Diabetes research and clinical practice最新文献

{"title":"Association of chronic kidney disease and type 2 diabetes mellitus with metabolic dysfunction-associated steatotic liver disease and liver fibrosis assessed by transient elastography: a cross-sectional study based on NHANES 2017–2020","authors":"Ting Xu ,&nbsp;Weifang Zhu","doi":"10.1016/j.diabres.2025.112418","DOIUrl":"10.1016/j.diabres.2025.112418","url":null,"abstract":"<div><h3>Aims</h3><div>The study endeavors to elucidate the separate and combined associations of chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) with the prevalence risks of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis (LF).</div></div><div><h3>Methods</h3><div>This cross-sectional study encompassed 6,035 American adults in the National Health and Nutrition Examination Survey (NHANES) from 2017 to March 2020. Hepatic steatosis (HS) and LF were diagnosed using transient elastography. The link of disease status to outcomes was examined via logistic regression analyses.</div></div><div><h3>Results</h3><div>MASLD and LF prevalences were 27 % and 16 %, respectively. When comorbidities were not excluded, both CKD and T2DM were related to increased risk of MASLD and LF (CKD vs. non-CKD: MASLD odds ratio (OR) = 1.266 [1.024–1.566], LF OR = 1.817 [1.518–2.174]; T2DM vs. non-T2DM: MASLD OR = 2.418 [1.937–3.017], LF OR = 2.163 [1.658–2.821]). After excluding comorbid cases and using individuals without CKD or T2DM as the reference group, CKD-only showed no significant association with MASLD, T2DM + CKD had comparable MASLD risk to T2DM-alone but higher LF risk (OR = 3.495 [2.671–4.574]), exceeding T2DM-only (1.662 [1.126–2.451]) or CKD-only (1.384 [1.068–1.794]) groups. Subgroup analyses confirmed elevated risks across all strata for combined T2DM + CKD.</div></div><div><h3>Conclusion</h3><div>T2DM with CKD is associated with increased LF risk, while T2DM alone is linked to higher MASLD risk.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112418"},"PeriodicalIF":7.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829913","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":"Gut microbiome and serum metabolic alterations in recurrent gestational diabetes mellitus","authors":"Wei Zheng ,&nbsp;Yixuan Lu ,&nbsp;Xianxian Yuan ,&nbsp;Ruihua Yang ,&nbsp;Yujie Zhang ,&nbsp;Li Zhang ,&nbsp;Guanghui Li","doi":"10.1016/j.diabres.2025.112416","DOIUrl":"10.1016/j.diabres.2025.112416","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to identify gut microbiome and serum metabolic alterations in women with recurrent gestational diabetes mellitus (GDM), which affects a significant proportion of those with a prior history.</div></div><div><h3>Methods</h3><div>Seventy pregnant women with prior GDM from Beijing, China, participated in this prospective cohort study. Fecal and serum samples were collected in the first (8–12 weeks) and second trimesters (24–28 weeks). Gut microbiota composition was analyzed via 16S rRNA sequencing, and serum metabolites were profiled using untargeted metabolomics. Mendelian randomization (MR) analyses integrated data from Finnish, Canadian, and UK Biobank cohorts to infer potential causal relationships.</div></div><div><h3>Results</h3><div>Recurrent GDM cases exhibited stage-specific microbial dysbiosis, characterized by an early enrichment of pro-inflammatory taxa (e.g., <em>Streptococcus</em>, <em>Enterobacter</em>) and a depletion of beneficial <em>Bacteroidales</em>, followed by a mid-pregnancy loss of <em>Lactobacillaceae</em> and <em>Desulfovibrio</em>. Network analysis identified reduced microbial community cohesion in recurrent GDM. Metabolomic profiling revealed a downregulation of caffeine metabolites and lipids in recurrent GDM. MR analyses suggested that 16 taxa may influence GDM risk, mediated by metabolites such as lipid signaling.</div></div><div><h3>Conclusions</h3><div>These findings highlight potential interventions for preventing GDM through modulation of gut microbiota and metabolic byproducts during pregnancy.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112416"},"PeriodicalIF":7.