Diabetic Medicine最新文献

{"title":"m6A demethylase ALKBH5 reduces ferroptosis in diabetic retinopathy through the m6A-YTHDF1-ACSL4 axis","authors":"Qinghui Liao,&nbsp;Yan Li,&nbsp;Meijing Cui,&nbsp;Min Liu","doi":"10.1111/dme.70033","DOIUrl":"10.1111/dme.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Diabetic retinopathy (DR) represents the main ocular complication of diabetes. Targeting ferroptosis is a promising treatment of choice for various diabetic complications. N6-methyladenosine (m6A) demethylase alkylation repair homolog protein 5 (ALKBH5) functions as a pivotal regulator of ferroptosis, and we investigated its role and molecular mechanisms in ferroptosis in DR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A DR mouse model was developed by streptozotocin (STZ) intraperitoneal injection. High glucose (HG)-induced human retinal pigment epithelial cells (ARPE-19) were used as a DR model <i>in vitro</i>. ALKBH5, YTH N6-methyladenosine RNA binding protein 1 (YTHDF1) and acyl-CoA synthetase long-chain family member 4 (ACSL4) expression levels were examined by RT-qPCR and Western blot. The biological functions of ALKBH5 <i>in vitro</i> and <i>in vivo</i> were investigated by gain-of-function and loss-of-function analyses. ALKBH5's downstream regulatory mechanisms were detected by bioinformatics analysis, RNA pull-down, MeRIP-qPCR and actinomycin D assay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ALKBH5 was under-expressed while YTHDF1 and ACSL4 were up-regulated in the retinal tissues of STZ-induced DR mice and HG-stimulated ARPE-19 cells. Ectopically expressed ALKBH5 or YTHDF1 knockdown partially reversed the increased ferroptosis <i>in vitro</i> and <i>in vivo</i>, evidenced by decreased levels of Fe²⁺, malondialdehyde and reactive oxygen species yet increased glutathione level. ALKBH5 mediated m6A modification of ACSL4 mRNA and disrupted its stability in a YTHDF1-dependent manner. Importantly, <i>in vivo</i> data demonstrated that overexpression of ALKBH5 or YTHDF1 knockdown repressed ferroptosis and alleviated DR by down-regulating ACSL4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest that ALKBH5 may delay DR progression by reducing ferroptosis through the m6A-YTHDF1-ACSL4 axis, offering therapeutic paradigms for the treatment of DR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972647","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":"No COVID-19 pandemic-associated increase of childhood type 1 diabetes incidence in Western Australia","authors":"Ewan Cameron,&nbsp;Aveni Haynes,&nbsp;Song Zhang","doi":"10.1111/dme.70047","DOIUrl":"10.1111/dme.70047","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981253","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 validation study of the Intentional Nonadherence Scale among people with type 2 diabetes in the United Kingdom","authors":"Vivien Teo,&nbsp;Anna Hodgkinson,&nbsp;John Weinman,&nbsp;Mark Chamley,&nbsp;Kai Zhen Yap","doi":"10.1111/dme.70040","DOIUrl":"10.1111/dme.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine the psychometric properties of the Intentional Nonadherence Scale (INAS) among people with type 2 diabetes mellitus (PwT2D) in the United Kingdom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This validation study recruited 260 PwT2D at diabetes intermediate care team clinics in London. Thirty of them participated in the test–retest reliability analysis in 2–4 weeks, while 124 were followed up in 3–6 months for the predictive validity analysis. The psychometric evaluation also comprised internal reliability, structural validity and construct validity that assessed the relationship between the INAS and other established measures, such as the Medication Adherence Report Scale-5 (MARS-5), Beliefs about Medicine Questionnaire (BMQ)-specific, Brief Illness Perception Questionnaire (BIPQ), Patient Health Questionnaire-2 (PHQ-2) and glycated haemoglobin (HbA1c).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Exploratory factor analysis revealed four factors, namely ‘Resisting illness’, ‘Resisting medication’, ‘Testing treatment’ and ‘Sensitivity to medication’. All INAS factors demonstrated high internal reliability (Cronbach's alpha = 0.92–0.96). Their test–retest reliability varied between &lt;0.001 and 0.92. Construct validity was demonstrated by its relationship with other measures, including its negative correlations with medication adherence and positive correlations with medication concerns. Significant correlations were also found with HbA1c, as well as with PwT2D's perceptions of diabetes consequences, treatment control, identity and emotional responses to diabetes. ‘Testing Treatment’ showed a trend towards statistical significance with adherence in 3–6 months (coefficient = −0.34, <i>p</i> = 0.09).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The INAS performed well on a number of psychometric properties in this study. It may be a helpful tool for clinicians in identifying specific drivers of intentional nonadherence among PwT2D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788054","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 role of willpower beliefs in diabetes distress and general emotional well-being in adults with type 2 diabetes","authors":"Ralph Geerling,&nbsp;Elizabeth Holmes-Truscott,&nbsp;Jane Speight,&nbsp;Tim Skinner","doi":"10.1111/dme.70035","DOIUrl":"10.1111/dme.