Diabetic Medicine最新文献

{"title":"Colorectal cancer outcomes show relationships with the type and extent of vascular complications in individuals with diabetes: A population-based study","authors":"Rebecca J. Birch,&nbsp;John C. Taylor,&nbsp;Amy Downing,&nbsp;Philip Quirke,&nbsp;Paul Finan,&nbsp;Katie Spencer,&nbsp;Eva J. A. Morris,&nbsp;Simon Howell,&nbsp;Ramzi A. Ajjan","doi":"10.1111/dme.70310","DOIUrl":"10.1111/dme.70310","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetes is associated with poorer prognosis and treatment-related outcomes in patients with cancer. Major surgical resection is the mainstay of potentially curative treatment for colorectal cancer (CRC). This study aimed to assess whether the risk of adverse outcomes for individuals with diabetes and CRC varies by diabetes status and associated diabetes-related complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Information for all individuals diagnosed with CRC in England between 2011 and 2021 was obtained from cancer registry data. Pre-existing diabetes was identified using diagnostic codes during hospital inpatient stay. Cox regression and logistic regression were used to assess the relationship between diabetes complication status and postoperative outcomes (5-year survival, 90-day mortality, death in hospital and unplanned readmission).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 372,477 individuals diagnosed with CRC, treatment using major surgical resection was highest amongst those with no diabetes (60%) and diabetes without complications (62%) compared to those with combined (microvascular and macrovascular) complications (34%). Five-year survival was lowest for those with combined complications when compared to those with no diabetes (45% vs. 69% after major resection; 5% vs. 18% without major resection). Increasing levels of complication severity were associated with increasing rates of 90-day postoperative mortality, with combined complications associated with the poorest outcome when compared to those without diabetes (10% vs. 4%, adjusted OR 2.18, 95% CI 1.90–2.51).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This population-based study demonstrates that the risk of adverse outcomes in patients with diabetes and CRC is heterogeneous. Future work is required to understand whether postoperative outcomes can be improved in individuals with diabetes and CRC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505971","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":"‘Dancing with diabetes’: Family coping strategies to promote psychological and behavioural adaptation in older children and adolescents with type 1 diabetes—A qualitative study","authors":"Huijing Zhang,&nbsp;Kun Li,&nbsp;Dan Luo,&nbsp;Yi Wu,&nbsp;Mingzi Li","doi":"10.1111/dme.70348","DOIUrl":"10.1111/dme.70348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore how families facilitate psychological and behavioural adaptation among older children and adolescents with T1D from the perspective of parents, children and families.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative descriptive study was conducted using maximum variance sampling method. Seventeen families in China, including 16 parents and 10 older children/adolescents with T1D, participated in semi-structured online interviews via phone or social software. Conventional content analysis was employed for data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three interrelated themes emerged: (1) emotional adjustment through support and compensation; (2) positive belief formation through transcendence and identity; and (3) enhanced self-management through cooperation and development. Emotional exchange, verbal support, companionship and practical compensation were identified from parents or children for regulating children's emotions. Parents fostered positive self-identity and set role models to encourage children's resilience and optimism. Shared responsibility, cognitive-behavioural adjustments, expansion of supportive environments and avoiding unhealthy behaviors were shown to be effective strategies for improving children's diabetes management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Perspectives on psychological and behavioural adaptation differed among parents, children and families, underscoring the need for family-centred approaches that address diverse emotional needs and align behavioural goals. Interventions should strengthen emotional connections, foster positive beliefs and enhance collaborative self-management within families to support children's adaptation to diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849096","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":"Beyond