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845000","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":"New-onset diabetes mellitus post COVID-19 infection: a systematic review and meta-analysis","authors":"Emma Cocking ,&nbsp;Joseph Daher ,&nbsp;Majid Alabbood","doi":"10.1016/j.diabres.2025.112417","DOIUrl":"10.1016/j.diabres.2025.112417","url":null,"abstract":"<div><h3>Aims</h3><div>This systematic review and <em>meta</em>-analysis aimed to determine the relative risk of new-onset diabetes mellitus (NODM) in COVID-19 patients compared to individuals without COVID-19, with subgroup analyses based on diabetes type, age, severity of COVID-19 infection and corticosteroid use.</div></div><div><h3>Methods</h3><div>PubMed, Medline, Embase, and Scopus were systematically searched for peer-reviewed cohort studies comparing NODM incidence in COVID-19 patients against a control group without COVID-19. A random-effects <em>meta</em>-analysis was conducted to determine the relative risk of NODM following COVID-19 infection.</div></div><div><h3>Results</h3><div>A total of 12 studies were included, involving over 48 million participants. The risk of developing NODM was 41 % higher in patients following COVID-19 infection compared to the control group (RR 1.41; 95 % CI 1.07–1.84). Subgroup analysis revealed a higher incidence of type 2 compared to type 1 diabetes mellitus post COVID-19 infection, and increased risk of NODM in adults and patients with higher severity of disease.</div></div><div><h3>Conclusion</h3><div>COVID-19 infection is associated with a significantly higher risk of NODM. Close monitoring for hyperglycaemia should be considered following COVID-19 infection, especially in adult patients requiring hospital or ICU admission.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112417"},"PeriodicalIF":7.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830450","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":"Sodium zirconium cyclosilicate (Lokelma) to enable ACEIs/ARBs use in the treatment of patients with diabetic kidney disease","authors":"Xu Hao ,&nbsp;Jian Liu ,&nbsp;Leyi Gu ,&nbsp;Xiujuan Zang ,&nbsp;Na Liu ,&nbsp;Yangbin Pan ,&nbsp;Chunming Jiang ,&nbsp;Ying Li ,&nbsp;Gengru Jiang ,&nbsp;Zhiguo Mao ,&nbsp;Jun Xue ,&nbsp;Rong Zhou ,&nbsp;Weiming Wang","doi":"10.1016/j.diabres.2025.112413","DOIUrl":"10.1016/j.diabres.2025.112413","url":null,"abstract":"<div><h3>Aims</h3><div>In diabetic kidney disease (DKD), Angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin receptor blockers (ARBs) are key treatments but may cause hyperkalemia. This randomized controlled trial (RCT) firstly evaluates sodium zirconium cyclosilicate (SZC) to optimize renin-angiotensin-aldosterone system inhibitor (RAASi) use in DKD, addressing evidence gaps in this field.</div></div><div><h3>Methods</h3><div>This 24-weeks prospective multicenter study enrolled 86 DKD patients at hyperkalemia risk to SZC + ACEIs/ARBs or ACEIs/ARBs alone. Primary outcome: ACEIs/ARBs dose up-titration at week 12. Exploratory outcomes included urinary albumin-to-creatinine ratio (UACR), serum creatinine, and blood pressure (BP).</div></div><div><h3>Results</h3><div>At week 12, 55.81 % of patients in the SZC + ACEIs/ARBs arm up-titrated their ACEIs/ARBs dosage (95 % confidence interval [CI]: 39.88 %-70.92 %), compared to 27.91 % in the ACEIs/ARBs arm (95 % CI: 15.33 %-43.67 %, <em>P</em> = 0.009). UACR decreased by 63.46 mg/g in the SZC + ACEIs/ARBs arm at week 24, while increasing by 316.87 mg/g in the ACEIs/ARBs arm (least squares mean difference [LSMD]: –333.63 mg/g [95 % CI: −1148.73 to 481.47]; Per-Protocol Set). BP reductions were greater numerically in the SZC + ACEIs/ARBs arm (systolic: −1.7 mmHg; diastolic: −1.4 mmHg).</div></div><div><h3>Conclusions</h3><div>SZC reduced hyperkalemia-related RAASi discontinuation risk, improved proteinuria and BP, supporting its prophylactic use in DKD patients on RAASi.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112413"},"PeriodicalIF":7.4,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820881","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":"Responsive feeding, diabetes management, weight status and diet quality in a culturally diverse group of 1–5-year-old Australian children with type 1 diabetes","authors":"Kristine Lobley ,&nbsp;Lesley Sharon Youde ,&nbsp;Leah Vandervliet ,&nbsp;Hattie Hoi Ting Wong ,&nbsp;Jenny Jia Ni Weng ,&nbsp;Stefanie Valakas ,&nbsp;Marthury Jeyalingam ,&nbsp;Ann M. Maguire","doi":"10.1016/j.diabres.2025.112402","DOIUrl":"10.1016/j.diabres.2025.112402","url":null,"abstract":"<div><h3>Aims</h3><div>To examine responsive feeding in culturally-and-linguistically diverse (CALD) Australian children (1–5 years) with type-1 diabetes (T1D) and associations with diabetes management, weight status and diet quality.