Diabetic Medicine最新文献

{"title":"The burden of diabetic foot ulcers in a multi-ethnic Asian cohort","authors":"Zongwen Wee,&nbsp;Yong Mong Bee,&nbsp;Sueziani Binte Zainudin","doi":"10.1111/dme.70335","DOIUrl":"10.1111/dme.70335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetic foot ulcers (DFUs) are a major source of morbidity among individuals with diabetes mellitus (DM), imposing a substantial burden on healthcare systems. Our institution established a multidisciplinary service aiming to facilitate early specialist intervention for DFU management. This study examined demographic and cardiovascular risk profiles associated with DFU, the clinical burden of DFU in a large population, and the impact of our multidisciplinary specialist care on clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using the SingHealth Diabetes Registry on patients aged ≥18 years with DM from a tertiary centre between August 2018 and December 2023. There were 22,830 individuals with DM analysed; 2527 (11.1%) were diagnosed with DFU. Baseline demographics and clinical characteristics data were collected. Subgroup analyses were performed among patients attending the Diabetic Rapid Evaluation and lower limb Amputation Management (DREAM) clinic to evaluate differences in outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Individuals with DFU were older, had a longer duration of DM, and had a significantly higher prevalence of cardiovascular and metabolic comorbidities compared with those without (<i>p</i> &lt; 0.001). After multivariable adjustment, DFU was independently associated with increased mortality and prolonged hospitalization. Within the DFU cohort, referral to the multidisciplinary DREAM clinic in our institution was independently associated with a significantly reduced risk of major LEA, but not minor LEA, after multivariable adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DFU represent a substantial clinical burden in Singapore and are independently associated with adverse outcomes. Beyond preventive screening, early multidisciplinary, multi-specialty management is critical to reduce amputations, hospitalization, and hence mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795150","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":"Barriers and enablers to physical activity in type 1 diabetes: A mixed-methods study of adults and parent-reported child perspectives in the UK","authors":"Emma J. Cockcroft,&nbsp;Chris Bright,&nbsp;Hilary Nathan,&nbsp;Dan Farrow,&nbsp;Catherine Russon,&nbsp;Richard M. Pulsford,&nbsp;Robert. C. Andrews","doi":"10.1111/dme.70378","DOIUrl":"10.1111/dme.70378","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To identify and compare barriers and enablers influencing physical activity in adults and parent-proxy responses for children with type 1 diabetes in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross sectional survey was distributed via BreakthroughT1D (formerly JDRF) networks between December 2022 and January 2023. The survey included closed and open-ended questions on physical activity behaviours and influencing factors. Responses were collected from adults with type 1 diabetes and parent-proxy responses for children with type 1 diabetes. Quantitative data were analysed using descriptive statistics and two-proportion <i>z</i>-tests. Free-text responses were analysed thematically. Barriers and enablers were synthesised using the COM-B model and socioecological framework to identify behavioural determinants and intervention targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>311 responses were analysed (182 adults; 129 parent proxies for children). Stigma and negative comments were reported by nearly three-quarters of both groups. Adults more frequently reported clinical and motivational barriers: fear of hypoglycaemia (53%) and lack of motivation (39%). Adults reported significantly less healthcare provider support for physical activity (24%) compared with parent-proxy responses for children (57%). Parent-proxy responses for children more frequently reported external barriers, including lack of education among coaches (31%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is one of the first UK-based studies to comprehensively compare barriers and enablers across age groups. Stigma in physical activity and sports settings emerges as a major, under-recognised barrier requiring urgent attention. Multilevel interventions are required, targeting individual knowledge and motivation alongside systemic changes. These should include mandatory diabetes education for coaches and teachers, policy enforcement to address discrimination and enhanced healthcare provider support for physical