This retrospective cohort study used US ambulatory electronic medical record data from January 2006 to November 2021 (covering market availability of first-generation GLP-1RAs) to assess time-to-treatment intensification following initiation of treatment with GLP-1RAs versus sodium-glucose cotransporter-2 inhibitors (SGLT2is), dipeptidyl peptidase-4 inhibitors (DPP-4is), and sulfonylureas (SUs) in 1:1 propensity score-matched adults living with T2D treated with metformin. The primary outcome was the time to treatment intensification (i.e., initiation of a third glucose-lowering medication). Secondary outcomes included change in glycated hemoglobin (HbA_1c) level and body mass index (BMI) at 12 months after treatment initiation.</p><p><strong>Results: </strong>Overall, 59,958 participants were included in this study (GLP-1RA [n = 11,933], SGLT2i [n = 13,726], DPP-4i [n = 14,415], SU [n = 19,884]). Initiation of treatment with GLP-1RAs was associated with a significantly lower rate of initiation of a subsequent glucose-lowering medication compared with SGLT2is (hazard ratio [HR]: 0.93 [95% confidence interval, CI, 0.88, 0.97]; p = 0.001), DPP-4is (HR: 0.77 [95% CI 0.74, 0.81]; p < 0.001), and SUs (HR: 0.84 [95% CI 0.80, 0.88]; p < 0.001). After 12 months, GLP-1RA treatment led to a significantly greater reduction in HbA_1c compared with SGLT2i (p = 0.005), DPP-4i (p < 0.001), and SU (p < 0.001) treatment. GLP-1RA treatment was also associated with significantly greater reductions in BMI after 12 months compared with DPP-4i and SU treatment (both p < 0.001) but not compared with SGLT2i treatment.</p><p><strong>Conclusion: </strong>These data suggest that among people living with T2D treated with metformin who require a second glucose-lowering therapy, GLP-1RAs may reduce or delay the need for further treatment intensification versus other standard glucose-lowering therapies.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Opinion on Optimizing Suboptimal Basal Insulin Titration in India: Addressing Challenges and Leveraging Digital Solutions.","authors":"Sanjay Kalra, Pramila Kalra, Kalyan Kumar Gangopadhyay, Sandeep Julka, Om J Lakhani, Manoj Chawla, Santhosh Ramakrishnan, Jasjeet Singh Wasir","doi":"10.1007/s13300-025-01747-2","DOIUrl":"https://doi.org/10.1007/s13300-025-01747-2","url":null,"abstract":"<p><p>Basal insulin titration is crucial for achieving optimal glycemic control in patients with type 2 diabetes mellitus (T2DM), yet many patients and healthcare providers encounter persistent challenges in adjusting insulin doses to meet individualized targets. In October 2024, an expert panel of digital health specialists comprising endocrinologists, and diabetologists convened to discuss the limitations associated with suboptimal basal insulin titration and explore the potential of digital health solutions to address these issues. The discussion focused on how digital health tools like app-based services could facilitate more effective self-management, enhance patient engagement, and enable real-time communication in T2DM management. The panel's deliberations underscored the promise of digital health technologies as one of the means to overcome current complexities in basal insulin titration. By leveraging real-time data monitoring, remote consultations, and tailored treatment approaches, these tools offer a scalable progress to improving glycemic outcomes and overall diabetes management.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Empagliflozin on Cardiovascular Outcomes and Renal Function in Patients with Obesity and Type 2 Diabetes: A Retrospective Cohort Study.","authors":"Shuxian Song, Yajv Guo, Yuan Lin, Haiyan Gao, Hongxia Ren","doi":"10.1007/s13300-025-01753-4","DOIUrl":"https://doi.org/10.1007/s13300-025-01753-4","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with both obesity and type 2 diabetes mellitus (T2DM) are at heightened risk for developing cardiovascular and kidney-related complications. Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, has shown promising effects on heart health and renal function. This study aims to evaluate the influence of empagliflozin on these outcomes among Chinese patients suffering from obesity and T2DM.