</div></div><div><h3>Methods</h3><div>A retrospective, cross-sectional multi-centre study assessed parental feeding practices, child feeding behaviours, mealtime structure and child’s dietary intake.</div></div><div><h3>Results</h3><div>76 families participated with CALD parents more likely to engage in <em>Reward for Behaviour</em> (p = 0.02), <em>Persuasive Feeding</em> (p = 0.04) and <em>Overt Restriction</em> (p = 0.01). Eating &gt; 2 meals/day in front of TV/screen was associated with <em>Reward for Eating</em> (p = 0.004), <em>Persuasive Feeding</em> (p = 0.01) and CALD background (p = 0.001). Children with HbA1c &lt; 7.0 % experienced more <em>Covert Restriction</em> (p = 0.002). Those on multiple daily injections were more likely to be <em>Rewarded for Eating</em> (p = 0.04) and experience <em>Persuasive Feeding</em> (p = 0.02) but more <em>Willing to try new foods</em> (p = 0.01) compared to children using insulin pump therapy. Only 9 % met Australian recommendations for vegetables and 67 % exceeded recommendations for discretionary foods.</div></div><div><h3>Conclusions</h3><div>Young children with T1D are not meeting healthy eating guidelines, with over half above a healthy weight. Exposure to non-responsive feeding practices is culturally sensitive and impacts diabetes management. A validated assessment tool identifies feeding and mealtime concerns, facilitating targeted conversations about not only what children eat, but also how they are fed.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112402"},"PeriodicalIF":7.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811900","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":"Cardiovascular outcomes of patients with type 2 diabetes after myocardial infarction and the impact of diabetes duration: a nationwide registry study","authors":"Anne M Kerola ,&nbsp;Markus Juonala ,&nbsp;Ville Kytö","doi":"10.1016/j.diabres.2025.112411","DOIUrl":"10.1016/j.diabres.2025.112411","url":null,"abstract":"<div><h3>Aims</h3><div>To study long-term cardiovascular outcomes following a myocardial infarction (MI) among patients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>Patients surviving 90 days after MI with type 2 diabetes (n = 10,440) or without diabetes (n = 65,315) during 2004–2018 were identified from Finnish nationwide registries. The primary outcome, a major adverse cardiovascular event (MACE; recurrent MI, ischemic stroke, heart failure hospitalization, or cardiovascular death), was studied using competing risk Fine-Gray analyses. Median (maximum) follow-up was 3.7 (12) years. Differences between groups were balanced by multivariable adjustments and propensity score matching (n = 10,300 patient pairs).</div></div><div><h3>Results</h3><div>12-year cumulative incidence of MACE was higher in patients with type 2 diabetes (68.8 %) compared to propensity score-matched patients without diabetes (56.1 %) (sub-distribution hazard ratio [sHR]: 1.36; 95 % CI: 1.31–1.41). Incidences of recurrent MI (sHR 1.49; 95 % CI 1.41–1.57), ischemic stroke (1.14; 1.05–1.23), heart failure hospitalization (1.48; 1.40–1.57), and cardiovascular death (1.30; 1.24–1.36) were higher in patients with type 2 diabetes. Longer diabetes duration was associated with MACE, recurrent MI, heart failure, and cardiovascular death.</div></div><div><h3>Conclusions</h3><div>Patients with type 2 diabetes have impaired long-term cardiovascular outcomes after an MI, underlining the importance of effective secondary prevention. Patients with a longer diabetes duration are at a particularly high risk.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112411"},"PeriodicalIF":7.