Diabetic Medicine最新文献

{"title":"Effectiveness of diabetes footwear fit assessment by people with diabetes and their family or partners: A reliability study","authors":"Petra J. Jones,&nbsp;Jade Bullock,&nbsp;Lesley Weaving,&nbsp;Melanie J. Davies,&nbsp;Cameron Razieh,&nbsp;Ehtasham Ahmad","doi":"10.1111/dme.70065","DOIUrl":"10.1111/dme.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Incorrectly fitting footwear is implicated in ulceration yet worn by more than two-thirds of people with diabetes. Our aim is to evaluate the accuracy, reliability and ease of use of a new intervention to train people with diabetes and their ‘footwear buddies’ (e.g., partner/family member) to assess footwear for adequate length and width. Participants were provided with foot and footwear measuring tools, written instructions, video and face-to-face training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>20 participants were recruited consisting of 10 people with diabetes aged 18+ and their 10 ‘footwear buddies’. Participants measured feet and footwear length repeatedly and completed ease-of-use Visual Analogue Score surveys after reading/viewing educational materials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean absolute difference (MAD) between study participants' and researchers' foot length and width measurements was 3–5 mm after only an average 6.5 ± 1.6 min of training. Repeated measurement Intraclass Correlation Coefficient (ICC) ranged from moderate to excellent (0.71–1.00) with excellent ease of use (7.8/10).</p>\u0000 \u0000 <p>MAD between participants' and researchers' footwear length measurements was 5 mm with excellent ICC (0.99–1.00) and ease of use scores (7.8/10). However, footwear width MAD was much larger (9-11 mm, 0.96 ICC), with poor ease of use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Diabetes footwear assessment shows potential—individuals at risk of foot ulceration and their footwear buddies can be empowered to assess their feet and footwear for length even after just 20 min' training. However, footwear width measurement remains challenging, requiring either a different methodology or tool for people with diabetes to accurately and confidently assess their footwear fit.</p>\u0000 \u0000 <p><b>Trial registration:</b> ClinicalTrials.gov NCT06200532</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A piperidinyl indole derivative, potential complement factor B inhibitor, plays a renoprotective role in diabetic nephropathy","authors":"Zi-Han Li,&nbsp;Zi-Jun Sun,&nbsp;Dong-Yuan Chang,&nbsp;Ming-Hui Zhao,&nbsp;Sydney C. W. Tang,&nbsp;Min Chen","doi":"10.1111/dme.70092","DOIUrl":"10.1111/dme.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus (DM) and the main cause of end-stage kidney disease (ESKD) worldwide. The pathogenesis of DN is complex, and cumulating evidence demonstrated that over-activation of the complement system is involved. Complement factor B (CFB), a serine protease, drives the central amplification loop of the alternative pathway (AP) of the complement, making it a potential therapeutic target. In this study, we investigated the therapeutic potential of a piperidinyl indole derivative in <i>db</i>/<i>db</i> mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A highly potent CFB-targeting compound, (+)-4-((2<i>S</i>,4<i>R</i>)-1-((5-methoxy-7-methyl-1<i>H</i>-indol-4-yl) methyl)-4-methylpiperidin-2-yl) benzoic acid (hereafter referred as the “compound”), was orally administered to the <i>db</i>/<i>db</i> mice model. Bioinformatics and network pharmacology analyses were applied in our research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Oral administration of the compound attenuated established DN in <i>db</i>/<i>db</i> mice, as evidenced by reduced urine albumin-to-creatine ratio (uACR), tubulointerstitial inflammation and fibrosis, and thickening of glomerular basement membrane. Besides binding to the active site of Bb, the enzyme-cleaved activated fragment of CFB, and inhibiting the activity of complement component 3 (C3) convertase of the AP, the compound could regulate the expression of cysteinyl aspartate specific proteinase 3 (CASP3, a key executor of renal tubular apoptosis) and dipeptidyl peptidase 4 (DPP4, a pro-fibrotic driver in tubulointerstitium) by bioinformatics and network pharmacology analysis. These complementary mechanisms cooperated to inhibit the over-activation of complements and the apoptosis/fibrosis cascade and together alleviated DN progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data revealed the potential therapeutic strategy of using the piperidinyl indole derivative for the treatment of DN and provided a basis for its clinical development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Astragaloside IV alleviates diabetic foot ulcers by promoting the METTL3-mediated m6A modification of SIRT1","authors":"Yu Liu,&nbsp;Hao Zheng,&nbsp;Jiayuan Zhang","doi":"10.1111/dme.70087","DOIUrl":"10.1111/dme.