Diabetes research and clinical practice最新文献_第8页

Untangling the role of diet quality and other risk factors in the severity of metabolic syndrome: Insights from the Hoveyzeh Cohort study using structural equation modeling 解开饮食质量和其他危险因素在代谢综合征严重程度中的作用：使用结构方程模型的Hoveyzeh队列研究的见解

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-25 DOI: 10.1016/j.diabres.2025.112436

Farnush Bakhshimoghaddam , Elham Maraghi , Ali Mohammad Hadianfard , Bahman Cheraghian , Sima Jafarirad

{"title":"Untangling the role of diet quality and other risk factors in the severity of metabolic syndrome: Insights from the Hoveyzeh Cohort study using structural equation modeling","authors":"Farnush Bakhshimoghaddam , Elham Maraghi , Ali Mohammad Hadianfard , Bahman Cheraghian , Sima Jafarirad","doi":"10.1016/j.diabres.2025.112436","DOIUrl":"10.1016/j.diabres.2025.112436","url":null,"abstract":"<div><h3>Aims</h3><div>In this study, we aim to employ structural equation modeling (SEM) to assess the relationships between adherence to diet quality scores, such as the Dietary Diversity Score (DDS), Paleolithic Diet Score (PDS), and EAT-Lancet Diet Score, and other risk factors, including, demographic, socio-economic, behavioral, and clinical characteristics, with MetS severity.</div></div><div><h3>Methods</h3><div>This cross-sectional study involved 8,086 participants from the Hoveyzeh Cohort Study (3,486 males and 4,600 females). Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire, which was also used to calculate energy-adjusted diet scores. Anthropometric, biochemical, and blood pressure measurements were evaluated following standardized protocols. The interrelationships between risk factors and MetS severity were analyzed using SEM.</div></div><div><h3>Results</h3><div>The models indicated that the DDS had a statistically significant association with MetS severity through direct effects (β<sub>Females</sub> = -0.04; β<sub>Males</sub> = -0.04) and indirect effects (β<sub>Females</sub> = -0.06; β<sub>Males</sub> = -0.09). Similarly, the PDS showed a statistically significant inverse relationship with MetS severity, including direct effects (β<sub>Females</sub> = -0.03; β<sub>Males</sub> = -0.02) and indirect effects (β<sub>Females</sub> = -0.05; β<sub>Males</sub> = -0.07). In contrast, the EAT-Lancet Diet Score demonstrated a statistically significant inverse association with MetS severity only through indirect effects (β<sub>Females</sub> = -0.04; β<sub>Males</sub> = -0.03).</div></div><div><h3>Conclusion</h3><div>The findings emphasize that improving diet quality as a means of managing modifiable risk factors may reduce MetS severity.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112436"},"PeriodicalIF":7.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916424","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 rapidly increasing incidence of type 2 diabetes and macrovascular and microvascular complications disproportionately affects younger age groups: A decade of evidence from an international federated database 2型糖尿病和大血管和微血管并发症发病率的迅速增加对年轻年龄组的影响尤为严重：来自国际联合数据库的十年证据

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-24 DOI: 10.1016/j.diabres.2025.112431

Matthew Anson , Alex E. Henney , Harry Edwards , Gema H. Ibarburu , Ify Mordi , Shabbar Jaffar , Anupam Garrib , Gregory Y.H. Lip , Duolao Wang , Katarzyna Nabrdalik , Bruce A. Perkins , Daniel J. Cuthbertson , Uazman Alam

