Diabetes research and clinical practice最新文献

{"title":"Step and weight tracking with targets and coaching interventions in gestational diabetes: A randomized factorial feasibility trial","authors":"Kaberi Dasgupta ,&nbsp;Deborah Chan ,&nbsp;Rachel Bond ,&nbsp;Susan Joanne Wang ,&nbsp;Natasha Garfield ,&nbsp;Jillian Coolen ,&nbsp;Ilana J. Halperin ,&nbsp;Tricia M. Peters ,&nbsp;Gary X. Shen ,&nbsp;Jennifer Yamamoto ,&nbsp;Sonia Butalia ,&nbsp;John Dowling ,&nbsp;Laura Rendon ,&nbsp;Kate Haichin ,&nbsp;Mona Sharafi ,&nbsp;Christopher Shields ,&nbsp;Ariane Godbout ,&nbsp;Deborah Da Costa ,&nbsp;Mohammed Kaouache ,&nbsp;Baiju R. Shah ,&nbsp;Sara Meltzer","doi":"10.1016/j.diabres.2025.112241","DOIUrl":"10.1016/j.diabres.2025.112241","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy guidelines recommend moderate to vigorous physical activity of ≥150 min/week (7000 steps/day) and weight gain specific to prepregnancy weight category. We aimed to assess step and weight changes, with tracking to achieve individualized targets and with coaching conversations on physical activity and eating. The overarching goal was to identify interventions warranting integration and evaluation through a larger trial assessing perinatal outcomes.</div></div><div><h3>Methods</h3><div>In this feasibility trial, we randomized 227 participants (GDM clinics, 5 Canadian cities) to ‘track &amp; target,’ ‘coaching,’ ‘both,’ or ‘neither’ arms. ‘Track &amp; target’ participants monitored steps/day (counter) and weight (scale). We delivered weekly targets, applying algorithms that incorporated step and weight data and nudged towards recommendations. Coaching participants conversed weekly with a coach, who applied motivational communication methods. We examined changes in steps/day and weight, between trial entry and 37 weeks’ gestation.</div></div><div><h3>Findings</h3><div>Weight change was guideline-concordant across arms. Steps/day averaged 6385 (SD 3406) at baselinue and were stable in the ‘track &amp; target’ arm (change −59, 95 %CI −749 to 630). The other arms declined (coaching: −915, 95 %CI −1605 to −225; both −1183, 95 %CI −1979 to −386; neither −1456, 95 %CI −2193 to −718).</div></div><div><h3>Interpretation</h3><div>Our algorithm-driven step target strategy prevents step count decline, meriting study for perinatal impact.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112241"},"PeriodicalIF":6.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934841","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":"Genome-wide Mendelian randomization study identifies therapeutic targets for diabetic microangiopathy","authors":"Xiongyi Yang ,&nbsp;Qian Liu ,&nbsp;Qian Ma ,&nbsp;Xin Fan ,&nbsp;Chang Huang ,&nbsp;Ya Zhao ,&nbsp;Jiao Xia ,&nbsp;Tianyi Liu ,&nbsp;Han Zhou ,&nbsp;Biao Yan","doi":"10.1016/j.diabres.2025.112237","DOIUrl":"10.1016/j.diabres.2025.112237","url":null,"abstract":"<div><h3>Aims</h3><div>This study aims to identify potential therapeutic targets for diabetic microangiopathy by integrating genome-wide association studies (GWAS) and Mendelian randomization (MR) analyses.</div></div><div><h3>Methods</h3><div>A comprehensive analysis of GWAS datasets on diabetic microangiopathy was conducted by using two-sample MR to determine the causal effects of blood-expressed druggable genes at both the transcriptional and protein levels. Co-localization analysis was conducted to validate gene-trait associations, while phenome-wide association studies (PheWAS) explored broader phenotypic implications. Additionally, protein–protein interaction (PPI) networks were constructed to elucidate gene interactions and molecular docking was conducted to determine therapeutic druggability.