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetic foot ulcer (DFU) is a common and serious complication of diabetes mellitus (DM) and one of the main causes of disability or mortality in diabetic patients. Astragaloside IV (AS-IV) is a naturally occurring plant product that can be used to treat DM and its complications. N6-methyladenosine (m6A) modification participates in the progression of DM. This study aimed to explore the potential molecular mechanisms of m6A modification induced by AS-IV treatment of DFU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The biological behaviours of cells were assessed by cell counting kit-8, EdU incorporation, wound healing, and transwell assays. The levels of m6A modification and relative genes mRNA were detected by dot blot assay and quantitative real-time PCR. The interactions between molecules were evaluated by methylated RNA immunoprecipitation (MeRIP), RIP, fluorescence in situ hybridisation, and dual-luciferase reporter analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results suggested AS-IV facilitated cell proliferation and migration of AGE-induced HaCaT cells and accelerated wound healing, thereby alleviating DFU progression. Mechanically, AS-IV promoted the m6A modification levels of SIRT1 in vivo and in vitro which was associated with increased METTL3. Besides, SIRT1 was the target of METTL3-mediated m6A modification. Silencing of SIRT1 abrogated the biological effects of METTL3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The mitigation effect of AS-IV on DFU is achieved by promoting m6A modification of SIRT1 to enhance SIRT1 stability. This study not only reveals the novel molecular mechanisms of AS-IV in the treatment of DFU but also provides new insights for the treatment of diabetes and its complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma experienced by adolescents with type 1 diabetes: A systematic review and meta-synthesis","authors":"Rui Wang,&nbsp;Wencai Liu,&nbsp;Cuicui Yang,&nbsp;Xinyi Weng,&nbsp;Meijing Zhou,&nbsp;Jiayin Ruan,&nbsp;Dan Luo","doi":"10.1111/dme.70088","DOIUrl":"10.1111/dme.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify and synthesize qualitative evidence on the stigma experiences of adolescents with type 1 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six databases were searched from inception to February 2024: PubMed, Cochrane Library, CINAHL, MEDLINE, Embase, and PsycINFO. This meta-synthesis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Findings from the included qualitative studies were synthesized using Thomas and Harden's methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>About 17 studies were included in the meta-synthesis. Two synthesized findings emerged, including living in stigma (individual perceived and internalized stigma, stigma in interpersonal interactions, implicit stigma in the social structure) and coping with stigma (active stigma coping and escape-avoidance).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review is the first meta-synthesis specifically aimed at exploring the stigma experiences among adolescents with type 1 diabetes across individual, interpersonal, and structural levels. The multisourced stigma identified in this review is instrumental in the development of culturally informed and multitiered anti-stigma interventions for this population. It is imperative to enhance adolescents' coping abilities regarding stigma, as is the creation of a stigma-free environment for them.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators of physical activity and exercise among adults with type 2 diabetes mellitus in Singapore – A mixed-methods sequential explanatory study mapped to the COM-B model, theoretical domains framework and behavioural change wheel","authors":"Ying Jie Chee,&nbsp;Huiling Liew,&nbsp;Alvin Wai Kit Tan,&nbsp;Sanchalika Acharyya,&nbsp;Rinkoo Dalan","doi":"10.1111/dme.70085","DOIUrl":"10.1111/dme.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Exercise is a cornerstone in type 2 diabetes mellitus (T2DM) management. This study investigates physical activity, its barriers, and facilitators among adults with T2DM in Singapore.