Diabetic Medicine最新文献

{"title":"Management of diabetic ketoacidosis in adult inpatients: A retrospective analysis of rates of hypoglycaemia with variable-rate and fixed-rate intravenous insulin infusion protocols","authors":"Stephanie Baddock,&nbsp;Lisa Raven,&nbsp;Gimhani Abeygunasekara,&nbsp;Mirelle Roche,&nbsp;Carolyn Petersons","doi":"10.1111/dme.70063","DOIUrl":"10.1111/dme.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To compare variable-rate intravenous insulin infusion (VRIII) to fixed-rate intravenous insulin infusion (FRIII) on the incidence of hypoglycaemia during DKA management. Secondary outcomes were time to resolution of ketosis and hospital length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Single-centre retrospective cohort study of adults with DKA managed with VRIII protocol and FRIII protocol.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty participants were included, 45 treated with VRIII and 35 with FRIII. Hypoglycaemia incidence did not differ, <i>n</i> = 7 (16%) in VRIII and <i>n</i> = 8 (23%) in FRIII (<i>p</i> = 0.565). Of those who developed early hypoglycaemia (&lt;12 h) 88% were in the FRIII cohort versus 29% in VRIII (<i>p</i> = 0.041). Time to resolution of ketosis did not differ between groups (VRIII median 11.5 h [IQR 7–24] vs. FRIII median 9 h [IQR 6–14.5], <i>p</i> = 0.163). The VRIII cohort had both longer hospital length of stay (VRII median 3 days [IQR 1–7] vs. FRIII median 2 days [IQR 1–4], <i>p</i> = 0.049) and longer time on insulin infusion (VRIII median 25 h [IQR 18–41] vs. FRIII median 18 h [IQR 14–28], <i>p</i> = 0.018).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There were similar rates of hypoglycaemia between VRIII and FRIII protocols; however, FRIII was associated with higher rates of early hypoglycaemia. Although time to resolution of ketosis was similar, VRIII was associated with longer hospital length of stay and time on insulin infusion. Further research is needed to determine the optimal insulin infusion regimen.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991152","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":"Does glycaemic control or renal function provide a better indicator for the service support required in type 1 diabetes?","authors":"Adrian H. Heald,&nbsp;Mike Stedman,&nbsp;Edward Jude,&nbsp;Hellena Habte-Asres,&nbsp;Angus Forbes,&nbsp;Martin Whyte,&nbsp;J. Martin Gibson,&nbsp;William Ollier","doi":"10.1111/dme.70050","DOIUrl":"10.1111/dme.70050","url":null,"abstract":"&lt;p&gt;Advances in blood glucose measurement and insulin dosing used in the management of type 1 diabetes (T1D) over the last 25 years have provided a frameshift of opportunity for improving outcomes relating to how clinical monitoring data are derived, and the perceptions that patients have regarding their care strategies to achieve therapeutic goals.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Chronic kidney disease (CKD) in people with T1D can be slowed or prevented through the use of renal protective therapies such as antagonists of the renin-angiotensin system.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; However, CKD remains a continuous and major management challenge, as does maintaining blood glucose levels within the target range. The number of specialist appointments attended each year and required by each patient might be used as a measure of the overall health status of the individual.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; This study aimed to determine whether glycaemic control (HbA&lt;sub&gt;1c&lt;/sub&gt;) or renal function [estimated glomerular filtration rate (eGFR) and albumin creatinine ratio (ACR)] is a better predictor for the need for intensive specialist care in T1D.&lt;/p&gt;&lt;p&gt;Only a relatively small number of long-term cohorts of people with T1D with longitudinal data have been described.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; We have been able to examine the continuous health records of T1D individuals collected for over 15 years (2008–2023) using the Salford (United Kingdom) Diabetes Cohort. This encompasses all individuals diagnosed as having T1D with primary and secondary care follow-up data for up to 25 years from 2000 onwards. Ethical permission was obtained (23/WS/0175 Favourable Opinion on 8 March 2024).&lt;/p&gt;&lt;p&gt;Patients with over 10 years of results within the study period were split across their middle calendar year (between 2008 and 2023). For cross-sectional analysis, the median value in each patient for HbA&lt;sub&gt;1c&lt;/sub&gt;, eGFR, ACR, and annual number of outpatient appointments was compared to the overall median value to classify their results as either high or low. For longitudinal analysis, the median change between the first and second halves of the period 2008–2023 was applied to calculate high and low change in eGFR versus outpatient appointments. For both cross-sectional and longitudinal analyses, the simple odds ratio linking the numbers in high and low classes of HbA&lt;sub&gt;1c&lt;/sub&gt;, eGFR and ACR to high and low outpatients was calculated.