Diabetic Medicine最新文献

{"title":"Examining the joint association of parental education and childhood adversities on gestational diabetes risk: A nationwide register study from Denmark","authors":"Hiroaki Onizuka,&nbsp;Naja H. Rod,&nbsp;Karoline Kragelund Nielsen,&nbsp;Peter Damm,&nbsp;Megan Davies","doi":"10.1111/dme.70091","DOIUrl":"10.1111/dme.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Low parental education during childhood may increase vulnerability to childhood adversities, which is known to increase the risk of gestational diabetes mellitus (GDM). We aimed to examine the joint association of parental education and childhood adversity on GDM risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used Danish nationwide register data of 206,819 women giving birth for the first time during 2004–2018. Five adversity groups were used to measure childhood adversity: low adversity, early material deprivation, persistent deprivation, loss or threat of loss, and high adversity. We examined the joint association of parental education and childhood adversity on GDM risk through interaction at the multiplicative and additive scale, using three levels of parental education: low, medium and high education, with high education and low adversity as the referent group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>4758 (2.3%) women were diagnosed with GDM in the study population. We found a significant joint association of parental education and childhood adversity on GDM risk. Women with a low parental education level and who experienced loss or threat of loss had a higher risk of GDM compared to women with a high parental education level and low childhood adversity (OR 2.60 [95% CI 2.15; 3.12]). The additive scale showed some additivity though did not reach statistical significance, and there was no evidence of interaction on the multiplicative scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Having both exposure to low parental education and childhood adversity may further increase the risk of GDM. Structural interventions aimed at providing better support and resources for low socioeconomic status families may reduce the risk of GDM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340792","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":"Impact of automated insulin delivery on subjective and objective sleep in children and young adults with very high HbA1c: Sleep outcomes from the CO-PILOT randomised controlled trial","authors":"Venus R. Michaels,&nbsp;Alisa Boucsein,&nbsp;Jillian J. Haszard,&nbsp;Barbara Galland,&nbsp;Kim A. Meredith-Jones,&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.70093","DOIUrl":"10.1111/dme.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess how automated insulin delivery (AID) impacts sleep in young people with type 1 diabetes and suboptimal glycaemia (HbA1c ≥ 69 mmol/mol).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a randomised controlled trial comparing AID to usual care in 80 participants (aged 7–25 years) over 13 weeks. Sleep was a secondary outcome assessed at baseline and 13 weeks using questionnaires (subjective) and accelerometry (objective).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All participants completed the trial; 64 provided subjective and 40 provided objective sleep data. Participants reported poor subjective sleep quality alongside high levels of sleep disturbance and sleep-related impairment at both timepoints. At 13 weeks, sleep-related impairment improved more in the intervention group than in controls (MD = −4.7; 95% CI = −8.7, −0.8; <i>p</i> = 0.02), with no between-group differences in other subjective measures. Accelerometry data showed the intervention group spent 21 more minutes awake after sleep onset (WASO) (MD = 21; 95% CI = 1, 41; <i>p</i> = 0.04) and experienced a 4 percentage point decline in sleep efficiency (MD = −4.2; 95% CI = −8.0, −0.3; <i>p</i> = 0.03), compared to controls after 13 weeks. These results paralleled substantial improvements in HbA1c for intervention participants compared to controls (MD = −34 mmol/mol; 95% CI = −43, −25; <i>p</i>-value &lt;0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although AID improved some subjective sleep aspects, sleep efficiency reduced and WASO increased. The relationship between glycaemia and sleep remains unclear, suggesting that effective sleep improvement in young people with T1D may require multifactorial approaches extending beyond improving glycaemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328377","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":"Associations between health literacy, well-being and general health in adults with type 2 diabetes, considering culturally and linguistically diverse background: Results from the first diabetes MILES Australia study","authors":"Yingting Cao,&nbsp;Elizabeth Manias,&nbsp;Olumuyiwa Omonaiye,&nbsp;Alison Beauchamp,&nbsp;Rebecca Jessup,&nbsp;Brian Oldenburg,&nbsp;Jane Speight,&nbsp;Elizabeth Holmes-Truscott","doi":"10.1111/dme.70090","DOIUrl":"10.1111/dme.