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To examine the role implicit theories of willpower play in the experience of diabetes distress and general emotional well-being using a cross sectional study design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Australian adults with type 2 diabetes (<i>N</i> = 270; 56% women; age: 61 ± 12 years), recruited via a national diabetes registry, completed an online survey assessing: willpower beliefs, general emotional well-being, diabetes distress, personality, general self-efficacy and diabetes self-efficacy. Analyses included bivariate correlations and linear regression, adjusted for demographic, clinical and psychological variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Unadjusted analyses showed willpower beliefs have moderate correlations with general emotional well-being, emotionality and general self-efficacy; and weak correlations with diabetes distress, diabetes self-efficacy, extraversion, conscientiousness and age. Adjusted analyses showed willpower beliefs are a significant predictor of general emotional well-being, but not diabetes distress, independent of self-efficacy and diabetes distress, and potentially mediated by personality and diabetes self-efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Willpower beliefs predict general emotional well-being, but not diabetes distress. Further research is needed to confirm these pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784354","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":"Psychological and self care outcomes for children and adolescents living with type 1 diabetes and their caregivers attending diabetes camp: A mixed methods study","authors":"Rita Sigley,&nbsp;Anna L. Boggiss,&nbsp;Benjamin Albert,&nbsp;Dug Yeo Han,&nbsp;Craig Jefferies","doi":"10.1111/dme.70038","DOIUrl":"10.1111/dme.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Diabetes camps for children and adolescents living with Type 1 Diabetes (T1D) offer an important opportunity to foster self-efficacy and ‘common humanity’, a sense that they are not alone in their challenges. The current study primarily aimed to assess whether psychological wellbeing, diabetes self care behaviours and HbA1c improved amongst campers and their caregivers, and whether these would be sustained at 3- and 6-months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children and adolescents aged 7–13 years who attended the 2023 diabetes camp in Auckland, Aotearoa New Zealand and one of their caregivers were invited to participate. Campers and caregivers were assessed at camp enrolment and then at 1-week, 3-months and 6-months post-camp. Guided by the Theoretical Framework of Acceptability, optional qualitative interviews were also used to explore campers' experiences of camp.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 31 children and adolescents who attended the 2023 camp, 27 (87%) participated in the study with a caregiver. Campers showed reduced feelings of isolation (<i>p</i> = 0.036) and overidentification (<i>p</i> = 0.036) 6 months. Caregivers demonstrated overall improvements in self-efficacy (<i>p</i> = 0.034), caregiver distress and burden (<i>p</i> = 0.006) and caregiver quality of life (<i>p</i> = 0.039). Qualitative findings confirmed high acceptability, with participants reporting positive camp experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Diabetes camps can improve caregivers' self-efficacy, diabetes distress and quality of life, and reduce feelings of isolation and overidentification among campers. Future work is needed to promote cultural inclusivity within camps and improve their accessibility, to be able to optimise the wellbeing of all children and adolescents living with T1D and their families.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771590","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":"Understanding behaviour change maintenance after attending a self-management education and support programme for type 2 diabetes: A longitudinal qualitative study","authors":"Márcia Carvalho,&nbsp;Eimear Morrissey,&nbsp;Pauline Dunne,&nbsp;Amanda Drury,&nbsp;Molly Byrne,&nbsp;Jenny McSharry","doi":"10.1111/dme.70032","DOIUrl":"10.1111/dme.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to explore behaviour change maintenance experiences of adults with type 2 diabetes over 15 months following attendance at a diabetes self-management education and support (DSMES) programme and their needs for post-programme support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A longitudinal qualitative study using four interviews and experience sampling (written notes and photographs) was conducted. Data were analysed through a deductive analysis based on an existing framework combined with an inductive thematic analysis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one adults (67% women, aged 39–74) participated; seventeen completed all interviews. Analysis resulted in the refined <b>S</b>upporting <b>U</b>nderstanding and <b>S</b>trategies for <b>T</b>ype 2 Diabetes M<b>ain</b>tenance Self-Management (SUSTAIN) framework and three themes capturing key trends and changes over time: (1) integrating the changes amidst the constant ebb and flow of life; (2) consolidating the changes: moving towards independent maintenance; and (3) building bridges to self-maintenance: the role of support post-programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>People may experience difficulties in maintaining behavioural changes post-DSMES programmes. Programmes should address the role of emotions, psychological and physical resources and environmental and social influences in behaviour change maintenance and promote the development of skills for longer-term management, including self-regulation, behavioural autonomy, intrinsic motivation and habit formation. As some people may also benefit from longer-term, ongoing support, digitally delivered with occasional sessions involving peers and educators beyond 12 months should be considered. Suggestions for ongoing support include progress monitoring, expert guidance, educational updates, troubleshooting opportunities and encouragement and motivational support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763259","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":"Improved self-management of type 1 diabetes in young women: Experiences of Guided Self-Determination-Young: A qualitative interview study","authors":"Josephine Haas,&nbsp;Martina Persson,&nbsp;Eva Hagström Toft,&nbsp;Johanna Bäck-Nirs,&nbsp;Marie Lindström,&nbsp;Anna Lindholm Olinder,&nbsp;Anna Lena Brorsson","doi":"10.1111/dme.70029","DOIUrl":"10.1111/dme.