Diabetic Medicine最新文献

{"title":"A cohort description and comparison of four European national diabetes registries for the REDDIE project","authors":"Jonah J. C. Thomas,&nbsp;Stefanie Lanzinger,&nbsp;Kathrine Kold Soerensen,&nbsp;Henrik Imberg,&nbsp;Stefanie Schmid,&nbsp;Emma Barron,&nbsp;Reinhard Holl,&nbsp;Ulrik Pedersen-Bjergaard,&nbsp;Amanda Adler,&nbsp;Martina Vettoretti,&nbsp;Shivani Misra,&nbsp;Jonathan Valabhji,&nbsp;Kamlesh Khunti,&nbsp;Marcus Lind,&nbsp;Christian Torp-Pedersen,&nbsp;Julia K. Mader,&nbsp;Pratik Choudhary,&nbsp;the REDDIE study group","doi":"10.1111/dme.70112","DOIUrl":"10.1111/dme.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The Real-world Evidence for Decisions in Diabetes (REDDIE) project aims to better understand how to use real-world data (RWD) to advance research related to diabetes. To achieve this aim, four national registries (National Diabetes Audit (NDA (England)), Diabetes Patienten Verlaufsdokumentation (DPV (Germany)), Swedish National Registries (NDR), Danish National Registries (DNR)) are contributing data to the REDDIE project. This publication aims to describe the four registries and compare their unique strengths and limitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data regarding the four registries were extracted from their inception until 2024. Data regarding demographics, prescriptions, outcomes, lifestyle and diabetes-specific variables (usage of continuous glucose monitors) were summarised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A core set of variables was identified across all four registries in the REDDIE project. Demographic information, diabetes-related medication, measures of glycaemic control and lifestyle factors are measured in all four registries. The DNR, NDA and NDR also contain wider prescription data, diagnosis data (cardiovascular disease, retinopathy) and mortality data. The DPV registry does not contain these data but contains detailed data on continuous glucose monitor and insulin pump usage. Differences in the methodologies employed and data fields collected were identified, including in data collection techniques, linkage processes, follow-up protocols and the range of variables recorded. Even with this diversity in data collection, there remains a significant opportunity to perform collaborative analysis between the registries. By combining RWD collected in different populations and health care systems with diverse demographics, the transferability of evidence will increase, enabling research studies to be more representative and inclusive of diverse populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The four registries that make up the REDDIE project contain many commonly collected variables. However, each registry presents specific strengths and limitations. By including all four databases, the REDDIE project benefits from the complementary strengths of each database.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UK best practice recommendations for children and young people <18 years with pre-stage 3 type 1 diabetes, on behalf of the British Society for Paediatric Endocrinology and Diabetes (BSPED)","authors":"Rachel E. J. Besser,&nbsp;Fiona Campbell,&nbsp;Katharine Damazer,&nbsp;Daniela Elleri,&nbsp;Kathleen M. Gillespie,&nbsp;Clare Hambling,&nbsp;Rebecca Martin,&nbsp;Fulya Mehta,&nbsp;Sarinda Millar,&nbsp;Pooja Sachdev,&nbsp;Tracy Savory,&nbsp;Ambika Shetty,&nbsp;Rabbi Swaby,&nbsp;Tabitha Randell,&nbsp;the BSPED","doi":"10.1111/dme.70117","DOIUrl":"10.1111/dme.70117","url":null,"abstract":"<p>Screening for childhood type 1 diabetes (T1D) is increasing worldwide. Historically, screening has been undertaken through research programmes, but increasingly in the UK, children and young people are also being tested in clinical care. This identifies children before the onset of clinical disease through measurement of four islet autoantibodies (IAb): anti-glutamic acid decarboxylase; anti-insulin; anti-IA2 tyrosine phosphatase; and anti-zinc transporter-8. Otherwise well individuals confirmed to have ≥2 IAb have early-stage T1D, meaning that they are in the pre-symptomatic phase of the disease. This is categorised into stages, where stage 1 indicates ≥2 IAb and normoglycaemia, and stage 2 the presence of ≥2 IAb and dysglycaemia. Stage 3 T1D indicates that the diagnostic threshold for T1D has been reached, which may occur with or without symptoms of diabetes.</p><p>The goal of screening and monitoring programmes is to reduce the adverse clinical consequences of diabetic ketoacidosis at diagnosis and to identify children who may benefit from disease-modifying therapies to delay or reverse progression to insulin requirement. Additional benefits include avoiding hospitalisation and preparation for the 'softer landing' into T1D. To seek these benefits, children should be monitored; yet many individuals decline follow-up in a research context. We therefore describe a pathway suitable for children identified from both screening programmes and clinical care settings.