HbA1c: A CGM-centred three-pillar framework for glycaemic variability in pre-diabetes and type 2 diabetes","authors":"Taoming Qian,&nbsp;Donghao Guo,&nbsp;Meijun Zhang,&nbsp;Yuhan Liu,&nbsp;Juan Jin","doi":"10.1111/dme.70404","DOIUrl":"10.1111/dme.70404","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traditional management of type 2 diabetes mellitus (T2DM) and pre-diabetes centres on HbA1c reduction, yet this single metric fails to capture glycaemic variability (GV)—an independent driver of β-cell dysfunction, endothelial damage, oxidative stress, inflammation and cardiovascular risk, even in the pre-diabetes stage. Unlike existing reviews that focus predominantly on T2DM or HbA1c-centric approaches, this perspective articulates a unified three-pillar closed-loop framework that integrates continuous glucose monitoring (CGM) across the entire pre-diabetes-to-remission continuum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Perspective</h3>\u0000 \u0000 <p>We synthesize evidence from prospective cohorts, mechanistic studies, randomized controlled trials and real-world data to demonstrate that GV is a modifiable therapeutic target. CGM uniquely reveals dynamic glucose patterns invisible to HbA1c, enabling precise, real-time interventions that improve time in range (TIR), reduce GV and hypoglycaemia and support the achievement of clinical remission (HbA1c &lt;48 mmol/mol (&lt;6.5%) without glucose-lowering medication for ≥3 months) in subsets of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CGM-centred management of glycaemic stability offers a clinically actionable paradigm shift from static, average-glucose control to dynamic, precision-guided care. The proposed three-pillar framework—tiered personalized targets, data-driven intelligent decision support and empowered patient–clinician collaboration—provides a structured roadmap grounded in current evidence. Long-term outcomes in pre-diabetes, cost-effectiveness and global accessibility remain important areas for future investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335561","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":"Does faster aspart improve time in range in children with type 1 diabetes with glycaemia close to target on insulin pump therapy?","authors":"Kowalczyk-Korcz Emilia,&nbsp;Dymińska Magdalena,&nbsp;Groele Lidia,&nbsp;Szypowska Agnieszka","doi":"10.1111/dme.70330","DOIUrl":"10.1111/dme.70330","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate whether faster insulin aspart (FIA) improves time in range (TIR) compared with standard insulin aspart (SIA) in children and adolescents with type 1 diabetes achieving glycaemia close to target treated with continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, open-label, randomized, 1:1 crossover trial included participants aged 6–17 years with T1D duration of ≥1 year, CSII use ≥3 months, CGM use ≥1 month, and HbA1c 64 mmol/mol (&lt;8%). After a 2-week run-in period, they then crossed over to the alternate insulin for another 4 weeks. All participants used the same CGM system. Assessments were performed at the end of each treatment phase. The primary endpoint was the between-treatment difference in TIR (3.9–10.0 mmol/L, 70–180 mg/dL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-seven children were enrolled (mean T1D duration approximately 7 years; 66% male; mean HbA1c 53 mmol/mol, 7%). Mean TIR was 68.5% (SD 12.3%) with SIA and 67.6% (SD 12.1%) with FIA, with no statistically significant difference (mean difference −0.9%; 95% CI –2.60 to 0.86; <i>P</i> = 0.322). Similar patterns were observed for additional glycaemic metrics. Time in tight range was also similar between treatments: 46.3% for SIA versus 45.4% for FIA (<i>P</i> = 0.674).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this randomised crossover study of children and adolescents with T1D achieving glycaemia close to target on CSII, switching from SIA to FIA does not improve TIR. The absence of improvement across CGM-derived metrics suggests that FIA does not meaningfully enhance glycaemic outcomes in this clinical setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679972","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":"Integrated care for type 1 diabetes: The West Bengal model: 24-month follow-up","authors":"Masuma Yasmin,&nbsp;Pradip Mukhopadhyay,&nbsp;Bobby Paul,&nbsp;Dipta K. Mukhopadhyay,&nbsp;Partha S. Kar,&nbsp;Graham D. Ogle,&nbsp;Sujoy Ghosh,&nbsp;Published on behalf of the Kolkata Type 1 Diabetes Study (K1DS) Group","doi":"10.1111/dme.70350","DOIUrl":"10.1111/dme.70350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to document outcomes of care for individuals with type 1 diabetes (T1D) facilitated by a government-funded model supporting establishment of clinics within secondary-level district hospitals in a lower-middle-income country.