Diabetes research and clinical practice最新文献

{"title":"Combination therapy for kidney protection in type 1 diabetes mellitus: quo vadis?","authors":"Djordje S. Popovic , Dimitrios Patoulias , Theocharis Koufakis","doi":"10.1016/j.diabres.2026.113167","DOIUrl":"10.1016/j.diabres.2026.113167","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113167"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225724","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":"Comparison and assessment of anthropometric index with risk of type 2 diabetes mellitus: two prospective cohort studies in China","authors":"Xiao-Hui Zhou ,&nbsp;Zhuo-Ying Li ,&nbsp;Dan-Ni Yang ,&nbsp;Qiu-Ming Shen ,&nbsp;Yu-Xin Zhou ,&nbsp;Yu-Ting Tan ,&nbsp;Hong-Lan Li ,&nbsp;Yong-Bing Xiang","doi":"10.1016/j.diabres.2026.113121","DOIUrl":"10.1016/j.diabres.2026.113121","url":null,"abstract":"<div><h3>Aim</h3><div>Obesity is a well-established risk factor for type 2 diabetes mellitus (T2DM), with specific anthropometric indices offering even greater predictive value. This study aimed to systematically examine the associations between 17 anthropometric indices and T2DM risk, as well as the predictive value of these indices for T2DM.</div></div><div><h3>Methods</h3><div>Data from the Shanghai Men’s and Women’s Health Studies were used. Cox regression models estimated hazard ratios (HRs). Receiver operating characteristic (ROC) curves assessed the predictive performance, with subgroup and sensitivity analyses conducted to evaluate robustness.</div></div><div><h3>Results</h3><div>The study included 71 356 women and 56 288 men, with a mean follow-up of 17.42 and 12.35 years, respectively. Relative fat mass (RFM) had the highest HR in women (HR _{per SD} = 2.42, 95% CI: 2.34–2.49) and men (HR _{per SD} = 2.22, 95% CI: 2.13–2.31). Abdominal adiposity indices (e.g., WC, waist-to-height ratio [WHtR], body roundness index [BRI]) outperformed general adiposity indices (e.g., BMI) in predicting T2DM risk.</div></div><div><h3>Conclusions</h3><div>Abdominal adiposity indices have significant value in predicting T2DM risk, with notable sex-specific differences. Among these, RFM were better predictors in both women and men. These findings suggest that abdominal obesity indices could be used to inform prevention strategies.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113121"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084794","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":"Corrigendum to “Predicting postpartum glucose intolerance in women with gestational diabetes mellitus in primary care: A machine learning approach using XGBoost and SHAP values” [Diabetes Res. Clin. Pract. 232 (2026) 113098]","authors":"Nur Aiza Idris ,&nbsp;Nurul Azreen Yusof ,&nbsp;Muhd Zulfadli Hafiz Ismail ,&nbsp;Siti Norazlina Juhari ,&nbsp;Nurulhuda Mat Hassan ,&nbsp;Norwati Daud ,&nbsp;Nurul Izza Yunus ,&nbsp;Mohd Faeiz Pauzi","doi":"10.1016/j.diabres.2026.113154","DOIUrl":"10.1016/j.diabres.2026.113154","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113154"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206274","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":"An expert narrative review on the brain-kidney axis in diabetic kidney disease: Mechanisms and therapeutic insights","authors":"Zongrui Zhang ,&nbsp;Rangzi Yi ,&nbsp;Shihong Xiong ,&nbsp;Yushu Zhang ,&nbsp;Xuebin Cao ,&nbsp;Wenqi Zhen ,&nbsp;Yang Yang ,&nbsp;Na Gong","doi":"10.1016/j.diabres.2025.113055","DOIUrl":"10.1016/j.diabres.2025.113055","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease. Conventional research focuses on renal-intrinsic pathophysiology, yet emerging evidence reveals bidirectional neuroimmune communication along the brain-kidney axis critically modulates DKD progression. Emerging evidence reveals that bidirectional neuroimmune communication along the brain-kidney axis critically modulates DKD progression through inflammatory, cholinergic, and metabolic pathways⁵, yet the clinical translational potential remains incompletely defined.