Diabetes research and clinical practice最新文献_第3页

The impact of sex-related disparities on the association between triglyceride-glucose index and renal function decline in patients with type 2 diabetes: Insights from the ACCORD trial 性别差异对2型糖尿病患者甘油三酯-葡萄糖指数和肾功能下降之间关系的影响：ACCORD试验的见解

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-16 DOI: 10.1016/j.diabres.2025.112163

Xiaopu Wang , Keyang Zheng , Xinqun Hu , Junyu Pei

{"title":"The impact of sex-related disparities on the association between triglyceride-glucose index and renal function decline in patients with type 2 diabetes: Insights from the ACCORD trial","authors":"Xiaopu Wang , Keyang Zheng , Xinqun Hu , Junyu Pei","doi":"10.1016/j.diabres.2025.112163","DOIUrl":"10.1016/j.diabres.2025.112163","url":null,"abstract":"<div><h3>Background</h3><div>The triglyceride-glucose (TyG) index has emerged as a surrogate marker for insulin resistance and is associated with the incidence and progression of chronic kidney disease (CKD) in patients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>Data from the ACCORD trial were used. The Cox proportional hazards model was employed to calculate hazard ratios (HRs), while generalized additive mixed models were used to capture the non-linear eGFR slope in each group. The primary outcome was CKD.</div></div><div><h3>Results</h3><div>9360 participants were included in this study, divided into tertiles based on their TyG index, with 3 119, 3 121, and 3 120 individuals in T1 (low), T2 (medium), and T3 (high), respectively. After a median follow-up of 4 years, 1 229 cases of CKD (13.30 %) occurred. Among women rather than men, CKD risk increased across ascending TyG index groups (adjusted HR for T3, Model 3, 1.46 [95 % CI, 1.13–1.88]) (<em>p</em> for interaction = 0.03). Additionally, longitudinal analysis revealed a rapid eGFR decline in women in the T3 group (−4.79 mL/min/1.73 m<sup>2</sup>) than the T1 group (−3.07 mL/min/1.73 m<sup>2</sup>, <em>p</em> < 0.05), but not in men.</div></div><div><h3>Conclusions</h3><div>A higher TyG index was associated with elevated CKD risk and accelerated eGFR decline, particularly in women.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112163"},"PeriodicalIF":6.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864538","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}

引用次数: 0

Neurovascular decoupling of frontoparietal cortex-putamen-cerebellum network in type 2 diabetes patient: Potential biomarker for abnormal eating patterns 2型糖尿病患者额顶皮层-壳核-小脑网络的神经血管解耦：异常饮食模式的潜在生物标志物

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-13 DOI: 10.1016/j.diabres.2025.112175

Ying Yu , Bo Hu , Xin-Wen Yu , Yan-Yan Cui , Xin-Yu Cao , Min-Hua Ni , Si-Ning Li , Pan Dai , Qian Sun , Xiao-Yan Bai , Yao Tong , Xiao-Rui Jing , Ai-Li Yang , Sheng-Ru Liang , Li-Juan Du , Shuo Guo , Lin-Feng Yan , Bin Gao , Guang-Bin Cui