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Young women with type 1 diabetes (T1D) have higher risks of diabetes complications and report higher diabetes distress and lower quality of life than men with T1D. Their experiences of self-management and need for support have received little attention, and targeted interventions are lacking. The aim of this qualitative interview study was to explore the experiences of young women with T1D after participating in an intervention with the person-centred reflection and problem-solving model Guided Self-Determination-Young (GSD-Y), with a focus on self-management and support in daily diabetes care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative interview study was performed in a paediatric and an adult diabetes outpatient clinic in Sweden. After participating in an intervention with GSD-Y, 12 women (15–20 years) with T1D were selected and interviewed individually. The interviews were analysed using inductive qualitative content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis revealed an overarching theme: ‘A person-centred approach facilitated deeper reflection on both an individual and a relational level’, and two main categories: ‘The process initiated within the individual’, and ‘The process initiated together with the health care provider’. The women experienced increased knowledge of, and increased ability to manage diabetes. They also experienced a new type of relationship with the health care provider, including exchange of in-depth information beyond glucose levels, which appeared to increase their ability to receive support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The GSD-Y model provided tools to explore and clarify the individual needs of young women with T1D, which supported diabetes self-management. Person-centred care was enabled when the women became engaged as active partners in diabetes health care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742634","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":"Weight gain as a complication of intensification of glucose control with automated insulin delivery systems","authors":"Julia Kelly,&nbsp;Devin Steenkamp,&nbsp;Elizabeth Brouillard,&nbsp;Howard Wolpert","doi":"10.1111/dme.70031","DOIUrl":"10.1111/dme.70031","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691502","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":"Managing discordance between HbA1c and glucose management indicator","authors":"Erna Lenters-Westra,&nbsp;Marion Fokkert,&nbsp;Eric S. Kilpatrick,&nbsp;Erwin Schleicher,&nbsp;Scott Pilla,&nbsp;Emma English,&nbsp;Peter van Dijk","doi":"10.1111/dme.70023","DOIUrl":"10.1111/dme.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The assessment of haemoglobin A1c (HbA_1c) continues to play an essential role in diabetes care; however, major advances in new technologies widen the armament available to clinicians to further refine treatment for their patients. Whilst HbA_1c remains a critical glycaemic marker, advances in technologies such as Continuous Glucose Monitoring (CGM) now offer real-time glucose monitoring, allowing a more instant assessment of glycaemic control. Discrepancies between laboratory-measured HbA_1c and Glucose Management Indicator (GMI) values are a significant clinical issue. In this article, we present a checklist of potential sources of error for both GMI and HbA_1c values and provide suggestions to mitigate these sources in order to continue to improve diabetes care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified key literature pertaining to GMI measurement, HbA_1c measurement, and potential factors of discordance between the two. Using these sources, we explore the potential factors leading to discordance and how to mitigate these when found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We have constructed a quick reference checklist covering the main sources of discordance between HbA_1c and GMI, with accompanying narrative text for more detailed discussion. Discordance can arise due to various factors, including CGM accuracy, sensor calibration, red blood cell turnover and other physiological conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GMI will likely continue to be used in the upcoming years by both persons with diabetes and their health care providers, and so it is important for users of CGM devices to be equipped with the knowledge to understand the potential causes of discordance between GMI and HbA_1c values.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691488","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 relevant outcomes for type 1 diabetes management: A qualitative evidence synthesis","authors":"Jessica Hanae Zafra-Tanaka,&nbsp;Adela del Valle,&nbsp;Nathaly Aya Pastrana,&nbsp;J. Jaime Miranda,&nbsp;David Beran","doi":"10.1111/dme.70016","DOIUrl":"10.1111/dme.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Identify and define relevant outcomes for people living with T1DM and their caregivers, and explore the differences across contexts and life stages. This exercise will inform the development of a Core Outcome Set (COS), an essential list of outcomes that should be measured for T1DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review of qualitative studies published between 2010 and 2024 using PubMed (Medline), EMBASE, PsychINFO, and CINHAL was conducted. Studies that explored the perspectives and opinions of people living with T1DM or their caregivers around care and the healthcare system were included. Qualitative evidence synthesis was used to identify relevant outcomes for people living with T1DM and their caregivers. People living with T1DM and patient representatives were consulted to provide feedback on the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>119 studies were included; 85/119 (71.4%) conducted in high-income countries. Through the qualitative evidence synthesis, we found three levels of outcomes: (1) individual level (diabetes burden, psychological distress, self-efficacy, hypoglycemia burden, and diabetes burnout), (2) caregivers and family level (caregiver burden, social support, support provided by diabetes management team, and financial impact), and (3) systemic level (access to healthcare, administrative burden, structural support).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found that outcomes can be categorized into three different levels (individual, caregivers/family, and systemic). COS usually considers individual level outcomes, but it was found that outcomes beyond the individual, such as those at the caregiver/family and healthcare levels, also matter for people living with T1DM. To meet the needs, all these levels should be measured.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669307","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}