Diabetic Medicine最新文献

{"title":"The effect of high-fibre diets on glycaemic control in women with diabetes in pregnancy: A systematic review and meta-analysis","authors":"Danielle Jones,&nbsp;Anna Kyriakidou,&nbsp;Louise Cooper,&nbsp;Nooria Atta,&nbsp;Patrycja Tobolska,&nbsp;Suzanne Smith,&nbsp;Elizabeth Turner,&nbsp;Clive Petry,&nbsp;Clare Gillies,&nbsp;Claire L. Meek","doi":"10.1111/dme.15435","DOIUrl":"10.1111/dme.15435","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Dietary fibre improves glycaemic control in type 2 diabetes, but its therapeutic role in women with diabetes in pregnancy is unclear. We assessed the effect of dietary fibre on markers of glycaemic control in women with diabetes in pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched four databases (Cochrane Library, MEDLINE, Embase and Web of Science) to identify RCTs exploring the effect of dietary fibre, high-fibre diets or fibre supplementation on fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG) and requirement for insulin therapy, among other glycaemic makers in pregnant women with diabetes. Data were pooled for each outcome to calculate change from baseline mean (SD) and overall mean difference (MD) between control and intervention groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1462 identified studies, data from 20 eligible trials containing 1061 participants were pooled. On meta-analysis, a higher fibre intake was associated with reduced FBG (MD: −0.35 mmol/L, 95% CI: −0.53, −0.18, <i>p</i> &lt; 0.01), PBG (MD: −0.90 mmol/L, 95% CI: −1.39, −0.40, <i>p</i> &lt; 0.01) and requirement for insulin (OR: 0.24, 95% CI: 0.13, 0.46, <i>p</i> &lt; 0.01). There was significant heterogeneity for FBG and PBG (&gt;90%), attributable to differences in Intervention type for PBG (Dietary Approach to Stop Hypertension [DASH] diet, low glycaemic index, supplement; <i>p</i> &lt; 0.01) and study duration (for FBG: <i>p</i> = 0.002; not for PBG). Studies were mostly scored as high risk of bias due to lack of blinding (Cochrane Risk of Bias Tool v.2.0).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>High-quality dietary intervention studies in pregnancy are lacking. Our results suggest that high-fibre diets improve fasting and postprandial glycaemia and reduce the likelihood of requiring insulin in women with diabetes in pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544336","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":"Comparison of ultrasound scanning and clinical examination for detecting insulin injection related Lipohypertrophy and construction of Lipohypertrophy classification table.","authors":"Hongmei Xu, Zhengnan Cheng, Xiaohui Li, Chun Mu, Di Bao, Qiuling Xing","doi":"10.1111/dme.15458","DOIUrl":"https://doi.org/10.1111/dme.15458","url":null,"abstract":"<p><strong>Aims: </strong>To explore an cost-effective, convenient method for lipohypertrophy (LH) detection with a high detection rate, and to construct a classification table for LH, so as to provide reference for LH screening and management.</p><p><strong>Methods: </strong>From December 2021 to November 2022, 395 hospitalized patients with diabetes from a Tianjin tertiary hospital were enrolled. The LH was detected through ultrasound scanning (USS), structured visual palpation (SVP), and ordinary visual palpation (OVP), and the detection rates were compared. A classification table for LH (LH-LNT table) was constructed based on SVP characteristics.</p><p><strong>Results: </strong>Under USS, SVP, and OVP, the detection of LH was 89.6%, 78.0%, and 66.6% respectively, with site detection at 92.3%, 71.2%, and 57.8% respectively, showcasing statistically significant differences among the three methods. SVP had a lower misdiagnosis rate than OVP, with upper arm and thighs being common misdiagnosed sites. LH was mostly found in the lower abdomen, flat, and soft on palpation. L1N2T1 (two soft LH on abdomen) was the main type, accounting for 35.4%.</p><p><strong>Conclusions: </strong>SVP is useful for detecting LH and deserves clinical promotion. The LH-LNT table constructed here effectively summarizes patient LH status, aiding doctor-nurse-patient communication.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15458"},"PeriodicalIF":3.