Diabetes research and clinical practice最新文献

{"title":"Association between obesity at age 20 and postpartum glucose tolerance in women with a history of gestational diabetes mellitus","authors":"Akiho Yamashita ,&nbsp;Masayuki Kaku ,&nbsp;Marina Matsunaga ,&nbsp;Satomi Inoue ,&nbsp;Koichi Arizono ,&nbsp;Takuya Ideguchi ,&nbsp;Takuro Watanabe ,&nbsp;Shuhei Nishida ,&nbsp;Takeshi Nishikawa","doi":"10.1016/j.diabres.2025.112930","DOIUrl":"10.1016/j.diabres.2025.112930","url":null,"abstract":"<div><h3>Aims</h3><div>We aimed to investigate the association between obesity at age 20 and weight gain from age 20 to pregnancy and postpartum glucose tolerance in women with a history of gestational diabetes mellitus (GDM).</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 433 patients with GDM who underwent prenatal glycemic control and a 75-g oral glucose tolerance test 6 to 12 weeks after delivery. The independent factors, adjusted risk ratios (aRR), and 95 % confidence intervals (CI) were calculated using multivariable Poisson regression with robust variance.</div></div><div><h3>Results</h3><div>Obesity at age 20 was an independent predictor for the onset of postpartum impaired glucose tolerance (IGT) and diabetes mellitus (DM) (aRR: 1.726, 95 % CI: 1.217–2.446) and postpartum insulin resistance (aRR: 1.532, 95 % CI: 1.085–2.164). Weight gain from age 20 to pregnancy was an independent predictor for the onset of postpartum insulin resistance (aRR: 1.050, 95 % CI: 1.024–1.077). Furthermore, the aRR for the onset of postpartum IGT and DM in the obesity at age 20, pre-pregnancy, and postpartum group was significantly higher than the no history of obesity group (aRR: 2.104, 95 % CI: 1.390–3.185).</div></div><div><h3>Conclusions</h3><div>Japanese women need to maintain a normal weight from age 20 to prevent the onset of DM.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112930"},"PeriodicalIF":7.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231883","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":"Promoting soluble guanylate cyclase activity via guanylate cyclase stimulators or guanylate cyclase activators: a feasible option in diabetic kidney disease","authors":"Baris Afsar ,&nbsp;Rengin Elsurer Afsar ,&nbsp;Krista L. Lentine","doi":"10.1016/j.diabres.2025.112929","DOIUrl":"10.1016/j.diabres.2025.112929","url":null,"abstract":"<div><div>Diabetic kidney disease (DKD) is a word-wide problem. In patients with diabetes mellitus (DM), DKD occurs in up to 40% of patients and is the most common cause of chronic kidney disease (CKD) in diabetic patients. Despite various reno-protective agents, DKD still progresses in the majority of patients necessitating further novel therapeutic options. Recently, another class of medications working by augmenting soluble guanylate cyclase (sGC) has been studied in DKD. Soluble guanylate cyclase activity can be increased by 2 classes of medications with different modes of action, namely sGC stimulators and sGC activators. Preclinical and clinical studies have shown that these medications may reduce albuminuria/proteinuria independent of BP lowering, decrease inflammation, reduce oxidative stress and kidney fibrosis, and have favorable impacts on lipid profile and glucose levels. Importantly, these medications can be used with other kidney protective agents such as Renin-angiotensin system inhibitors and Sodium-glucose cotransporter-2 inhibitors. In this review, we summarized the experimental and clinical studies specifically investigating the effects of sGC stimulators and sGC activators in the context of DKD. Additionally, we explore the effects of increasing sGC on laboratory and clinical parameters in DKD. We also identify knowledge gaps and proposals for future studies.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112929"},"PeriodicalIF":7.