Diabetic Medicine最新文献

{"title":"Complement anaphylatoxins: Potential therapeutic target for diabetic kidney disease.","authors":"Jingyuan Ma, Wai Han Yiu, Sydney C W Tang","doi":"10.1111/dme.15427","DOIUrl":"https://doi.org/10.1111/dme.15427","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD) is the most common cause of kidney failure, characterized by chronic inflammation and fibrosis. The complement system is increasingly implicated in the development and progression of diabetic nephropathy. The important complement anaphylatoxins C3a and C5a are key mediators of the innate immune system, which regulates cellular inflammation, oxidative stress, mitochondrial homeostasis and tissue fibrosis. This review summarizes the involvement of anaphylatoxins in the pathogenesis of diabetic kidney disease, highlights their important roles in the pathophysiologic changes of glomerulopathy, tubulointerstitial damage and immune cell infiltration, and discusses the modulatory effects of new anti-diabetic drugs acting on the complement system. Based on available clinical data and findings from the preclinical studies of complement blockade, anaphylatoxin-targeted therapeutics may become a promising approach for patients with DKD in the future.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072329","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 emotional burden of type 1 diabetes: A cross-sectional study to understand associations between diabetes distress and glucose metrics in adulthood","authors":"Caitlin S. Kelly,&nbsp;Huyen Nguyen,&nbsp;Katherine S. Chapman,&nbsp;Wendy A. Wolf","doi":"10.1111/dme.15425","DOIUrl":"10.1111/dme.15425","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Advancements in type 1 diabetes (T1D) management, such as continuous glucose monitoring (CGM), have helped people achieve narrower glucose ranges, but associations between CGM and diabetes distress are unclear. Although higher HbA_1c is associated with higher distress, associations with other glucose metrics are unknown. To better understand this relationship, we characterized diabetes distress in a sample of CGM users and compared differences in glucose metrics (measured via CGM) between those with higher versus lower distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CGM users with T1D from the T1D Exchange Registry completed an online survey including diabetes distress (DDS-2) and shared CGM data (<i>N</i> = 199). CGM metrics were computed from all available data within 3 months prior to survey completion. Participants were grouped by distress level: lower (DDS-2 &lt; 3, <i>n</i> = 120) or higher (DDS-2 ≥ 3, <i>n</i> = 79). Welch's <i>t</i>-tests were used to compare mean differences in CGM metrics between groups and MANCOVA was used to further probe mean differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately 39.7% participants reported higher diabetes distress. Welch's <i>t</i>-tests revealed participants with higher distress spent significantly more time in higher glucose ranges (above 180 mg/dL and above 250 mg/dL), less time in target glucose ranges (between 70 and 180 mg/dL and between 70 and 140 mg/dL) and had higher glucose management index values compared to those with lower distress (<i>p</i> &lt; 0.01). MANCOVA models showed similar results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CGM users continue to experience diabetes distress. Moreover, higher distress appears to be associated with hyperglycaemia. These findings provide support for broader screening efforts for diabetes distress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987615","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":"Protocol for the Australian Type 1 Diabetes National Screening Pilot: Assessing the feasibility and acceptability of three general population screening models in children","authors":"Kirstine J. Bell,&nbsp;Shannon Brodie,&nbsp;Jennifer J. Couper,&nbsp;Peter Colman,&nbsp;Elizabeth Davis,&nbsp;Gary Deed,&nbsp;William Hagopian,&nbsp;Aveni Haynes,&nbsp;Christel Hendrieckx,&nbsp;Amanda Henry,&nbsp;Adrienne Gordon,&nbsp;Kirsten Howard,&nbsp;Tony Huynh,&nbsp;Bernadette Kerr,&nbsp;Kara Mikler,&nbsp;Natasha Nassar,&nbsp;Sarah Norris,&nbsp;Richard Oram,&nbsp;Dorota Pawlak,&nbsp;Antonia Shand,&nbsp;Richard O. Sinnott,&nbsp;Bethany Wadling,&nbsp;John M. Wentworth,&nbsp;Maria E. Craig,&nbsp;the Type 1 Diabetes National Screening Pilot Study Group","doi":"10.1111/dme.15419","DOIUrl":"10.1111/dme.15419","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>One third of Australian children diagnosed with type 1 diabetes present with life-threatening diabetic ketoacidosis (DKA) at diagnosis. Screening for early-stage, presymptomatic type 1 diabetes, with ongoing