Diabetes research and clinical practice最新文献

{"title":"Knowledge, health beliefs, and diabetic retinopathy screening practices among adults living with diabetes in Ebonyi state, Nigeria: a community-based cross-sectional study.","authors":"Onyekachi Jane Ireka, Chukwuemeka Okpara, Okoro Uchenna Okoro, Nneka Ogbu, Emmanuel Sunday Onah, David Ukwu, Ginger-Eke Helen, Uche E Mba","doi":"10.1016/j.diabres.2026.113617","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113617","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a major preventable cause of visual impairment among people living with diabetes, yet uptake of recommended retinal screening remains low in many low- and middle-income countries. This study assessed knowledge, health beliefs, behavioural practices, and DR screening uptake among adults living with diabetes in Ebonyi State, South-Eastern Nigeria.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted among adults with physician-diagnosed diabetes in selected communities in Ebonyi State. Participants completed a structured interviewer-administered questionnaire assessing DR knowledge, Health Belief Model-based health beliefs, diabetes-related behavioural practices, and previous DR screening. Knowledge was assessed using a predefined scoring system, while health beliefs were measured using five-point Likert-scale items. Descriptive statistics were used to summarize findings.</p><p><strong>Results: </strong>Among 300 participants, 183 (61.0%) were male, 201 (67.0%) lived in rural communities, and 283 (94.3%) owned a mobile phone. Knowledge of DR was limited: 111 (37.0%) knew diabetes could cause eye problems, 114 (38.0%) knew DR could cause vision loss or blindness, and 112 (37.3%) recognized that DR could occur without symptoms. Only 122 (40.7%) knew that regular eye examinations were necessary despite normal vision. Health beliefs toward screening were generally favourable, with 189 (63.0%) considering regular screening important and 156 (52.0%) considering it worth the time and cost. Only 36 (12.0%) had undergone a diabetes-specific eye examination within the preceding 12 months, while 259 (86.3%) had never been screened. Among never-screened participants, lack of physician recommendation was the most frequent reason (49.7%), followed by cost (23.0%) and lack of knowledge (11.7%).</p><p><strong>Conclusions: </strong>Adults living with diabetes in Ebonyi State demonstrated substantial knowledge gaps and very low DR screening uptake despite generally favourable health beliefs. Strengthening patient education, routine provider recommendation, and accessible community-based screening may improve early detection and reduce avoidable vision loss.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113617"},"PeriodicalIF":4.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215357","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":"Association of peripheral neuropathy severity and cardiac autonomic dysfunction in individuals with neuropathic diabetic foot versus those with diabetic peripheral neuropathy alone.","authors":"Chunjie Ma, Shuang Lin, Mingxin Bai, Ruixue Feng, Guorui Wan, Daizhen Xiong, Xingwu Ran, Chun Wang, Dawei Chen, Lihong Chen, Sen He, Donge Yan, Bo Luo, Yan Liu, Yun Gao","doi":"10.1016/j.diabres.2026.113606","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113606","url":null,"abstract":"<p><strong>Aims: </strong>To investigate whether cardiac autonomic dysfunction severity is associated with diabetic peripheral neuropathy (DPN) severity, and whether this association differs between individuals with neuropathic foot ulceration (DFU) and those with DPN alone.</p><p><strong>Methods: </strong>Among 794 participants with DPN (268 with neuropathic DFU and 526 without DFU), cardiac autonomic dysfunction was assessed using heart rate variability and DPN severity using nerve conduction studies. Multivariate logistic regression evaluated the association between DPN severity and cardiac autonomic dysfunction. Subgroup and interaction analyses assessed whether the association differed by DFU status.</p><p><strong>Results: </strong>As the standard deviation of the normal sinus interval (SDNN) decreased, conduction velocities and amplitudes of all tested nerves declined. In both groups, greater reductions in sural or common peroneal nerve conduction parameters were independently associated with lower SDNN (all P < 0.01). In neuropathic DFU group, 29.6 %-31.1 % of those with both conduction velocity and amplitude abnormalities had SDNN < 50 ms. No significant interactions between DFU and lower extremity nerve conduction parameters were observed (all P for interaction > 0.05).