Diabetes Therapy最新文献

{"title":"Real-World Glucometric Outcomes of the MiniMed 780G Advanced Hybrid Closed-Loop System in Users with Type 1 Diabetes in Spain.","authors":"Marga Giménez, Virginia Bellido, Carmen Quirós, Ignacio Conget, Noelia Gros Herguido, Daria Roca, Ana Pérez-Morales, Tim van den Heuvel, Maria Joanna Juachon, Goran Petrovski","doi":"10.1007/s13300-026-01878-0","DOIUrl":"10.1007/s13300-026-01878-0","url":null,"abstract":"<p><strong>Introduction: </strong>Automated insulin delivery systems are effective for the management of type 1 diabetes (T1D). However, analyses of how such effectiveness translates into real-world practice in Spain are lacking. The aim of this study was therefore to examine real-world data generated by users of the MiniMed 780G system with T1D in Spain.</p><p><strong>Methods: </strong>The CareLink Personal software program was used to collect data from 16,392 users of the MiniMed 780G system. Outcomes assessed included measures of glycemic control. Comparisons were made between age groups and between pre- and post-advanced hybrid closed-loop (AHCL) system initiation. Additionally, longitudinal data from 12 months of continuous usage were analyzed.</p><p><strong>Results: </strong>Overall, the mean time in range (TIR) was 75.9%, the time in tight range (TITR) was 51.0%, the time below 70 mg/dL (TB70) was 2.2%, and most users achieved international glycemic control targets with 77.4% having a TIR > 70%. Results were similar across age groups but tended to be better among users who utilized recommended optimal settings, with a TIR of 79.8%, TITR of 55.4%, and TB70 of 2.0%. Substantial improvements were observed between pre- and post-initiation of AHCL (n = 4294), with mean TIR increasing from 64.7% to 75.8% and the proportions of users achieving a TIR of > 70% more than doubling. In a longitudinal analysis of a cohort with 12 months of data (n = 6664), improvements in glycemic control were stable.</p><p><strong>Conclusions: </strong>This analysis provides evidence of sustained improvements in glycemic control among users of the MiniMed 780G system in Spain, demonstrating how the use of such a system can result in large increases in the time individuals with T1D spend in range.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1171-1185"},"PeriodicalIF":4.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351023","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":"Blood Glucose Monitoring Expert Group and Best Practice Recommendation-FITTER BiG.","authors":"Siew Pheng Chan, Tri Juli Edi Tarigan, Beena Bansal, Joy Arabelle Castillo Fontanilla, Sueziani Zainudin, Uoonjeong Shin, Supawadee Likitmaskul","doi":"10.1007/s13300-026-01867-3","DOIUrl":"10.1007/s13300-026-01867-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Diabetes mellitus presents a growing public health challenge across geographies including Asia, particularly in countries where blood glucose monitoring (BGM)-referring to capillary finger-prick self-monitoring of blood glucose (SMBG) using a meter and test strips-is underutilized. Having evolved and improved over recent decades, glucose monitoring (GM)-including SMBG and continuous glucose monitoring (CGM)-has become an essential tool for effective diabetes management, yet remains underutilized because of systemic, economic, and educational barriers. This work synthesizes expert insights and published evidence to develop best practice recommendations for BGM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A targeted literature review (TLR) was conducted across five thematic domains: monitoring practices, clinical decision-making, patient engagement and adherence, technology and innovation, and policy and reimbursement. Insights were complemented by a structured expert forum involving clinicians from seven Asian countries, underscoring larger implications in geographies where SMBG remains underutilized within the diabetes care continuum. The forum highlighted disparities in device access, affordability, and insurance coverage, and emphasized the need for structured diabetes self-management education (DSME) and digital integration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Findings support the use of structured SMBG for non-insulin-treated type 2 diabetes and CGM for insulin-treated individuals and those at risk of hypoglycemia. Evidence from the literature review also highlighted the importance