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217917","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":"One-hour plasma glucose defining stages of type 2 diabetes − The ELSA-Brasil study","authors":"Jayne Feter ,&nbsp;Danilo de Paula ,&nbsp;Paula Bracco ,&nbsp;Jainara Spagiari ,&nbsp;Natan Feter ,&nbsp;Bruce B. Duncan ,&nbsp;Michael Bergman ,&nbsp;Maria Inês Schmidt","doi":"10.1016/j.diabres.2025.112916","DOIUrl":"10.1016/j.diabres.2025.112916","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate a previously proposed type 2 diabetes staging schema by examining the decline in oral beta-cell compensation and the increase in diabetes risk.</div></div><div><h3>Methods</h3><div>We analyzed 1,235 participants (43–85 years) from one ELSA-Brasil center. We defined stages as previously proposed: stage 1, isolated 1-h PG ≥155 mg/dL; stage 2, also having prediabetes/intermediate hyperglycemia (preDM/IH) defined by the American Diabetes Association (ADA); and stage 3, diabetes. We made additional evaluations defining IH based on the World Health Organization (WHO)/International Expert Committee (IEC) criteria. We estimated beta-cell compensation with the insulin secretion-sensitivity index-2 (ISSI-2).</div></div><div><h3>Results</h3><div>ISSI-2 declined (p &lt; 0.001) across stages. After 5.29 (0.44) years (n = 850), the adjusted diabetes incidence increased from stage 0 (normoglycemia) to stage 1 (RR = 2.64;1.12,6.22) and stage 2 (RR = 5.94;2.83,12.44), considering WHO/IEC criteria. With the ADA criteria, RRs were larger but not progressive. Adding 1-h PG testing doubled the detection of unknown diabetes. A strategy combining FPG with 1-h PG performed just as well as using all four tests.</div></div><div><h3>Conclusions</h3><div>Staging captured progressive deterioration to type 2 diabetes. Adding 1-h PG improved current and future case detection, which represents a major advance in diabetes prevention. However, refinements in staging will require further evaluation of tests and their thresholds.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112916"},"PeriodicalIF":7.4,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198772","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 the metabolic dysfunction-associated steatotic liver disease with cardiovascular and kidney disease in patients with type 2 diabetes mellitus: a cross-sectional study","authors":"Huihui Ren ,&nbsp;Mengyuan Hu ,&nbsp;Yongli Yan ,&nbsp;Mengke Cheng ,&nbsp;Chengru Yang ,&nbsp;Gang Yuan ,&nbsp;Tingting Du","doi":"10.1016/j.diabres.2025.112927","DOIUrl":"10.1016/j.diabres.2025.112927","url":null,"abstract":"<div><h3>Purpose</h3><div>This study explored the link between liver fibrosis and left ventricular hypertrophy (LVH), a good indicator of cardiovascular disease (CVD), and chronic kidney disease (CKD) risk in type 2 diabetes mellitus (T2DM) patients.</div></div><div><h3>Methods</h3><div>We analyzed data from 2,436 T2DM patients who visited our clinic between 2022 and 2024. Liver fibrosis was evaluated using NAFLD Fibrosis Score (NFS). We applied logistic regression to assess the relationship between liver fibrosis and LVH/CKD risk.</div></div><div><h3>Results</h3><div>Among the 2,436 participants (63.79 % male, mean [SD] age 53.08 [12.65] years), the prevalence of LVH, and CKD was 38.88 %, and 34.69 %. Individuals with NFS-defined advanced fibrosis had significantly higher risks of LVH (OR 1.45, 95 % CI [1.16–1.81]) and CKD (OR 1.94, 95 % CI [1.56–2.41]), after adjusting for established cardiovascular risk markers. Results remained consistent regardless of body mass index (BMI), or lipid profile status. We also observed that worsening liver fibrosis was associated with a higher stage of cardiovascular-kidney-metabolic (CKM) syndrome.</div></div><div><h3>Conclusions</h3><div>Liver fibrosis is independently associated with increased LVH/CKD risk and CKM stage in T2DM patients. These findings indicate that metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive stage (liver fibrosis) should be introduced into the CKM staging structure to enhance risk stratification.