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In Phase I of this sequential explanatory mixed-methods study, participants with T2DM were recruited to complete the Physical Activity Stage of Change Questionnaire and were examined for metabolic profiles, physical activity and cardiorespiratory fitness (via a 3-min step test) across different stages of change. In Phase II, 20 participants stratified by their stage of change were interviewed to identify barriers and facilitators to exercise, which were classified using the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the theoretical domains framework (TDF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 100 recruited participants, 83 had complete data and 36 completed the step test. Stages of change assessment identified participants in pre-contemplation(<i>n</i> = 5), contemplation(<i>n</i> = 49), preparation(<i>n</i> = 2), action(<i>n</i> = 3), and maintenance(<i>n</i> = 24) stages. Participants in early stages (pre-contemplation/contemplation) had significantly lower daily step counts (mean ± SD 5983 ± 2788 vs. 7667 ± 3299; <i>p</i> = 0.024) and step test completion rates (29.6% vs. 68.9%; <i>p</i> = 001) than those in the later stages. Qualitative interviews revealed barriers to exercise, including low cardiorespiratory fitness, fear of injuries, lack of opportunities and inadequate motivation. Facilitators included individualized exercise regimens, exercise guidance, goal setting, family support and role modelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides insights into barriers and facilitators to exercise among individuals with T2DM in Singapore, systematically analysed using the COM-B model and TDF. Future interventions could target different components of COM-B and leverage the behavioural change wheel framework to enhance personalization and promote sustainable behavioural change to exercise.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes distress screening using PAID-5 and PAID-1 among adults attending a tertiary multidisciplinary type 1 diabetes clinic","authors":"Jonathan Vu,&nbsp;Krisha Solanki,&nbsp;Jenny McKay,&nbsp;Kavita Kumareswaran,&nbsp;Isobel Duncan,&nbsp;Annita Joseph,&nbsp;Tomasz J. Block,&nbsp;Anthony W. Russell,&nbsp;Sophia Zoungas,&nbsp;Steven Trawley,&nbsp;Sybil A. McAuley","doi":"10.1111/dme.70083","DOIUrl":"10.1111/dme.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Living with type 1 diabetes can be challenging, and diabetes distress may be overlooked during time-constrained clinical assessments. Screening for diabetes distress with the one-item Problem Areas in Diabetes Scale (PAID)-1, in conjunction with the five-item PAID-5, may offer an efficient method to improve type 1 diabetes assessment. We aimed to evaluate the utility of this approach to identify possible diabetes distress and its clinically significant covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective, real-world, cross-sectional study of adults attending a multidisciplinary type 1 diabetes outpatient clinic at a tertiary centre from October 2023 to September 2024, inclusive. Screening was conducted using PAID-5 (incorporating PAID-1) during the initial consultation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 160 adults included (median age 38 years [IQR 30–52]; type 1 diabetes duration 16 years [4–24]; <i>n</i> = 138 [86%] were using continuous glucose monitoring [CGM]). PAID-5 median score was 8 [4–12]; 83 individuals (52%) had a score ≥8, indicating possible diabetes distress. Higher diabetes distress screening scores were associated with CGM metrics indicative of hyperglycaemia; no associations were observed with CGM-detected hypoglycaemia. PAID-1 had sensitivity 81% and specificity 96% for PAID-5-detected diabetes distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A high prevalence of diabetes distress was detected on screening among adults attending a tertiary type 1 diabetes service. This highlights the importance of psychological assessment and implementation of management strategies for diabetes distress to reduce the burden of living with type 1 diabetes. Our findings support the use of the PAID-1 as a rapid screening tool to assess for diabetes distress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251811","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":"Experiences of diabetes stigma among adults with type 1 and type 2 diabetes: A multi-study, multi-country, secondary analysis","authors":"Elizabeth Holmes-Truscott,&nbsp;Eloise Litterbach,&nbsp;Uffe Søholm,&nbsp;Paul A. Agius,&nbsp;Hamzah Alzubaidi,&nbsp;Valery Bodziony,&nbsp;Joncarl Bresolin,&nbsp;Kim Fletcher,&nbsp;Matthew Garza,&nbsp;Kevin L. Joiner,&nbsp;Rebecca M. Puhl,&nbsp;Michio Shimabukuro,&nbsp;Laura Syron,&nbsp;Hiroko Takaike,&nbsp;Michael Vallis,&nbsp;Heather Verry,&nbsp;Jennifer A. Halliday,&nbsp;Sarah L. Manallack,&nbsp;Timothy C. Skinner,&nbsp;Jane Speight","doi":"10.1111/dme.70082","DOIUrl":"10.1111/dme.