of proper SMBG technique, with common errors such as inadequate handwashing, repeated lancet use, and excessive finger squeezing contributing to inaccurate readings and finger-site injuries. Hybrid models combining CGM and SMBG for calibration or confirmation are pragmatic solutions balancing clinical utility and affordability. Digital platforms, AI-driven analytics, and mobile apps enhance patient engagement and glycemic control but face challenges of scalability and regulation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Policy reforms, including inclusion of BGM in national health benefit packages, expanded insurance coverage, and public-private partnerships, are critical to improving access. The recommendations advocate for personalized, context-specific monitoring strategies that balance clinical efficacy with affordability and infrastructure realities. This consensus-based framework aims to guide healthcare professionals in optimizing BGM practices and improving long-term outcomes for people living with diabetes. FITTER BiG is a new extension of the long-standing FITTER initiative, which has provided insulin injection technique recommendations for more than two decades. FITTER BiG complements this work by focusing specifically on best practice recommendations for blood glucose monitoring. FITTER BiG will provide BGM-specific recommendations designed ","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1225-1250"},"PeriodicalIF":4.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835009","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":"Overlap of Gestational Diabetes Mellitus and Pre-eclampsia: A Scoping Review.","authors":"Lunghar Janeline, Thyparambil Aravindakshan PramodKumar, Mohan Deepa, Balaji Bhavadharini, Uddhav Chaudhari, Geetanjali Sachdeva, Sadhana Joshi, Haritha Sagili, Anish Keepanasseril, Sadish Kumar Kamalanathan, Polina Popova, Ponnusamy Saravanan, Uma Ram, Ranjit Unnikrishnan, Ranjit Mohan Anjana, Viswanathan Mohan","doi":"10.1007/s13300-026-01880-6","DOIUrl":"10.1007/s13300-026-01880-6","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) and preeclampsia (PE) are among the most common medical complications in pregnancy, with prevalence rates of 10-25% and 3-9.4%, respectively. Both conditions are important causes of maternal and neonatal morbidity and pose considerable risks to maternal and fetal health. GDM and PE are traditionally viewed as distinct clinical entities. However, they share several common risk factors, including advanced maternal age, obesity, family history of metabolic disease, dyslipidemia and genetic predisposition. The two conditions also have overlapping pathophysiological pathways, particularly involving metabolic and vascular dysfunctions such as insulin resistance, chronic inflammation and endothelial dysfunction. This article reviews the prevalence of GDM and PE, the risk factors common to the two conditions and biomarkers that may aid in early identification of these disorders. The report also discusses clinical implications of the overlap between the two disorders, with a plea for integrated management strategies. Finally, the article also highlights potential preventive measures and underscores the importance of multidisciplinary approaches to improve pregnancy outcomes in those with GDM and PE.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"937-958"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249644","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":"Change in Effectiveness and Safety Parameters After Initiation of SGLT2 Inhibitors for Post-Transplant Diabetes Mellitus: A Real-World Observational Study.","authors":"Maria Cristina Crepaldi, Monica Vedovato, Mario Luca Morieri, Giovanni Basso, Lucia Federica Stefanelli, Marianna Alessi, Paola Fioretto, Gian Paolo Fadini","doi":"10.1007/s13300-026-01885-1","DOIUrl":"10.1007/s13300-026-01885-1","url":null,"abstract":"<p><strong>Introduction: </strong>Post-transplant diabetes mellitus (PTDM) is frequent and associated with increased cardiovascular and renal risk. Evidence regarding the long-term effectiveness and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in PTDM remains limited.