{"title":"Neurovascular decoupling of frontoparietal cortex-putamen-cerebellum network in type 2 diabetes patient: Potential biomarker for abnormal eating patterns","authors":"Ying Yu , Bo Hu , Xin-Wen Yu , Yan-Yan Cui , Xin-Yu Cao , Min-Hua Ni , Si-Ning Li , Pan Dai , Qian Sun , Xiao-Yan Bai , Yao Tong , Xiao-Rui Jing , Ai-Li Yang , Sheng-Ru Liang , Li-Juan Du , Shuo Guo , Lin-Feng Yan , Bin Gao , Guang-Bin Cui","doi":"10.1016/j.diabres.2025.112175","DOIUrl":"10.1016/j.diabres.2025.112175","url":null,"abstract":"<div><h3>Aim</h3><div>High rates of dropout and binge eating triggered by restrictive diet limit the effectiveness of dietary interventions in type 2 diabetes mellitus (T2DM). However, it remains unclear what the potential central underpinnings of T2DM-specific dietary behavior characteristics are.</div></div><div><h3>Methods</h3><div>41 T2DM patients and 43 matched healthy controls (HC) who underwent resting state functional MRI were enrolled to screen for the suspicious network by effective connectivity (EC) analysis and to explore its dynamic temporal and neurovascular coupling properties. Additionally, the timeline of neuropathological changes during T2DM progression was evaluated.</div></div><div><h3>Results</h3><div>Increased uncontrolled eating, internal and external loci of hunger were found in T2DM. EC of the frontoparietal cortex–putamen–cerebellum network was significantly higher in T2DM patients (<em>P</em> = 0.023). The fractional windows (<em>P</em> = 0.009) and mean dwell time (<em>P</em> = 0.009) of the densest state were significantly higher in T2DM patients. Neurovascular decoupling of the frontoparietal cortex-putamen-cerebellum network was correlated with these T2DM-specific eating behavior characteristics. Neurovascular decoupling coefficient of right putamen (Putamen_R) changed at the very beginning of T2DM.</div></div><div><h3>Conclusion</h3><div>The frontoparietal cortex–putamen–cerebellum network was the suspicious T2DM-related abnormal eating pattern network. Neurovascular decoupling of the network, especially that of Putamen_R, occurred early and might serve as a biomarker for abnormal eating patterns in T2DM patients.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112175"},"PeriodicalIF":6.1,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838336","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}

引用次数: 0

Sodium-Glucose Cotransporter2 inhibitors and associated Liver-Related outcomes in diabetes patients 葡萄糖钠转运体 2 抑制剂与糖尿病患者的相关肝脏结果

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-12 DOI: 10.1016/j.diabres.2025.112174

Fu-Shun Yen , James Cheng-Chung Wei , Chen Wang , Ming-Chih Hou , Teng-Shun Yu , Yuhan Huang , Chii-Min Hwu , Chih-Cheng Hsu

{"title":"Sodium-Glucose Cotransporter2 inhibitors and associated Liver-Related outcomes in diabetes patients","authors":"Fu-Shun Yen , James Cheng-Chung Wei , Chen Wang , Ming-Chih Hou , Teng-Shun Yu , Yuhan Huang , Chii-Min Hwu , Chih-Cheng Hsu","doi":"10.1016/j.diabres.2025.112174","DOIUrl":"10.1016/j.diabres.2025.112174","url":null,"abstract":"<div><h3>Aims</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with poorer liver-related outcomes in type 2 diabetes (T2D) patients. We compared risk of liver-related outcomes and all-cause mortality between sodium-glucose cotransporter-2 inhibitor (SGLT-2i) users and nonusers in T2D patients.</div></div><div><h3>Methods</h3><div>We identified 282,161 T2D patients from the Taiwan National Health Insurance Research Database (2009–2020), excluding those with viral hepatitis or alcohol-related disorders. Propensity score matching created patient pairs on SGLT-2i and other antidiabetic drugs, and Cox proportional hazard models assessed outcomes.</div></div><div><h3>Results</h3><div>Over a mean follow-up of 2.7 years, SGLT-2i use was associated with significantly lower risk of liver cirrhosis (adjusted hazard ratio [aHR] 0.78, 95 % CI: 0.70–0.87), decompensated cirrhosis (aHR 0.79, 95 % CI: 0.70–0.89), liver failure (aHR 0.78, 95 % CI: 0.68–0.89), and all-cause mortality (aHR 0.52, 95 % CI: 0.51–0.54). Compared to dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1 RA), pioglitazone, and sulfonylureas, SGLT-2i use was associated with lower risk of cirrhosis, liver failure, and all-cause mortality. SGLT-2i use was associated with lower liver-related mortality than DPP-4i or GLP-1 RA use.</div></div><div><h3>Conclusions</h3><div>This cohort study suggests that SGLT-2i may reduce the risk of liver cirrhosis, decompensated cirrhosis, liver failure, and liver-related and all-cause mortality in T2D patients.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"223 ","pages":"Article 112174"},"PeriodicalIF":6.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826087","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}

引用次数: 0

Corneal confocal microscopy identifies early and definite diabetic cardiac autonomic neuropathy 角膜共聚焦显微镜识别早期和明确的糖尿病心脏自主神经病变

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-11 DOI: 10.1016/j.diabres.2025.112172