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To conduct a multi-study, cross-country examination of diabetes stigma among adults with type 1 and type 2 diabetes (T1D, T2D).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pre-existing, cross-sectional studies of adults (aged ≥18) completing the T1D or T2D Diabetes Stigma Assessment Scales (DSAS-1/DSAS-2) were collated. Descriptive statistics were calculated for (sub)scale and item scores. Variance-components linear random-effect multi-level modelling (nested random intercepts for country and study) estimated overall mean (sub)scale scores, 95% confidence intervals, intraclass correlation coefficients (ICC) and 95% prediction intervals. Likelihood ratio (LR) tests provided inference for country- and study-specific heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven studies were included from six countries (Australia <i>k</i> = 2, Canada <i>k</i> = 1, Japan <i>k</i> = 2, New Zealand <i>k</i> = 1, UAE <i>k</i> = 1, USA <i>k</i> = 4) in four languages (Arabic <i>k</i> = 1, English <i>k</i> = 7, Japanese <i>k</i> = 2, Spanish <i>k</i> = 1). Six studies included <i>n</i> = 3114 adults with T1D (insulin pump: 42%; 75% aged &lt;60 years). Ten studies included <i>n</i> = 6586 adults with T2D (insulin-treated: 37%; 44% aged &lt;60 years). Most reported ≥1 experience of diabetes stigma (T1D = 91%; study range: 84%–96%; T2D = 77%; 69%–89%). In 10 studies, the ‘blame and judgment’ subscale was most endorsed (T1D = 83%; 62%–89%, T2D = 70%; 53%–79%). Most adults with T1D reported ‘identity concerns’ (73%; 62%–80%), and 47% of adults with T2D reported ‘self-stigma’ (30–60%). Being ‘treated differently’ was least common (T1D = 46%; 40%–54%, T2D = 37%; 28%–47%). Low levels of heterogeneity were observed in mean [SE] total scores (DSAS-1: 54 [0.94] ICC = 0.02, <i>p</i> &lt; 0.001; DSAS-2: 44 [1.1], ICC ≤0.4, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings suggest a high and relatively consistent prevalence of diabetes stigma across studies and within and across countries, supporting calls for local and global action.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251905","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 loss is associated with improved daytime time in range in adults with prediabetes and non-insulin-treated type 2 diabetes undergoing dietary intervention","authors":"Souptik Barua,&nbsp;Dhairya Upadhyay,&nbsp;Lauren T. Berube,&nbsp;Collin J. Popp,&nbsp;Margaret Curran,&nbsp;Mary Lou Pompeii,&nbsp;Lu Hu,&nbsp;Jose O. Aleman,&nbsp;Michael Bergman,&nbsp;Mary Ann Sevick","doi":"10.1111/dme.70052","DOIUrl":"10.1111/dme.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To characterize changes in continuous glucose monitoring (CGM)-derived time in tight range (TIR) measures in individuals with prediabetes or non-insulin-treated type 2 diabetes undergoing dietary weight loss intervention and to quantify the association between weight loss and TIR improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Personal Diet Study, a 6-month behavioural weight loss intervention in adults with prediabetes or non-insulin-treated type 2 diabetes [HbA_1c ≤ 8.0% (64 mmol/mol), managed with diet alone or with metformin], was analysed. Participants wore a CGM for a maximum of 2 weeks at baseline and 6 months. Changes in overall, daytime (06:00 h–23:59 h) and overnight (00:00 h–05:59 h) time in 54–140 mg/dL or 3.0–7.8 mmol/L (TIR_54–140), 70–140 mg/dL or 3.9–7.8 mmol/L (TIR_70–140) and &gt;140 mg/dL or &gt;7.8 mmol/L (TAR_&gt;140) were analysed. The association between weight change and TIR change adjusted for demographic and clinical covariates was computed using linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline and 6 months CGM data from 76 participants (63 ± 8 years, 62% female, 64% White, BMI 33 ± 5 kg/m², HbA_1c 5.8 ± 0.6%) were analysed. Overall TIR_54–140 increased (3.3% [0.3, 6.3]%; <i>p</i> = 0.03), with improvement in daytime (3.8% [0.9, 6.8]%; <i>p</i> = 0.01) but not overnight TIR_54–140 (2.0% [−2.2, 6.1]%; <i>p</i> = 0.36). In adjusted analysis, every 5% points of weight loss was associated with a 3.2% points increase in overall TIR_54–140 (<i>p</i> = 0.016), driven by a 3.5% points increase in daytime TIR_54–140 (<i>p</i> = 0.006). Similar associations were found for TAR_&gt;140 but not TIR_70–140. There were no associations between weight loss and change in any overnight TIR measure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Weight loss was associated with improved daytime TIR_54–140 and TAR_&gt;140 in individuals with prediabetes and non-insulin-treated type 2 diabetes undergoing dietary intervention. The daytime time in tight range measures can complement traditional markers like HbA1c, offering a more comprehensive view of glycaemic variations during dietary weight loss programmes for individuals with prediabetes and type 2 diabetes not on insulin.