follow-up, can substantially reduce this risk (&lt;5% risk). Several screening models are being trialled internationally, without consensus on the optimal approach. This pilot study aims to assess three models for a routine, population-wide screening programme in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An implementation science-guided pilot study to evaluate the feasibility, acceptability and costs of three screening models in children will be conducted between July 2022 and June 2024. These models are as follows: (1) Genetic risk-stratified screening using newborn heel prick dried bloodspots, followed by autoantibody testing from 11 months of age; (2) genetic risk-stratified screening of infant (6–12 months) saliva followed by autoantibody testing from 10 months of age; and (3) autoantibody screening using capillary dried bloodspots collected from children aged 2, 6 or 10 years. Cohorts for each model will be recruited from targeted geographic areas across Australia involving ≥2 states per cohort, with a recruitment target of up to 3000 children per cohort (total up to 9000 children). The primary outcome is screening uptake for each cohort. Secondary outcomes include programme feasibility, costs, parental anxiety, risk perception, satisfaction, well-being and quality of life, and health professional attitudes and satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This pilot is the first direct comparison of three screening implementation models for general population screening. Findings will provide evidence to inform a potential national screening programme for Australian children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ACTRN12622000381785.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of the safety and effectiveness of insulin aspart with other bolus insulins in women with pre-existing Type 1 diabetes during pregnancy: A post hoc analysis of a prospective cohort study","authors":"Elisabeth R. Mathiesen,&nbsp;Amra Ciric Alibegovic,&nbsp;Gayathri Anil,&nbsp;Fidelma Dunne,&nbsp;Tariq Halasa,&nbsp;Marina Ivanišević,&nbsp;David R. McCance,&nbsp;Rikke Baastrup Nordsborg,&nbsp;Peter Damm,&nbsp;the EVOLVE study group","doi":"10.1111/dme.15411","DOIUrl":"10.1111/dme.15411","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The safety and efficacy of insulin analogue insulin aspart (IAsp) have been demonstrated in a randomised clinical trial in pregnant women with Type 1 diabetes (T1D), and IAsp is widely used during pregnancy. The aim of this study was to assess glycaemic control and safety of IAsp versus other bolus insulins in Type 1 diabetic pregnancy in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a post hoc analysis of a prospective cohort study of 1840 pregnant women with T1D, treated with IAsp (<i>n</i> = 1434) or other bolus insulins (<i>n</i> = 406) in the Diabetes Pregnancy Registry. The primary (composite) outcome was the proportion of pregnancies resulting in major congenital malformations or perinatal or neonatal death. Secondary outcomes included all HbA_1c values measured immediately before and during pregnancy and major hypoglycaemia, as well as abortion, pre-eclampsia, pre-term delivery, large for gestational age at birth, stillbirth and fetal malformations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant differences found in any of the pregnancy outcomes between treatment with IAsp and other bolus insulins in either the crude or propensity score-adjusted analyses. However, maternal HbA_1c was lower in the IAsp group at the end of the third trimester (adjusted difference, −0.16% point [95% CI −0.28;−0.05]; −1.8 mmol/mol [95% CI −3.1;−0.6]; <i>p</i> = 0.0046).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>No significant differences in safety or pregnancy outcomes were demonstrated when comparing treatment with IAsp versus other bolus insulins in women with T1D during pregnancy. The observed improvement in HbA_1c with IAsp in late pregnancy should be confirmed in other studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901271","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":"Health-related quality of life assessment in health economic analyses involving type 2 diabetes","authors":"Hayley Smith,&nbsp;Steven James,&nbsp;Fran Brown,&nbsp;Michele Gaca,&nbsp;David O'Neal,&nbsp;An Tran-Duy,&nbsp;Nancy Devlin,&nbsp;Ray Kelly,&nbsp;Elif I. Ekinci","doi":"10.1111/dme.15418","DOIUrl":"10.1111/dme.15418","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Incorporating health-related quality of life (HRQoL) measures into health economic analyses can help to provide evidence to inform decisions about how to improve patient outcomes in the most cost-effective manner. The aim of this narrative