Shazli Azmi , Maryam Ferdousi , Alise Kalteniece , Ioannis N Petropoulos , Uazman Alam , Georgios Ponirakis , Omar Asghar , Andrew Marshall , Andrew JM Boulton , Nathan Efron , Rayaz A Malik

{"title":"Corneal confocal microscopy identifies early and definite diabetic cardiac autonomic neuropathy","authors":"Shazli Azmi , Maryam Ferdousi , Alise Kalteniece , Ioannis N Petropoulos , Uazman Alam , Georgios Ponirakis , Omar Asghar , Andrew Marshall , Andrew JM Boulton , Nathan Efron , Rayaz A Malik","doi":"10.1016/j.diabres.2025.112172","DOIUrl":"10.1016/j.diabres.2025.112172","url":null,"abstract":"<div><h3>Objective</h3><div>Advanced cardiac autonomic neuropathy (CAN) is associated with increased mortality in people with diabetes. Early identification and reduction of risk factors can limit the progression of CAN. However, the diagnosis of early CAN relies on cardiac autonomic reflex testing (CART’s) which is not widely available. We have compared the diagnostic utility of corneal confocal microscopy (CCM) to CART’s in diagnosing CAN.</div></div><div><h3>Research design and methods</h3><div>Two-hundred and thirty eight individuals with type 1 and type 2 diabetes and thirty seven healthy controls were assessed using CARTs and CCM.</div></div><div><h3>Results</h3><div>There was a progressive and significant reduction in DB-HRV, E:I ratio, 30:15 ratio, corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fibre length (CNFL) with increasing severity of CAN. The receiver operating characteristic (ROC) area under the curve (AUC) and sensitivity/specificity of CCM were comparable to those of CARTs for identifying early and definite CAN.</div></div><div><h3>Conclusion</h3><div>CCM is a rapid, non-invasive ophthalmic test which could be used to detect early and established CAN.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112172"},"PeriodicalIF":6.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834743","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}

引用次数: 0

Persistence with once-weekly glucagon-like peptide 1 receptor agonist therapy decreases the risk of major adverse cardiovascular events: A retrospective analysis of patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease 坚持每周一次胰高血糖素样肽1受体激动剂治疗可降低主要不良心血管事件的风险：对2型糖尿病和动脉粥样硬化性心血管疾病患者的回顾性分析

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-10 DOI: 10.1016/j.diabres.2025.112162

Tyler J. Dunn , Yong Zhu , Noelle N. Gronroos , Lin Xie , Andrew Sargent , Cory Gamble , Liana K. Billings

{"title":"Persistence with once-weekly glucagon-like peptide 1 receptor agonist therapy decreases the risk of major adverse cardiovascular events: A retrospective analysis of patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease","authors":"Tyler J. Dunn , Yong Zhu , Noelle N. Gronroos , Lin Xie , Andrew Sargent , Cory Gamble , Liana K. Billings","doi":"10.1016/j.diabres.2025.112162","DOIUrl":"10.1016/j.diabres.2025.112162","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the association between remaining persistent with once-weekly glucagon-like peptide-1 receptor agonists (OW GLP-1 RAs) and the risk of major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD).</div></div><div><h3>Methods</h3><div>We used the Optum Research Database to identify patients who initiated OW GLP-1 RAs between 1/1/2018–11/30/2022. Patients were classified as persistent or non-persistent depending on whether there was a ≥ 60-day gap in medication supply after they continuously used the medication for the first three months. Adjusted time-varying Cox proportional hazards models assessed the associations between persistence status and risks of 2-point MACE, stroke, and myocardial infarction (MI).</div></div><div><h3>Results</h3><div>Persistent (n = 18,849) and non-persistent (n = 10,667) patients were followed for an average of 418 and 741 days, respectively. Mean (SD) persistence was 418 (339), and 288 (234) days for persistent and non-persistent patients, respectively. Remaining persistent was associated with significantly lower risks of 2-point MACE, stroke, and MI (all <em>p</em> < 0.001). The corresponding HRs (95 %CI) were 0.696 (0.626–0.774), 0.668 (0.573–0.777), and 0.710 (0.621–0.813).</div></div><div><h3>Conclusions</h3><div>Persistence with OW GLP-1 RA therapy was associated with significantly lower MACE risk among patients with T2DM and ASCVD in a real-world setting.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"223 ","pages":"Article 112162"},"PeriodicalIF":6.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828733","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}