</p><p><strong>Methods: </strong>This study included 500 adults with obesity and T2DM who were treated with empagliflozin for at least 6 months. Demographic information, clinical data, and treatment records were collected. Primary outcomes included changes in cardiovascular parameters and renal function measured at 1 week and 1, 3, and 6 months after treatment initiation. Secondary outcomes included heart failure hospitalization, mortality, and safety events.</p><p><strong>Results: </strong>Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) showed significant reductions after 6 months of empagliflozin therapy (p < 0.001). Renal function improved significantly, with a rise in estimated glomerular filtration rate (eGFR) and a decline in serum creatinine levels (p < 0.01). Glycated hemoglobin (HbA1c) levels initially increased after 1 week but continued to decrease thereafter (p < 0.001). Albuminuria modestly reduced over time, with significant decreases from baseline to 3 months (p < 0.01). Body weight was also significantly reduced after 6 months (p < 0.001). Major adverse cardiovascular events (MACE) occurred in 8.4% of patients, and 1.0% progressed to end-stage renal disease. Multivariate analysis identified higher HbA1c levels and lower DBP as significant predictors of MACE, while reduced eGFR and elevated albuminuria were significant predictors of chronic kidney disease (p < 0.05).</p><p><strong>Conclusion: </strong>Empagliflozin significantly improved cardiovascular and renal outcomes in Chinese populations with obesity and T2DM, with sustained benefits observed over 6 months. Elevated HbA1c, lower DBP, increased albuminuria, and reduced eGFR were associated with higher risks of adverse events during treatment period, highlighting the necessity of careful monitoring in high-risk patients.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease: Mapping Across Different Indian Populations (MAP Study).","authors":"Viswanathan Mohan, Shashank Joshi, Saket Kant, Altamash Shaikh, L Sreenivasa Murthy, Banshi Saboo, Parminder Singh, Aravind R Sosale, Debmalya Sanyal, G Shanmugasundar, Santosh Kumar Singh, A K Pancholia, Sunetra Mondal, Rishi George, Ashok Jaiswal, Kunal Jhaveri","doi":"10.1007/s13300-025-01748-1","DOIUrl":"https://doi.org/10.1007/s13300-025-01748-1","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern. MASLD is strongly linked to obesity, sedentary lifestyles, and metabolic syndrome. In India, the prevalence of MASLD exhibits regional variations because of genetic, dietary, and socioeconomic factors. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) are standardized non-invasive tools for assessing fibrosis and steatosis in MASLD. This study aimed to determine the prevalence and severity of MASLD across different Indian regions and examine regional disparities in MASLD burden.</p><p><strong>Methods: </strong>This retrospective, multicenter, cross-sectional study analyzed the data of 13,750 adults from 105 diabetes and endocrine clinics across six geographic zones in India between May 2023 and February 2024. Participants underwent LSM and CAP assessment using FibroScan™. Based on LSM, liver fibrosis was categorized as F0-F1 (2-7 kPa), F2 (7-10 kPa), F3 (10-14 kPa), and F4 (≥ 14 kPa). Based on CAP, MASLD was classified as mild (238-260 dB/m), moderate (261-292 dB/m), and severe (≥ 293 dB/m).</p><p><strong>Results: </strong>The prevalence of MASLD was 68.2% (CAP ≥ 238 dB/m), and the prevalence of fibrosis was 33.7% (LSM ≥ 7 kPa). The highest MASLD burden was observed in North India (73.3%), particularly in Uttarakhand (80.0%). Severe fibrosis (F4) was highly prevalent in Kerala (20.0%), whereas severe steatosis (S3) was highly prevalent in Jammu and Kashmir (50.3%). The prevalence of MASLD was significantly associated with regional variations (P < 0.001) but not with age.</p><p><strong>Conclusion: </strong>This study highlights significant regional disparities in MASLD burden. The high burden in North India calls for region-specific public health interventions, standardized screening, and preventive strategies.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}