</p><p><strong>Methods: </strong>We conducted a single-center retrospective observational study including 86 solid organ transplant recipients with diabetes treated with SGLT2 inhibitors between January 2017 and July 2025. Seventy patients who received treatment for ≥ 6 months were included in efficacy analyses. The primary endpoint was change in HbA1c over time. Secondary endpoints included changes in body weight, systolic blood pressure (SBP), estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (uACR), treatment modifications, and safety outcomes.</p><p><strong>Results: </strong>Participants (72/86 men; mean age 65.9 years) were followed for a mean of 1.6 ± 1.4 years. A significant HbA1c reduction was observed only between years 2 and 3 (- 0.6% vs baseline), while overall longitudinal variation was not statistically significant. Body weight significantly decreased over time (p = 0.007), with a maximum reduction of - 5.5 kg. No significant changes were observed in SBP or uACR. A progressive decline in eGFR was detected during follow-up (p < 0.001), but only four patients had a ≥ 50% eGFR decline. Urogenital infections occurred in 7% of patients (5.1 cases/100 person-years), leading to treatment discontinuation in 4.6%. Overall discontinuation rate was 19.8%.</p><p><strong>Conclusion: </strong>In this real-world descriptive study on PTDM, initiation of an SGLT2 inhibitor was followed by sustained weight reduction and delayed glycemic improvement, with an acceptable safety profile. The observed long-term renal decline warrants further investigation in controlled prospective studies.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1015-1026"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148100956","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":"Dose-Response and Clinical Equivalence of Semaglutide and Tirzepatide for Weight Loss in Type 2 Diabetes: A Model-Based Analysis.","authors":"Carlos E Builes-Montaño, Andres F Suarez-Rodriguez, Maria A Alzate-Vinasco","doi":"10.1007/s13300-026-01886-0","DOIUrl":"10.1007/s13300-026-01886-0","url":null,"abstract":"<p><strong>Introduction: </strong>Semaglutide and tirzepatide are highly effective incretin-based therapies for weight reduction in individuals with type 2 diabetes (T2DM). However, direct comparisons across the full range of clinically relevant doses in T2DM are limited. This study aimed to evaluate dose-response relationships and clinical equivalence between semaglutide and tirzepatide using a model-based approach.</p><p><strong>Methods: </strong>Arm-level data from phase III randomized controlled trials of semaglutide (SUSTAIN, STEP) and tirzepatide (SURPASS, SURMOUNT-2) in T2DM were analyzed. Dose-response relationships for percent weight change were modeled using generalized additive models and Bayesian hierarchical spline models. Posterior probabilities of clinical equivalence were estimated across prespecified dose pairs using an equivalence margin of ± 2 percentage points. Model-based intensification scenarios were evaluated to estimate incremental benefit associated with treatment switching or dose escalation.</p><p><strong>Results: </strong>A total of 48 treatment arms (n = 16,524 participants) were included. Both agents demonstrated nonlinear dose-response relationships, with attenuation of incremental effects at higher doses. High probabilities of equivalence were observed for semaglutide 2.4 mg versus tirzepatide 10 mg (99.4%) and semaglutide 7.2 mg versus tirzepatide 15 mg (94.8%). Lower doses of semaglutide were not equivalent to higher doses of tirzepatide. In intensification scenarios, both switching and dose escalation strategies improved weight loss, although the probability of achieving ≥ 2 additional percentage points varied across regimens.</p><p><strong>Conclusion: </strong>Semaglutide and tirzepatide demonstrate comparable weight-loss efficacy at specific dose combinations, with equivalence driven by dose rather than drug identity. Model-based analyses provide a quantitative framework to support individualized treatment decisions when direct comparative evidence is unavailable.