&lt;/p&gt;&lt;p&gt;Six hundred and ninety-six (696) individuals with T1D (mean age 51.4 years, &lt;i&gt;n&lt;/i&gt; = 302 females) had sufficient data to analyse. We took a threshold of &gt;4 outpatient (OP) attended appointments per year as indicative of intense input using simple linear regression as the median number of OP appointments per day was 4.1.&lt;/p&gt;&lt;p&gt;There was no link between mean level of HbA&lt;sub&gt;1c&lt;/sub&gt; (&lt;65 vs. ≥65 mmol/mol) and relative number of attended OP appointments each year (OR 0.84 95% confidence interval [CI] 0.64–1.04).&lt;/p&gt;&lt;p&gt;In any calendar year, i","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991285","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":"Glycated albumin and fructosamine do not improve accuracy of glycaemic control assessment in patients with conditions reported to affect HbA1c reliability","authors":"Anxious J. Niwaha,&nbsp;Priscilla A. Balungi,&nbsp;Timothy J. McDonald,&nbsp;Andrew T. Hattersley,&nbsp;Beverley M. Shields,&nbsp;Moffat J. Nyirenda,&nbsp;Angus G. Jones","doi":"10.1111/dme.70011","DOIUrl":"10.1111/dme.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>HbA_1c testing in African populations may be limited due to high prevalence of hemoglobinopathies, anaemia, malaria and renal impairment. We aimed to assess the performance of glycated albumin (GA) and fructosamine in comparison to HbA_1c for determining glycaemic control in Africans living with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We compared the relationship between fructosamine, GA, and HbA_1c with mean continuous glucose monitoring (CGM) glucose and assessed the impact of sickle cell trait (SCT), anaemia and renal impairment on the relationship between each measure and CGM glucose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall association of HbA_1c, GA and fructosamine with CGM glucose was similar (<i>r</i> = 0.88 [95%CI: 0.84, 0.91], 0.84 [0.79, 0.88] and 0.84 [0.79, 0.88]), respectively. For detecting those with mean CGM glucose &gt;8 mmol/L HbA_1c had similar diagnostic accuracy to GA and fructosamine, even in those with conditions reported to affect HbA_1c performance (<i>n</i> = 63). We found no evidence that SCT (<i>n</i> = 43/192) altered the relationship between HbA_1c, fructosamine or GA with CGM glucose (<i>p</i> &gt; 0.3 for all). However, individuals with anaemia showed an underestimation of CGM glucose by HbA_1c and fructosamine compared to those without anaemia (<i>p</i> for interaction &lt;0.005 for both). In contrast, GA with average CGM glucose between those with anaemia and those without were not significantly different.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Switching to fructosamine or GA is unlikely to improve the accuracy of laboratory glycaemic monitoring beyond that of HbA_1c in a population with high prevalence of conditions reported to affect HbA_1c reliability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982712","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":"Improving access to diabetes technologies in children and young people with type 1 diabetes: Healthcare professionals' perspectives and views","authors":"Rachel Dlugatch,&nbsp;David Rankin,&nbsp;Mark Evans,&nbsp;Nick Oliver,&nbsp;Sze May Ng,&nbsp;Julia Lawton","doi":"10.1111/dme.70058","DOIUrl":"10.1111/dme.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To understand and explore the strategies, resources, and interventions healthcare professionals are implementing, or recommend implementing, to promote more equitable access to diabetes technology amongst children and young people (CYP) with type 1 diabetes in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Interviews were conducted with (<i>n</i> = 29) healthcare professionals working in paediatric diabetes in England from (<i>n</i> = 15) purposively selected sites. Data were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Healthcare professionals reported many strategies to help address diabetes technology access disparities in CYP, structured under the following themes: ‘Re-evaluating staff levels, roles, and efficiency’; ‘Improving communication’; ‘Promoting peer support and community outreach’; ‘Providing financial and social support for deprived CYP/caregivers’; ‘Encouraging CYP/caregiver choice;’ and ‘Funding, sustainability, and burnout.’ Many of these strategies appeared to be local (e.g., site-specific) solutions, made possible by short-term, one-off funding schemes and innovation by individual team members. While some proposed strategies appeared to improve staff time-efficiencies allowing greater numbers of CYPs to be moved onto technology, others, as interviewees noted, could add to individual team members' workloads and stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Healthcare professionals appeared highly committed to addressing technology access disparities in CYP. While some of their recommendations may be easier to implement than others, our findings underscore the importance of adopting a joined-up, integrated approach to promoting equitable technology access across the UK. This would require closer collaboration and resource-sharing within and across sites, backed by sustainable, long-term funding, with a significant portion dedicated to increasing staffing capacity to support the practical implementation of these strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974534","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":"The cardio-renal-metabolic role of the nod-like receptor protein-3 and senescence-associated secretory phenotype in early sodium/glucose cotransporter-2 inhibitor therapy in people with diabetes who have had a myocardial infarction","authors":"M. U. Shah,&nbsp;C. L. Cliff,&nbsp;P. E. Squires,&nbsp;K. Lee,&nbsp;C. E. Hills","doi":"10.1111/dme.70059","DOIUrl":"10.1111/dme.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Following an acute myocardial infarction (AMI), individuals with type 2 diabetes (T2DM) have a 2-to-3 fold increased risk of mortality compared to those without diabetes, and globally cardiorenal complications account for 50% of diabetes-related deaths. The use of sodium/glucose cotransporter-2 inhibitors (SGLT2i) in people with T2DM-AMI is associated with decreased inflammatory burden and improved cardiorenal outcomes. The mechanisms behind this protection are unclear and form the basis of this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single centre, prospective study with randomisation will utilise plasma and monocyte-derived macrophages from patients with T2DM who have recently had an AMI and are prescribed Empagliflozin (SGLT2i) either immediately following the acute cardiac event or at 3 months post-AMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study will test the hypothesis that Empagliflozin provides anti-inflammatory protection by suppressing systemic NOD-like receptor protein-3 (NLRP3) inflammasome activation and the pro-inflammatory senescence-associated secretory phenotype (SASP), perpetrators of sterile (non-pathogen evoked) inflammation linked to poor clinical outcomes in T2DM-AMI patients. The study will also assess the benefits of early intervention on these parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elucidating a role for an SGLT2i in suppressing sterile inflammation will enhance understanding of how they can be used effectively to treat cardiorenal complications and will identify novel pathways for future intervention. Furthermore, the optimal timing of when to initiate SGLT2i therapy post-AMI is unclear. Correlating the level of protection to the onset of therapy in individuals with T2DM, AMI and at cardiovascular risk will establish if Empagliflozin provides greater benefit when intervention is initiated earlier.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984265","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":"HLA haplotype diversity, islet autoantibody status and discriminative ability of type 1 diabetes genetic risk score in Indians","authors":"Alagu Sankareswaran,&nbsp;Pooja Kunte,&nbsp;Diane P. Fraser,&nbsp;Mobeen Shaik,&nbsp;Dimple Lavanuru,&nbsp;Michael N. Weedon,&nbsp;Richard A. Oram,&nbsp;Chittaranjan S. Yajnik,&nbsp;Giriraj R. Chandak","doi":"10.1111/dme.70041","DOIUrl":"10.1111/dme.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We have reported that a 9SNPs type 1 diabetes (T1D) Genetic Risk Score (GRS) developed from European data had a lower power in Indians to distinguish T1D from type 2 diabetes (T2D). We explore the performance of an improved (67SNPs) T1DGRS and also the potential reasons for lower discriminative ability to classify types of diabetes in Indians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied the discriminative ability of a 67SNPs European T1DGRS in 611 clinically diagnosed T1D and 1153 T2D patients, and 321 non-diabetic controls, using receiver operating characteristic (ROC) area under the curve (AUC). We also compared the frequency and effect sizes of HLA risk haplotypes between Indians and Europeans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The T1DGRS was discriminative of T1D from T2D and controls. However, the ability is lower in Indians than Europeans (AUC, Europeans 0.92, Indians all T1D 0.83, AA-positive 0.86). The T1DGRS was higher in