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496921","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":"Integrated multiomic analyses: An approach to improve understanding of diabetic kidney disease.","authors":"Claire Hill, Amy Jayne McKnight, Laura J Smyth","doi":"10.1111/dme.15447","DOIUrl":"https://doi.org/10.1111/dme.15447","url":null,"abstract":"<p><strong>Aim: </strong>Diabetes is increasing in prevalence worldwide, with a 20% rise in prevalence predicted between 2021 and 2030, bringing an increased burden of complications, such as diabetic kidney disease (DKD). DKD is a leading cause of end-stage kidney disease, with significant impacts on patients, families and healthcare providers. DKD often goes undetected until later stages, due to asymptomatic disease, non-standard presentation or progression, and sub-optimal screening tools and/or provision. Deeper insights are needed to improve DKD diagnosis, facilitating the identification of higher-risk patients. Improved tools to stratify patients based on disease prognosis would facilitate the optimisation of resources and the individualisation of care. This review aimed to identify how multiomic approaches provide an opportunity to understand the complex underlying biology of DKD.</p><p><strong>Methods: </strong>This review explores how multiomic analyses of DKD are improving our understanding of DKD pathology, and aiding in the identification of novel biomarkers to detect disease earlier or predict trajectories.</p><p><strong>Results: </strong>Effective multiomic data integration allows novel interactions to be uncovered and empathises the need for harmonised studies and the incorporation of additional data types, such as co-morbidity, environmental and demographic data to understand DKD complexity. This will facilitate a better understanding of kidney health inequalities, such as social-, ethnicity- and sex-related differences in DKD risk, onset and progression.</p><p><strong>Conclusion: </strong>Multiomics provides opportunities to uncover how lifetime exposures become molecularly embodied to impact kidney health. Such insights would advance DKD diagnosis and treatment, inform preventative strategies and reduce the global impact of this disease.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15447"},"PeriodicalIF":3.2,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496922","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 development and progression of albuminuria in South Asians with type 2 diabetes compared with Western Europeans. Results from the HinDu the Hague diabetes study.","authors":"Judith van Niel, Nel Geelhoed-Duijvestijn, Janet Kist, Mattijs Numans, Rimke Vos","doi":"10.1111/dme.15454","DOIUrl":"https://doi.org/10.1111/dme.15454","url":null,"abstract":"<p><strong>Aim: </strong>Although South Asians have an increased risk to develop diabetes, data on the difference in development and progression of diabetic nephropathy between ethnic groups are not consistent. The aim of this study was to evaluate possible differences in the development and progression of albuminuria in South Asians and Western Europeans (WE) with type 2 diabetes in a large closed cohort of South Asians with type 2 diabetes.</p><p><strong>Methods: </strong>Data on 1269 South Asians and 2272 Dutch adults with type 2 diabetes who were treated in our diabetes clinic in 2006 or referred thereafter were extracted from electronic medical records. Microalbuminuria and macroalbuminuria were defined separately for men and women based on albumin/creatinine ratios in early morning urine samples. We defined 3 outcomes: (1) no albuminuria, (2) persistent microalbuminuria and (3) macroalbuminuria at the end of follow-up. Cox proportional hazard models were used to discriminate differences in time from diabetes diagnosis until development and progression of albuminuria between the two ethnic groups, adjusted for retinopathy, hypertension, smoking and age at diabetes diagnosis.</p><p><strong>Results: </strong>South Asians have a higher adjusted risk for developing microalbuminuria: HR 1.4, (95% CI 1.2, 1.6) and macroalbuminuria: HR: 1.2 (1.0, 1.4) compared to Western Europeans. However, mean time to progress from micro- to macroalbuminuria was not different between the ethnic groups (3.9 ± 4.0 yrs vs. 3.4 ± 3.9 yrs respectively).</p><p><strong>Conclusion: </strong>South Asians have a higher adjusted risk to develop micro- and macroalbuminuria compared with Western Europeans. When microalbuminuria is present, time to progression from micro- to macroalbuminuria is not different between the two groups.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15454"},"PeriodicalIF":3.