review was to assess which HRQoL instruments have been used in economic evaluations of type 2 diabetes management including in Indigenous communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>MEDLINE (Ovid), Embase (Ovid) and Cochrane were searched from inception to June 2022. Studies included patients with type 2 diabetes; economic evaluations, derived scores from direct questioning of individuals; and were in English. Records were assessed for bias using the JBI critical appraisal tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3737 records were identified, with 22 publications meeting the criteria for inclusion. Across those 22 articles, nine HRQoL instruments had been utilised. Generic tools were most frequently used to measure HRQoL, including EQ-5D (−3 L and −5 L) (<i>n</i> = 10, 38%); SF-12 (<i>n</i> = 5, 19%); and SF-36 (<i>n</i> = 4, 15%). Two tools addressing the specific stressors faced by people with type 2 diabetes were utilised: Problem Areas In Diabetes tool (<i>n</i> = 1, 4%) and Diabetes Distress Scale (<i>n</i> = 1, 4%). Two publications reported whether the study population included Indigenous peoples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A wide range of HRQoL instruments are used in economic evaluations of type 2 diabetes management, with the most frequent being varying forms of the EQ-5D. Few economic evaluations noted whether Indigenous peoples were featured in the study population. More research into HRQoL in people living with type 2 diabetes is urgently needed to improve evidence on effectiveness and cost-effectiveness of interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901273","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":"Patient-reported outcomes in diabetes-related foot conditions: Is patient experience influenced by ethnicity? A mixed-methods systematic review","authors":"Patrick Highton,&nbsp;Shavez Jeffers,&nbsp;Ayesha Butt,&nbsp;Lauren O'Mahoney,&nbsp;Sian Jenkins,&nbsp;Ruksar Abdala,&nbsp;Louise Haddon,&nbsp;Clare Gillies,&nbsp;Ffion Curtis,&nbsp;Michelle Hadjiconstantinou,&nbsp;Kamlesh Khunti","doi":"10.1111/dme.15420","DOIUrl":"10.1111/dme.15420","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Research in diabetes-related foot conditions (DRFC) often focuses on ulcer-related care, whilst the patient experience and influence of sociodemographic factors are under-researched. This systematic review investigated patient-reported outcomes and experience in people with DRFC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multiple databases were searched from inception to 16 August 2023. All original articles that assessed any patient-reported outcome or experience in DRFC and reported participant ethnicity were included. Data were synthesized using a sequential contingent approach. Study quality was assessed using study design-specific tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three studies were included (11 qualitative, 11 quantitative and one mixed-methods). DRFC had a largely negative impact on various life dimensions, including social and daily life, work, emotional and psychological well-being, necessitating dependence on others in the form of emotional, social and/or religious support, which were experienced differently by different groups. Patient DRFC knowledge and self-care habits were typically suboptimal, and levels of hope and feeling of control over their condition varied between groups. Outcomes varied slightly between ethnicities across studies, with some ethnicity-specific themes identified such as beliefs about disease cause and footwear habits. Quantitative and qualitative findings were mostly congruent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DRFC profoundly and negatively impacts patient-reported outcomes and experience, with limited evidence suggesting an influence of ethnicity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893138","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":"Healthcare costs attributable to diabetes in pregnancy: A cost of illness study in Tasmania, Australia","authors":"Thi Thu Ngan Dinh,&nbsp;Barbara de Graaff,&nbsp;Julie A. Campbell,&nbsp;Matthew D. Jose,&nbsp;John Burgess,&nbsp;Timothy Saunder,&nbsp;Alex Kitsos,&nbsp;Andrew J. Palmer","doi":"10.1111/dme.15417","DOIUrl":"10.1111/dme.15417","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To estimate the direct costs during the prenatal, delivery and postpartum periods in mothers with diabetes in pregnancy, compared to those without.