{"title":"The rapidly increasing incidence of type 2 diabetes and macrovascular and microvascular complications disproportionately affects younger age groups: A decade of evidence from an international federated database","authors":"Matthew Anson , Alex E. Henney , Harry Edwards , Gema H. Ibarburu , Ify Mordi , Shabbar Jaffar , Anupam Garrib , Gregory Y.H. Lip , Duolao Wang , Katarzyna Nabrdalik , Bruce A. Perkins , Daniel J. Cuthbertson , Uazman Alam","doi":"10.1016/j.diabres.2025.112431","DOIUrl":"10.1016/j.diabres.2025.112431","url":null,"abstract":"<div><h3>Aims</h3><div>To characterise recent trends in incidence and prevalence of type 2 diabetes (T2D) associated complications, and their relative impact across the lifespan.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX global federated database. Incidence and prevalence of T2D and associated complications: ischaemic heart disease (IHD), heart failure, cerebral infarction, neuropathy, nephropathy, and retinopathy were assessed between 2012 and 2023. Incidence odds ratios (IOR) were calculated by age group.</div></div><div><h3>Results</h3><div>7,918,666 individuals had T2D. The IOR (95 % CI), comparing individuals aged ≥ 85 years to < 35 years decreased for all complications from 2012 to 2023: <strong>IHD</strong> [IOR 6.82, (6.40, 7.26) to IOR 2.27 (2.17, 2.38)], <strong>heart failure</strong> [IOR 5.38, (5.03, 5.75) to IOR 1.80 (1.72, 1.89)], <strong>cerebral infarction</strong> [IOR 3.06, (2.76, 3.40) to IOR 1.45 (1.34, 1.57)], <strong>neuropathy</strong> [IOR 0.84, (0.74, 0.95) to IOR 0.47 (0.44, 0.49)], <strong>nephropathy</strong> [IOR 1.14, (1.03, 1.27) to IOR 0.90 (0.87, 0.94)] and <strong>retinopathy</strong> [IOR 0.56, (0.50, 0.63) to IOR 0.27 (0.25, 0.29)].</div></div><div><h3>Conclusions</h3><div>Rising rates of T2D associated complications in younger adults signal an emerging epidemic of early-onset comorbidity with substantial lifetime burden. These findings emphasise the urgent need for earlier detection, aggressive risk factor management, and targeted prevention strategies in younger populations.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112431"},"PeriodicalIF":7.4,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896163","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

Geriatric nutritional risk index predicts incident kidney failure with replacement therapy among patients with biopsy-proven diabetic nephropathy 在活检证实的糖尿病肾病患者中，老年营养风险指数预测替代治疗后发生肾衰竭

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-23 DOI: 10.1016/j.diabres.2025.112433

Takayuki Uemura , Masatoshi Nishimoto , Masahiro Eriguchi , Hiroyuki Tamaki , Hikari Tasaki , Riri Furuyama , Takaaki Kosugi , Akiko Itano , Katsuhiko Morimoto , Masaru Matsui , Ken-ichi Samejima , Kazuhiko Tsuruya

{"title":"Geriatric nutritional risk index predicts incident kidney failure with replacement therapy among patients with biopsy-proven diabetic nephropathy","authors":"Takayuki Uemura , Masatoshi Nishimoto , Masahiro Eriguchi , Hiroyuki Tamaki , Hikari Tasaki , Riri Furuyama , Takaaki Kosugi , Akiko Itano , Katsuhiko Morimoto , Masaru Matsui , Ken-ichi Samejima , Kazuhiko Tsuruya","doi":"10.1016/j.diabres.2025.112433","DOIUrl":"10.1016/j.diabres.2025.112433","url":null,"abstract":"<div><h3>Aims</h3><div>The geriatric nutritional risk index (GNRI) is a predictor for kidney prognosis. However, malnutrition can lead to overestimation of creatinine-based estimated glomerular filtration rate (eGFR), particularly in diabetic nephropathy (DN). This study examined whether GNRI was associated with kidney prognosis after accounting for muscle mass-independent kidney function markers in DN.</div></div><div><h3>Methods</h3><div>This observational study included patients with biopsy-proven DN at Nara Medical University Hospital. The exposure was GNRI at the time of kidney biopsy. The outcome was kidney failure with replacement therapy (KFRT). Multivariable Cox regression analyses were performed to examine the association of GNRI with KFRT.</div></div><div><h3>Results</h3><div>Among 405 patients were categorized by GNRI cutoff of 98. During a median follow-up of 6.7 years, 99 patients developed KFRT. Lower GNRI was associated with higher incidence of KFRT after adjustment for clinical and kidney histopathological factors (hazard ratio [95 % confidence interval]: 3.13 [1.74–5.61]). The association remained robust even after additional adjustment for muscle mass-independent kidney function markers (serum β2-microglobulin or muscle mass-adjusted eGFR).</div></div><div><h3>Conclusions</h3><div>Among patients with DN, lower GNRI was associated with incident KFRT even after adjustment for muscle mass-independent kidney function markers. Further research is warranted to clarify whether nutritional improvement can attenuate kidney function decline.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112433"},"PeriodicalIF":7.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902867","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 and mortality for amputations in the diabetic foot: a nationwide cohort study. 糖尿病足截肢的危险因素和死亡率：一项全国性队列研究。