引用次数: 0

The automated correction index (ACI), a novel report-derived metric correlated to glucose control and variability in patients with type 1 diabetes on advanced hybrid closed loop therapy 自动校正指数（ACI）是一种新的报告衍生指标，与1型糖尿病患者接受晚期混合闭环治疗的血糖控制和变异性相关

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-10 DOI: 10.1016/j.diabres.2025.112173

Andrea Tumminia , Gaetano Maria Santoro , Vittorio Oteri , Francesco Galeano , Roberto Baratta , Damiano Gullo , Lucia Frittitta , Laura Sciacca , Rosario Le Moli , Tommaso Piticchio , Antonino Di Pino , Giulia Pezzino , Francesco Frasca , Letizia Grazia Tomaselli

{"title":"The automated correction index (ACI), a novel report-derived metric correlated to glucose control and variability in patients with type 1 diabetes on advanced hybrid closed loop therapy","authors":"Andrea Tumminia , Gaetano Maria Santoro , Vittorio Oteri , Francesco Galeano , Roberto Baratta , Damiano Gullo , Lucia Frittitta , Laura Sciacca , Rosario Le Moli , Tommaso Piticchio , Antonino Di Pino , Giulia Pezzino , Francesco Frasca , Letizia Grazia Tomaselli","doi":"10.1016/j.diabres.2025.112173","DOIUrl":"10.1016/j.diabres.2025.112173","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to correlate the parameters of advanced hybrid closed loop (AHCL) function to the glycometabolic outcomes in a cohort of patients with type 1 diabetes (T1D) using different AHCL systems.</div><div><em>Research design and methods:</em> This was a retrospective cross-sectional study on 124 adult (n = 87) and pediatric (n = 37) patients correlating the total daily insulin dose (TDD), the total daily basal (TDBa) and bolus (TDBo) insulin doses, the percentage of auto-bolus out of total daily bolus (Automated Correction Index − ACI) to the glycated hemoglobin (HbA1c) and the sensor-derived metrics.</div></div><div><h3>Results</h3><div>The ACI was the only AHCL-derived parameter directly associated to HbA1c (p = 0.03) and time above range (TAR<sub>180-250 mg/dL, 10-13.9 mmol/L</sub>, p < 0.01), and inversely correlated to time in range (TIR<sub>70-180 mg/dL, 3.9-10 mmol/L</sub>, p < 0.01). Patients with ACI < 30 % showed reduced HbA1c levels (6.21 % ± 0.5 vs. 6.95 % ± 0.8, p = 0.02) and a higher probability of having TIR > 70 % (OR 3.18, CI 1.19–8.46, p = 0.02) and coefficient of variation (CV) < 36 % (OR 2.86, CI 1.07–8.27, p = 0.03) compared to those with ACI ≥ 30 %.</div></div><div><h3>Conclusion</h3><div>The ACI could represent a useful and easy-to-assess metric for AHCL-treated individuals with T1D. In our cohort an ACI < 30 % was associated to better glucose control and variability.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112173"},"PeriodicalIF":6.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834742","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}

引用次数: 0

Risk factors for peripheral arterial disease in type 2 diabetes mellitus patients: A systematic review and meta-analysis 2型糖尿病患者外周动脉疾病的危险因素：系统回顾和荟萃分析

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-10 DOI: 10.1016/j.diabres.2025.112170

Martha Rosana , Em Yunir , Ninik Saragih , Lusiani Rusdi , Dyah Purnamasari , Tri Juli Edi Tarigan , Dicky Levenus Tahapary , Pradana Soewondo