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study used a population-based dataset from 2004 to 2017, including 57,090 people with diabetes and 114,179 people without diabetes in Tasmania, Australia. Based on diagnostic codes, delivery episodes with gestational diabetes mellitus (GDM) were identified and matched with delivery episodes without diabetes in pregnancy. A group of delivery episodes with pre-existing diabetes was identified for comparison. Hospitalisation, emergency department and pathology costs of these groups were calculated and adjusted to 2020–2021 Australian dollars.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 2774 delivery episodes with GDM, 2774 delivery episodes without diabetes and 237 delivery episodes with pre-existing diabetes identified. Across the 24-month period, the pre-existing diabetes group required the highest costs, totalling $23,536/person. This was followed by the GDM ($13,210/person), and the no diabetes group ($11,167/person). The incremental costs of GDM over the no diabetes group were $890 (95% CI 635; 1160) in the year preceding delivery; $812 (616; 1031) within the delivery period and $341 (110; 582) in the year following delivery (<i>p</i> &lt; 0.05). Within the year preceding delivery, the incremental costs in the prenatal period were $803 (579; 1058) (<i>p</i> &lt; 0.05). Within the year following delivery, the incremental costs in the postpartum period were $137 (55; 238) (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results emphasised the importance of proper management of diabetes in pregnancy in the prenatal and postpartum periods and highlighted the significance of screening and preventative strategies for diabetes in pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15417","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878490","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":"Incidence rates of amputations in patients with diabetes in Denmark have been decreasing continuously for the last four decades, but further reduction is still needed","authors":"Ole Lander Svendsen","doi":"10.1111/dme.15413","DOIUrl":"10.1111/dme.15413","url":null,"abstract":"&lt;p&gt;Worldwide, a patient with diabetes is amputated every 30 s, and patients with diabetes fear amputation, with the loss of limbs and mobility, more than any other late diabetic complication, including death.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The incidence of lower extremity amputations (LEA) in patients with diabetes has been much higher than in patients without diabetes, with a 12-fold higher risk in the UK in the early 1990s.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The Saint Vincent Declaration from Europe, 1989, aimed for a reduction by half of LEA within 5 years in patients with diabetes.&lt;/p&gt;&lt;p&gt;In the United States, there has been a resurgence of LEA in patients with diabetes,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; which has caused the American Heart Association to set a goal of reducing the incidence rate of LEA by 20% by 2030.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Furthermore, a new declaration for feet's sake: halving the global diabetic foot disease burden, from 2% to 1% with next-generation care, has recently been suggested by members of the International Working Group on the Diabetic Foot.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In 2022 in Denmark, an ‘Amputation Scandal’, where patients had been amputated unnecessarily, was described by Danish Press. The reason was a high frequency of LEA in the Central Region of Jutland compared with other Regions of Denmark, caused by cuts in budgets for vascular surgery. A later analysis also showed regional differences, where the annual rate of LEA was halved in the Capital Region, but was increased by 10% in Region Zealand, from 2016 to 2021,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; probably due to differences in socioeconomic and health status, as well as access to health services and general practitioners. However, the impact of diabetes was not reported.&lt;/p&gt;&lt;p&gt;Several studies have examined the incidence rates of LEA in patients with diabetes in Denmark (Table 1).&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; As shown in Table 1, significant decreases in the incidence rates of LEA in patients with diabetes have occurred in all the studies over the past 40 years. Several of the studies in the table suggest that the reasons for the significant decrease in incidence rates of LEA in patients with diabetes are increased vascular surgical treatment, establishment of multidisciplinary teams to handle foot ulcers in patients with diabetes, better treatment of metabolic and lifestyle factors, improved organization of diabetes foot clinics, better and more aggressive early prevention and treatment of foot ulcers, and improved patient education.