</div></div><div><h3>Objective</h3><div>To comprehensively evaluate the neuroimmune regulatory mechanisms of the brain-kidney axis in DKD, identify key therapeutic targets (TNF-α/NF-κB pathway, α7nAChR, SGLT inhibitors, GLP-1 receptor agonists), and assess their efficacy and central nervous system safety profiles.</div></div><div><h3>Methods</h3><div>We performed a comprehensive literature search of PubMed, Cochrane Library, Web of Science, and Embase from inception to November 2025, supplemented by hand-searching reference lists. Studies investigating neuroimmune mechanisms, therapeutic interventions, or multimodal imaging biomarkers related to the brain-kidney axis in DKD were critically appraised and narratively synthesized using a thematic analysis approach. Evidence quality was evaluated using GRADE criteria.</div></div><div><h3>Results</h3><div>We identified three core pathways: TNF-α/NF-κB-mediated neuroinflammation amplification (primarily preclinical evidence), α7nAChR-driven cholinergic anti-inflammatory responses (very low-quality evidence), and SGLT-dependent metabolic modulation. High-quality randomized controlled trials demonstrate that SGLT2 inhibitors reduce hard renal endpoints by 30–40%, while GLP-1 receptor agonists improve renal outcomes but raise concerns regarding autonomic dysfunction and neuropathy. Multimodal imaging reveals correlative brain-kidney functional connectivity alterations, supporting axis involvement in DKD pathogenesis; however, the proposed ’brain-kidney connectivity score’ remains an exploratory concept that requires validation through standardized multimodal registration and algorithm development.</div></div><div><h3>Conclusion</h3><div>The brain-kidney axis provides a novel framework for DKD pathophysiology. While high-quality evidence supports SGLT2 inhibitors and GLP-1 receptor agonists for renoprotection, central nervous system safety monitoring remains critical. Future research must validate dynamic multimodal imaging tools and develop personalized combination therapeutic strategies to optimize clinical translation.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113055"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767409","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":"Reproductive factors, insulin resistance surrogate indices, and circadian syndrome among middle-aged and elderly women a mediation analysis using two-national cohorts","authors":"Linli Liu ,&nbsp;Jun Lin ,&nbsp;LinHong Li ,&nbsp;Sanshan Wu ,&nbsp;Zhang Shen ,&nbsp;JinHua Chen ,&nbsp;Y. Peng ,&nbsp;Minlan Lin ,&nbsp;Xiafei Ye ,&nbsp;Danru Chen ,&nbsp;Quping Tan","doi":"10.1016/j.diabres.2026.113141","DOIUrl":"10.1016/j.diabres.2026.113141","url":null,"abstract":"<div><h3>Aims</h3><div>We investigated the mediation effects of seven insulin resistance(IR) indices: triglyceride glucose (TyG), triglyceride glucose-waist to height ratio (TyG-WHtR), triglyceride glucose-waist circumference (TyG-WC), estimated glucose disposal rate (eGDR), metabolic score for IR, lipid accumulation product (LAP), and Chinese visceral adiposity index (CVAI) on the associations between reproductive factors and circadian syndrome (CircS) in middle-aged and elderly women.</div></div><div><h3>Methods</h3><div>This study was conducted using the China Health and Retirement Longitudinal Study (CHARLS) as training set and the English Longitudinal Study on Aging (ELSA) as validation set, with baseline non-CircS individuals. Regression models established causal relationships between reproductive factors and incident CircS. Mediation analysis quantified IR mediation effects. Receiver operating characteristic curves evaluated IR indices’ predictive capacity.</div></div><div><h3>Results</h3><div>The incidence of new-onset CircS was 465 (15.94%) in CHARLS and 291 (11.89%) in ELSA, respectively. The CircS incidence was higher in earlier age at menarche or menopause. Mediation analyses revealed that TyG, TyG-WHtR, TyG-WC, LAP, CVAI, and eGDR mediated the menarche-CircS association, with TyG-WHtR accounting for 14.3% of the mediating effect. The TyG-WHtR cutoff value for predicting CircS was identified 4.507 for early menarche.