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-23 DOI: 10.1016/j.diabres.2025.112435

Dong Woo Shim, Wonwoo Lee, Kwang Hwan Park, Yeo Kwon Yoon, Minae Park, Sojeong Park, Seung Hwan Han, Jin Woo Lee

{"title":"Risk factors and mortality for amputations in the diabetic foot: a nationwide cohort study.","authors":"Dong Woo Shim, Wonwoo Lee, Kwang Hwan Park, Yeo Kwon Yoon, Minae Park, Sojeong Park, Seung Hwan Han, Jin Woo Lee","doi":"10.1016/j.diabres.2025.112435","DOIUrl":"https://doi.org/10.1016/j.diabres.2025.112435","url":null,"abstract":"<p><strong>Objective: </strong>To investigate risk factors and mortality associated with major amputations in people with diabetic foot ulcers (DFUs), and to differentiate them from minor amputations STUDY DESIGN: We conducted a nationwide, retrospective longitudinal study using cohort data from the Korean National Health Insurance Service (2002-2020), including people with DFUs who underwent lower extremity amputation. People were categorized into minor and major amputation groups. Comparative analyses were conducted using variables available from health insurance data.</p><p><strong>Results: </strong>Among 40,809 people with DFU-related amputations, the major amputation group showed a higher proportion of males, older age, and lower income. Revascularization procedures and use of top-tier antibiotics were more common in the major group. Comorbidities such as end-stage renal disease (ESRD), dementia, cerebrovascular disease, and ischemic heart disease were also more frequent (P < 0.001). The major group had higher mortality (73.9 % vs. 52.2 %) and shorter survival (986 vs. 1209 days). Dementia, ESRD, and prior major amputation had the highest adjusted hazard ratios for mortality.</p><p><strong>Conclusions: </strong>Major amputation in people with DFUs is associated with advanced age, vascular disease, comorbidities, and increased mortality. In contrast, minor amputation is linked to better survival. Limb-sparing approaches may improve long-term outcomes in this high-risk population.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"112435"},"PeriodicalIF":7.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946676","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

Global, regional, and national burden of type 1 diabetes mellitus and chronic kidney disease due to type 1 diabetes mellitus in children aged 0–14 years from 1990 to 2021 1990年至2021年全球、地区和国家0-14岁儿童1型糖尿病和由1型糖尿病引起的慢性肾脏疾病负担

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-23 DOI: 10.1016/j.diabres.2025.112432

Jiang Li , Jingbin Zhang

{"title":"Global, regional, and national burden of type 1 diabetes mellitus and chronic kidney disease due to type 1 diabetes mellitus in children aged 0–14 years from 1990 to 2021","authors":"Jiang Li , Jingbin Zhang","doi":"10.1016/j.diabres.2025.112432","DOIUrl":"10.1016/j.diabres.2025.112432","url":null,"abstract":"<div><h3>Background</h3><div>Type 1 diabetes mellitus (T1DM) and chronic kidney disease(CKD) due to T1DM pose a substantial global health burden. However, the epidemiology of T1DM and CKD due to T1DM in children aged 0–14 years remains poorly quantified worldwide. We aimed to evaluate the global burden and trends of these conditions in this pediatric population.</div></div><div><h3>Methods</h3><div>Using the Global Burden of Disease (GBD) 2021 data, we evaluated the incidence, prevalence, and disability-adjusted life years (DALYs) of T1DM and CKD due to T1DM among children aged 0–14 years from 1990 to 2021.</div></div><div><h3>Results</h3><div>From 1990 to 2021, the global incidence number of T1DM in children aged 0–14 years increased, and the age-standardized incidence rate(ASIR) increased. The prevalence increased, the age-standardized prevalence rate(ASPR)increased, but the age-standardized DALYs rate(ASDR) decreased. The ASIR, ASPR, and ASDR of CKD due to T1DM decreased. At the same time, health inequality analysis reveals a worsening of disparities among different countries.</div></div><div><h3>Conclusion</h3><div>The global burden of T1DM and CKD due to T1DM among children aged 0–14 years is facing new challenges, highlighting the urgent need to reinforce and develop more effective public health policies and clinical prevention strategies.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112432"},"PeriodicalIF":7.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912561","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