AA-positive than in AA-negative persons [13.01 (12.79–13.23) vs. 12.09 (11.64–12.56)], <i>p</i> &lt; 0.0001. The association of common HLA-DQA1 ~ HLA-DQB1 haplotypes was broadly similar; however, important differences were noted in the frequency, direction and magnitude of effect for some haplotypes between Indians and Europeans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We confirm broad applicability of European 67SNPs T1DGRS to Indian T1D persons. However, differences in HLA allele frequencies, magnitude and directional differences reduced the predictive value. Our results stress the need to generate ancestry-specific GRS, which we plan to do in the near future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977540","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":"Skin reactions to Freestyle Libre Pro among individuals with and without diabetes","authors":"Suresh Rama Chandran,&nbsp;Karen Jui Lin Choo,&nbsp;Hong Chang Tan,&nbsp;May Zin Oo,&nbsp;Celine Yu Hui Wong,&nbsp;Wei Mian Ang,&nbsp;Daphne Gardner","doi":"10.1111/dme.70062","DOIUrl":"10.1111/dme.70062","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985679","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":"Age- and sex-dependent lipid trajectories in children and adolescents with type 1 diabetes-A Danish nationwide registry-based study.","authors":"Emma Lund, Dorte Vistisen, Jannet Svensson, Niels H Birkebaek, Pernille F Rønn","doi":"10.1111/dme.70055","DOIUrl":"https://doi.org/10.1111/dme.70055","url":null,"abstract":"<p><strong>Aims: </strong>To examine age and sex differences in lipid trajectories in paediatric type 1 diabetes. Secondly, to examine the effect of HbA_1c and BMI on low-density lipoprotein (LDL-C) trajectories and the proportion of children meeting the LDL-C threshold for intervention according to ISPAD guidelines.</p><p><strong>Methods: </strong>Information on children and adolescents with type 1 diabetes was retrieved from DanDiabKids from 2005 to 2019. All individuals <19 years with at least two lipid measurements were included. Linear mixed effects models were used to model lipid trajectories over age with adjustment for potential confounders. Sex differences were examined as interactions.</p><p><strong>Results: </strong>We analysed 1188 girls and 1,288 boys with a total of 8563 lipid measurements and a median (Q1-Q3) diabetes duration of 6.4 years (4-9.6 years) at last visit. Total cholesterol (TC), LDL-C and triglycerides increased across all ages for girls, while high-density lipoprotein (HDL-C) declined slightly. In boys, TC, LDL-C and HDL-C decreased from around 12 years, while triglycerides increased over the entire age scale. Higher HbA_1c and BMI z-scores were associated with higher LDL-C. Depending on age and sex, 19%-42% of individuals had LDL-C values above the limit for intervention.</p><p><strong>Conclusions: </strong>TC, LDL-C, HDL-C and triglycerides vary with age and sex in children and adolescents with type 1 diabetes. In addition, a high proportion of adolescents, particularly girls, have LDL-C levels above the intervention threshold. The results call for more research on age- and sex-specific levels of LDL-C that should lead to intervention to prevent future cardiovascular events.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70055"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959165","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":"Accelerating diabetes innovation for real-world community impact through interdisciplinary research: Who is at the table?","authors":"Elizabeth Holmes-Truscott,&nbsp;Joanne Jordan,&nbsp;Leonid Churilov,&nbsp;Wendy Davis,&nbsp;Sarah Glastras,&nbsp;Marlena Klaic,&nbsp;Meaghan Read,&nbsp;An Tran-Duy,&nbsp;David O'Neal,&nbsp;Elif Ekinci","doi":"10.1111/dme.70057","DOIUrl":"10.1111/dme.70057","url":null,"abstract":"&lt;p&gt;Diabetes represents a range of conditions characterised by hyperglycaemia, impacting β-cell function and insulin action, and requiring daily self management in the form of tailored pharmacological and behavioural interventions. This heterogeneity is further compounded by the broad spectrum of acute and chronic diabetes-related complications which may compromise the function of every organ in the body and, ultimately, impact quality and quantity of life. It is therefore not surprising that generating innovative solutions to support the physical, emotional and social well-being for people living with diabetes is correspondingly complex and cannot be addressed successfully by a single academic discipline.