</div></div><div><h3>Conclusion</h3><div>Significant inverse relationships were observed between early age at menarche/menopause and increased CircS risk, with IR largely mediating these associations.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113141"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140787","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 prior COVID-19 infection with gestational diabetes mellitus","authors":"J. Sajnani ,&nbsp;M. Siavoshi ,&nbsp;L. Kwan ,&nbsp;C.S. Han","doi":"10.1016/j.diabres.2026.113144","DOIUrl":"10.1016/j.diabres.2026.113144","url":null,"abstract":"<div><h3>Background</h3><div>There is an increase incidence of diabetes and anti-hyperglycemic use after COVID-19 infection in non-pregnant adult populations. COVID-19 has also been shown to be associated with adverse pregnancy outcomes such as pre-eclampsia and preterm birth.</div></div><div><h3>Objective</h3><div>To evaluate if COVID-19 infection during preconception or in early pregnancy is associated with increased risk of gestational diabetes mellitus (GDM) diagnosis.</div></div><div><h3>Study design</h3><div>We performed a retrospective matched cohort study of patients delivering at two university affiliated hospitals from 6/1/2021 to 12/31/2021, prior to widespread vaccinations or home antigen testing for SARS-CoV-2. We included pregnant individuals aged 18 to 45 who were ≥ 24 weeks gestational age at time of delivery. We excluded those with a history of pre-gestational diabetes, multiple gestation, or prior diagnosis of cystic fibrosis or pancreatic insufficiency. Subjects with confirmed COVID-19 infection during preconception or the first 20 weeks of pregnancy were identified as cases and were matched 1:1 by age and BMI with eligible controls. GDM diagnosis was based on a two-step approach using Carpenter-Coustan criteria. Kruskal-Wallis and Chi-Square tests were performed as appropriate.</div></div><div><h3>Results</h3><div>During the study period, 183 cases with prior positive COVID-19 antigen test and 1066 potential controls were identified. One case could not be matched due to an outlier BMI; therefore 182 matched patients were included in each group. The cases were less likely to have public insurance and more likely to have reported thyroid disorder, sleep apnea, or asthma. No differences were seen in GDM incidence between the cases and controls (OR 0.75, 95% CI 0.38–1.46) or based on timing of COVID-19 infection (p = 0.097). No differences were noted in delivery method, obstetrical lacerations, or Apgar scores.</div></div><div><h3>Conclusions</h3><div>COVID-19 infection in the preconception or early pregnancy period was not associated with increased incidence of GDM.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113144"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141446","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":"Solute carrier inhibitors in kidney disease therapy: mechanisms and clinical implications","authors":"Nan Li ,&nbsp;Hongmei Yu ,&nbsp;Harvest F. Gu","doi":"10.1016/j.diabres.2025.113071","DOIUrl":"10.1016/j.diabres.2025.113071","url":null,"abstract":"<div><div>Recent single-cell sequencing analyses confirm that solute carriers (SLCs) are highly expressed in renal tubular epithelial cells, where they are critical for maintaining systemic metabolic homeostasis through solute reabsorption, secretion, and detoxification. SLC dysfunction underpins renal disorders, including chronic kidney disease, diabetic kidney disease, and acute kidney injury. Recent advances in SLC biology have enabled the development of selective inhibitors, offering precise pathway modulation with minimal off-target effects. Clinically, SLC inhibitors have demonstrated efficacy in nephrology, with five SLCs emerging as validated therapeutic targets: SLC5A2 (Na⁺-glucose co-transporter 2), SLC7A11 (xCT cystine/glutamate antiporter), SLC12A3 (Na⁺-Cl⁻ co-transporter), SLC22A12 (urate transporter 1), and SLC47A1 (multidrug and toxin extrusion protein 1). This article systematically reviews the pharmacological mechanisms of SLC inhibitors targeting these five transporters, analyzing their physiological and pathological roles in kidney diseases, and further discusses clinical applications and future prospects of SLC-targeted therapies in nephrology.