activity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148285077","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":"Renal outcomes following fundus fluorescein angiography in patients with diabetic nephropathy: Incidence, risk factors and three-month kidney function changes","authors":"Hakan Ozer,&nbsp;Hafize Irem Demir,&nbsp;Sermin Coban,&nbsp;Gokhan Atay,&nbsp;Yasin Ozturk","doi":"10.1111/dme.70455","DOIUrl":"10.1111/dme.70455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study was to determine the incidence of contrast-associated acute kidney injury (CA-AKI) after fundus fluorescein angiography (FFA) in a high-risk diabetic nephropathy (DN) population, to identify clinical predictors of renal injury and to evaluate the effect of acute exacerbation on 3-month eGFR changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 307 patients diagnosed with DN. CA-AKI was defined as an increase of ≥0.3 mg/dL in serum creatinine level within 48 h or ≥1.5-fold increase within 7 days after FFA exposure. Patients' medication history and 3-month post-procedure eGFR values were recorded. Independent factors predicting CA-AKI development were assessed using multivariate logistic regression, while long-term losses were evaluated using linear regression and ROC analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CA-AKI occurred in 5.2% of patients. Lower baseline eGFR and diuretic use were independent predictors of CA-AKI. ROC analysis identified a baseline eGFR threshold of ≤32 mL/min/1.73 m² for increased CA-AKI risk, and a combined model including eGFR and diuretic use demonstrated superior predictive accuracy. Although SGLT-2 inhibitor use was associated with CA-AKI in univariate analysis, it was not independently significant after adjustment. Notably, 13 of 16 patients (81.3%) who developed CA-AKI experienced persistent eGFR decline at 3 months, and CA-AKI was the strongest predictor of subsequent renal function deterioration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FFA is associated with a clinically meaningful risk of CA-AKI in patients with advanced DN, particularly in those with eGFR ≤32 mL/min/1.73 m² and concurrent diuretic therapy. Careful pre-procedural risk stratification, individualized hydration and post-procedure renal monitoring are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842199","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":"Exploring women's preferences for diabetes prevention programs after gestational diabetes: A qualitative descriptive study","authors":"Katelyn Sushko,&nbsp;Diana Sherifali,&nbsp;Kelly Smith,&nbsp;Lorraine L. Lipscombe","doi":"10.1111/dme.70397","DOIUrl":"10.1111/dme.70397","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetes prevention programs (DPPs) that target the risk factors of type 2 diabetes (T2D) are critical for women with gestational diabetes mellitus (GDM). A new postpartum DPP developed in Toronto, Canada, has undergone successful pilot and feasibility testing. Preparation is now underway to implement this multi-centre DPP in Ontario, Canada. We aimed to explore the perspectives and preferences of women with GDM to inform program refinements and implementation strategy design for this DPP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used qualitative descriptive methods to elicit the perspectives of women with GDM regarding preferences for a postpartum DPP. The results of semi-structured interviews were analyzed using directed content analysis. We mapped the resulting findings to the Capability, Opportunity, Motivation – Behavior (COM-B) Model of Behavior Change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified three findings and six sub-findings that coincided with the components and sub-components of the COM-B Model of Behavior Change: (1) Capability—(a) physical and (b) psychological, balancing the ability to make behavior changes and the emotional impact of those changes; (2) Opportunity—(a) physical and (b) social, considering physical limitations of behavior changes and participating in a community of new mothers; and (3) Motivation—(a) reflexive and (b) automatic, examining the reasons for avoiding diabetes and understanding the correlation between diet, physical activity and well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Women with GDM desire the support of a DPP to avoid diabetes that considers their unique needs. A tailored approach that accounts for the capabilities, opportunities and motivations distinct to new mothers may optimize DPP uptake and engagement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335310","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":"Glycaemic penalty index as an independent predictor of healthcare-associated infection in surgical inpatients: A nested cohort study from the STOIC-D