{"title":"Risk factors for peripheral arterial disease in type 2 diabetes mellitus patients: A systematic review and meta-analysis","authors":"Martha Rosana , Em Yunir , Ninik Saragih , Lusiani Rusdi , Dyah Purnamasari , Tri Juli Edi Tarigan , Dicky Levenus Tahapary , Pradana Soewondo","doi":"10.1016/j.diabres.2025.112170","DOIUrl":"10.1016/j.diabres.2025.112170","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral arterial disease (PAD) is a complication of type 2 diabetes mellitus (T2DM). No systematic review and meta-analysis has been conducted regarding the risk factors of PAD in T2DM populations.</div></div><div><h3>Aim</h3><div>To analyze the pooled effect estimates of risk factors of PAD in T2DM populations.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in PubMed/MEDLINE, ProQuest, and EMBASE databases. The Newcastle-Ottawa Scale was used to assess the risk of bias. Meta-analysis was performed using RevMan version 5.4.</div></div><div><h3>Results</h3><div>Ten studies were included in this review (73,834 samples in total). All the studies had a low risk of bias<em>.</em> Significant association with PAD in T2DM was found in the group of age ≥ 70 years old (OR 3.44; 95 % CI 2.11, 5.62), diabetes duration ≥ 5 years (OR 1.81; 95 % CI 1.24, 2.64), coronary artery disease (CAD) history (OR 1.55; 95 % CI 1.30, 1.83), hypertension (OR 1.43; 95 % CI 1.10, 1.86), and increased LDL (OR 2.51; 95 % CI 1.38, 4.56).</div></div><div><h3>Conclusion</h3><div>Age ≥ 70 years old, diabetes duration ≥ 5 years, CAD history, hypertension, and increased LDL are significant risk factors for PAD in the T2DM population.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112170"},"PeriodicalIF":6.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842754","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}

引用次数: 0

Over 250 million people worldwide unaware they have diabetes, according to new research from the International Diabetes Federation (IDF) 根据国际糖尿病联合会（IDF）的最新研究，全球有超过2.5亿人不知道自己患有糖尿病。

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-10 DOI: 10.1016/j.diabres.2025.112176

引用次数: 0

Bridging household ties and diabetes outcomes: A Turkish perspective 弥合家庭关系与糖尿病结局：土耳其视角

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-09 DOI: 10.1016/j.diabres.2025.112169

Mohammad Aziz Abed Miakhail

引用次数: 0

Impact of diabetes on long-term mortality following major lower limb amputation: A population-based cohort study in Wales 糖尿病对主要下肢截肢后长期死亡率的影响：威尔士一项基于人群的队列研究

IF 6.1 3区医学

Diabetes research and clinical practice Pub Date : 2025-04-09 DOI: 10.1016/j.diabres.2025.112156

Jennifer Hayes , James M Rafferty , Wai-Yee Cheung , Ashley Akbari , Rebecca L Thomas , Steve Bain , Claire Topliss , Jeffery W Stephens

{"title":"Impact of diabetes on long-term mortality following major lower limb amputation: A population-based cohort study in Wales","authors":"Jennifer Hayes , James M Rafferty , Wai-Yee Cheung , Ashley Akbari , Rebecca L Thomas , Steve Bain , Claire Topliss , Jeffery W Stephens","doi":"10.1016/j.diabres.2025.112156","DOIUrl":"10.1016/j.diabres.2025.112156","url":null,"abstract":"<div><h3>Background</h3><div>Major lower limb amputation is associated with high morbidity and mortality, particularly among patients with diabetes. Previous studies suggest variable mortality rates, but none have investigated the impact of diabetes in Wales.</div></div><div><h3>Methods</h3><div>A population-based cohort study was conducted using anonymised data from the Secure Anonymised Information Linkage Databank. Survival from all incident major amputations in persons ≥ 18 years from 2006 to 2013 in Wales was assessed over 5-year follow-up. Kaplan-Meier survival curves and Cox regression models, stratified by amputation level, were used to examine the time-dependent effect of diabetes on mortality while adjusting for confounding factors.</div></div><div><h3>Results</h3><div>2542 individuals underwent major amputation, 48.4 % had diabetes. Mortality at 30 days was 9.2 % and 61.9 % within 5 years. Patients with diabetes had higher 5-year mortality (67.0 %) compared to those without diabetes (57.1 %). Diabetes was associated with an increased risk of long-term mortality (hazard ratio 1.62, p < 0.001), but a reduced risk of death in the first 30 days post-amputation. A history of peripheral vascular disease and above-knee amputation were strong predictors of mortality.</div></div><div><h3>Conclusion</h3><div>Time-stratified analysis demonstrates lower short-term but higher long-term mortality risk for persons with diabetes following major amputation. Further research is required to explore interventions aimed at improving survival.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"223 ","pages":"Article 112156"},"PeriodicalIF":6.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816618","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}

引用次数: 0