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine the relationships between health literacy, well-being and general health among adults with type 2 diabetes (T2DM) in Australia, overall and separately for those reporting culturally and linguistically diverse (CALD) backgrounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data were analyzed from 1962 adults with T2DM (aged 59 ± 9 years; 51% men) from the Diabetes MILES-1 survey. Participants completed the Health Literacy Management Scale (HeLMS), Personal Well-being Index (PWI) and EuroQOL Group Visual Analogue Scale (EQ-VAS) for general health status. Multiple linear regression examined associations between HeLMS Domains and outcomes (PWI; EQ-VAS) overall, and separately for CALD participants (13.7%; overseas-born in a primarily non-English-speaking country and/or primary non-English language).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately &gt;70% of participants (regardless of CALD background) reported high health literacy across all HeLMS Domains (HeLMS score &gt;4). Greater health literacy was associated with greater well-being and health status. ‘Attitudes toward health’ (Domain 1; PWI: <i>β</i> = 6.9, 95% CI (4.6–9.3); EQ-VAS: <i>β</i> = 9.0, (6.7–11.3)) and ‘socioeconomic considerations’ (Domain 4; <i>β</i> = 8.0, 95% CI (5.8, 10.3); <i>β</i> = 5.5, 95% CI (3.3–7.7)) were associated with both well-being and health status. ‘Social support’ (Domain 3; <i>β</i> = 4.3 95% CI (1.9–6.7)) and ‘being proactive’ (Domain 7; <i>β</i> = 4.6 95% CI (2.2, 7.0)) were associated with well-being only. Among participants from CALD backgrounds, Domain 1 was consistently associated with subjective well-being and general health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest the importance of domain-specific health literacy in protecting well-being and general health among adults with T2DM, including those from CALD backgrounds. Longitudinal studies are needed to understand these inter-relationships and to inform the development of appropriate interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311213","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":"SARS-CoV-2 infection and new-onset type 1 diabetes in the post-acute period among children and young people in England","authors":"Joseph L. Ward,&nbsp;Joana Cruz,&nbsp;Rachel Harwood,&nbsp;Simon Kenny,&nbsp;Dougal Hargreaves,&nbsp;Kamlesh Khunti,&nbsp;Jonathan Valabhji,&nbsp;Bianca De Stavola,&nbsp;Russell M. Viner","doi":"10.1111/dme.70084","DOIUrl":"10.1111/dme.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To examine if SARS-CoV-2 infection is associated with new-onset type 1 diabetes in the post-acute period in children and young people (CYP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this population cohort, we used data on all hospital activity in England to estimate type 1 diabetes incidence among CYP aged 0–17 exposed to SARS-CoV-2 between May 2020 and August 2022, from day 28 after a positive test for the following 6 months. We compared this with unexposed CYP who were hospitalized for elective procedures or following trauma during the pandemic, and in the 2 years prior to the pandemic (historic cohorts). We excluded CYP with prior chronic illnesses. We undertook Cox regression analyses adjusted for age, sex, ethnicity, deprivation and season of index date, and stratified by periods when different SARS-CoV-2 variants were dominant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 1,087,604 CYP in the exposed cohort, 143,748 in the trauma cohort, 253,368 in the elective cohort, 160,925 in the historic trauma cohort and 388,673 in the historic elective cohort. Hazard of developing type 1 diabetes was significantly higher among those exposed than unexposed CYP: 2.4 [1.58–3.64] relative to the trauma cohort, 2.9 [2.00–4.13] relative to the elective cohort, 4.2 [2.56–7.04] relative to the historic trauma cohort and 2.4 [1.81–3.10] relative to the historic elective cohort. Associations may be strongest during the Delta period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SARS-CoV-2 infection is associated with subsequent incident type 1 diabetes in the 1–7 months after an acute infection in previously healthy CYP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319177","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":"Simulation-based training significantly improved confidence and clinical skills of resident doctors in acute diabetes management","authors":"Kalyaani Persad,&nbsp;Aqeelah Khatoon,&nbsp;Aashritha Buchipudi,&nbsp;Amanda Ling Jie Yee,&nbsp;Nevil C. Philip,&nbsp;Angelica Sharma,&nbsp;Akshat Sinha,&nbsp;Sofia Salahuddin,&nbsp;Punith Kempegowda,&nbsp;DEVI collaboration","doi":"10.1111/dme.70068","DOIUrl":"10.1111/dme.