surgery trial","authors":"Gabrielle Blomson,&nbsp;Rahul D. Barmanray,&nbsp;Mervyn Kyi,&nbsp;Peter G. Colman,&nbsp;Leon J. Worth,&nbsp;Minh V. Le,&nbsp;Emily Sun,&nbsp;Spiros Fourlanos","doi":"10.1111/dme.70385","DOIUrl":"10.1111/dme.70385","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate the utility of the Glycemic Penalty Index (GPI), a validated tool for assessing risk of adversity associated with inpatient dysglycaemia in surgical intensive care patients, in predicting adverse clinical outcomes among surgical inpatients at a quaternary Australian hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This nested cohort study analysed data from the control arm of the Specialist Treatment of Inpatients: Caring for Diabetes in Surgery (STOIC-D Surgery) randomised controlled trial. The GPI was calculated using blood glucose values to derive patient-day weighted mean GPI (PDWMGPI). Univariable and multivariable analyses assessed associations between GPI and the outcomes of healthcare-associated infection (HAI) and acute kidney injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>691 surgical inpatients with diabetes receiving standard care were included. On multivariable analysis, increasing PDWMGPI was independently associated with healthcare-associated infection (odds ratio 1.02 per one-unit increase, 95% CI 1.01–1.04, <i>p</i> = 0.008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The association between PDWMGPI and HAI suggests that linearised summary glycaemic measures may support clinicians in identifying patients at increased risk of adverse inpatient outcomes related to glycaemic patterns when interpreted alongside clinical factors. The simplicity of GPI as a single score may assist risk stratification and prioritisation of specialist diabetes input in surgical inpatient settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70385","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267333","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":"Metabolic and bariatric surgery for patients with obesity type 1 diabetes mellitus: A comprehensive updated systematic review and meta-analysis","authors":"Sebastian Mitchell,&nbsp;Ketaki Patwardhan,&nbsp;James Lucocq,&nbsp;Georgios Geropoulos,&nbsp;Peter J. Lamb,&nbsp;Omar Ghanem,&nbsp;Roland H. Stimson,&nbsp;Andrew G. Robertson","doi":"10.1111/dme.70305","DOIUrl":"10.1111/dme.70305","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This systematic review evaluated the impact of metabolic and bariatric surgery (MBS) on weight loss, glycaemic control, insulin requirements and postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A PRISMA-compliant, PROSPERO-registered systematic review and meta-analysis (CRD42025123500) was conducted. Medline, PubMed, Embase, Scopus and CENTRAL were searched. Primary outcomes were changes in body weight, BMI, HbA1c and insulin requirements following MBS. Risk of bias was assessed using ROBINS-I and RoB-2, and certainty of evidence using GRADE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two studies, including 1324 adults with type 1 diabetes mellitus (mean age 42.2 ± 11.6 years; mean follow-up 31.6 ± 18.2 months), were analysed. Of 753 participants with reported sex, 74.6% were women (<i>n</i> = 562). A total of 1304 procedures were performed, most commonly Roux-en-Y gastric bypass (44.5%; <i>n</i> = 580) and sleeve gastrectomy (39.2%; <i>n</i> = 512), followed by adjustable gastric banding (13.0%; <i>n</i> = 170). Meta-analysis demonstrated significant reductions in body weight (mean difference 29.55 kg; 95% CI 25.72 to 33.39; <i>I</i>² = 20%) and BMI (11.35 kg/m²; 95% CI 10.36 to 12.34; <i>I</i>² = 32%). HbA1c decreased by 4 mmol/mol (95% CI 2.05 to 6.78; <i>I</i>² = 19%), and insulin requirements declined by 43%–48% (0.20 U/kg; 95% CI 0.13 to 0.26; <i>I</i>² = 58%). Postoperative complications included diabetic ketoacidosis (15/182, 8%) and severe hypoglycaemia (21/516, 4%); any complication occurred in 21/495 (4%). Evidence quality was low.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MBS achieves weight loss and reduces insulin requirements in adults with type 1 diabetes mellitus and obesity, but glycaemic improvements are minimal. Given the observational evidence base and inconsistent safety reporting, true metabolic risk remains uncertain. High-quality prospective studies with standardised outcome definitions are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577513","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":"Real-world performance of point-of-care metre, blood gas and laboratory glucose methods in Australian and American hospital inpatient cohorts","authors":"Jack A. L. Cooper,&nbsp;Rahul D. Barmanray,&nbsp;Timothy N. Fazio,&nbsp;Daniel