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1067-1083"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197801","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":"Improving Precision Diagnosis and Treatment of Diabetes in Low-Resource Settings in Africa Through Structured Clinical Phenotyping: A Narrative Review.","authors":"Davis Kibirige, Anxious Niwaha, Jean Claude Katte, William Lumu","doi":"10.1007/s13300-026-01881-5","DOIUrl":"10.1007/s13300-026-01881-5","url":null,"abstract":"<p><p>Precision diabetes care is an evolving evidence-based, personalised approach that uses an individual's clinical, metabolic, and genetic data to accurately classify them into distinct subgroups and tailor diabetes prevention, treatment, and monitoring strategies. The use of genomics data, advanced biomarker testing, and artificial intelligence-driven diagnostics has improved precision diabetes care in high-income countries. This has enabled accurate identification of diabetes subtypes and targeted treatment. Despite the rising burden of diabetes, high rates of undiagnosed cases, and emerging evidence of atypical manifestations of diabetes in Africa, such advancements in precision diabetes care remain unavailable in many low-resource settings, directly impacting treatment outcomes. To improve precision diabetes care in low-resource settings in Africa, we suggest using a structured clinical phenotyping approach based on routinely collected clinical characteristics. In this review, we explore how using a combination of readily available clinical characteristics, such as age at diagnosis, body mass index, clinical presentation, family history of diabetes, and coexisting medical conditions, can help healthcare professionals in Africa to diagnose and treat different diabetes subtypes accurately. By adopting a pragmatic, structured clinical phenotyping approach, African healthcare systems can deliver region-specific, cost-effective precision diabetes care without overreliance on advanced laboratory tests and digital technologies.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"921-935"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175375","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":"Real-World Effectiveness of Tirzepatide in Japanese Patients with Type 2 Diabetes: A Multicenter Retrospective Observational Study.","authors":"Noriyuki Takahashi, Makoto Ohara, Hiroki Yokoyama, Hiroaki Seino, Munenori Hiromura, Shutaro Ozawa, Takemasa Omachi, Nobuaki Takehana, Tomoki Fujikawa, Ayako Ohara, Shunichiro Irie, Naoya Osaka, Michishige Terasaki, Aya Yoshihara, Yusaku Mori, Tomoyasu Fukui, Sho-Ichi Yamagishi","doi":"10.1007/s13300-026-01877-1","DOIUrl":"10.1007/s13300-026-01877-1","url":null,"abstract":"<p><strong>Introduction: </strong>Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist, significantly affects glucose and body weight-lowering effects in randomized controlled trials. However, real-world clinical evidence in Japan remains limited. This study aimed to evaluate the real-world effectiveness of tirzepatide on glycemic and metabolic factors in Japanese patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>In this multicenter, retrospective, observational study, we included patients with T2DM from seven Japanese institutions who received tirzepatide treatment for at least 24 weeks. Tirzepatide effectiveness was evaluated by comparing clinical and biochemical parameters, including glycated hemoglobin (HbA1c), plasma glucose levels, body weight, blood pressure, lipid profiles, liver enzyme levels, and renal function, before and after 24 weeks of treatment.</p><p><strong>Results: </strong>We included 324 patients (mean age, 56.8 ± 11.4 years; median body mass index (BMI), 30.4 kg/m² (interquartile range 26.8-34.0)). At 24 weeks, 42 (13.0%), 211 (65.1%), 35 (10.8%), 25 (7.7%), and 11 (3.4%) patients received 2.5 mg, 5 mg, 7.5 mg, 10 mg, and 12.5/15 mg tirzepatide, respectively. HbA1c and body weight significantly decreased after tirzepatide administration; the median HbA1c and body weight reduced from 7.9% [7.2-8.6] to 6.8% [6.1-7.5] and from 82.5 kg [73.5-94.6] to 80.0 kg [70.9-92.5], respectively, whereas the medians of changes in HbA1c and body weight from baseline to week 24 were - 0.9% [- 1.6 to - 0.3] and - 2.0 kg [- 4.0 to 0.0] (p < 0.001). HbA1c reduction was greater in GLP-1 receptor agonist-naïve patients (p < 0.001). Changes in HbA1c levels significantly correlated with baseline HbA1c levels (r_s = - 0.473, p < 0.001), but not BMI.</p><p><strong>Conclusions: </strong>In real-world clinical practice, tirzepatide was associated with improvements in glycemic control and reductions in body weight in Japanese patients with T2DM, across diverse baseline therapies. These results suggest that tirzepatide may be a useful option across diverse treatment backgrounds, with greater observed benefits in GLP-1RA-naïve individuals with higher baseline HbA1c levels.