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The joint consensus of the American Diabetes Association and the European Association for the Study of Diabetes highlights the need for practical, up-to-date training in acute diabetes care. Therefore, this session aimed to develop an applied learning intervention that identifies key gaps in acute diabetes training, assesses participants' change in confidence in managing these scenarios following the intervention and evaluates participants' satisfaction and the intervention's relevance to practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To design the programme, we adopted Kern's six-step curriculum development framework. Clinical experts were interviewed to assess general needs, and students and resident doctors were interviewed to assess targeted needs. The SIMBA (Simulation via Instant Messaging for Bedside Application) model was adopted to develop cases alongside generative AI and expert input. Pre- and post-session surveys assessed participants' confidence, while the latter also assessed satisfaction and relevance to practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>33 participants attended the session. 17 participants completed both pre- and post-session surveys and were included in the study. Simulation performance scores averaged 4.0/5 for history taking, interpretation and clinical judgement; 3.9/5 for physical examination and investigations; and 3.6/5 for management. Confidence in managing acute diabetes scenarios improved significantly (pre vs. post: 33.3% vs. 78.4%, <i>p</i> &lt; 0.001). 94.1% strongly agreed the cases were relevant, and 82.3% preferred this teaching method over traditional approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The model identified the need for targeted education on physical examination, investigations and management specific to acute diabetes scenarios. Simulation-based education significantly enhances confidence and is perceived as highly relevant for training in acute diabetes management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319178","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":"Effectiveness of diabetes footwear fit assessment by people with diabetes and their family or partners: A reliability study","authors":"Petra J. Jones,&nbsp;Jade Bullock,&nbsp;Lesley Weaving,&nbsp;Melanie J. Davies,&nbsp;Cameron Razieh,&nbsp;Ehtasham Ahmad","doi":"10.1111/dme.70065","DOIUrl":"10.1111/dme.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Incorrectly fitting footwear is implicated in ulceration yet worn by more than two-thirds of people with diabetes. Our aim is to evaluate the accuracy, reliability and ease of use of a new intervention to train people with diabetes and their ‘footwear buddies’ (e.g., partner/family member) to assess footwear for adequate length and width. Participants were provided with foot and footwear measuring tools, written instructions, video and face-to-face training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>20 participants were recruited consisting of 10 people with diabetes aged 18+ and their 10 ‘footwear buddies’. Participants measured feet and footwear length repeatedly and completed ease-of-use Visual Analogue Score surveys after reading/viewing educational materials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean absolute difference (MAD) between study participants' and researchers' foot length and width measurements was 3–5 mm after only an average 6.5 ± 1.6 min of training. Repeated measurement Intraclass Correlation Coefficient (ICC) ranged from moderate to excellent (0.71–1.00) with excellent ease of use (7.8/10).</p>\u0000 \u0000 <p>MAD between participants' and researchers' footwear length measurements was 5 mm with excellent ICC (0.99–1.00) and ease of use scores (7.8/10). However, footwear width MAD was much larger (9-11 mm, 0.96 ICC), with poor ease of use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Diabetes footwear assessment shows potential—individuals at risk of foot ulceration and their footwear buddies can be empowered to assess their feet and footwear for length even after just 20 min' training. However, footwear width measurement remains challenging, requiring either a different methodology or tool for people with diabetes to accurately and confidently assess their footwear fit.