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112927"},"PeriodicalIF":7.4,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198822","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":"GLP-1 receptor agonists and sarcopenia: Weight loss at a cost? A brief narrative review","authors":"Dimitrios Pantazopoulos,&nbsp;Evanthia Gouveri,&nbsp;Dimitrios Papazoglou,&nbsp;Nikolaos Papanas","doi":"10.1016/j.diabres.2025.112924","DOIUrl":"10.1016/j.diabres.2025.112924","url":null,"abstract":"<div><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual agonists targeting both GLP-1 and glucose-dependent insulinotropic polypeptide receptors (GLP-1/GIP RAs) are established therapies for type 2 diabetes mellitus (T2DM) and obesity. However, there is evidence that treatment with these agents may lead to significant loss of muscle mass, potentially resulting in sarcopenia or sarcopenic obesity. This brief narrative review explores the complex relationship between GLP-1 based therapies and muscle health. Some studies have linked GLP-1 RAs and dual GLP-1/GIP RAs with significant reductions in lean mass, and sarcopenia. However, preclinical evidence suggests that these agents can attenuate skeletal muscle atrophy, improve muscle function, and enhance mitochondrial health. Moreover, limited clinical data indicate a potential role in preserving muscle mass under certain conditions. Management includes optimised diet, targeted exercise, and novel pharmacological interventions, such as blockade of growth differentiation factor-8 (GDF8) and activin A (ActA). These measures hold potential to preserve muscle mass and to improve patient outcomes. Further research is warranted to clarify these mechanisms and to evaluate combination therapies aimed at preventing sarcopenia in patients receiving GLP-1 RAs.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112924"},"PeriodicalIF":7.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191307","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":"SGLT-2 inhibitors beyond diabetes: a new frontier in cancer treatment","authors":"Ali Nakhaei ,&nbsp;Kiana Delavar ,&nbsp;Azin Sadat Azim ,&nbsp;Sadaf Afshari ,&nbsp;Alireza Mohtashami ,&nbsp;Mohammad Jalili-Nik ,&nbsp;Mahsa Jalali ,&nbsp;Seyed Sajad Ahmadi ,&nbsp;Sercan Karav ,&nbsp;Amir R. Afshari ,&nbsp;Prashant Kesharwani ,&nbsp;Amirhossein Sahebkar","doi":"10.1016/j.diabres.2025.112925","DOIUrl":"10.1016/j.diabres.2025.112925","url":null,"abstract":"<div><div>Sodium-glucose co-transporter 2 (SGLT-2) inhibitors, a new class of antidiabetic medications including canagliflozin, dapagliflozin, ipragliflozin, and empagliflozin, recently came to light as possible anti-cancer therapeutics. The confirmed presence of SGLT-2 in many cancer cell lines further substantiates their potential as therapeutic targets. Because many cancer cells change their metabolism to become more glucose-dependent, blocking glucose absorption with SGLT-2 inhibitors is an intriguing anti-cancer therapy. In addition to their physiological function in renal proximal tubules, SGLT-2 has been identified in specific tumor cells. Clinical trials have shown that SGLT-2 inhibitors are safe and well-tolerated in individuals with diabetes and heart failure. Significantly, these medicines demonstrate antiproliferative effects across multiple cancer types, as substantiated by both in vitro and in vivo models, frequently via mechanisms that are independent of SGLT-2 itself. They seem to regulate a diverse array of intracellular and extracellular signaling pathways, encompassing those associated with microRNAs, AMPK, ERK, DNA and RNA metabolism, ATP homeostasis, and mitochondrial function. These data collectively underscore the potential of SGLT-2 inhibitors in clinical oncology and elucidate the processes driving their anti-cancer efficacy.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112925"},"PeriodicalIF":7.