Diabetic Medicine最新文献

{"title":"Hypertensive disorders of pregnancy and gestational diabetes mellitus and predicted risk of maternal cardiovascular disease 10–14 years after delivery: A prospective cohort","authors":"Kartik K. Venkatesh,&nbsp;William A. Grobman,&nbsp;Jiqiang Wu,&nbsp;Nilay S. Shah,&nbsp;Michael Pencina,&nbsp;Maged M. Costantine,&nbsp;Mark B. Landon,&nbsp;Patrick Catalano,&nbsp;William L. Lowe,&nbsp;Denise M. Scholtens,&nbsp;Sadiya S. Khan","doi":"10.1111/dme.15516","DOIUrl":"10.1111/dme.15516","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Studies evaluating the relationship between adverse pregnancy outcomes (APOs), namely hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), with the estimated risk of atherosclerotic cardiovascular disease (ASCVD) remains limited and could inform patient-centred decision-making in the postpartum period. We examined whether HDP or GDM were associated with a higher 10- and 30-year predicted risk of ASCVD measured 10–14 years after delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A secondary analysis from the international prospective Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (2013–2016) cohort. The exposures were HDP or GDM (untreated according to the International Association of the Diabetes and Pregnancy Study Groups criteria). Outcomes were 10- and 30-year predicted risk of ASCVD (composite of fatal and non-fatal coronary heart disease and stroke) as quantified by the validated Framingham Risk Score as a continuous measure, and secondarily, at thresholds used for clinical decision-making of ≥7.5% for 10-year predicted risk and ≥20% for 30-year predicted risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4432 individuals at a median age of 30.5 years and a median gestational age of 27.9 weeks at pregnancy enrollment, 10.7% developed HDP and 13.7% developed GDM. At 10–14 years after delivery, individuals with HDP had a higher 10-year predicted risk of ASCVD (least squares mean: 2.9% vs. 2.2%; adj. <i>β</i>: 0.59; 95% CI: 0.41–0.77) and a higher 30-year predicted risk of ASCVD (7.7% vs. 6.1%; adj. <i>β</i>: 1.27; 95% CI: 0.81–1.72) compared with those without HDP. Similarly, individuals with GDM had a higher predicted risk of ASCVD (10-year: 3.2% vs. 2.1%; adj. <i>β</i>: 0.51; 95% CI: 0.34–0.67 and 30-year: 8.8% vs. 5.8%; adj. <i>β</i>: 1.56; 95% CI: 1.11–2.01) compared with those without GDM. These results were similar when predicted ASCVD risk was assessed at thresholds of ≥7.5% at 10 years and ≥20% at 30 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Individuals who experienced HDP or GDM had a higher predicted 10- and 30-year risk of ASCVD measured 10–14 years after delivery compared with individuals who did not experience these APOs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15516","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001890","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":"Differential effect of nonpharmacological interventions according to prediabetes phenotype: Systematic review and meta-analysis of randomized clinical trials","authors":"J. Pierre Zila-Velasque,&nbsp;Rodrigo M. Carrillo-Larco,&nbsp;Antonio Bernabe-Ortiz","doi":"10.1111/dme.15511","DOIUrl":"10.1111/dme.15511","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Impaired glucose intolerance (IGT) and impaired fasting glucose (IFG) are totally different. Lifestyle modification is effective in moving from prediabetes to normoglycaemia. There is a lack of information showing the effect of lifestyle modification according to each prediabetes and assessing its effect on the degree of reversibility to normoglycaemia and on cardiometabolic markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We searched for randomized controlled trials (RCT) that enrolled individuals with IGT or IFG. Meta-analysis was performed to compare the proportion of subjects progressing to type 2 diabetes mellitus (T2DM); proportion reversing to normoglycaemia and mean differences in glucose level and cardiometabolic parameters. Thirty-six RCTs were included. The proportion of subjects progressing from impaired glycaemia to T2DM was higher among those with IGT (16.3% vs. 10.9%), whereas reversion to normoglycaemia was higher in subjects with IFG (27.2% vs. 24.8%). The effect of lifestyle modification on glucose level was significant on those with IFG (mean difference [MD] = −1.56 mg/dL, 95% CI: −2.71, −0.40), but not on those with IGT of (MD = 1.47 mg/dL, 95% CI: −1.33, 4.28).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Diverse lifestyle modification interventions improved glucose levels in people with IFG, but not in those with IGT. Our findings imply that different non-pharmacological interventions are warranted for IGT and IFG.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001881","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 trauma-informed approach to type 1 diabetes mellitus in adults","authors":"Hadassah Buechner,&nbsp;Shreena Unadkat,&nbsp;Joanne Skeldon,&nbsp;Gregory C. Jones","doi":"10.1111/dme.15510","DOIUrl":"10.1111/dme.15510","url":null,"abstract":"<p>Suggested mechanisms for an association between early life adversity and worse glycaemic control.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969045","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 missing piece: The clinical translation of precision diabetes medicine requires precision mental health care: A call to action from the international PsychoSocial Aspects of Diabetes (PSAD) Study Group","authors":"François Pouwer,&nbsp;Katharine Barnard-Kelly,&nbsp;Bryan Richard Cleal,&nbsp;Debbie Cooke,&nbsp;Mary de Groot,&nbsp;Sonya Deschênes,&nbsp;Dominic Ehrmann,&nbsp;Anthony Fernandez,&nbsp;Lisbeth Frostholm,&nbsp;David Hopkins,&nbsp;Norbert Hermanns,&nbsp;Richard I. G. Holt,&nbsp;Marjolein Memelink Iversen,&nbsp;Thomas Kubiak,&nbsp;Christina Maar Andersen,&nbsp;Briana Mezuk,&nbsp;Giesje Nefs,&nbsp;Susanne S. Pedersen,&nbsp;Miranda Schram,&nbsp;Frank Snoek,&nbsp;Uffe Søholm,&nbsp;Timothy C. Skinner,&nbsp;Søren Skovlund,&nbsp;Marietta Stadler,&nbsp;Ragnhild B. Strandberg,&nbsp;Sarah Bro Trasmundi,&nbsp;Michael Vallis,&nbsp;Kirsty Winkley,&nbsp;Per Winterdijk,&nbsp;Maartje de Wit,&nbsp;Natalie Zaremba,&nbsp;Jane Speight,&nbsp;the international PsychoSocial Aspects of Diabetes (PSAD) Study Group","doi":"10.1111/dme.15514","DOIUrl":"10.1111/dme.15514","url":null,"abstract":"&lt;p&gt;Diabetes is an increasingly common, long-term condition, requiring 24/7 self-care and constituting one of the greatest health challenges of our time. As with all ‘wicked problems’, a one-size-fits-all approach to care is doomed to fail.