</p>\u0000 \u0000 <p><b>Trial registration:</b> ClinicalTrials.gov NCT06200532</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304362","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":"A piperidinyl indole derivative, potential complement factor B inhibitor, plays a renoprotective role in diabetic nephropathy","authors":"Zi-Han Li,&nbsp;Zi-Jun Sun,&nbsp;Dong-Yuan Chang,&nbsp;Ming-Hui Zhao,&nbsp;Sydney C. W. Tang,&nbsp;Min Chen","doi":"10.1111/dme.70092","DOIUrl":"10.1111/dme.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus (DM) and the main cause of end-stage kidney disease (ESKD) worldwide. The pathogenesis of DN is complex, and cumulating evidence demonstrated that over-activation of the complement system is involved. Complement factor B (CFB), a serine protease, drives the central amplification loop of the alternative pathway (AP) of the complement, making it a potential therapeutic target. In this study, we investigated the therapeutic potential of a piperidinyl indole derivative in <i>db</i>/<i>db</i> mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A highly potent CFB-targeting compound, (+)-4-((2<i>S</i>,4<i>R</i>)-1-((5-methoxy-7-methyl-1<i>H</i>-indol-4-yl) methyl)-4-methylpiperidin-2-yl) benzoic acid (hereafter referred as the “compound”), was orally administered to the <i>db</i>/<i>db</i> mice model. Bioinformatics and network pharmacology analyses were applied in our research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Oral administration of the compound attenuated established DN in <i>db</i>/<i>db</i> mice, as evidenced by reduced urine albumin-to-creatine ratio (uACR), tubulointerstitial inflammation and fibrosis, and thickening of glomerular basement membrane. Besides binding to the active site of Bb, the enzyme-cleaved activated fragment of CFB, and inhibiting the activity of complement component 3 (C3) convertase of the AP, the compound could regulate the expression of cysteinyl aspartate specific proteinase 3 (CASP3, a key executor of renal tubular apoptosis) and dipeptidyl peptidase 4 (DPP4, a pro-fibrotic driver in tubulointerstitium) by bioinformatics and network pharmacology analysis. These complementary mechanisms cooperated to inhibit the over-activation of complements and the apoptosis/fibrosis cascade and together alleviated DN progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data revealed the potential therapeutic strategy of using the piperidinyl indole derivative for the treatment of DN and provided a basis for its clinical development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304361","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":"Astragaloside IV alleviates diabetic foot ulcers by promoting the METTL3-mediated m6A modification of SIRT1","authors":"Yu Liu,&nbsp;Hao Zheng,&nbsp;Jiayuan Zhang","doi":"10.1111/dme.70087","DOIUrl":"10.1111/dme.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetic foot ulcer (DFU) is a common and serious complication of diabetes mellitus (DM) and one of the main causes of disability or mortality in diabetic patients. Astragaloside IV (AS-IV) is a naturally occurring plant product that can be used to treat DM and its complications. N6-methyladenosine (m6A) modification participates in the progression of DM. This study aimed to explore the potential molecular mechanisms of m6A modification induced by AS-IV treatment of DFU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The biological behaviours of cells were assessed by cell counting kit-8, EdU incorporation, wound healing, and transwell assays. The levels of m6A modification and relative genes mRNA were detected by dot blot assay and quantitative real-time PCR. The interactions between molecules were evaluated by methylated RNA immunoprecipitation (MeRIP), RIP, fluorescence in situ hybridisation, and dual-luciferase reporter analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results suggested AS-IV facilitated cell proliferation and migration of AGE-induced HaCaT cells and accelerated wound healing, thereby alleviating DFU progression. Mechanically, AS-IV promoted the m6A modification levels of SIRT1 in vivo and in vitro which was associated with increased METTL3. Besides, SIRT1 was the target of METTL3-mediated m6A modification. Silencing of SIRT1 abrogated the biological effects of METTL3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The mitigation effect of AS-IV on DFU is achieved by promoting m6A modification of SIRT1 to enhance SIRT1 stability. This study not only reveals the novel molecular mechanisms of AS-IV in the treatment of DFU but also provides new insights for the treatment of diabetes and its complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288050","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":"Stigma experienced by adolescents with type 1 diabetes: A systematic review and meta-synthesis","authors":"Rui Wang,&nbsp;Wencai Liu,&nbsp;Cuicui Yang,&nbsp;Xinyi Weng,&nbsp;Meijing Zhou,&nbsp;Jiayin Ruan,&nbsp;Dan Luo","doi":"10.1111/dme.70088","DOIUrl":"10.1111/dme.