</p><p><strong>Conclusion: </strong>Cardiac autonomic dysfunction was associated with greater DPN severity. Although neuropathic DFUs exhibited more severe cardiac autonomic dysfunction and DPN, the association between their severities did not differ by DFU status.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113606"},"PeriodicalIF":4.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215283","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":"Diabetes, Long-Term mortality, and LDL-C target attainment after an acute coronary syndrome: A population-based cohort study (2016-2024).","authors":"Gracia Cascales Guerrero, Esther Chicharro-Luna, Alberto Cordero, Xavier Barber-Valles, Emilio Flores Pardo, José María Salinas Serrano, Francisco José Pomares Gómez","doi":"10.1016/j.diabres.2026.113602","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113602","url":null,"abstract":"<p><strong>Aims: </strong>To quantify the excess acute coronary syndrome (ACS) burden and post-ACS mortality associated with diabetes and assess LDL-C target attainment, focusing on sex differences.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 5,361 patients with the first ACS admission identified during the study period (2016-2024) in a Spanish healthcare department. Hospitalization trends were analyzed using population-based regression models. Long-term mortality was assessed by Kaplan-Meier and multivariable Cox regression. LDL-C target attainment was evaluated according to ESC/EAS recommendations.</p><p><strong>Results: </strong>Diabetes was present in 36.9 % of patients. ACS hospitalization rates declined by 8.3 % annually (95 % CI 6.1-10.4), with no diabetes-by-time interaction (p = 0.17). In-hospital case fatality was 6.3 % and did not differ by diabetes status. During a median 4.9-year follow-up, diabetes was associated with higher all-cause mortality (adjusted HR 1.22, 95 % CI 1.11-1.33), with a stronger association in women than men (interaction p = 0.009). Only 28.9 % achieved LDL-C < 55 mg/dL, with no temporal improvement; female sex independently predicted poor LDL-C control (adjusted OR 1.65, 95 % CI 1.38-1.97).</p><p><strong>Conclusions: </strong>Despite declining ACS hospitalizations, DM remained associated with increased long-term mortality, particularly in women. LDL-C target attainment remained suboptimal, highlighting persistent gaps in secondary prevention.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113602"},"PeriodicalIF":4.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192155","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 vaccination on the development of type 1 diabetes in children and vaccine safety in pediatric patients with T1DM: A systematic review.","authors":"Milena Polewka, Wiktoria Skibowska, Sara Kubera, Przemysława Jarosz-Chobot, Ewa Rusak","doi":"10.1016/j.diabres.2026.113616","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113616","url":null,"abstract":"<p><p>Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease associated with increased susceptibility to infections, making immunization an important component of pediatric diabetes care. Despite the established benefits of vaccination, concerns persist regarding its potential role in triggering autoimmune diseases, including T1DM. This systematic review evaluated the impact of vaccination on the risk of developing T1DM in children and assessed vaccine safety in those with established disease. PubMed and Embase were searched for studies published between 2015 and 2025 in accordance with PRISMA 2020 guidelines. Twenty-one original studies met the eligibility criteria. For three rotavirus cohort studies reporting directly comparable adjusted hazard ratios (HRs) for subsequent T1DM, an exploratory inverse-variance random-effects meta-analysis was performed. Overall, the available evidence showed no increased risk of T1DM associated with vaccination. Five studies suggested possible protective effects of rotavirus or BCG vaccination against T1DM development. Influenza and SARS-CoV-2 vaccines were safe in children with established T1DM, with adverse events predominantly mild and transient. Some studies also reported reduced hospitalization rates and fewer infectious complications among vaccinated individuals. Current evidence strongly supports routine childhood vaccination and indicates that immunization is safe and may provide additional benefits for children with or at risk of T1DM.