</p><p>The pathway consists of 5 themes (IAb confirmation, monitoring of individuals in early-stage T1D, starting insulin, monitoring in single IAb positivity, and audit standards against which the pathway can be assessed during implementation).</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study protocol for exploring diabetes numeracy and health literacy across Europe (EDUCATE): A multicentre cross-sectional study","authors":"Elisabeth J. den Brok,&nbsp;Cecilie Hornborg-Svensson,&nbsp;Nefeli M. Dimitropoulou,&nbsp;Sofie Broeng-Mikkelgaard,&nbsp;Mikkel T. Olsen,&nbsp;Lubnaa Abdur Rahman,&nbsp;Ioannis Papathanail,&nbsp;Antje Wiede,&nbsp;Juliane Peters,&nbsp;Peter R. Mertens,&nbsp;Eva Zikou,&nbsp;Georgios Karamanakos,&nbsp;Stavros Athanasopoulos,&nbsp;Asimina Mitrakou,&nbsp;Konstantinos Makrilakis,&nbsp;Sander M. J. van Kuijk,&nbsp;Stavroula Mougiakakou,&nbsp;Marleen M. J. van Greevenbroek,&nbsp;Ulrik Pedersen-Bjergaard,&nbsp;Bastiaan E. de Galan,&nbsp;Cassy F. Dingena,&nbsp;the MELISSA consortium","doi":"10.1111/dme.70140","DOIUrl":"10.1111/dme.70140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Effective diabetes self-management increasingly depends on the interplay between health literacy, numeracy and digital health literacy, given the growing integration of advanced digital tools into diabetes care routines. Little is known about the current state of these skills among people with insulin-treated diabetes. Therefore, this study aims to assess (digital) health literacy and numeracy in people with diabetes on intensive insulin therapy and to explore their associations with glycaemic control, health behaviours, clinical outcomes and patient-reported outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The <i>Exploring Diabetes Health Literacy and Numeracy across Europe</i> (EDUCATE) study is a multicentre cross-sectional study aiming to recruit 209 adults with type 1, type 2, or pancreatogenic diabetes on intensive insulin therapy in four European outpatient clinics. Participants will be asked to complete questionnaires, record their dietary patterns, and wear both a physical activity tracker and a blinded continuous glucose monitor for two weeks. The primary outcome is health literacy, assessed using the validated Health Literacy questionnaire. Secondary outcomes include numeracy, digital health literacy, glycaemic outcomes, health behaviour (e.g., diet and physical activity), and patient-reported-outcomes (e.g., quality-of-life and diabetes distress).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings will be diseminated through peer-reviewed scientific journals, and academic conferences or media outlets to inform the wider public.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EDUCATE will assess digital health literacy and numeracy in people with diabetes on intensive insulin regimens across four European countries. A deeper understanding of the current landscape of health literacy and its association with glycaemic outcomes may support the development of targeted interventions. These interventions are aimed at empowering people with diabetes and reducing socio-economic and cultural health disparities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quantitative process evaluation of a feasibility randomised controlled trial of a co-designed cognitive behavioural therapy intervention for people with type 1 diabetes and disordered eating (steady trial): Auditing treatment integrity and delivery","authors":"Amy Harrison,&nbsp;Natalie Zaremba,&nbsp;Jennie Brown,&nbsp;Divina Pillay,&nbsp;Jacqueline Allan,&nbsp;Rachael Tan,&nbsp;Janet Treasure,&nbsp;Khalida Ismail,&nbsp;Marietta Stadler","doi":"10.1111/dme.70124","DOIUrl":"10.1111/dme.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Safe management of people with Type 1 diabetes and Eating Disorders study (STEADY), a complex psychological intervention, defined by the Medical Research Council as involving multiple interacting components and individualised delivery, is a treatment designed for people with Type 1 diabetes and mild-to-moderate disordered eating (T1DE) which integrates cognitive behavioural therapy (CBT) with diabetes education. STEADY was previously tested in a feasibility randomised controlled trial (RCT), and the purpose of this work was to maximise trial learning to support future scaling up of STEADY in a multi-site RCT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study addressed three research questions: (1) Which STEADY toolkit tools were used in the intervention, and at which point? (2) To what extent was treatment delivered as intended, reflecting the minimum competency (≥3) on the Cognitive Therapy Rating Scale (Revised; CTS-R)? (3) How long did it take to deliver the STEADY intervention?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A range of STEADY tools were used during the trial; the five most frequent tools were CBT formulation (72 uses), behavioural experiments (47 uses), thought records (43 uses), goal setting (40 uses) and understanding emotions and ‘riding the wave’ (40 uses). The CTS-R mean score was 3.81 ± 0.74, indicating competent adherence to CBT. Mean time to completion was 153.3 days (SD = 73).