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify and synthesize qualitative evidence on the stigma experiences of adolescents with type 1 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six databases were searched from inception to February 2024: PubMed, Cochrane Library, CINAHL, MEDLINE, Embase, and PsycINFO. This meta-synthesis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Findings from the included qualitative studies were synthesized using Thomas and Harden's methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>About 17 studies were included in the meta-synthesis. Two synthesized findings emerged, including living in stigma (individual perceived and internalized stigma, stigma in interpersonal interactions, implicit stigma in the social structure) and coping with stigma (active stigma coping and escape-avoidance).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review is the first meta-synthesis specifically aimed at exploring the stigma experiences among adolescents with type 1 diabetes across individual, interpersonal, and structural levels. The multisourced stigma identified in this review is instrumental in the development of culturally informed and multitiered anti-stigma interventions for this population. It is imperative to enhance adolescents' coping abilities regarding stigma, as is the creation of a stigma-free environment for them.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295609","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":"Barriers and facilitators of physical activity and exercise among adults with type 2 diabetes mellitus in Singapore – A mixed-methods sequential explanatory study mapped to the COM-B model, theoretical domains framework and behavioural change wheel","authors":"Ying Jie Chee,&nbsp;Huiling Liew,&nbsp;Alvin Wai Kit Tan,&nbsp;Sanchalika Acharyya,&nbsp;Rinkoo Dalan","doi":"10.1111/dme.70085","DOIUrl":"10.1111/dme.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Exercise is a cornerstone in type 2 diabetes mellitus (T2DM) management. This study investigates physical activity, its barriers, and facilitators among adults with T2DM in Singapore.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In Phase I of this sequential explanatory mixed-methods study, participants with T2DM were recruited to complete the Physical Activity Stage of Change Questionnaire and were examined for metabolic profiles, physical activity and cardiorespiratory fitness (via a 3-min step test) across different stages of change. In Phase II, 20 participants stratified by their stage of change were interviewed to identify barriers and facilitators to exercise, which were classified using the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the theoretical domains framework (TDF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 100 recruited participants, 83 had complete data and 36 completed the step test. Stages of change assessment identified participants in pre-contemplation(<i>n</i> = 5), contemplation(<i>n</i> = 49), preparation(<i>n</i> = 2), action(<i>n</i> = 3), and maintenance(<i>n</i> = 24) stages. Participants in early stages (pre-contemplation/contemplation) had significantly lower daily step counts (mean ± SD 5983 ± 2788 vs. 7667 ± 3299; <i>p</i> = 0.024) and step test completion rates (29.6% vs. 68.9%; <i>p</i> = 001) than those in the later stages. Qualitative interviews revealed barriers to exercise, including low cardiorespiratory fitness, fear of injuries, lack of opportunities and inadequate motivation. Facilitators included individualized exercise regimens, exercise guidance, goal setting, family support and role modelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides insights into barriers and facilitators to exercise among individuals with T2DM in Singapore, systematically analysed using the COM-B model and TDF. Future interventions could target different components of COM-B and leverage the behavioural change wheel framework to enhance personalization and promote sustainable behavioural change to exercise.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268420","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}