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This commentary article represents a call to action for comprehensive interdisciplinary diabetes research to become the standard to accelerate diabetes innovation and realise research advancements into ‘real-world’ community impacts. The authors are members of the Australian Centre for Accelerating Diabetes Innovation (ACADI)—a collaborative interdisciplinary national diabetes centre uniting over 70 different partners, including academic, advocacy, health service, industry and community partners. Importantly, the authors represent diverse disciplines (Figure 1) and lived experience (of gestational diabetes, EHT; and type 1 diabetes, MR).&lt;/p&gt;&lt;p&gt;While there is a substantial body of work dedicated to the meaning of &lt;i&gt;interdisciplinary research&lt;/i&gt;,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; for this commentary, it is defined as the integration of knowledge, techniques and perspectives ‘from two or more disciplines to advance fundamental understanding or to solve problems whose solutions are beyond the scope of a single discipline’.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Interdisciplinary diabetes research offers several benefits. Combining different areas of expertise and innovative thinking is of central influence in scientific achievements and breakthroughs.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Interdisciplinary research can bring novel insights, overcome feasibility or logistical constraints by pooling available resources to increase capacity and enhance complexity and sophistication of research outputs.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Thus, interdisciplinary research can reduce duplication, and ensures that the best approach and methods are used to assess outcomes, thereby increasing the appropriate allocation and efficient use of research funding to the needs and priorities of diverse communities.&lt;/p&gt;&lt;p&gt;Methodologies and frameworks have been developed specifically to assist researchers to engage in and understand the process of interdisciplinary research,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; including making disciplinary perspectives explicit to assist mutual understanding.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; Figure 1 provides a high-level outline of a range of disciplines (and example disciplinary questions) that can contribute to the diabetes research table to increase the likelihood of t","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968288","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 Simplera Sync™ sensors and Extended™ Wear Infusion Sets on glycaemia and system performance of the MiniMed™ 780G system in children and young adults with previously high HbA1c","authors":"Venus R. Michaels,&nbsp;Alisa Boucsein,&nbsp;Yongwen Zhou,&nbsp;Shirley D. Jones,&nbsp;Ryan G. Paul,&nbsp;Esko Wiltshire,&nbsp;Craig Jefferies,&nbsp;Martin I. de Bock,&nbsp;Benjamin J. Wheeler","doi":"10.1111/dme.70048","DOIUrl":"10.1111/dme.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The MiniMed™ 780G improves glycaemia and reduces burden in type 1 diabetes. We investigated how new all-in-one “Simplera Sync™” sensors and 7-day Extended™ Wear Infusion Sets (EIS) affect glycaemia and system performance in young people with previously elevated HbA1c levels (≥69 mmol/mol [≥8%]) after transitioning from 780G with Guardian 4™ sensors and 3-day infusion sets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an extension phase analysis in 75 participants (aged 7–25 years) initially enrolled in the CO-PILOT randomised controlled trial. For this analysis, baseline was defined as the period following the use of 780G with Guardian 4™ sensors and 3-day infusion sets. Participants then transitioned to 780G with Simplera Sync™ and EIS. We compared glycaemic and system performance outcomes from baseline to those after the transition to 780G with Simplera Sync™ and EIS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline HbA1c was 66.1 mmol/mol ± 14.2 mmol/mol and remained stable at 66.7 mmol/mol ± 11.2 mmol/mol after the transition (<i>p</i> = 0.38). Time in range (3.9–10.0 mmol/L [70–180 mg/dL]) at baseline was 58.5% ± 14.9% and 60.4% ± 15.7% after transition (<i>p</i> = 0.09). Time in tight range (3.9–7.8 mmol/L [70–140 mg/dL]) increased from 38.1% ± 13.1% at baseline to 40.5% ± 13.6% after the transition (<i>p</i> = 0.04). While using 780G with Simplera Sync™ and EIS, automation time increased from baseline 79.2% ± 25.9% to 85.8% ± 21.8% (<i>p</i> = 0.007), and sensor wear time from 80.7% ± 22.4% at baseline to 88.4% ± 17.2% (<i>p</i> &lt; 0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Simplera Sync™ and EIS improved time in automation and sensor wear time when using 780G AHCL in this high-risk young population. This was associated with incremental improvement in time in tight range despite the challenges of this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973604","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}