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>When scaling up for a multi-site RCT, some participants may need greater flexibility regarding timing to access all STEADY sessions. STEADY can be personalised through its toolkit-based approach, and therapists should be mindful and trained in the range of tools available.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of outcomes measured in interventional trials in people with diabetic sensorimotor polyneuropathy","authors":"Galvin Chiam,&nbsp;Sasha Smith,&nbsp;Tony Tu,&nbsp;Amaan Din,&nbsp;Pasha Normahani,&nbsp;Alun Davies","doi":"10.1111/dme.70134","DOIUrl":"10.1111/dme.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetic sensorimotor polyneuropathy (DSPN) is the most common chronic complication of diabetes. Heterogeneity in outcome measures across DSPN trials may have hindered the development of novel therapies. No core outcome set (COS) exists to standardise DSPN trial outcomes. This systematic review aims to identify and synthesise outcomes reported in DSPN interventional trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The protocol was pre-registered on PROSPERO (CRD42023408403) and reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Prospective DSPN interventional trials since 2018 were searched with a predefined strategy, and primary and secondary verbatim outcomes were extracted, merged and organised using a taxonomy recommended by Core Outcome Measures in Effectiveness Trials (COMET). Outcome measuring tools were summarised descriptively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 4851 abstracts screened, 184 were eligible (protocols, <i>n</i> = 24; ongoing trials, <i>n</i> = 48 completed trials without published results, <i>n</i> = 11; published trials with results, <i>n</i> = 101). Pain was the most common primary (<i>n</i> = 127) and secondary (<i>n</i> = 64) unique outcome. By taxonomy, nervous system outcomes were the most common primary (<i>n</i> = 174) and secondary (<i>n</i> = 89) measure. The most common measuring tools were the visual analogue scale (<i>n</i> = 37), numerical rating scale (<i>n</i> = 37) and nerve conduction study (<i>n</i> = 34). Over 30 distinct measuring tools were utilised to measure nervous system outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite consistent outcome reporting, variability in measuring tools highlights the need for a COS with standardised tools. Patient-reported outcomes were more common than assessor-reported outcomes; however, using both may reduce response variability and bias. These findings will inform a future Delphi process to develop a COS for DSPN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study to explore experiences and views of patients and their family members managing steroid-induced hyperglycaemia (SIH) out of hospital","authors":"Nyangi Gityamwi,&nbsp;Suzanne van Even,&nbsp;Younes Ramazan Younes,&nbsp;Jo Armes,&nbsp;Benjamin C. T. Field","doi":"10.1111/dme.70138","DOIUrl":"10.1111/dme.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore the experiences of patients, families and clinicians managing steroid-induced hyperglycaemia (SIH) out of the hospital and identify areas for improved care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched hospital records to identify patients requiring input from the diabetes inpatient team between February 2022 and March 2023 due to steroid usage. Clinicians, patients and their family members were interviewed remotely about their experiences of care and views on how to improve it. Patient characteristics were extracted from hospital records and descriptively summarised. Interview data were subjected to framework analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We interviewed 23 patients (60% male, aged 40–88 years). The median (IQR) glucocorticoid daily dose (prednisolone-equivalent) was 40 mg (20–60). Fifteen (65%) patients were followed up after discharge by the diabetes specialist team, the remainder being referred to primary care. Nine family members and five diabetes care clinicians were also interviewed.</p>\u0000 \u0000 <p>SIH impacts negatively on patients' and families' physical and social well-being and increases clinical workload. Participants reported feeling anxious and uncertain when self managing SIH out of hospital, particularly those with multimorbidity and no prior history of diabetes. Regular post-discharge clinical follow-up builds patients' confidence and satisfaction, but there was limited post-discharge follow-up care, and conflicting advice was provided on SIH management from different care teams. Better discharge care planning, communication, family support and provision of SIH self management resources could improve care and experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings emphasise having robust, individualised, post-discharge care planning; better communication across care pathways; and provision of skills and resources to all partners in healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring gender differences in physical activity and related barriers in children and adults living with type 1 diabetes: A narrative review","authors":"Elsa Heyman,&nbsp;Tricia M. Peters,&nbsp;Elodie Lespagnol,&nbsp;Cassandra Parent,&nbsp;Anne-Sophie Brazeau,&nbsp;Jane E. Yardley","doi":"10.1111/dme.70132","DOIUrl":"10.1111/dme.