</div></div><div><h3>Results</h3><div>Nine candidate therapeutic targets (PSORS1C3, HLA-C, RAMP1, CTSG, SREBF1, BTN3A2, PPA1, PRKD2, and PPIG) were identified, with co-localization analysis confirming their involvement in diabetic microangiopathy. Among them, HLA-C exhibited associations with additional traits, suggesting the specificity of the remaining targets. Functional enrichment analysis indicated a predominant involvement of immune-related pathways, underscoring their relevance to the pathogenesis of diabetic microangiopathy. Furthermore, molecular docking studies revealed strong binding affinities.</div></div><div><h3>Conclusions</h3><div>This study provides compelling genetic evidence supporting the role of immune-related druggable genes in diabetic microangiopathy and identifies novel therapeutic targets for intervention.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"225 ","pages":"Article 112237"},"PeriodicalIF":6.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974791","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 low-dose rivaroxaban combined with low-dose aspirin versus low-dose aspirin alone on in vivo platelet activation, endothelial function and inflammation in type 2 diabetes patients with stable atherosclerotic disease: the RivAsa randomized, crossover study","authors":"Alessandro Rizzi ,&nbsp;Giovanna Petrucci ,&nbsp;Monica Sacco ,&nbsp;Luca Viti ,&nbsp;Maura Brioschi ,&nbsp;Cristina Banfi ,&nbsp;Francesco Zaccardi ,&nbsp;Stefano Lancellotti ,&nbsp;Giuseppe Simone ,&nbsp;Raimondo De Cristofaro ,&nbsp;Bianca Rocca ,&nbsp;Dario Pitocco","doi":"10.1016/j.diabres.2025.112244","DOIUrl":"10.1016/j.diabres.2025.112244","url":null,"abstract":"<div><h3>Aims</h3><div>A very-low-dose regimen of the anti-factor Xa rivaroxaban combined with low-dose aspirin reduces vascular events more than aspirin alone in atherosclerotic patients, including those with type 2 diabetes (T2DM). Given the high platelet activation in T2DM patients, we investigated whether this combination reduces platelet activation versus aspirin alone and the possible mechanisms.</div></div><div><h3>Methods</h3><div>Seventy-5 patients (12 females, aged 69 [65–72]), with stable atherothrombotic disease, on low-dose aspirin, participated in a randomized, cross-over, open-label, study with two arms: 4-week aspirin (100 mg once-daily) followed by 4-week aspirin plus rivaroxaban (2.5 mg twice-daily); 4-week aspirin plus rivaroxaban followed by 4-week aspirin. We investigated: <em>in vivo</em> platelet activation by urinary thromboxane A₂ metabolite (TXM), thrombin generation (TG), endothelial function by urinary prostacyclin and plasma nitric oxide metabolites, lipid oxidation by urinary isoprostane, inflammation, coagulation biomarkers.</div></div><div><h3>Results</h3><div>No carryover effects were observed. Rivaroxaban plus aspirin significantly reduced urinary TXM and isoprostane versus aspirin alone (20% [95 %CI:5–31 %] and 19% [12–26%], respectively, n = 73, p &lt; 0.01). At rivaroxaban’s maximal concentration, TG velocity index and peak were reduced by 44% [37–52%] and 81%[75–87%], respectively, versus aspirin alone. Inflammation and endothelial biomarkers were unchanged.</div></div><div><h3>Conclusions</h3><div>Very-low-dose rivaroxaban and low-dose aspirin in T2DM patients significantly inhibit <em>in vivo</em> platelet function, TG and isoprostane formation.</div><div>EudraCT Number: 2019-000610-10.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112244"},"PeriodicalIF":6.