Comparative effectiveness and prescribing patterns of dapagliflozin vs empagliflozin in type 2 diabetes patients: a target trial emulation 达格列净与恩格列净在2型糖尿病患者中的比较疗效和处方模式：一项目标试验模拟

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-22 DOI: 10.1016/j.diabres.2025.112427

I-Ning Yang , Kah-Suan Chong , Zi-Yang Peng , Huang-Tz Ou , Ming-Cheng Wang

{"title":"Comparative effectiveness and prescribing patterns of dapagliflozin vs empagliflozin in type 2 diabetes patients: a target trial emulation","authors":"I-Ning Yang , Kah-Suan Chong , Zi-Yang Peng , Huang-Tz Ou , Ming-Cheng Wang","doi":"10.1016/j.diabres.2025.112427","DOIUrl":"10.1016/j.diabres.2025.112427","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to compare the real-world effectiveness of dapagliflozin versus empagliflozin in patients with type 2 diabetes (T2D) and to examine prescribing patterns across specialties.</div></div><div><h3>Methods</h3><div>We conducted a target trial emulation using multi-institutional electronic health records from January 2016 to August 2023, identifying 2649 new users of dapagliflozin and 2046 of empagliflozin. The primary composite outcome was sustained eGFR decline ≥30 %, end-stage renal disease, heart failure hospitalization, or all-cause mortality. Safety outcomes included acute kidney injury, hypoglycemia, urinary tract infection, and fracture. Inverse probability of treatment weighting (IPTW) was used for confounding adjustment, and Cox regression estimated hazard ratios.</div></div><div><h3>Results</h3><div>After IPTW, 1662 patients remained in each group. No significant differences were found in primary, secondary, or safety outcomes. However, analysis among patients without stable prior ACEI/ARB exposure revealed a higher risk of all-cause mortality with empagliflozin. Dapagliflozin was more often prescribed by cardiologists, while endocrinologists and nephrologists favored empagliflozin.</div></div><div><h3>Conclusions</h3><div>Dapagliflozin and empagliflozin showed similar cardiorenal and safety outcomes in T2D. However, unstable prior ACEI/ARB use may influence mortality risk with empagliflozin. Prescribing patterns highlight the importance of multidisciplinary care. Further prospective studies are needed.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112427"},"PeriodicalIF":7.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896164","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

Bedtime sliding scale insulin is unnecessary for hospitalized patients with bedtime glucose < 300 mg/dL: A nudge-based quasi-experiment 睡前血糖< 300 mg/dL的住院患者无需使用睡前滑动刻度胰岛素：一项基于轻推的准实验

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-22 DOI: 10.1016/j.diabres.2025.112428

James H. Flory , Emily A. Vertosick , Gilad Kuperman , Jessica S. Ancker , Scott Kim , Christine Fitzpatrick , Kimberly Gould , Everett Weiss , Andrew J. Vickers