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In the general population, individuals who self-identify as girls and women are typically less active and report more barriers to physical activity (PA), often influenced by gender stereotypes and sociocultural norms. These barriers may be accentuated in individuals with type 1 diabetes (T1D), who face additional diabetes-related barriers to engaging in PA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this narrative review, electronic databases were searched using keywords related to PA barriers and T1D. Titles, abstracts and full texts were screened to select articles analysing gender effects or reporting specific data on girls/women with T1D versus peers without diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>While many studies have examined gender effects on PA levels in T1D (consistently reporting lower overall and vigorous-intensity PA in girls/women), few have explored gender effects on barriers to PA. Among the ten barrier-related studies, some (but not all) suggest that girls/women report higher overall PA barrier scores and diabetes-related concerns, such as fear of hypoglycaemia, hyperglycaemia or losing control over diabetes management, compared with boys/men. The interactions between PA barriers and PA levels appear complex and may vary between adults and children. However, these interactions remain understudied from a gender perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fear of glycaemic challenges related to PA appears to be a greater barrier for girls/women with T1D versus boys/men. However, further research is needed to examine universal barriers to PA. Interactions between diabetes-related or universal barriers with lower habitual PA also require exploration as a first step towards developing appropriate PA promotion initiatives, whether focused on glycaemic management education or social factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal cohort study describing childhood type 1 diabetes incidence and prevalence rates in British Columbia, Canada over 27 years (1997–2023)","authors":"Shazhan Amed,&nbsp;Jeffrey N. Bone,&nbsp;Shreya B. Kishore,&nbsp;Qian Zhang,&nbsp;Joseph Leung","doi":"10.1111/dme.70133","DOIUrl":"10.1111/dme.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Our study described incidence and prevalence trends of type 1 diabetes in children and youth under 20 years of age from 1997 to 2023 in the Canadian province of British Columbia (BC) and assessed for a 4-, 5-, or 6-year cyclicity or increase in incidence during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using linked population-level databases and a validated case-finding and diabetes differentiating algorithm, we identified children with type 1 diabetes diagnosed between 1997 and 2023. Data sources included hospital admissions, outpatient physician visits, and dispensed prescriptions. Population denominators were based on annual age- and sex-stratified population estimates. We calculated incidence per 100,000 and prevalence per 100 cases, using JoinPoint regression to identify trend changes. Cyclical patterns were tested using sine and cosine terms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1997 to 2023, the incidence of paediatric type 1 diabetes increased markedly until 2008 and then declined very gradually, with similar patterns across age and sex. Incidence was higher in boys, highest among children aged 5 to 14 years, and lowest in those aged 15 to 19 years. After 2012, prevalent cases stabilized in those under 10 and decreased in those over 10 years old. There was no evidence of cyclical trends or changes in incidence or prevalence during or after the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions/Interpretation</h3>\u0000 \u0000 <p>We report a stabilization of type 1 diabetes incidence and prevalence, along with the absence of pandemic-related increases. These trends may in part reflect demographic changes in British Columbia's paediatric population, including a growing proportion of children from immigrant backgrounds with historically lower type 1 diabetes risk. Unfortunately, our data sources do not include ethnicity, limiting our ability to explore these patterns directly. This study will support the optimization of resource allocation and inform healthcare improvement and long-term management of childhood type 1 diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Omnipod 5 automated insulin delivery on continuous glucose monitoring metrics and predictors of improvement in time in range","authors":"Roland H. Stimson,&nbsp;Mark W. J. Strachan,&nbsp;Shareen Forbes,&nbsp;Rohana J. Wright,&nbsp;Scott D. Mackenzie,&nbsp;Gayle McRobert,&nbsp;Emily M. McMurray,&nbsp;Marcus J. Lyall,&nbsp;Anna R. Dover,&nbsp;Fraser W. Gibb","doi":"10.1111/dme.70137","DOIUrl":"10.1111/dme.