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, multicentre, single-arm pre-post implementation evaluation study was conducted in government-funded ‘model’ clinics in district hospitals in West Bengal, India. All consecutive persons with physician-diagnosed T1D (<i>N</i> = 366) were enrolled and immediately transitioned to basal–bolus insulin regimen, with structured monthly follow-up visits. Clinical measures, psychological well-being and diabetes-related expenditures were assessed at baseline, 12 months and 24 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, median age and age at diagnosis were 15 (10–21) and 8 (5–11) years, respectively, with 41.4% from lower socio-economic class, and most parents/caregivers had not completed primary education. There were no dropouts, with a mean of 23.5 follow-up visits over 24 months. Median glycated haemoglobin (HbA1c) fell from 79 mmol/mol (64–104) [9.4% (8.0–11.7)] at baseline to 72 mmol/mol (58–87) [8.7% (7.5–10.1)] at 12 months, which further fell to 64 mmol/mol (54–73) [8.0% (7.1–8.8)] at 24 months (<i>p</i> &lt; 0.0001). No episodes of documented diabetic ketoacidosis, hospital admissions or deaths occurred. Psychological well-being improved. Median monthly expenditures dropped from 2600 INR (~30 USD) at baseline to 200 INR (~2 USD) at 24 months (p &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This novel public health system-supported model of T1D improved clinical parameters and psychological well-being of those living with T1D and their parents/caregivers and reduced expenditures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214132","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":"Receipt of postpartum diabetes screening after gestational diabetes mellitus in the United States, 2016–2022","authors":"Hedda L. Boege,&nbsp;Lauren T. Berube,&nbsp;Rachel A. Ryan,&nbsp;Andrea L. Deierlein","doi":"10.1111/dme.70327","DOIUrl":"10.1111/dme.70327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To examine temporal trends in, as well as social and clinical factors associated with, the prevalence of postpartum diabetes screening after gestational diabetes mellitus (GDM) in the United States (U.S.).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional, population-based data were from the Pregnancy Risk Assessment Monitoring System (PRAMS) 2016–2022 from 44 U.S. states and jurisdictions. The analytic sample included postpartum individuals with self-reported GDM who attended a postpartum checkup and reported on postpartum diabetes screening (<i>n</i> = 21,559). Overall and annual prevalence of postpartum diabetes screening were calculated, and associations between social and clinical factors and postpartum diabetes screening were examined using multivariable modified Poisson regression (adjusted prevalence ratios [aPR] with 95% confidence intervals [CI]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall weighted prevalence of postpartum diabetes screening was 55.8% (95% CI: 54.8–56.9). Screening prevalence increased from 2016 (55.6%) to 2019 (60.3%), declined at the onset of the COVID-19 pandemic (2020: 52.6%) and subsequently increased through 2022 (55.8%). Screening prevalence was 6%–38% higher among individuals who were ≥30 years of age; identified as racial or ethnic minoritized groups; did not graduate from high school; had public prenatal health insurance; had pre-pregnancy overweight or obesity and had adequate plus prenatal care. Screening prevalence was 5%–14% lower among individuals with a previous live birth, preterm birth and residents of rural areas, the South or U.S. Territories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While postpartum diabetes screening has increased and aligns with recognized risk factors, overall prevalence remains suboptimal. Postpartum diabetes screening represents a critical opportunity to identify individuals at elevated cardiometabolic disease risk and initiate timely interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655618","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":"Expert considerations to guide the development and delivery of an exercise intervention in people with type 2 diabetes-related foot ulcer disease","authors":"Vicki L. Johnson,&nbsp;Vicky Hall,&nbsp;Rachel Berrington,&nbsp;Julia Burdon,&nbsp;Sally Schreder,&nbsp;Matthew McCarthy,&nbsp;Chris Brough,&nbsp;Patrick J. Highton,&nbsp;Michelle Hadjiconstantinou,&nbsp;Frances L. Game,&nbsp;Lisa J. Keogh,&nbsp;Solomon Tesfaye,&nbsp;Jonathan