Capurro,&nbsp;Spiros Fourlanos,&nbsp;Cherie Chiang","doi":"10.1111/dme.70395","DOIUrl":"10.1111/dme.70395","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Point-of-care (‘POC’) glucose metres are ubiquitous in hospitals, with results guiding clinical glucose management. Inpatient accuracy can diverge from controlled evaluations and may alter decision making. We therefore aim to characterise real-world inpatient glucose metre performance against gold standard methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assess POC metre, blood gas and laboratory glucose measures across two large, retrospective, adult, inpatient cohorts (Australian quaternary centre and US MIMIC-IV dataset). Glucose ‘pairs’ were defined as measurements by different modalities occurring within 15 min, with sensitivity analysis within 5 min. Agreement was evaluated using robust regression, mean absolute relative difference, and error-grid analyses. Stratified analyses assessed the effect of haemoglobin and pO₂.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Blood gas closely paralleled laboratory glucose, supporting its use as a practical comparator. POC glucose metres in both datasets exhibited systematic bias: positive at lower glucose and negative at higher glucose, with greatest variability at extremes. Narrowing the pairing window modestly improved overall error in the Australian dataset but still did not meet ISO or FDA numerical targets. For both datasets, on Parkes/Consensus Error Grids, &gt;98% of pairs fell within low-risk zones (A/B). On the DTS grid, zone-A percentages were 90.7% in the Australian cohort and 75.7% in MIMIC-IV. Low haemoglobin amplified negative bias at higher glucose, while pO₂ strata showed no consistent impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In routine inpatient care, POC glucose metres show systematic bias, amplified by anaemia. Our results support local validation of glucose metre performance and identification of high-risk results to prompt confirmatory testing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274510","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":"The Ligustrum lucidum-derived glycoside specnuezhenide alleviates metabolic-associated fatty liver disease in mice via modulation of gut microbiota and the PPARα signalling pathway","authors":"Kai Gao,&nbsp;Kai Wang,&nbsp;Jikun Hao,&nbsp;Wei Zhang,&nbsp;Meina Zhao,&nbsp;Dong Xu,&nbsp;Xingru Tao,&nbsp;Chao Guo,&nbsp;Wangting Li,&nbsp;Meiyou Liu,&nbsp;Yunyang Lu,&nbsp;Jingwen Wang","doi":"10.1111/dme.70362","DOIUrl":"10.1111/dme.70362","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic-associated fatty liver disease (MAFLD), particularly advanced metabolic dysfunction-associated steatohepatitis (MASH), leads to irreversible liver damage. Specnuezhenide (SPE), naturally isolated from <i>Ligustrum lucidum Ait,</i> has been demonstrated to exert hepatoprotective effects. However, its functional role and underlying mechanisms in MAFLD remain poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study investigated the therapeutic effects and potential mechanism of SPE on MAFLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MAFLD mice induced by high-fat diet (HFD) were employed to assess SPE's therapeutic effects in vivo. The impact of SPE on gut microbiota was analysed by 16S rRNA sequencing. RNA-seq analysis was conducted to uncover SPE's molecular mechanisms. Complementary in vitro investigations utilized FFA-treated HepG2 cells to systematically examine SPE's cellular-level impacts and regulatory pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicated that SPE could improve hepatic steatosis, liver injury and oxidative stress in MAFLD mice. SPE treatment also affected the diversity of gut microbiota and altered their composition by decreasing the Firmicutes/Bacteroidetes (F/B) ratio. The results of 16S rRNA sequencing, RNA-seq and Western blot analysis indicated that the effect of SPE on MAFLD was related to fatty acid beta-oxidation and the PPARα signalling pathway. Moreover, in HepG2 cells, SPE reduced FFA-induced lipid accumulation and oxidative stress, which was dependent on PPARα up-regulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study to demonstrate that SPE alleviates MAFLD and is associated with modulation of gut microbiota composition and activation of the PPARα signalling pathway. Our findings suggest a potential link between gut microbiota remodelling and PPARα-mediated fatty acid oxidation, highlighting its potential as a therapeutic candidate for MAFLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950669","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":"Gestational diabetes mellitus and disordered eating behaviours: A qualitative study of online