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to assess the impact of the Omnipod 5 automated insulin delivery (AID) system on continuous glucose monitoring (CGM) metrics, HbA1c, and weight in a real-world setting. Additionally, independent predictors of glycaemic response were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Observational analysis of adults with type 1 diabetes using Omnipod 5 (<i>n</i> = 353). Paired data on CGM metrics (<i>n</i> = 268), HbA1c (<i>n</i> = 193), and weight (<i>n</i> = 173) were collected at baseline and compared after median of 191, 120, and 221 days, respectively. Independent predictors of TIR response (≥5%) and HbA1c (≥5 mmol/mol) were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Omnipod 5 use was associated with improved TIR (+16%, <i>p</i> &lt; 0.001) and a reduction in HbA1c (−3 mmol/mol, <i>p</i> &lt; 0.001). The greatest improvements (−7 mmol/mol, <i>p</i> &lt; 0.001) were observed in individuals with elevated baseline HbA1c (≥58 mmol/mol). Sensor choice (Dexcom G6 vs. Freestyle Libre 2 Plus) influenced time in full auto mode (94% vs. 96%, <i>p</i> &lt; 0.001) but did not affect the likelihood of improved TIR or HbA1c. Logistic regression identified baseline HbA1c (OR 1.24 per mmol/mol, <i>p</i> &lt; 0.001) as the main association with improved HbA1c. Similarly, baseline TIR was associated with improvement in TIR (OR 0.83 per %, <i>p</i> &lt; 0.001). Greater time in automation and using the lowest glucose target were also associated with improved outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Omnipod 5 is associated with significant and sustained improvements in CGM metrics and HbA1c, particularly in individuals with higher baseline HbA1c. The results suggest the potential benefits of prioritizing AID for individuals at greatest risk of complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription distribution and inequities in diabetes care: A comparative analysis of continuous glucose monitoring access by diabetes status, ethnicity and socio-economic factors in England","authors":"Samuel Seidu,&nbsp;John Tetteh,&nbsp;Setor Kunutsor,&nbsp;Pratik Choudhary,&nbsp;Kamlesh Khunti,&nbsp;Ramzi A. Ajjan","doi":"10.1111/dme.70130","DOIUrl":"10.1111/dme.70130","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Diabetes affects over 3.3 million people in England, creating a significant health and economic burden. Continuous glucose monitoring (CGM) improves diabetes management but remains unevenly accessible, especially among Black and minority groups who face onset at younger ages, higher diabetes rates and complications. Updated NICE guidelines promote CGM access for all people with T1D and certain people with T2D, yet data on prescribing patterns in England are limited. This study investigates CGM prescribing across integrated care boards (ICBs) and primary care networks (PCNs), focusing on ethnicity and deprivation, to identify and address access disparities.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Cross-sectional analysis of publicly available data examined CGM prescribing patterns across England's PCNs, focusing on ethnicity and socio-economic factors. Data from OpenPrescribing, the National Diabetes Audit and Public Health England were analysed through descriptive and inferential statistics, including regression and Intraclass Correlation Coefficient (ICC) calculations, to assess disparities in prescribing ratio per 1000 people.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Significant disparities in CGM prescribing across PCNs and ICBs are identified, shaped by ethnicity, age and socio-economic factors. The mean items prescription ratio is 4.87 per 1000 people, ranging from 0.26 to 11.59. People with T1D are generally younger, with only 15.5% over 65, compared to 52.0% in T2D. White individuals represent 83.6% of T1D cases, while South Asians and Afro-Caribbeans are more prevalent in T2D (14.5% and 5.3%, respectively). ICBs with below-average CGM prescribing have a higher percentage of Afro-Caribbean and South Asian populations compared to ICBs with above-average prescribing. For T1D, Afro-Caribbean representation is 6.7 (SD:7.0) in lower-prescribing ICBs versus 2.1 (SD:2.8) in higher-prescribing ICBs, and for T2D, it is 8.4 (10.4) versus 1.8 (SD:3.4) South Asian representation in low-prescribing ICBs is 10.6 (SD:13.7) for T1D and 21.9 (SD:20.5) for T2D, compared to 3.2 (SD:4.9) for T1D and 6.5 (SD:9.7) for T2D in higher-prescribing ICBs. CGM prescribing variance attributed to ethnicity and deprivation is 46.6% in T1D and 77.3% in T2D, indicating considerable socio-demographic impact.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study reveals significant ethnic disparities in CGM access, with Afro-Caribbean and South Asian groups facing a reduced prescribing ratio per 1000 people. Consistent N","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 11","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}