Valabhji,&nbsp;John R. Petrie,&nbsp;Ketan K. Dhatariya,&nbsp;Tom Yates,&nbsp;Melanie J. Davies,&nbsp;Kamlesh Khunti","doi":"10.1111/dme.70338","DOIUrl":"10.1111/dme.70338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Engaging in exercise presents unique challenges for those with type 2 diabetes (T2D) and diabetes-related foot ulcer disease (DFUD). This brief report describes the development of practical considerations aiming to support exercise in people with T2D and DFUD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Research Design and Methods</h3>\u0000 \u0000 <p>An expert group of multidisciplinary healthcare professionals (HCPs), researchers and individuals with DFUD reviewed available evidence and developed practical considerations for the assessment, prescription and monitoring of exercise within an ongoing randomised controlled trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Key considerations include screening for contraindications, individualising exercise prescription, determining weight-bearing status and initial supervision by HCPs. Self monitoring of exercise and appropriate foot protection advice and care are also encouraged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We have developed practical considerations to use when delivering an exercise intervention within a study aiming to improve cardiovascular health for people with T2D and DFUD. For this specific population, these recommendations include prescribing non-weight bearing physical activity (such as arm ergometry or chair-based upper limb exercises) for those with active foot ulcers, educating and encouraging footcare self-management (including how to check feet and when to seek advice), monitoring glucose levels in participants at high risk of hypoglycaemia or hyperglycaemia and reducing the barriers to exercise. Pragmatic measures aimed at maintaining safety include determining the level of pre-assessment and individualised monitoring based on clinical presentation and/or risk as well as equipment and staff resource. This approach may also be helpful when supporting exercise in a wider population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826126","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":"D-ACTnow—A diabetes-specific group-based psychological intervention for young adults with type 1 diabetes and elevated diabetes distress: Results from a single-arm pilot study","authors":"Tanja Schmidt,&nbsp;Emilie Just-Østergaard,&nbsp;Julie Drotner Mouritsen,&nbsp;Grete Skøtt Pedersen,&nbsp;François Pouwer,&nbsp;Claus Bogh Juhl","doi":"10.1111/dme.70357","DOIUrl":"10.1111/dme.70357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To test the feasibility of a group-based psychological intervention for young adults with type 1-diabetes and elevated diabetes distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Young adults (18–30 years), screened for diabetes distress using the Type 1 Diabetes Distress Scale (T1-DDS), participated in six group sessions led by a psychologist and a diabetes nurse. The intervention was based on Acceptance and Commitment Theory (ACT) and focused on reducing diabetes distress. Feasibility was assessed through trial recruitment, intervention completion, intervention acceptability and preliminary estimates of effect size (T1-DDS, HbA_1c, continuous glucose measurement), using descriptive statistics, <i>t</i>-test and systematic text condensation of interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During May 2023–December 2023, 22 young adults were recruited; 20 completed the intervention with high acceptability. Participants (85% women, mean age 23.6 years) showed significant reductions in diabetes distress (T1-DDS: 1.2, <i>p</i> &lt; 0.0001). No changes were found in HbA_1c or glucose time-in-range. Qualitative analyses highlighted benefits of sharing experiences with peers, gaining clarity and practicing coping strategies, supporting the intervention's feasibility and potential effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The intervention is feasible and acceptable with encouraging diabetes distress improvements. Minor adjustments will optimize the intervention for the upcoming RCT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059380","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":"Risk of progression to type 2 diabetes or regression to normoglycaemia among Ghanaians with prediabetes living in Ghana and the Netherlands: The RODAM prospective study","authors":"Emmanuel Bannerman-Williams,&nbsp;Yacoba Atiase,&nbsp;Bert-Jan H. van den Born,&nbsp;Felix Patience Chilunga,&nbsp;Eva van der Linden,&nbsp;Karlijn A. C. Meeks,&nbsp;Erik Beune,&nbsp;Charles