forum discussions","authors":"Yasaman Noori,&nbsp;Emilie Cote,&nbsp;Shaneh Clark,&nbsp;Hayden Chambers,&nbsp;Madeleine Benton","doi":"10.1111/dme.70322","DOIUrl":"10.1111/dme.70322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore how gestational diabetes mellitus (GDM) and disordered eating behaviours (DEBs) in pregnancy and postpartum are discussed on an online forum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative reflexive thematic analysis of threads and comments from publicly accessible Reddit forums. Posts were included if they referred to current or previous GDM and described experiences related to DEBs. Only English-language posts were analysed, with no geographical restrictions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 144 posts referring to DEBs in the context of current or previous GDM were analysed. Three overarching themes were developed: (1) GDM management as a trigger for DEBs, capturing how clinical demands around diet and glucose monitoring intensified preoccupations with food and control; (2) Multilayered distress impacting on relationship with food and disordered eating, highlighting how feelings of shame, unpredictability of GDM, and perceived blame compounded food-related anxiety and DEBs; (3) Reclaiming agency—disclosure, coping, and adaptive strategies, capturing how some women regained feelings of control by sharing experiences, using adaptive coping strategies, and engaging with online peer support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GDM care protocols may exacerbate or precipitate DEBs due to their focus on dietary surveillance, glucose control and fear-based messaging. Individualised, evidence-informed care that considers psychological experiences across pregnancy and postpartum could improve both clinical and psychological outcomes for women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719279","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 diabetes mellitus on the menopausal experience: A scoping review","authors":"Rachel Black,&nbsp;Felicity Hasson,&nbsp;Lisa King,&nbsp;Mark Davies,&nbsp;Deborah Muldrew,&nbsp;Paul Slater,&nbsp;Jenny Johnston,&nbsp;Dawn Adams,&nbsp;Rhonda Murphy,&nbsp;George Kernohan,&nbsp;Vivien Coates","doi":"10.1111/dme.70420","DOIUrl":"10.1111/dme.70420","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To identify, appraise and synthesise the current evidence relating to symptoms, experiences, management and impact of menopause on QoL among women with type 1 diabetes (T1DM) or type 2 diabetes (T2DM) and to identify evidence gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a scoping review guided by Arksey and O'Mally's framework by searching CINAHL, MEDLINE, EMBASE, PsychINFO and PubMed using an iterative approach to pre-specified eligibility criteria which were reviewed with increasing familiarity with the literature. Studies focusing on peri-menopausal and menopausal people assigned female at birth with a diagnosis of T1DM or T2DM were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 16,681 records were identified from which 77 papers were subjected to full review, with 22 eligible. Research focus and methodology varied: 16 observational studies, 2 expert consensus reviews, 2 interventional studies, 1 patient and public involvement paper and 1 qualitative grounded theory paper. PRISMA-ScR guidelines were followed for transparency of reporting. Findings indicate women with diabetes experience menopausal symptoms similar to those of women without diabetes; however, they may be at risk of increased severity of symptoms, HRT use was linked to lower HbA1c levels but is largely overlooked, limited research has been undertaken exploring women's experiences and awareness of support during the menopause; existing research evidence suggests they are ill-informed and lacking effective evidence based support. There is a particular dearth of evidence relating to women with T1DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review provides evidence that menopause has a negative influence upon quality of life for many women with diabetes. The impacts span managing diabetes and menopausal symptoms and seeking and receiving support. A hypothesised bidirectional relationship between diabetes and menopause may exist: whereby progression of one may be influenced by the other also resulting in a lower quality of life. While high-level evidence on this complex inter-relationship remains limited, particularly in T1DM populations, it suggests significant unmet need for those experiencing diabetes and menopause together.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 10","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805214","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}