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1027-1041"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148100983","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":"Identification of Patient Clusters with Distinct Disease Progression Patterns Utilizing a Nationwide Finnish Population with Type 2 Diabetes.","authors":"Kim Nygård, Riitta Ryhänen, Aaron Kortteenniemi, Kajsa Järvinen, Aino Vesikansa, Juha Mehtälä, Mirkka Koivusalo, Annakaisa Tirronen, Eralda Asllanaj, Jarmo Kaukua, Sami Pakarinen, Juha Tuominen","doi":"10.1007/s13300-026-01879-z","DOIUrl":"10.1007/s13300-026-01879-z","url":null,"abstract":"<p><strong>Introduction: </strong>Variability in the clinical presentation of patients with type 2 diabetes (T2D) is high and underlines the need for more personalized patient care. This nationwide study aimed to describe characteristics, treatment patterns, and disease progression of Finnish patients with T2D (N = 302,987), and to identify patient clusters with distinct progression patterns based on the occurrence of diabetes-related complications.</p><p><strong>Methods: </strong>The study included all adult patients with incident T2D in Finland between 2010 and 2019. Data were collected from national health and social care registers, data lakes, and a private healthcare provider between 1996 and 2021. Patient clusters were identified based on disease progression, defined by the occurrence of 22 pre-defined end-points, using likelihood-based growth mixture modeling.</p><p><strong>Results: </strong>Five patient clusters with stable (C1; n = 133,951), mild (C2; n = 52,819), moderate (C3, n = 43,488), rapid (C4; n = 10,159), and extremely rapid progression (C5; n = 1973) were identified. The mean number of end-point complications per patient at baseline ranged from 0.2 to 2.3 across clusters and remained stable in C1-C3 over the first 5 years. In C5, the number increased to 5.5 and 7.2 during the first and third follow-up years, respectively, with a similar but more modest annual increase observed in C4. Cardiovascular complications increased more rapidly in C5 and C4 than C1-C3. T2D medication use was more common in milder clusters, whereas 31.4% and 48.2% of patients in C4 and C5, respectively, had no T2D medication. The rate of certain infections and values of creatinine, hemoglobin, and erythrocytes, increased with cluster severity.</p><p><strong>Conclusions: </strong>Diagnosis of several other new conditions, particularly cardiovascular complications, at or soon after incident T2D diagnosis predicts poor prognosis. The results further support a comprehensive approach in diabetes care, including evaluation and treatment of cardiovascular diseases alongside glycemic control.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"1043-1065"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175337","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 Anthropometric Indices and Presence of Type 2 Diabetes Mellitus in Obesity.","authors":"Shehla Shaikh, Sambit Das, Sunil Kota, Nitin Kapoor, Sanjay Kalra, Saptarshi Bhattacharya","doi":"10.1007/s13300-026-01876-2","DOIUrl":"10.1007/s13300-026-01876-2","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity and type 2 diabetes mellitus (T2DM) are global challenges, with obesity increasing risk of T2DM. Body mass index (BMI), the conventional measure of obesity, may not accurately predict metabolic risk, especially in Asian individuals. Evaluation of alternative anthropometric indices may offer additional approaches for risk assessment.</p><p><strong>Methods: </strong>The multicenter, cross-sectional study examined whether anthropometric indices-such as waist, hip, neck, calf, and wrist circumferences, as well as waist-hip, neck-height, and waist-calf ratios-are associated with T2DM in adults with obesity. The study included 750 adults (BMI ≥ 25 kg/m²) recruited from four endocrinology centers across India. Anthropometric and clinical data were recorded using a standardized electronic form.