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496923","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":"Using technology to support diabetes care in hospital: Guidelines from the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) group and Diabetes Technology Network (DTN) UK.","authors":"Parizad Avari, Pratik Choudhary, Alistair Lumb, Shivani Misra, Gerry Rayman, Daniel Flanagan, Ketan Dhatariya","doi":"10.1111/dme.15452","DOIUrl":"https://doi.org/10.1111/dme.15452","url":null,"abstract":"<p><p>This article summarises the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) Group guidelines on the use of technology to support diabetes care in hospital. The guideline incorporates two main areas: (i) use of wearable technology devices to improve diabetes management in hospital (including continuous glucose monitoring and insulin pump therapy) and (ii) information technology. Although it is reasonable to extrapolate from the evidence available, that devices developed to enhance diabetes care outside hospital will show similar benefits, there are challenges posed within the inpatient setting in hospital. This guidance provides a pragmatic approach to supporting self-management in individuals using wearable technology admitted to hospital. Furthermore, it also aims to provide a best practice guide for using information technology to monitor diabetes care and communicate between health professionals.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15452"},"PeriodicalIF":3.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460387","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 diabetes annual review in a postal box: A qualitative study exploring the views of people living with diabetes (DiaBox-Qual)","authors":"Jack Colley,&nbsp;Stephanie Hughes,&nbsp;Hajira Dambha-Miller,&nbsp;Hermione Price","doi":"10.1111/dme.15445","DOIUrl":"10.1111/dme.15445","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The diabetes annual review is an important part of clinical care. Non-attendance is increasingly common and associated with poor health outcomes. At-home self-collection of blood tests, urine samples and anthropometric data through a postal box may facilitate engagement. We aimed to explore the views of people living with diabetes on the use of a postal box as an alternative to usual care for self-collecting blood samples, urine samples and anthropometric data and to understand whether the availability of a postal box would facilitate the uptake of the diabetes annual review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semi-structured interviews and focus groups with adults who have type 1 or type 2 diabetes. Purposive sampling was used to obtain a high representation of infrequent attendees of annual review appointments within the study population. Transcripts were collated and analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty participants took part including eight infrequent attendees. All infrequent attendees and most regular attendees responded positively to a postal box, with convenience being the most prominent value described. Concerns raised related to capability of self-collection and the accuracy of results. Participants were asked for suggestions to improve the postal box. The most common themes related to communication; needing clearer information about each test in the postal box; feedback of results; and utilising the box to communicate priorities for discussion at future consultations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Postal boxes for annual reviews were well-received by those living with diabetes. Designed well, they have the potential to overcome more than just the physical barriers to annual review attendance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460386","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":"Current management of chronic kidney disease in type-2 diabetes-A tiered approach: An overview of the joint Association of British Clinical Diabetologists and UK Kidney association (ABCD-UKKA) guidelines.","authors":"Indranil Dasgupta, Sagen Zac-Varghese, Khuram Chaudhry, Kieran McCafferty, Peter Winocour, Tahseen A Chowdhury, Srikanth Bellary, Gabrielle Goldet, Mona Wahba, Parijat De, Andrew H Frankel, Rosa M Montero, Eirini Lioudaki, Debasish Banerjee, Ritwika Mallik, Adnan Sharif, Naresh Kanumilli, Nicola Milne, Dipesh C Patel, Ketan Dhatariya, Stephen C Bain, Janaka Karalliedde","doi":"10.1111/dme.15450","DOIUrl":"https://doi.org/10.1111/dme.15450","url":null,"abstract":"<p><p>A growing and significant number of people with diabetes develop chronic kidney disease (CKD). Diabetes-related CKD is a leading cause of end-stage kidney disease (ESKD) and people with diabetes and CKD have high morbidity and mortality, predominantly related to cardiovascular disease (CVD). Despite advances in care over the recent decades, most people with CKD and type 2 diabetes are likely to die of CVD before developing ESKD. Hyperglycaemia and hypertension are modifiable risk factors to prevent onset and progression of CKD and related CVD. People with type 2 diabetes often have dyslipidaemia and CKD per se is an independent