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948679","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":"Trends in use of sodium-glucose cotransporter 2 inhibitors among people with type 2 diabetes following hospitalisation with heart failure: A population-based study","authors":"Jialing Lin ,&nbsp;Tamara Y. Milder ,&nbsp;Claire T. Deakin ,&nbsp;Juliana de Oliveira Costa ,&nbsp;Alys Havard ,&nbsp;Brendon L. Neuen ,&nbsp;Nicholas A. Buckley ,&nbsp;David Brieger ,&nbsp;Jerry R. Greenfield ,&nbsp;Min Jun ,&nbsp;Richard O. Day ,&nbsp;Sallie-Anne Pearson ,&nbsp;Michael O. Falster","doi":"10.1016/j.diabres.2025.112242","DOIUrl":"10.1016/j.diabres.2025.112242","url":null,"abstract":"<div><h3>Aims</h3><div>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a pillar of therapy among people with both type 2 diabetes (T2D) and heart failure (HF). Despite being a population at high-risk of cardio-renal events, little is known on SGLT2i uptake following hospitalisation, a key opportunity for prescribing.</div></div><div><h3>Methods</h3><div>Using linked administrative data, we identified adults with T2D hospitalised with HF from January 2014 to June 2021, New South Wales, Australia. We measured quarterly trends in prevalence of SGLT2i use, and factors associated with use in 2020–2021.</div></div><div><h3>Results</h3><div>We identified 18,932 people with T2D hospitalised with HF. We found a 13-fold increase in SGLT2i use, reaching 13.2 % by mid-2021. SGLT2i use was higher in males (adjusted odds ratio [aOR] = 1.49, 95 % confidence interval [CI]: 1.24–1.79) and people with a primary diagnosis of HF (aOR = 1.21, 95 % CI: 1.01–1.45), lower in older age groups (≥85 vs 18–64 years: aOR = 0.18, 95 % CI: 0.12–0.26), among people with increasing clinical complexity (e.g. higher Charlson Score; frailty) and chronic kidney disease (aOR = 0.60, 95 % CI: 0.48–0.75).</div></div><div><h3>Conclusions</h3><div>While SGLT2i use has increased among people with T2D hospitalised with HF, uptake remains low. Optimising medication use at transitions from hospital to community care may ensure clinical benefits of these medicines are realised.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112242"},"PeriodicalIF":6.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934840","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":"Continuous glucose monitoring as equinox of nocturnal and daytime hypoglycaemia in type 1 diabetes: insights from the randomized controlled HypoDE trial","authors":"Norbert Hermanns ,&nbsp;Lutz Heinemann ,&nbsp;Bernhard Kulzer ,&nbsp;Arne Schäfer ,&nbsp;Malte Jacobsen ,&nbsp;Dominic Ehrmann","doi":"10.1016/j.diabres.2025.112228","DOIUrl":"10.1016/j.diabres.2025.112228","url":null,"abstract":"<div><h3>Aims</h3><div>This study re-analysed data from the HypoDE trial to assess the prevalence of nocturnal hypoglycaemia, evaluate the impact of continuous glucose monitoring (CGM) on nocturnal and daytime hypoglycaemia, and explore their influence on severe hypoglycaemia (SH).</div></div><div><h3>Methods</h3><div>The HypoDE trial was a randomized controlled trial involving 141 adults with type 1 diabetes, impaired hypoglycaemia awareness, or prior SH. Participants were randomized to CGM (Dexcom G5) or self-monitoring of blood glucose (control). Outcomes included the percentage of time spent in hypoglycaemia (&lt;3.9 mmol/L, &lt;3.0 mmol/L), episode duration, and SH incidence.</div></div><div><h3>Results</h3><div>At baseline, nocturnal hypoglycaemia (&lt;3.0 mmol/L) exposure exceeded daytime by 1.4 percentage points (95 % CI 0.6–2.2; p &lt; 0.002), with episodes lasting 30.7 min longer (CI 21.5–39.9). Using CGM, these differences disappeared (&lt;3.0 mmol/L: 0.3 percentage points, CI 0.7–1.3), while they persisted in the control group. Daytime hypoglycaemia significantly increased SH risk (IRR 1.10 per percentage point, CI 1.01–1.21; IRR 1.04 per minute, CI 1.01–1.07).</div></div><div><h3>Conclusions</h3><div>CGM effectively reduced nocturnal and daytime hypoglycaemia. Without CGM, nocturnal hypoglycaemia contributes to daytime risks, while daytime hypoglycaemia elevates SH risk. Expanding CGM access and addressing nocturnal hypoglycaemia in resource-limited settings are critical.