&lt;/p&gt;&lt;p&gt;In the latest national study of non-traumatic LEA in Denmark from 1997 to 2017, 60% had diabetes.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; The total number of LEA had increased, both in people with and without diabetes, probably because the number of elderly and people with diabetes in Denmark had increased. However, the incidence rate of major LEA decreased by 2–9% per year and minor LEA by 6–7% per year in patients with diabetes. In people without diabetes, the","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15413","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751253","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":"Insulin icodec: A novel once-weekly treatment for diabetes","authors":"Hannah Schaffner,&nbsp;Jordyn Wiener,&nbsp;Amanda DeLuca,&nbsp;Ariana Genovese,&nbsp;Alexander Deeb,&nbsp;Wasim Deeb,&nbsp;Mae Sheikh-Ali,&nbsp;David Sutton,&nbsp;Ashwini Gore,&nbsp;Jason Berner,&nbsp;Jessica Huston,&nbsp;Rebecca Goldfaden","doi":"10.1111/dme.15414","DOIUrl":"10.1111/dme.15414","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To summarize the results of clinical studies of insulin icodec, an investigational insulin analog designed for once-weekly administration, in adults with type 1 and type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirteen published articles describing clinical studies of insulin icodec were identified in PubMed, and data pertinent to key study outcomes were selected for inclusion in this review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In insulin-naïve and insulin-treated individuals, icodec demonstrated efficacy in glycaemic control superior or noninferior to that of insulins glargine U100, glargine U300 and degludec. Icodec exhibited a safety profile comparable to marketed insulins, with the exception of hypoglycaemic event rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>As a once-weekly alternative to daily basal insulin, icodec is expected to improve patient adherence and satisfaction, reducing the required number of injections per year from 365 to 52 and providing a dosing option potentially attractive to a wide range of insulin users. However, clinical data suggest a notable risk of hypoglycaemia with weekly icodec administration, especially in individuals with type 1 diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751254","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 effect of physical activity on glycaemic control in people with type 1 diabetes mellitus: A systematic literature review and meta-analysis","authors":"Diederik De Cock,&nbsp;Lucas Schreurs,&nbsp;Nele Steenackers,&nbsp;Sofia Pazmino,&nbsp;Wilfried Cools,&nbsp;Lauren Eykerman,&nbsp;Hannah Thiels,&nbsp;Chantal Mathieu,&nbsp;Bart Van der Schueren","doi":"10.1111/dme.15415","DOIUrl":"10.1111/dme.15415","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Type 1 diabetes mellitus (T1DM) is characterised by insulin deficiency. Due to perceived physical activity (PA)-related hypoglycaemia, a minority of people with T1DM exercise regularly. However, the relationship between T1DM and PA remains poorly understood. Our aim was to summarise the existing literature on the effects of PA on short-term glucose control (glycated haemoglobin or time in range) in people with T1DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched seven electronic databases (PubMed, Embase, Cochrane library, Cinahl, SPORTDiscus, PEDro and Web Of Science) and two sources of the grey literature (ClinicalTrials.gov and ICTRP). All reviews were screened via title/abstract and full text by two independent reviewers (LE and HT), conflicts were solved by a third independent reviewer (DDC). We excluded animal studies, case reports, non-English articles, qualitative studies, conference abstracts and articles without full-text access. A meta-analysis using random effects model was performed to study the effect of PA on haemoglobin A1c (HbA1c) levels in people with T1DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We obtained 19,201 unique references across nine different electronic databases. After screening and snowballing, 68 articles were found investigating the effect of PA on glycaemic control in people with T1DM. Overall, HbA1c levels in the PA group (mean difference = 0.29% (0.20%–0.39%)), were lower compared with the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An overall small beneficial effect of PA on glycaemic control in people with T1DM was found. Caution is advised when interpreting the results of this meta-analysis, given variations in study type, duration, frequency and intensity of physical activity across included studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733753","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}