{"title":"Bedtime sliding scale insulin is unnecessary for hospitalized patients with bedtime glucose < 300 mg/dL: A nudge-based quasi-experiment","authors":"James H. Flory , Emily A. Vertosick , Gilad Kuperman , Jessica S. Ancker , Scott Kim , Christine Fitzpatrick , Kimberly Gould , Everett Weiss , Andrew J. Vickers","doi":"10.1016/j.diabres.2025.112428","DOIUrl":"10.1016/j.diabres.2025.112428","url":null,"abstract":"<div><h3>Aims</h3><div>Bedtime rapid-acting insulin is commonly given to hospitalized patients with moderate hyperglycemia. Its effectiveness has been evaluated in one randomized controlled trial (RCT), the results of which might not generalize to specific populations such as cancer patients.</div></div><div><h3>Methods</h3><div>An order set encouraging use of rapid-acting bedtime insulin was replaced with one defaulting to rapid-acting bedtime insulin only for glucoses ≥300 mg/dL, deployed over a two-month period in which approximately half of providers were arbitrarily assigned to the new order set. Analysis assessed the effect of the new order set on whether a less-aggressive bedtime sliding scale was actually ordered and mean morning glucose levels.</div></div><div><h3>Results</h3><div>An inpatient insulin order set was placed for 458 patients. Exposure to the new order set was associated with a 91 % (95 % CI 87 % to 95 %) increase in use of the less-aggressive sliding scale. Mean morning glucose decreased by 16 mg/dL (95 % CI −16 to −1.1 mg/dL, p = 0.035).</div></div><div><h3>Conclusion</h3><div>These results show it is unnecessary to give rapid-acting bedtime insulin for glucoses <300 mg/dL. Further research should be conducted using changes in the order set as a way of conducting well-controlled trials at low cost with minimum disruption to usual clinical care.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112428"},"PeriodicalIF":7.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902868","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

Mass spectrometry-based metabolomic and lipidomic profiling stratifies stages of diabetic retinopathy 基于质谱的代谢组学和脂质组学分析对糖尿病视网膜病变的分期进行分层

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-22 DOI: 10.1016/j.diabres.2025.112423

Junwei Fang , Hanying Wang , Tian Niu, Xindan Xing, Xin Shi, Yan Jiang, Yuan Qu, Qian Zhu, Lu Cheng, Kun Liu

{"title":"Mass spectrometry-based metabolomic and lipidomic profiling stratifies stages of diabetic retinopathy","authors":"Junwei Fang , Hanying Wang , Tian Niu, Xindan Xing, Xin Shi, Yan Jiang, Yuan Qu, Qian Zhu, Lu Cheng, Kun Liu","doi":"10.1016/j.diabres.2025.112423","DOIUrl":"10.1016/j.diabres.2025.112423","url":null,"abstract":"<div><h3>Aims</h3><div>Diabetic retinopathy is a metabolic complication of diabetes. This study aimed to elucidate metabolic and lipidomic alterations associated with diabetic retinopathy progression and identify biomarkers for its diagnosis and staging.</div></div><div><h3>Methods</h3><div>We analyzed serum profiles of 962 molecules, including 653 lipids and 309 polar small metabolites, from 167 individuals: 45 without retinopathy, 69 with non-proliferative diabetic retinopathy of varying severity, and 53 with proliferative diabetic retinopathy. Statistical models were applied to single-omics datasets, and machine learning algorithms were used to integrate metabolomic and lipidomic data for identifying features that best discriminate disease stages.</div></div><div><h3>Results</h3><div>Purine and sphingolipid metabolism were significantly altered in both non-proliferative and proliferative stages. Tyrosine metabolism was disrupted in non-proliferative disease, while glycine-serine-threonine metabolism was prominent in proliferative disease. Progression was associated with reduced sphingomyelins, phosphatidylcholines, and lysophosphatidylcholines. Among ten machine learning models, the K-nearest neighbor algorithm achieved the highest classification performance. The lipid ST 24:1;O4 and metabolite beta-hydroxyisovaleric acid were the top contributors.</div></div><div><h3>Conclusions</h3><div>Mass spectrometry-based metabolomics/lipidomics integrated with machine learning accurately stratify diabetic retinopathy and identify novel molecular markers, and may support early diagnosis and targeted intervention of diabetic retinopathy.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112423"},"PeriodicalIF":7.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904113","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

Associations of accelerometer-measured weekend sleep catch-up and loss with risk of type 2 diabetes: a prospective cohort study 加速计测量的周末睡眠补足和睡眠缺失与2型糖尿病风险的关联：一项前瞻性队列研究

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-22 DOI: 10.1016/j.diabres.2025.112420

Yinan Jiang , Zou Su , Sibo Liu , Hongkun Di , Qi Wu , Wen Hu , Tianzhu Qin , Shili Zhou , Jiawei Yin , Ying Chen , Xiang Cheng , Gang Liu , Liegang Liu , Yanjun Guo , Zhilei Shan