risk factor for CVD, therefore people with CKD and type 2 diabetes require intensive lipid lowering to reduce burden of CVD. Recent clinical trials of people with type 2 diabetes and CKD have demonstrated a reduction in composite kidney end point events (significant decline in kidney function, need for kidney replacement therapy and kidney death) with sodium-glucose co-transporter-2 (SGLT-2) inhibitors, non-steroidal mineralocorticoid receptor antagonist finerenone and glucagon-like peptide 1 receptor agonists. The Association of British Clinical Diabetologists (ABCD) and UK Kidney Association (UKKA) Diabetic Kidney Disease Clinical Speciality Group have previously undertaken a narrative review and critical appraisal of the available evidence to inform clinical practice guidelines for the management of hyperglycaemia, hyperlipidaemia and hypertension in adults with type 2 diabetes and CKD. This 2024 abbreviated updated guidance summarises the recommendations and the implications for clinical practice for healthcare professionals who treat people with diabetes and CKD in primary, community and secondary care settings.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15450"},"PeriodicalIF":3.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460385","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":"Attributable one-year healthcare cost of incident type 2 diabetes: A population-wide difference-in-differences study in Denmark.","authors":"Eskild Klausen Fredslund, Annelli Sandbæk, Thim Prætorius","doi":"10.1111/dme.15455","DOIUrl":"https://doi.org/10.1111/dme.15455","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study is to estimate the causally attributable one-year healthcare costs for individuals getting a type 2 diabetes diagnosis compared to a matched sample and show the incurred costs of medication and in primary and secondary healthcare.</p><p><strong>Methods: </strong>Causal estimation using a difference-in-differences design to estimate the one-year health care costs attributable to type 2 diabetes. Danish registry data consisting of the entire population in years 2016-2019. Newly diagnosed individuals with type 2 diabetes in 2018 were identified using a validated method. Sociodemographic and historical health data were used to identify a matched control group. Individuals were followed for two years before and one year after the date of diagnosis using. Three cost components were analysed: medication and primary and secondary healthcare costs.</p><p><strong>Results: </strong>A total of 18,133 individuals were diagnosed with type 2 diabetes in 2018 and matched successfully 1:1 to a control group. The total attributable one-year cost of type 2 diabetes was EUR 1316. The main cost component was hospital care (EUR 1004) and primary care (EUR 167). The total attributable cost of incident diabetes in Denmark in 2018 was approx. EUR 24 million.</p><p><strong>Conclusions: </strong>The majority of the first year health care cost of incident diabetes is incurred at the hospital level followed by primary care and medication. Our yearly cost estimate per newly diagnosed is considerably lower than estimates from the US and Australia.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15455"},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460384","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":"Bringing the assessment and treatment of diabetes distress into the real world of clinical care: Time for a shift in perspective","authors":"Lawrence Fisher,&nbsp;Susan Guzman,&nbsp;William Polonsky,&nbsp;Danielle Hessler","doi":"10.1111/dme.15446","DOIUrl":"10.1111/dme.15446","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetes distress (DD) refers to the emotional and behavioural challenges associated with managing this demanding chronic disease over time. DD is alarmingly common and it has a significant impact on self-management behaviours and clinical outcomes. Thus, there is growing recognition that DD is a pressing problem that deserves careful attention in clinical care. Translating the application of validated DD assessment and intervention protocols from the research to the clinical setting, however, presents challenges that require a reconsideration of some common assumptions about what DD is, how prevalent it is, how it presents itself clinically, how it might best be assessed and by whom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We employed data from six large-scale studies using five common DD measures. Using these data, we review and challenge several common assumptions about DD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>These data suggest that, because of its relative ubiquity, DD