</p><p><strong>Results: </strong>T2DM was present in 73% of the cohort (81.6% of men, 67% of women). Obesity classes did not reliably predict the diabetes risk. In men, univariate analysis showed that T2DM increased with age [odds ratio (OR) 1.09, 95% confidence interval (CI) 1.06-1.12, p < 0.001], higher pulse rate (OR 1.03, 95% CI 1.00-1.06, p = 0.04), lower BMI (OR 0.94, 95% CI 0.88-1.00, p = 0.048), higher waist-hip ratio (WHR) (OR 2.63, 9% CI 1.45-4.76, p = 0.001), and neck-height ratio (NHR) (OR 3.35, 95% CI 1.05-10.65, p = 0.041). On logistic regression analysis, age, pulse rate, WHR, and NHR independently predicted diabetes in men. In women, T2DM was more prevalent with increasing age (OR 1.09, 95% CI 10.7-1.11, p < 0.001), higher systolic blood pressure (OR 1.05, 95% CI 1.03-1.06, p < 0.001), lower weight (OR 0.98, 95% CI 0.97-1.00, p = 0.032), higher neck circumference (OR 1.10, 95% CI 1.05-1.16, p < 0.001), and NHR (OR 7.83, 95% CI 3.52-17.42, p < 0.001), on univariate analysis. On logistic regression analysis, age, systolic blood pressure, and NHR retained statistical significance. Receiver operating characteristic analysis generated an optimal NHR cutoff of 0.24 (AUC 0.63) for predicting T2DM with moderate discriminatory ability.</p><p><strong>Conclusion: </strong>NHR showed the strongest association with T2DM risk in both men and women, although with moderate discriminatory ability. Additionally, WHR may be associated with risk of T2DM only in men. Anthropometric measures, such as NHR and WHR, may complement BMI, but require validation in larger multiethnic cohorts.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"997-1014"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971148","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":"Treatment Options for Patients with Maturity-Onset Diabetes of the Young (MODY): A Systematic Review of Literature: 2026 Update.","authors":"Luca Zagaroli, Alessio Di Berardino, Francesco Petragnano, Serena Lustri, Irene Fasciani, Mario Rossi, Marco G Baroni, Maurizio Delvecchio","doi":"10.1007/s13300-026-01884-2","DOIUrl":"10.1007/s13300-026-01884-2","url":null,"abstract":"<p><strong>Introduction: </strong>Maturity-onset diabetes of the young (MODY) is a rare monogenic form of diabetes characterized by impaired insulin secretion and genetic and clinical heterogeneity. Accurate molecular diagnosis enables precision medicine by guiding gene-specific treatment, improving glycemic control, and avoiding unnecessary therapies. Since our previous systematic review in 2020, new studies have further clarified therapeutic strategies and emerging treatment options. This review updates the evidence on pharmacological management of MODY and its clinical implications.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA 2020 recommendations. PubMed was searched for studies published between April 2020 and October 2025. Eligible studies included individuals with genetically confirmed MODY receiving pharmacological treatment, therapeutic switches, or adjunctive therapies. Data were extracted and synthesized qualitatively due to heterogeneity in study design and outcome reporting.</p><p><strong>Results: </strong>Ninety-one studies were included. Strong evidence confirms sulfonylureas (SUs) as first-line therapy in Hepatocyte Nuclear Factor 1A (HNF1A)-, Hepatocyte Nuclear Factor 4A (HNF4A)-, ATP-binding cassette transporter sub-family C member 8 (ABCC8)-, and potassium inwardly rectifying channel subfamily J member 11 (KCNJ11)-MODY, frequently enabling improved glycemic control and transition from insulin. Glucokinase (GCK)-MODY remains managed without pharmacological treatment outside pregnancy, but dorzagliatin, a novel agent acting as a glucokinase activator, may further expand precision treatment approaches. Insulin remains the mainstay of treatment in Hepatocyte Nuclear Factor 1B (HNF1B)- and Insulin (INS)-MODY, although adjunctive therapies may provide benefits. While SUs are supported by consistent observational evidence, the role of incretin-based therapies and sodium-glucose co-transporter 2 inhibitors remains exploratory, largely based on small studies and case reports.</p><p><strong>Conclusions: </strong>A major limitation of the available evidence is the predominance of small, heterogeneous observational studies, which limits the strength and generalizability of therapeutic recommendations. Recent literature largely confirms existing genotype-guided treatment recommendations while suggesting expanded therapeutic options for selected MODY subtypes. Precision medicine based on molecular diagnosis remains essential for optimal management.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"959-983"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249630","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}