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113071"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827130","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":"Multidimensional feature-based assessment of microcirculatory hemodynamic dysfunction in patients with Wagner Grade 0 diabetic foot","authors":"Yanan Zhao ,&nbsp;Jing Zhang ,&nbsp;Yangxi Li ,&nbsp;Ziwei Hu ,&nbsp;Qi Qi ,&nbsp;Shengmei Zhao ,&nbsp;Lingyu Zhang ,&nbsp;Liwei Jing","doi":"10.1016/j.diabres.2026.113138","DOIUrl":"10.1016/j.diabres.2026.113138","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study characterizes the hemodynamic abnormalities of the microcirculation in the feet of patients with diabetic foot (DF) based on multidimensional features, including time-domain and frequency-domain metrics, rhythmicity, and symmetry. It further elucidates the relationship between these abnormalities and plantar pressure hotspots, specifically the forefoot first metatarsal head (MT1) and fifth metatarsal head (MT5), and constructs a cross-sectional discriminative model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A total of 286 consecutive participants were included in the study (non-DF: 157, DF: 129). Microcirculation signals from MT1 and MT5 were collected, with features extracted across various domains: time (mean, standard deviation, range, kurtosis), frequency domain (relative power endothelial, neurogenic, myogenic, respiratory, and cardiac bands), rhythmicity (number of peaks, peak intervals, and their dispersion), and symmetry (absolute value of the mean difference between left and right, left–right correlation coefficient). Inter-group comparisons were conducted using the Mann–Whitney &lt;em&gt;U&lt;/em&gt; test, and effect sizes were calculated with the Hodges–Lehmann median difference (Δ) and Cliff’s δ. Correlations were assessed using Spearman’s method with Benjamini-Hochberg false discovery rate (BH-FDR) correction. Variables selected by LASSO were entered into a multivariable logistic regression model. Model performance was evaluated using the area under the receiver operating characteristic curve (ROC-AUC), and the optimal classification threshold was determined using the Youden index.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Mean perfusion at MT1 and MT5 was significantly lower in the DF group (both &lt;em&gt;p&lt;/em&gt; &lt; 0.001), representing the largest between-group differences among the assessed features. Variability metrics differed by measurement site. Notably, the relative power in the neurogenic and myogenic bands at MT1 was significantly decreased, suggesting a weakening of low-frequency autonomic regulation. Furthermore, MT1 exhibited fewer peaks, prolonged inter-peak intervals, and increased dispersion, indicating slower and less stable rhythmicity. Left-right correlation coefficients at bothsites were decreased (&lt;em&gt;p&lt;/em&gt; &lt; 0.001), whereas the absolute left–right mean differences did not increase, suggesting reduced synchrony rather than increased amplitude asymmetry. Spearman correlation and multifactor models consistently aligned in direction. Regarding the discriminative models, the area under the curve (AUC) for the MT1 model was 0.845, for the MT5 model was 0.822, and for the combined model (MT1 + MT5) was 0.906, which outperformed the single-site models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Patients with DF demonstrate a composite pattern of microcirculatory dysfunction characterized by insufficient perfusion, attenuated autonomic regulation, altered rhythmicity, and impaired bilateral coordination. Mu","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113138"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118211","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 maternal folic acid during pregnancy exacerbates ectopic fat accumulation in the liver and muscle of male offspring","authors":"Tomoyo Kawakubo-Yasukochi ,&nbsp;Yoshikazu Hayashi ,&nbsp;Karen Tan ,&nbsp;Koji Kinoshita ,&nbsp;Keita Maki ,&nbsp;Navin Michael ,&nbsp;Suresh