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185000","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":"Low Bacteroides abundance is related to endothelial dysfunction in type 2 diabetes.","authors":"Yoko Omura-Ohata, Cheol Son, Hisashi Makino, Ryo Koezuka, Mayu Tochiya, Masaki Matsubara, Kyoko Honda-Kohmo, Tamiko Tamanaha, Michio Noguchi, Tsutomu Tomita, Yukako Tastumi, Masanari Kuwabara, Keita Watanabe, Ikuo Kimura, Kiminori Hosoda, Yoshihiro Miyamoto, Satoshi Yasuda","doi":"10.1016/j.diabres.2025.112915","DOIUrl":"https://doi.org/10.1016/j.diabres.2025.112915","url":null,"abstract":"<p><strong>Aim: </strong>Gut microbiota dysbiosis causes atherosclerosis. Patients with atherosclerosis and type 2 diabetes mellitus (T2D) often have low Bacteroides abundance, potentially increasing atherosclerosis risk. This study investigated the association between low Bacteroides abundance and endothelial dysfunction in patients with T2D.</p><p><strong>Methods: </strong>The relationship between the relative Bacteroides abundance in fecal gut microbiota, assessed by 16S ribosomal RNA analysis, and the reactive hyperemia index (RHI) was investigated in 93 patients with T2D (68 men and 25 women). Clinical parameters, including plasma short-chain fatty acids and inflammatory markers, were also examined. Heatmap analysis compared lower Bacteroides group vs. upper Bacteroides group.</p><p><strong>Results: </strong>Natural log-transformed RHI (Ln-RHI) was positively correlated with Ln-relative Bacteroides abundance (p < 0.05). The low Bacteroides group had a considerably lower Ln-RHI than the high group (p = 0.038). Plasma acetate content was correlated with relative Bacteroides abundance (p = 0.036) but not with Ln-RHI content. The low Bacteroides group tended to have higher high-sensitivity C-reactive protein levels than the high group (p = 0.069). No other bacterial differences between the groups were associated with the RHI.</p><p><strong>Conclusions: </strong>Low Bacteroides abundance is associated with low RHI and may be associated with the risk of atherosclerosis in patients with T2D.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112915"},"PeriodicalIF":7.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181842","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 continuous glucose monitoring on dietary behavior and physical activity: A systematic review and meta-analysis","authors":"Dan Zhang ,&nbsp;Jing Huang ,&nbsp;Yiyun Zhang ,&nbsp;Zixuan Wei ,&nbsp;Tianxue Long ,&nbsp;Xiaojing Guo ,&nbsp;Mingzi Li","doi":"10.1016/j.diabres.2025.112907","DOIUrl":"10.1016/j.diabres.2025.112907","url":null,"abstract":"<div><div>This systematic review and <em>meta</em>-analysis examined the impact of continuous glucose monitoring (CGM) on dietary behaviors and physical activity. A comprehensive search of six databases was conducted up to May 3, 2025, identifying 21 trials involving 1,488 adults with type 1 or type 2 diabetes, overweight, or obesity. Most studies used real-time CGM systems. Compared with control groups, CGM users showed a significantly lower proportion of energy intake from carbohydrates, although no significant differences were observed in total energy intake or in the proportions of energy from fat or protein. Pre-post analyses within intervention groups revealed significant reductions in total energy intake and changes in macronutrient composition. However, CGM use did not result in significant improvements in sedentary time or time spent in light or moderate physical activity. These findings suggest that CGM may facilitate healthier dietary behaviors through real-time, individualized feedback, though its effects on physical activity are limited. Further research is needed to evaluate the integration of CGM with AI-based interventions and to address the role of user health literacy in optimizing outcomes.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112907"},"PeriodicalIF":7.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155581","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":"In-depth analysis of metabolic hormones and inflammatory markers following Roux-en-Y gastric bypass in humans and rodents: similarities and differences","authors":"Simon Kloock ,&nbsp;Lukas Scheller ,&nbsp;Julia Hasinger ,&nbsp;Ilja Balonov ,&nbsp;Max Kurlbaum ,&nbsp;Martin Fassnacht ,&nbsp;Ann-Cathrin Koschker ,&nbsp;Florian Seyfried ,&nbsp;Ulrich Dischinger","doi":"10.1016/j.diabres.2025.112923","DOIUrl":"10.1016/j.diabres.2025.112923","url":null,"abstract":"<div><h3>Background</h3><div>Bariatric surgery causes changes in the levels of metabolically active hormones that control energy expenditure. This study aims to (1) validate a Roux-en-Y gastric bypass (RYGB) rat model in comparison to RYGB operated humans and (2) investigate the correlation of amino acids with GLP-1 and PYY levels in both species.