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811897","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":"Ethnic differences in adipose tissue dysfunction and insulin resistance: a scoping review","authors":"Mohammad AlShehab,&nbsp;Adele Costabile,&nbsp;Michael Patterson,&nbsp;Olah Hakim","doi":"10.1016/j.diabres.2025.112363","DOIUrl":"10.1016/j.diabres.2025.112363","url":null,"abstract":"<div><h3>Aims</h3><div>The objective of this scoping review is to synthesize ethnic comparison studies focused on characteristics of adipose tissue dysfunction including ectopic fat, adipokines and insulin resistance in populations of south Asian (SA), black (BA) and white (WE) ethnicity.</div></div><div><h3>Methods</h3><div>A search of the literature was conducted on MEDLINE using keywords for adipose tissue dysfunction and ethnicity. Studies were included if they compared ectopic fat in adults (&gt;18-years) of SA, BA or WE ethnicity, with data on insulin sensitivity and adipokines extracted where present.</div></div><div><h3>Results</h3><div>Thirty-one studies were included in this review. Trends showed most studies were conducted in USA (n = 22); BA were the focus of most ethnic comparison studies (n = 28). Most studies focused on intrahepatic lipids (n = 26), with fewer investigating intrapancreatic lipids (n = 3) and intramyocellular lipids (n = 8). Only 2 studies investigated leptin and adiponectin alongside ectopic fat deposition by ethnicity.</div></div><div><h3>Conclusions</h3><div>Current trends indicate intrahepatic lipid is lower in BA but greater in SA compared to WE populations, indicting possible ethnic disparities in the role ATD in the development of T2D. Few ethnicity studies have investigated multiple characteristics of ATD between BA and SA groups in a single study which may be needed to elucidate ethnic-specific pathophysiology of T2D.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112363"},"PeriodicalIF":7.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803867","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":"Adherence patterns to cardiovascular medications in people with type 2 diabetes mellitus: a retrospective cohort study using group-based trajectory analysis in primary care","authors":"Sri Chodapuneedi ,&nbsp;Jia Wei Koh ,&nbsp;Zhomart Orman ,&nbsp;Danijela Gasevic ,&nbsp;Dianna J. Magliano ,&nbsp;Sophia Zoungas ,&nbsp;Peter Hamblin ,&nbsp;Caroline Trin ,&nbsp;Ella Zomer ,&nbsp;Pilar Cataldo ,&nbsp;Stella Talic","doi":"10.1016/j.diabres.2025.112409","DOIUrl":"10.1016/j.diabres.2025.112409","url":null,"abstract":"<div><h3>Aim</h3><div>To assess adherence to glucose-, lipid-, and blood pressure-lowering medications in people with T2DM and identify predictors of non-persistent adherence behaviours.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using primary care data from 2013 to 2023 for people diagnosed with T2DM. Medication adherence was assessed over 60 months, defined as receiving at least one prescription every six months. Group-Based Trajectory Analysis (GBTA) identified adherence patterns. Multinomial logistic regression explored predictors of trajectory membership.</div></div><div><h3>Results</h3><div>Three consistent adherence trajectories were observed across all medication classes: persistent adherence (40.6 %–44.3 %), gradual decline (32.7 %–36.6 %), and early discontinuation (21.0 %–26.7 %). Persistent adherers maintained high adherence (0.70–0.76) at 60 months. Gradual decliners exhibited a steady decrease in adherence from approximately 0.84 at 12 months to below 0.20 at 60 months. Early discontinuers ceased therapy almost entirely by 24 months. Key risk factors for early discontinuation included female sex (glucose-lowering: RRR 0.72; 95 % CI: 0.57–0.92 for males vs females), metropolitan residence (RRR 1.38; 95 % CI: 1.07–1.78), and having an elevated LDL cholesterol in the lipid-lowering cohort (RRR 1.75; 95 % CI: 1.36–2.26).</div></div><div><h3>Conclusion</h3><div>This study highlights distinct long-term adherence patterns among individuals with T2DM, with over half showing non-persistent use over a five-year period, falling into either early discontinuation or gradual decline groups. These trajectories, while both clinically significant, likely reflect different underlying factors and underscore the need for tailored intervention strategies to support sustained treatment adherence.