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113616"},"PeriodicalIF":4.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192091","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":"Effects of diagnostic thresholds for gestational diabetes on perinatal mental health: Data from the GEMS randomised clinical trial.","authors":"Phyllis Ohene-Agyei, Greg D Gamble, Thach Tran, Jane E Harding, Caroline A Crowther","doi":"10.1016/j.diabres.2026.113590","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113590","url":null,"abstract":"<p><strong>Aim: </strong>To assess the effect of diagnosis using the lower International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria compared with the higher New Zealand criteria on perinatal mental health.</p><p><strong>Methods: </strong>Secondary analysis of the GEMS Trial, a randomised trial assessing optimum glycaemic diagnostic thresholds for gestational diabetes. Women completing any questionnaire assessing anxiety (6-item State-Trait Anxiety Inventory >15), depression (Edinburgh Postnatal Depression Scale >12) or health-related quality of life (SF-36) at enrolment, 36 weeks' gestation or 6 months postpartum were eligible. Generalised linear mixed-effects models adjusted for age, BMI, recruitment centre, and gestational age at randomisation generated adjusted relative risks (aRR) and adjusted mean differences (aMD).</p><p><strong>Results: </strong>Among 3452 women, 1737 (50.3%) were randomised to the lower criteria group and 1715 (49.7%) to the higher criteria group. No significant differences were observed between groups in anxiety, depression, or mental health-related quality of life at 36 weeks' gestation or 6 months postpartum after adjustment for baseline scores. However, women with mild GDM diagnosed and treated under the lower criteria reported better general health, vitality, social functioning, and postpartum mental component summary scores.</p><p><strong>Conclusion: </strong>Use of the IADPSG criteria does not adversely affect maternal perinatal mental health.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113590"},"PeriodicalIF":4.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180044","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":"Effectiveness of technology-enabled teleophthalmology and emerging retinal imaging techniques for diabetic retinopathy screening: a systematic review and meta-analysis.","authors":"Kai-Yang Chen, Hoi-Chun Chan, Chi-Ming Chan","doi":"10.1016/j.diabres.2026.113610","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113610","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic retinopathy (DR) is a major microvascular complication of diabetes and causes preventable visual loss. Technology-enabled screening can extend retinal assessment beyond specialist settings and strengthen screening, referral, and follow-up across diabetes care pathways.</p><p><strong>Methods: </strong>We systematically reviewed randomized and non-randomized implementation studies, diagnostic-accuracy and comparative retinal-imaging studies, and economic evaluations of technology-enabled DR screening. PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar were searched from inception to 23 May 2026 without language restriction. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Random-effects meta-analyses synthesized comparative and proportional outcomes, and GRADE assessed certainty.</p><p><strong>Results: </strong>Thirty-three studies were included. Teleophthalmology increased DR screening uptake/completion versus usual care or pre-implementation practice (RR 1.966, 95% CI 1.451-2.664; I² = 75.2%) and improved adherence to recommended eye care (OR 2.464, 95% CI 1.477-4.112; I² = 66.47%). The pooled ungradable-image rate was 7.4% (95% CI 3.0%-17.1%; I² = 59.17%). Advanced retinal imaging showed pooled sensitivity of 97.59% (95% CI 94.50%-100.00%; I² = 0%) and specificity of 91.22% (95% CI 78.46%-100.00%; I² = 88.7%) for prespecified vascular lesion detection. OCTA demonstrated a pooled eye-level retinal neovascularization detection yield of 63.6% (95% CI 49.9%-75.4%; I² = 46.29%). Economic evaluations supported cost-effective or cost-saving technology-enabled screening across assessed health systems.</p><p><strong>Conclusion: </strong>Technology-enabled DR care improves screening participation, adherence, and health-system efficiency, supporting integration of teleophthalmology and advanced imaging into scalable diabetes complication-management pathways.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113610"},"PeriodicalIF":4.