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218546","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":"Unravelling the heterogeneity of diabetes in chronic pancreatitis: Alpha and beta cell dysfunction and association with glycaemic control","authors":"Line Davidsen,&nbsp;Simon Lebech Cichosz,&nbsp;Cecilie Siggaard Knoph,&nbsp;Isabelle Myriam Larsen,&nbsp;Peter Bisgaard Stæhr,&nbsp;Peter Vestergaard,&nbsp;Morten Hasselstrøm Jensen,&nbsp;Bolette Hartmann,&nbsp;Jens Juul Holst,&nbsp;Asbjørn Mohr Drewes,&nbsp;Caroline Trunk-Black Juel,&nbsp;Filip Krag Knop,&nbsp;Søren Schou Olesen","doi":"10.1111/dme.70080","DOIUrl":"10.1111/dme.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetes in patients with chronic pancreatitis is a heterogeneous condition with some patients presenting with pre-existing diabetes and others developing diabetes after pancreatitis onset. We aimed to characterise beta and alpha cell function in these patients and examine differences between those with and without pre-existing diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 26 patients with chronic pancreatitis and insulin-treated diabetes, divided into two subgroups: 13 with pre-pancreatitis diabetes (having type 2 diabetes before their chronic pancreatitis diagnosis) and 13 with post-pancreatitis diabetes. Patients underwent comprehensive clinical characterisation, including an arginine stimulation test to measure fasting and stimulated levels of C-peptide and glucagon. Additionally, they were monitored with continuous glucose monitoring over 20 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with chronic pancreatitis and diabetes exhibited reduced fasting and stimulated C-peptide and glucagon responses to arginine, though responses varied considerably among individuals. Post-pancreatitis diabetes patients had lower glucagon responses than those with pre-pancreatitis diabetes (mean difference −19.3 pmol/L, 95% confidence interval (CI) −35.6 to −3.0). However, C-peptide levels were similar between the groups. Pre-pancreatitis diabetes patients spent more time in level 2 hyperglycaemia compared to post-pancreatitis patients (12.9% vs. 6.7%, <i>p</i> = 0.02). In contrast, post-pancreatitis diabetes patients had more time in both level 1 and level 2 hypoglycaemia (<i>p</i> = 0.03 and <i>p</i> = 0.05, respectively). A low glucagon response was correlated with time spent in hypoglycaemia (Rho = −0.54, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Diabetes in chronic pancreatitis is a heterogeneous entity. The presence of type 2 diabetes prior to chronic pancreatitis is associated with a reduced risk of alpha cell dysfunction and hypoglycaemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192593","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":"Recovery factors and development of a grounded theory of recovery in type 1 disordered eating","authors":"Ronda Embick,&nbsp;Rose Stewart","doi":"10.1111/dme.70070","DOIUrl":"10.1111/dme.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Type 1 disordered eating (T1DE) is an unofficial diagnostic term that describes specific eating disorder behaviours in individuals living with type 1 diabetes. This study aimed to develop a recovery model for individuals living with T1DE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirteen people met the study criteria and participated in semi-structured interviews. Interviews were analysed using constructivist grounded theory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A theory of recovery was developed by data grounded in the narratives of people with lived experience. Five major categories were constructed and linked to the process of recovery. These are presented as the 5rs of recovery: (1) readiness to change, (2) roadblocks, (3) recovery factors, (4) risk factors and (5) relapse. Underpinning each category is a combination of biological, psychological, social and systemic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings propose a theory on the process of recovery and present common recovery factors. The presented model of recovery could be used as a formulation tool to help individuals living with T1DE and their healthcare teams, both in mental health and diabetes settings. Those working with this population may want to consider how their services can facilitate any of the listed recovery factors as well as limit the barriers mentioned.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188773","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}