</div><div><strong>Trial</strong> <span><span><strong>registrationClinicaltrials.gov</strong></span><svg><path></path></svg></span>: NCT02671968.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112228"},"PeriodicalIF":6.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948680","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":"Metabolic profile of urine of albuminuric and non-albuminuric nephropathic diabetic patients suggests TCA-cycle related biomarkers","authors":"Patrícia C. Braga ,&nbsp;Bárbara Guerra-Carvalho ,&nbsp;Manuela Almeida ,&nbsp;Sofia S. Pereira ,&nbsp;Pedro F. Oliveira ,&nbsp;Marco G. Alves ,&nbsp;Anabela Rodrigues","doi":"10.1016/j.diabres.2025.112215","DOIUrl":"10.1016/j.diabres.2025.112215","url":null,"abstract":"<div><h3>Aim</h3><div>Diabetic kidney disease (DKD) is a common and serious complication of diabetes. Moreover, ∼25 % of DKD patients are non-albuminuric, complicating diagnosis. This study aimed to identify potential urinary metabolic biomarkers in healthy and DKD patients, both with (A-DKD) and without albuminuria (NA-DKD).</div></div><div><h3>Methods</h3><div>We analyzed urine samples from healthy controls (n = 23) and DKD (n = 17) patients. DKD patients were further split into NA-DKD (n = 5) and A-DKD (n = 12). Non-targeted proton nuclear magnetic resonance (¹H NMR) metabolomics was used to explore metabolic differences.</div></div><div><h3>Results</h3><div>DKD patients exhibited lower levels of citrate, hypoxanthine, formate, isobutyrate, glycine, phenylacetate, dimethylamine, and valine in urine samples, and higher levels of <em>trans</em>-aconitate, glycolate, and taurine. Citrate presented the strongest negative correlation (r = -0.65,p &lt; 0.0001), followed by hypoxanthine (r = -0.49,p = 0.004), isobutyrate (r = −0.45,p = 0.004) and formate (r = -0.41,p = 0.009). On the other hand, glycolate (r = 0.46,p = 0.003), taurine (r = 0.47,p = 0.007), and <em>trans</em>-aconitate (r = 0.41,p = 0.05) were positively correlated with albuminuria. Glycine was decreased, and alanine was increased in NA-DKD compared to A-DKD. Receiver operating characteristic curve analysis identified citrate, hypoxanthine, and taurine as key predictors for distinguish patients with normal and higher levels of albuminuria.</div></div><div><h3>Conclusion</h3><div>Urinary metabolites related to tricarboxylic acid (TCA) and purine metabolism can potentially serve as a marker to individualize therapeutic choices in DKD, especially for non-albuminuric phenotype.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"225 ","pages":"Article 112215"},"PeriodicalIF":6.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988823","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":"Trends in Type 2 Diabetes Mellitus and Parkinson’s Disease Related Mortality in the United States from 1999 to 2020","authors":"Muhammad Umer Sohail ,&nbsp;Ruqiat Masooma Batool ,&nbsp;Jazza Aamir ,&nbsp;Muhammad Saad ,&nbsp;Eliza Aisha ,&nbsp;Hritvik Jain ,&nbsp;Muhammad Sameer Arshad ,&nbsp;Raheel Ahmed","doi":"10.1016/j.diabres.2025.112239","DOIUrl":"10.1016/j.diabres.2025.112239","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence indicates that individuals with Type 2 Diabetes Mellitus (T2DM) are at an elevated risk of Parkinson’s Disease (PD). While mortality trends for each condition have been studied individually, the combined burden of T2DM- and PD-related mortality remains poorly understood. This study aims to evaluate national trends and disparities in T2DM and PD related mortality among older adults in the United States (U.S.). from 1999 to 2020.