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112409"},"PeriodicalIF":7.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798448","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":"Systematic review and meta-analysis of the prevalence and clinical profile of lean type 2 diabetes mellitus in Africa","authors":"Nankunda Oreb ,&nbsp;Katuramu Richard ,&nbsp;Bwayo Denis ,&nbsp;Ahmed Waheed","doi":"10.1016/j.diabres.2025.112406","DOIUrl":"10.1016/j.diabres.2025.112406","url":null,"abstract":"<div><h3>Introduction</h3><div>Lean Type 2 diabetes mellitus (T2DM), defined as individuals with body mass index (BMI) &lt; 25 kg/m², presents distinct clinical and biochemical characteristics across populations, particularly in Africa. This review assessed the prevalence and clinical-biochemical profiles of lean T2DM in Africa, aiming to improve understanding and management strategies.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis involved 11 observational studies on lean T2DM in African adults. Specific BMI definitions [&lt;25 Kg/m²] and clinical parameters were assessed, while non-observational studies were excluded. Data was analysed using STATA 18.</div></div><div><h3>Results</h3><div>The pooled prevalence of lean T2DM in African populations was 38.5 % (95 % CI: 26.8 %-50.9 %, I2 = 96.71 %, p &lt; 0.001]). Clinical characteristics reveal a mean age of 48.35 years and a pooled mean BMI of 25.45 kg/m². Metabolic assessments indicated raised HbA1c levels with a pooled median 9.34 % [95 %CI: 8.60–10.08 %, I2 = 97.44 %, p &lt; 0.001]). Insulin resistance was low, as indicated by HOMA2-IR levels.</div></div><div><h3>Conclusions</h3><div>This review revealed a high prevalence of lean T2DM in Africa and identified unique clinical and biochemical characteristics. The findings suggest a potential need for more tailored approaches in assessing this phenotype, which remains underrepresented in current guidelines. Larger, well-designed studies are needed to strengthen the evidence base and inform effective treatment strategies.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112406"},"PeriodicalIF":7.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781098","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":"First-year oral antidiabetic adherence and long-term complications in newly diagnosed type 2 diabetes","authors":"Nam Hoon Kim ,&nbsp;Jun Sung Moon ,&nbsp;Kyoung Hwa Ha ,&nbsp;Jihyun Kim ,&nbsp;Kyoung-Eun Kwon ,&nbsp;Sin Gon Kim ,&nbsp;Dae Jung Kim","doi":"10.1016/j.diabres.2025.112405","DOIUrl":"10.1016/j.diabres.2025.112405","url":null,"abstract":"<div><h3>Aims</h3><div>Type 2 diabetes (T2D) is a growing public health issue, with early treatment adherence potentially impacting long-term outcomes. This study assessed the association between adherence to oral antidiabetic drugs (OADs) during the first year after diagnosis and the risk of complications and mortality.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using a nationally representative health claims database. Patients newly diagnosed with T2D in 2009 who initiated OAD monotherapy within 12 months were included. Follow-up continued from the adherence index date until death, loss of follow-up, or study end. Patients were categorized by adherence level during the first year: good (≥ 80 %) and poor (&lt; 80 %). Outcomes included macrovascular events, diabetes-related hospitalizations, and all-cause mortality. Hazard ratios were estimated using Cox proportional hazards models with inverse probability of treatment weighting.</div></div><div><h3>Results</h3><div>Among 65,340 patients, 46.9 % (n = 30,657) showed good adherence. Compared to poor adherence, good adherence was associated with a 23 % lower risk of macrovascular events, an 8% lower risk of diabetes-related hospitalizations, and a 28 % lower risk of all-cause mortality.</div></div><div><h3>Conclusions</h3><div>Early adherence to OADs was associated with a reduced risk of complications and mortality in T2D patients. Promoting adherence in newly diagnosed individuals is crucial for improving long-term outcomes.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112405"},"PeriodicalIF":7.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793763","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}