{"title":"Associations of accelerometer-measured weekend sleep catch-up and loss with risk of type 2 diabetes: a prospective cohort study","authors":"Yinan Jiang , Zou Su , Sibo Liu , Hongkun Di , Qi Wu , Wen Hu , Tianzhu Qin , Shili Zhou , Jiawei Yin , Ying Chen , Xiang Cheng , Gang Liu , Liegang Liu , Yanjun Guo , Zhilei Shan","doi":"10.1016/j.diabres.2025.112420","DOIUrl":"10.1016/j.diabres.2025.112420","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the relationship between weekend sleep catch-up and loss and risk of type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This study included 80,414 adults aged 43–79 years from the UK Biobank. Weekend sleep catch-up and loss were derived from wrist-worn accelerometer data. Cox hazard models were used to examine the associations of weekend sleep catch-up and loss with T2D risk (identified from linked medical records, death registers and self-reported diagnosis). Leveraging metabolic biomarker and metabolomics data, we further explored the underlying biological mechanisms.</div></div><div><h3>Results</h3><div>Over a median (IQR) follow-up of 7.3 years (6.8–7.8 years), 1,465 T2D cases occurred, with a cumulative incidence of 1.8 %. Among individuals with short weekday sleep duration, weekend sleep catch-up >1.5 h was associated with lower T2D risk (HR 0.64, 95 % CI 0.45–0.92). Conversely, among individuals with normal weekday sleep duration, weekend sleep loss was associated with higher T2D risk (HR 1.33, 95 % CI 1.01–1.76). Weekend sleep catch-up and loss showed distinct metabolic biomarker and metabolomic responses. Tyrosine, leucine, creatinine, and some lipid metabolites may link weekend sleep catch-up and loss to T2D.</div></div><div><h3>Conclusions</h3><div>Weekend sleep catch-up could be a potential strategy against T2D among individuals with sleep deprivation during weekdays.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112420"},"PeriodicalIF":7.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919772","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

Development and performance of a generative pretrained transformer for diabetes care 糖尿病护理生成式预训练变压器的开发和性能

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-22 DOI: 10.1016/j.diabres.2025.112425

Miguel Garrido-Bueno , Pilar Santa Cruz-Álvarez , Manuel Pabón-Carrasco , Rocío Romero-Castillo

{"title":"Development and performance of a generative pretrained transformer for diabetes care","authors":"Miguel Garrido-Bueno , Pilar Santa Cruz-Álvarez , Manuel Pabón-Carrasco , Rocío Romero-Castillo","doi":"10.1016/j.diabres.2025.112425","DOIUrl":"10.1016/j.diabres.2025.112425","url":null,"abstract":"<div><h3>Aims</h3><div>To design and evaluate the performance of a diabetes-related Generative Pretrained Transformer (GPT).</div></div><div><h3>Methods</h3><div>A prompt-engineered layer over GPT was developed in four stages: (1) literature review on GPT tools development; (2) selection and preprocessing of 65 information sources about diabetes care strategies, patient education, diabetes technologies, and cultural care, among others; (3) prototype development; and (4) final tool evaluation using 420 diabetes-related questions adapted from three validated instruments. Outcomes were accuracy, rationale, citations, disclaimers, and emoji exclusion. Statistical analyses included descriptive statistics, chi-square tests and bias assessment. Compliance with data protection regulations and ethical standards was ensured.</div></div><div><h3>Results</h3><div>Diabetes Help GPT showed high overall accuracy (91.7 %), with 100 % rationale inclusion, 93.3 % citations, 84.8 % disclaimers, and minimal emoji use (13.3 %). Accuracy was highest in general diabetes knowledge and nutrition questions; slightly lower in insulin-related items (82.3 %). Disclaimer and emoji usage varied significantly by question format (p = 0.026 and p < 0.001). No accuracy bias was detected.</div></div><div><h3>Conclusions</h3><div>Diabetes Help GPT delivers accurate, well-sourced responses, supporting healthcare professionals in diabetes care. Unlike existing GPT models in medicine, it was developed through a transparent, expert-led process with curated content and iterative validation. It should complement, and not replace, professionals’ criteria.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112425"},"PeriodicalIF":7.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892241","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}

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