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180102","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":"Capturing human-machine interplay in automated insulin delivery systems through day-to-day variability of the automated correction index (ACI-V%).","authors":"Andrea Tumminia, Giuseppe Papa, Rossella Cannarella, Francesco Galeano, Vittorio Oteri, Vincenzo Amato, Roberto Baratta, Rosita A Condorelli, Roberto Palazzolo, Carmelo Gusmano, Concetta Finocchiaro, Gianfranco Gruttadauria, Donatella Lo Presti, Salvatore Scirè Calabrisotto, Massimiliano Anzaldi, Tommaso Piticchio, Sandro La Vignera, Lucia Frittitta, Francesco Frasca, Aldo E Calogero","doi":"10.1016/j.diabres.2026.113613","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113613","url":null,"abstract":"<p><strong>Background: </strong>The Automated Correction Index (ACI) reflects the proportion of algorithm-driven correction boluses relative to total bolus insulin in advanced hybrid closed-loop (AHCL) systems. While mean ACI has been associated with glycemic outcomes in patients with type 1 diabetes mellitus (T1DM), the clinical significance of its day-to-day variability (ACI-V%) remains unknown.</p><p><strong>Methods: </strong>In this multicenter real-world study, 330 pediatric and adult patients with T1DM using the MiniMed™ 780G system were studied. ACI-V% was defined as the coefficient of variation of daily ACI values over a 30-day period. Associations between ACI-V% and continuous glucose monitoring (CGM) metrics were assessed.</p><p><strong>Results: </strong>Higher ACI-V% was associated with greater time in range (TIR_{70-180 mg/dL}) and lower time above range, while no significant association with time below range was observed. ACI-V% showed an inverse correlation with mean ACI, suggesting greater day-to-day variability in settings of lower overall automated correction insulin delivery. Moreover, ACI-V% independently predicted achievement of TIR_{70-180 mg/dL} > 70%, with a threshold of ≥ 32.6% identifying patients more likely to reach this target (sensitivity 52.4%, specificity 71.4%).</p><p><strong>Conclusions: </strong>ACI-V% provides an exploratory descriptor of day-to-day variability in automated correction insulin delivery that may complement mean ACI for clinical interpretation of AHCL system behavior.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113613"},"PeriodicalIF":4.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180110","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":"Dapagliflozin and 54-week kidney function in kidney transplant recipients with post-transplant diabetes mellitus: a randomized controlled trial.","authors":"Jinghui Li, Zhirong Fu, Rongkun Xu, Yanqian Zhuang, Pin Chen, Jingbo Chen","doi":"10.1016/j.diabres.2026.113605","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113605","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate dapagliflozin effects on kidney function and safety in kidney transplant recipients with post-transplant diabetes mellitus (PTDM).</p><p><strong>Methods: </strong>In this single-center, prospective, open-label randomized trial, 68 participants were assigned 1:1 to dapagliflozin 10 mg daily plus standard care or standard care alone. Week-54 observed-data analyses included 27 participants per group; an intention-to-treat multiple-imputation sensitivity analysis included all randomized participants.</p><p><strong>Results: </strong>At week 54, the baseline-adjusted between-group eGFR difference was 6.81 mL/min/1.73 m² (95 % CI, 1.68 to 11.94; P = 0.010) in the complete-case analysis and 6.05 mL/min/1.73 m² (95 % CI, 0.99 to 11.11; P = 0.020) after multiple imputation. The estimate was attenuated after additional multivariable adjustment, with the 95 % CI including no difference. Serum magnesium declined less with dapagliflozin, whereas HbA1c and tacrolimus trough concentrations were similar. Observed adverse-event frequencies were similar between groups, although the trial was not powered to assess uncommon safety events.</p><p><strong>Conclusions: </strong>Dapagliflozin showed an exploratory week-54 eGFR signal, but the estimate was sensitive to covariate adjustment and missing-data assumptions. This small trial does not establish a definitive clinically meaningful kidney benefit.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113605"},"PeriodicalIF":4.