</div></div><div><h3>Methods</h3><div>Using CDC WONDER database, we analyzed deaths among U.S. residents aged 65 + from 1999 to 2020, identifying T2DM (ICD-10: E11) and PD (ICD-10: G20) related deaths. Crude and age-adjusted mortality rates (AAMR) per 100,000 individuals were calculated, and Joinpoint regression analysis was employed to estimate the annual percent change (APC).</div></div><div><h3>Results</h3><div>Between 1999 and 2020, a total of 26,020 deaths occurred among older adults with T2DM and PD. The AAMR increased from 1.65 in 1999 to 5.61 in 2020, with a sharp rise between 2015 and 2020 (APC: +14.42 %; 95 % CI: 11.22 to 20.80). Males experienced higher AAMRs than females (4.51 vs. 1.80). Across racial groups, Hispanic or Latino individuals exhibited the highest AAMR (3.61), while non-Hispanic Black Americans had the lowest (1.96). Non-metropolitan areas experienced higher AAMRs than metropolitan areas (3.64 vs. 2.71).</div></div><div><h3>Conclusions</h3><div>T2DM and PD-related mortality has surged over the past two decades, particularly since 2015, with significant racial, sex-based, and regional disparities. Targeted public health strategies are needed to address these growing health concerns.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112239"},"PeriodicalIF":6.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931488","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":"Prognostic value of the Glucose-to-Albumin ratio in sepsis-related mortality: A retrospective ICU study","authors":"Yuanshuo Ge ,&nbsp;Zhe Wang ,&nbsp;Youran Ma ,&nbsp;Cheng Zhang","doi":"10.1016/j.diabres.2025.112217","DOIUrl":"10.1016/j.diabres.2025.112217","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the prognostic value of the glucose-to-albumin ratio (GAR) in predicting 30-day and 90-day mortality in septic ICU patients.</div></div><div><h3>Methods</h3><div>Kaplan-Meier analysis with log-rank tests assessed survival by GAR quartiles. Multivariable Cox regression and restricted cubic splines (RCS) explored GAR’s relationship with mortality. ROC curves evaluated predictive performance, and Boruta identified key variables. Machine learning models assessed GAR’s predictive ability, with indirect effects analyzed through anion gap and BUN.</div></div><div><h3>Results</h3><div>Quartile 4 exhibited the lowest survival probability (log-rank p &lt; 0.0001). GAR demonstrated the highest AUC for 30-day (0.66) and 90-day (0.65) mortality among individual predictors, while the stacked model achieved an AUC of 0.826. Cox regression showed GAR was independently associated with both 30-day (HR: 1.071 (95 % CI: 1.063–1.078, p &lt; 0.001).) and 90-day mortality (HR: 1.071 (95 % CI: 1.064–1.078, p &lt; 0.001). RCS analysis revealed an L-shaped relationship between GAR and mortality.</div></div><div><h3>Conclusions</h3><div>GAR is a strong predictor of 30-day and 90-day mortality in septic ICU patients. Incorporating GAR into clinical risk models could improve decision-making and sepsis management.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112217"},"PeriodicalIF":6.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929479","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 between hemoglobin, albumin, lymphocyte, and platelet score and all-cause and cardiovascular mortality among population with diabetes: Evidence from the NHANES 2003–2016","authors":"Yiting He ,&nbsp;Zeming Ma ,&nbsp;Xiutong Chen ,&nbsp;Jingsa Wang ,&nbsp;Xiaojing Chen ,&nbsp;Zhijian Deng ,&nbsp;Kun Lin","doi":"10.1016/j.diabres.2025.112212","DOIUrl":"10.1016/j.diabres.2025.112212","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigated the relationship between the Hemoglobin, Albumin, Lymphocyte, and Platelets (HALP) score and all-cause and cardiovascular mortality risk in diabetes patients.