Agyemang,&nbsp;Charles Frederick Hayfron-Benjamin","doi":"10.1111/dme.70332","DOIUrl":"10.1111/dme.70332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Evidence shows that ethnicity affects the risk of progression of prediabetes to type 2 diabetes(T2D) or regression to normoglycaemia However, little is known about progression rates among sub-Saharan African populations or whether geographical context affects risk variations. We compared the risk of progression to T2D or regression to normoglycemia in West Africans with prediabetes living in Africa and their migrant compatriots living in Europe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed data from 615 Ghanaians with prediabetes at baseline (245 in Ghana/370 in Amsterdam) in the prospective RODAM cohort with an average follow-up of 6.7 years. Prediabetes was defined according to the WHO criteria. Incidence risk ratios for progression to T2D and regression to normoglycaemia were calculated with adjustment for age, sex, follow-up duration, socioeconomic status and baseline BMI and fasting plasma glucose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, the cumulative incidences of T2D and normoglycaemia from prediabetes were 12.6% and 28.9%, respectively. While the proportions of individuals who progressed to T2D did not differ between non-migrants and migrants (16.0% vs. 10.9%, <i>p</i>-value = 0.108), the proportion who regressed to normoglycaemia was higher in non-migrants (51.5% vs. 17.1%, <i>p</i> &lt; 0.001) with an incident risk ratio of 3.48 (95% CI 2.39–5.05, <i>p</i> &lt; 0.001) in the fully adjusted model. However, the risk of progression of prediabetes to T2D remained similar in the two groups after full adjustment [1.20 (0.71–2.05), 0.498].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among Ghanaians with prediabetes, regression to normoglycaemia was more frequent than progression to T2D, and more likely in non-migrants than in migrants. Future studies could identify factors underlying the higher rates of regression to normoglycaemia in non-migrants to improve outcomes in individuals with prediabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694311","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 retrospective sub-study of perioperative glycaemia and insulin treatment for hospital inpatients at a quaternary centre from the specialist treatment of inpatients: Caring for diabetes in surgery trial (STOIC-D Surgery)","authors":"Florence Ho,&nbsp;Mervyn Kyi,&nbsp;Spiros Fourlanos,&nbsp;Peter G. Colman,&nbsp;Leon J. Worth,&nbsp;Rahul D. Barmanray","doi":"10.1111/dme.70370","DOIUrl":"10.1111/dme.70370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Surgical inpatients experience variable glycaemia, with hyper and hypoglycaemia, contributing towards increased morbidity and mortality. Understanding of mechanisms for glycaemic variability and clinician responses remains limited. We aimed to describe patterns of glycaemia in the immediate perioperative period and its drivers, including treatment with glucose-lowering agents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a sub-analysis of participants in the STOIC-D Surgery trial, a randomised controlled trial of early specialist-led glycaemic management for inpatients with pre-admission diabetes or inpatient hyperglycaemia. Patients in this sub-study underwent at least one procedure during admission. Data from day prior to surgery, day of surgery and day after surgery were collected, including blood glucose levels and factors influencing glycaemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>518 participants were included, with a mean HbA1c of 52 mmol/mol (6.9%). 295 (57%) patients received insulin during the three perioperative days; 130 (44%) of these insulin-receiving patients had a consistent increase in their total daily insulin dose across the 3 days. These patients had the highest perioperative glycaemia compared to patients with different insulin titration trends, particularly on the day of and day after surgery. Fasting duration was the only variable identified as being significantly associated with increased postoperative glycaemia. Hypoglycaemia was uncommon, occurring in 3% of all patients for each perioperative day. This was higher for patients receiving perioperatively insulin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study characterised perioperative glycaemia trends and suggests that clinicians identify patients who require intensification of insulin treatment in the perioperative period, which needs to be counterbalanced with the risk of hypoglycaemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990734","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}