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180026","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":"Metagenomic and systematic analyses reveal the association between hemoglobin levels and metabolic disorders: an open cohort study of Tibetan adults in Qinghai Plateau.","authors":"Ruijie Xu, Zhiyi Wang, Lin Shi, Jingyao Guo, Bizhong Che, Xue Li, Xiaping Zhao, Dandan Sun, Bin Zhang, Youfa Wang, Wen Peng","doi":"10.1016/j.diabres.2026.113608","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113608","url":null,"abstract":"<p><strong>Aim: </strong>Hemoglobin (Hb) varies with altitude, but evidence linking Hb levels to metabolic diseases in high-altitude populations remains limited. We examined associations between Hb and seven metabolic diseases in high-altitude adults and potential mediation by gut microbiota.</p><p><strong>Methods: </strong>We analyzed an observational cohort of 1,646 Tibetan adults from the Qinghai Plateau, stratified by Hb tertiles. Mixed-effects logistic regression and generalized additive mixed models assessed Hb-metabolic disease associations using pooled person-time data. Gut metagenomic sequencing and mediation analysis were performed on 534 fecal samples, with KEGG annotation characterizing microbial functional potential.</p><p><strong>Results: </strong>Hb correlated positively with six metabolic diseases (P < 0.05). Compared with the lowest tertile (122-151 g/L), the highest Hb tertile (169-252 g/L) showed significantly increased adjusted ORs for diabetes (10.02; 95% CI 3.00-33.43), hypertension (2.08; 1.14-3.80), hypercholesterolemia (3.04; 1.24-7.45), hypertriglyceridemia (4.66; 1.60-13.56), overweight/obesity (5.15; 1.83-14.48) and metabolic syndrome (4.58; 2.50-8.38). High Hb were associated with differences in gut microbiota β-diversity (P = 0.001) and composition. Prevotella and Collinsella were enriched in high-Hb, Bifidobacterium and Anaerostipes dominated low-Hb. Twenty-three microbial species mediated Hb-metabolic relationships. Fructose-mannose metabolism and oxidative phosphorylation were enriched in high-Hb, while ABC transporters and fatty acid biosynthesis/metabolism were upregulated in low-Hb.</p><p><strong>Conclusion: </strong>Hb may serve as a useful biomarker for metabolic risk assessment in high-altitude populations, with gut microbiota potentially mediating this association.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113608"},"PeriodicalIF":4.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164189","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":"Impaired muscle quality and physical performance in diabetic neuropathy: associations with skeletal characteristics from the Deep Phenotyping Study.","authors":"Julie L Graversen, Annika V Kvist, Marie B Sjogaard, Mia D Madsen, Nicklas H Rasmussen, Peter Vestergaard, Johan Røikjer","doi":"10.1016/j.diabres.2026.113609","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113609","url":null,"abstract":"<p><strong>Aims: </strong>We examined whether diabetic neuropathy is associated with altered muscle morphology, strength, and physical performance, and whether muscle characteristics relate to skeletal health.</p><p><strong>Methods: </strong>In this cross-sectional study, 123 individuals with type 2 diabetes were classified into +/- neuropathy based on peripheral and autonomic assessments. Tibial muscle morphology and bone microarchitecture were assessed using high-resolution peripheral quantitative computed tomography, while dual-energy X-ray absorptiometry assessed appendicular lean mass (ALM/height²) and femoral neck bone mineral density (FN aBMD). Muscle strength was evaluated by handgrip and knee extension, and physical performance by chair stand test (CST), timed up-and-go (TUG), and usual gait speed (UGS). Associations were examined using multivariate linear regression adjusted for age, sex, and BMI.</p><p><strong>Results: </strong>Neuropathy was associated with lower muscle volume and density, but not ALM/height² or muscle strength. Individuals with neuropathy performed fewer CST repetitions, had longer TUG times, and slower UGS. Higher muscle density was associated with higher FN aBMD, favorable cortical bone parameters, and greater estimated bone strength.</p><p><strong>Conclusions: </strong>Diabetic neuropathy is associated with lower distal muscle density and volume, poorer physical performance but preserved strength and ALM. Associations between muscle density and bone characteristics suggest an interrelationship between neuropathy, muscle quality and skeletal fragility in type 2 diabetes.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113609"},"PeriodicalIF":4.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165774","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}