Anand Sadananthan ,&nbsp;Fabian Yap ,&nbsp;Jun Shi Lai ,&nbsp;Shohei Yoshimoto ,&nbsp;Ayaka Saeki ,&nbsp;Ayano Ogura ,&nbsp;Kento Minami ,&nbsp;Mya Thway Tint ,&nbsp;Ena Yano ,&nbsp;Soi Kimura ,&nbsp;Atsushi Yasukochi ,&nbsp;Yi-Chen Lo ,&nbsp;Ichiro Takahashi ,&nbsp;Sendhil S. Velan ,&nbsp;Masato Hirata","doi":"10.1016/j.diabres.2026.113161","DOIUrl":"10.1016/j.diabres.2026.113161","url":null,"abstract":"<div><h3>Background</h3><div>Folic acid (FA), an essential nutrient for one-carbon metabolism, has been implicated in metabolic disease development. Although FA supplementation during pregnancy prevents neural tube defects, its broader metabolic effects remain unclear.</div></div><div><h3>Methods</h3><div>Eight-week-old C57BL/6 female mice were mated and fed an FA-deficient or control diet during gestation. Male offspring were weaned onto either a normal or Western-type diet, and monitored until 3 months of age. In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort, associations between maternal plasma FA levels during pregnancy and ectopic fat accumulation in offspring at age 6 years were examined.</div></div><div><h3>Results</h3><div>Maternal FA deficiency promoted ectopic fat accumulation in the liver and skeletal muscle of male offspring and increased obesity susceptibility. These effects were associated with disrupted one-carbon metabolism and impaired fatty acid β-oxidation, potentially due to reduced expression of Adenosylmethionine Decarboxylase 1 (Amd1) in male offspring. Consistently, in the GUSTO cohort, maternal plasma FA concentrations were inversely associated with hepatic and muscular fat accumulation in children.</div></div><div><h3>Conclusion</h3><div>Maternal FA status plays a critical role in regulating male offspring metabolic health. Maintaining adequate maternal plasma FA levels, rather than focusing solely on dietary intake, may be essential for preventing ectopic fat accumulation in the next generation.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113161"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206281","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":"Comparative risk of infections with GLP-1 receptor agonists versus SGLT2 inhibitors in patients with advanced chronic kidney disease and type 2 diabetes","authors":"Ching Chung Hsiao ,&nbsp;Jia-Jin Chen ,&nbsp;Shu-Chun Huang ,&nbsp;Chieh-Li Yen ,&nbsp;Wen-Yu Ho ,&nbsp;Yu-Wei Fang ,&nbsp;Mon-Ting Chen ,&nbsp;Jeng How Yang ,&nbsp;Ming-Hsien Tsai","doi":"10.1016/j.diabres.2026.113115","DOIUrl":"10.1016/j.diabres.2026.113115","url":null,"abstract":"<div><h3>Aims</h3><div>To compare the risk of infections between GLP-1 receptor agonists (GLP-1 RAs) and SGLT2 inhibitors (SGLT2i) in patients with type 2 diabetes mellitus (T2DM) and advanced chronic kidney disease (CKD).</div></div><div><h3>Methods</h3><div>Using the TriNetX U.S. Collaborative Network, we conducted a retrospective cohort study of adults with T2DM and eGFR ≤ 45 mL/min/1.73 m² from 2016 to 2023. After 1:1 propensity score matching, 22,393 new users of GLP-1 RAs and SGLT2i were compared. Infection outcomes were analyzed over a 4-year follow-up using Cox models and Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>GLP-1 RA use was associated with a modest increase in overall infection risk compared to SGLT2i (HR 1.04, 95% CI: 1.00–1.07; P = 0.044). Notably, higher risks were observed for biliary tract infections (HR 1.37), catheter-related infections (HR 1.34), and infective endocarditis (HR 1.31). No differences were seen in pneumonia, sepsis, or urinary tract infections. Subgroup analyses showed consistent trends across age, sex, BMI, and cardiovascular status.</div></div><div><h3>Conclusions</h3><div>In patients with T2DM and advanced CKD, GLP-1 RAs were associated with higher risks of select infections compared to SGLT2i. These findings highlight the need for careful infection monitoring in this vulnerable population.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"233 ","pages":"Article 113115"},"PeriodicalIF":7.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084789","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}