</div></div><div><h3>Methods</h3><div>An analysis included 2154 individuals with diabetes from the 2003–2016 National Health and Nutrition Examination Survey (NHANES), with mortality data tracked until December 31, 2019. Cox regression models were adopted to evaluate the association of HALP score with mortality. The nonlinear relationship was examined using restricted cubic splines (RCS), and a two-segmented Cox proportional risk model analyzed data around identified threshold values.</div></div><div><h3>Results</h3><div>During a median follow-up of 90 months, 565 (26.23 %) deaths occurred, of which 166 (7.71 %) caused by cardiovascular disease. In the Cox regression models, participants in the highest quartile of HALP score had lower risks of all-cause mortality (HR = 0.59,95 % CI:0.43–0.83, p = 0.002) and cardiovascular mortality (HR = 0.38,95 % CI:0.22–0.66, p &lt; 0.001) compared to the lowest quartile. Based on the restricted cubic splines (RCS) curve, a L-shaped relationship was found, with thresholds of 49.81 for all-cause and 48.78 for cardiovascular mortality. HALP scores below these thresholds were associated with increased mortality (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>HALP score may serve as a valuable clinical indicator for predicting mortality risk in diabetes patients.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"224 ","pages":"Article 112212"},"PeriodicalIF":6.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922430","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":"Altered BAG3-insulin colocalization is associated with impaired first phase insulin secretion in humans.","authors":"Verena Damiani, Gianfranco Di Giuseppe, Giulia Gliozzo, Gea Ciccarelli, Erika Pizzinato, Francesco Del Pizzo, Doriana Fruci, Michela Brunetti, Laura Soldovieri, Giuseppe Quero, Andrea Mari, Sergio Alfieri, Alfredo Pontecorvi, Andrea Giaccari, Vincenzo De Laurenzi, Teresa Mezza","doi":"10.1016/j.diabres.2025.112232","DOIUrl":"https://doi.org/10.1016/j.diabres.2025.112232","url":null,"abstract":"<p><strong>Aims: </strong>Alterations in first-phase insulin secretion are pivotal in the early development of T2DM. BAG3 has been implicated in regulating insulin secretion in murine models, but its role in humans remains unexplored. This study investigates BAG3 expression in human pancreatic islets and its relationship with β-cell functionality.</p><p><strong>Methods: </strong>Pancreatic tissue samples were obtained from 12 patients with no previous T2DM diagnosis enrolled for partial pancreatectomy. Patients underwent deep metabolic evaluation, including OGTT, hyperglycemic clamp and euglycemic hyperinsulinemic clamp. Immunofluorescence and confocal microscopy were used to assess BAG3-insulin colocalization and further correlated with metabolic findings, categorizing subjects into LOW and HIGH BAG3 groups.</p><p><strong>Results: </strong>Patients with HIGH BAG3 expression exhibited significantly impaired first-phase insulin secretion, evidenced by reduced rate sensitivity during OGTT and higher plasma glucose levels at 30 and 60 min post-glucose challenge. Islets from HIGH BAG3 patients showed increased size but no differences in insulin/glucagon ratios or insulin sensitivity, suggesting a specific disruption in the insulin secretory machinery rather than β-cell mass or insulin resistance.</p><p><strong>Conclusions: </strong>BAG3 appears associated to first-phase insulin secretion in humans by influencing insulin granule exocytosis. Targeting BAG3 could represent a novel therapeutic approach to prevent or delay β-cell dysfunction and the onset of T2DM.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112232"},"PeriodicalIF":6.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988827","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}