</div></div><div><h3>Methods</h3><div>Fasting plasma samples were derived from the randomized controlled WAS trial (NCT01352403; RYGB = 20, Controls = 17) at baseline and after 12 months and from male Wistar rats with diet-induced obesity seven weeks after surgery (RYGB = 12, sham surgery = 12). 18 peptide hormones and 21 amino acids were measured using magnetic multiplex assays, ELISA and LC-MS/MS.</div></div><div><h3>Results</h3><div>Levels of GLP-1 and PYY3-36 were found to be significantly lower in humans after RYGB (both p &lt; 0.001), while in rats a trend towards an increase was observed. Fasting insulin was found to be lower in humans (p &lt; 0.001) and rats (p &lt; 0.01) after RYGB. Leptin was significantly lower in humans (p &lt; 0.001) and rats (p &lt; 0.05) after RYGB. The cytokines IL-6 and MCP-1 were significantly lower in humans (p &lt; 0.01, p &lt; 0.05), but unchanged in rats after RYGB. Interestingly, GLP-1 levels in humans before RYGB correlated positively with the weight change after 12 months (Pearson’s r = 0.733;<!--> <!-->p &lt; 0.05). Leucine showed a positive correlation with GLP-1 levels 12 months after RYGB in humans (Pearson’s r = 0.588;<!--> <!-->p &lt; 0.05), but not in rats.</div></div><div><h3>Conclusion</h3><div>Preoperative GLP-1 levels in humans correlate with weight loss after RYGB and could potentially be predictive. The investigated rat model shows largely comparable patterns of incretins and adipokines. Given its physiological similarity, this model is suitable for testing pharmacological agents that mimic anorexigenic hormones, potentially guiding novel treatments for severe obesity.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112923"},"PeriodicalIF":7.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174081","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":"Clinical outcomes of SGLT2 inhibitors among patients with MASLD and T2DM","authors":"Jheng-Yan Wu ,&nbsp;Hsuan-Yuan Chang ,&nbsp;Yu Tsung ,&nbsp;Yu-Min Lin","doi":"10.1016/j.diabres.2025.112918","DOIUrl":"10.1016/j.diabres.2025.112918","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) frequently coexists with type 2 diabetes mellitus (T2DM), increasing the risk of cardiovascular, renal, and hepatic complications. Pharmacologic options remain limited. This study aimed to evaluate the association between sodium-glucose cotransporter-2 inhibitors (SGLT2is) and one-year clinical outcomes in patients with MASLD and T2DM, compared to dipeptidyl peptidase-4 inhibitors (DPP4is).</div></div><div><h3>Approach and Results</h3><div>This retrospective cohort study used data from 147 healthcare organizations in the TriNetX global research network. Adults with MASLD and T2DM initiating SGLT2is or DPP4is between January 1, 2013, and February 28, 2025, were identified. After matching, 10,232 patients were included in each group. The primary outcome was a composite of all-cause mortality, major adverse cardiovascular events (MACE), kidney events (MAKE), and liver outcomes (MALO). SGLT2is were associated with lower risks of the composite outcome (HR, 0.65) and all individual components. Subgroup and sensitivity analyses yielded consistent results.</div></div><div><h3>Conclusions</h3><div>Among patients with MASLD and T2DM, SGLT2is were associated with lower risks of major clinical events compared to DPP4is, supporting their potential therapeutic role pending confirmation in randomized trials.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112918"},"PeriodicalIF":7.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155580","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}