should not be viewed as a ‘co-morbidity’ or ‘complication’ of diabetes and it should not be seen as a mental health/illness ‘condition’. Furthermore, we argue that DD assessment should: (1) be accepted as a standard part of comprehensive diabetes care, (2) occur regularly using broad rather than brief screening measures and (3) be addressed directly by diabetes clinicians, rather than exclusively by behavioural specialists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results form the basis of a series of suggestions to enhance the translation, adoption and implementation of DD knowledge derived from the research setting directly into the real world of clinical care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"41 12","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406230","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":"Outcomes after 1 year in adults using Omnipod 5: Real-world data from a UK diabetes centre","authors":"Roland H. Stimson,&nbsp;Mark W. J. Strachan,&nbsp;Anna R. Dover,&nbsp;Rohana J. Wright,&nbsp;Shareen Forbes,&nbsp;Gayle McRobert,&nbsp;Fraser W. Gibb","doi":"10.1111/dme.15453","DOIUrl":"10.1111/dme.15453","url":null,"abstract":"&lt;p&gt;Despite substantial advances in diabetes care over the previous decade, only a minority of people with type 1 diabetes achieve an HbA1c &lt;53 mmol/mol.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Automated insulin delivery (AID) systems have consistently demonstrated efficacy in reducing HbA1c.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Omnipod 5 (Insulet Corp) is a tubeless AID system which was launched in the United Kingdom in 2023. Here, we report the first 1-year CGM, HbA1c and weight outcomes in people using Omnipod 5, under routine clinical care, in the United Kingdom.&lt;/p&gt;&lt;p&gt;This was a prospective, observational assessment based in a single Scottish centre which provides diabetes care for approximately 5000 adults with type 1 diabetes. As a service evaluation of routinely collected data, this project did not require ethical approval. We included all adults who transitioned from Omnipod DASH (standalone CSII) to Omnipod 5 (hybrid closed loop with Dexcom G6 CGM) between June and August 2023. Data were obtained from the electronic health record (SCI-Diabetes), LibreView, Dexcom Clarity and Glooko.&lt;/p&gt;&lt;p&gt;Paired CGM data were available in 45/50 (90 days prior to Omnipod 5 and 90 days after 1 year of use) and paired HbA1c data were available in 41/50 (measured at a median 200 days [202–336] after OP5 commencement). CGM metrics reported are consistent with those described in the international consensus document.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Paired weight data were available in 28/50 (median 308 days after OP5 commencement [244–370]). Results are presented as median (IQR). Paired data were compared with Wilcoxon signed rank tests and correlations were assessed by Spearman correlation coefficient. &lt;i&gt;p&lt;/i&gt; &lt;0.05 were considered statistically significant. Statistical analyses were performed using R Studio.&lt;/p&gt;&lt;p&gt;Median age was 42 years (IQR: 30–53), duration of diabetes was 24 years (13–34) and 64% were female. Baseline HbA1c was 69 mmol/mol (61–75) and 22% had an HbA1c &lt;58 mmol/mol. Thirty-eight per cent had BMI &gt;30 kg/m&lt;sup&gt;2&lt;/sup&gt;. Fifty-nine per cent were predominantly using the lowest glucose target (6.1 mM) at the end of follow-up and median time in auto mode was 94% (91–99).&lt;/p&gt;&lt;p&gt;In those with paired HbA1c data, median baseline HbA1c was 70 mmol/mol (63–76) and fell to 58 mmol/mol (52–63) during Omnipod 5 use (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Data summarising CGM changes are presented in the figure (Figure 1), including a change in TIR from 42% (33–58) to 60% (53–68, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). GMI fell from 66 mmol/mol (57–70) to 58 mmol/mol (54–62, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and coefficient of variation for glucose fell from 37% (34–42) to 34% (32–38, &lt;i&gt;p&lt;/i&gt; = 0.009). Change in TIR at 1 year was strongly negatively correlated with baseline TIR (&lt;i&gt;R&lt;/i&gt; −0.581, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Percentage of insulin delivered as bolus was negatively correlated with increase in TIR (&lt;i&gt;R&lt;/i&gt; −0.518, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Age, sex and socio-economic deprivation were not associated with TIR response to ","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"41 12","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406231","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}