&lt;/p&gt;&lt;p&gt;In 2020, we welcomed the first international consensus report on precision diabetes medicine, which included a section on patient-centred mental health and quality of life outcomes.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This included the recommendation that, &lt;i&gt;‘in the setting of precision diabetes medicine, providers should assess symptoms of diabetes distress, depression, anxiety, disordered eating and cognitive capacities using appropriate standardized and validated tools at the initial visit, at periodic intervals and when there is a change in disease, treatment or life circumstance (..), information that, when combined with other data, are likely to improve the precision of clinical decision making’&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In 2023, the Precision Medicine in Diabetes Initiative (PMDI) published the second international consensus report, on gaps and opportunities for the clinical translation of precision diabetes medicine.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; This report focused on results ‘&lt;i&gt;from a systematic evidence review across the key pillars of precision medicine (prevention, diagnosis, treatment, prognosis) in four recognized forms of diabetes (monogenic, gestational, type 1, type 2)&lt;/i&gt;’, to inform the translation of precision medicine research into practice.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Regrettably, the second consensus omits any such recommendation or discussion of mental health issues. Furthermore, among the ‘key sources of heterogeneity in diabetes’, only ‘behaviour’ was included, while among the ‘pillars of precision medicine’, only ‘lifestyle interventions’ were included.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The first consensus called for ‘&lt;i&gt;a rigorous review elucidating effective precision medicine strategies, areas of promise and notable gaps across …[diabetes]… to inform an evidence-based road map to optimize the integration of precision medicine into the global response to the diabetes crisis’&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Of the 15 new systematic reviews conducted to inform the second consensus report, none includes the psychosocial aspects of diabetes.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Yet, there is a robust evidence base demonstrating the crucial role of psychosocial factors for people living with, or at risk of, diabetes; and this evidence has only strengthened since the first consensus. For example, a recent umbrella review of 25 systematic reviews of longitudinal studies concluded that common mental disorders, such as depression, anxiety disorders, sleep disorders and schizophrenia, are associated with increased risks for developing type 2 diabetes.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Various psychotropic medications can increase weight, and people living with mental disorders often face additional challenges, such as","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15514","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964252","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":"Evaluating the impact of severe hypoglycaemia definition wording on severe hypoglycaemia history assessment","authors":"Yu Kuei Lin,&nbsp;Wen Ye,&nbsp;Emily Hepworth,&nbsp;Lynn Ang,&nbsp;Stephanie A. Amiel,&nbsp;Simon J. Fisher","doi":"10.1111/dme.15513","DOIUrl":"10.1111/dme.15513","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Several wordings of the definition of severe hypoglycaemia (SH) exist. This study aims to evaluate how different SH definition wordings affect SH history assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, surveys were emailed to registrants of the T1D Exchange, a U.S. national type 1 diabetes patient registry. Participants' demographic information was collected. Six-month SH history was evaluated with questionnaires including SH definition wordings from either (1) professional societies, (2) a diabetes community website, or (3) a hypoglycaemia research questionnaire. Analyses included the McNemar test, pairwise Wilcoxon signed-rank test, logistic regression analysis, Kappa statistics, and Spearman correlation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1580 valid responses were obtained from participants (52% female; mean ± SD age: 46 ± 15 years; 95% White; mean ± SD diabetes duration: 25 ± 16 years). Questionnaires with four different SH definition wordings yielded significant variations in the prevalence of SH (i.e., having developed at least one episode of SH) and the number of SH episodes: the ADA/ENDO 2013 definition wording yielded the highest results on both metrics, whereas HypoA-Q and ADA 2023 yielded the lowest. Among participants reporting at least one SH episode, the number of episodes identified with the different SH definition wordings was poorly correlated (R_s: 0.09–0.37; <i>p</i> &lt; 0.001). Race, education level, and household income were associated with higher odds of discrepancies in SH history (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This U.S. national survey with individuals living with type 1 diabetes demonstrated significant discrepancies in SH history when assessed with different SH definition wordings. Race and socioeconomic status were associated with these discrepancies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15513","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964201","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":"Exploring the potential role of C-peptide in type 2 diabetes management","authors":"YeunYi Lin,&nbsp;Rory J. McCrimmon,&nbsp;Ewan R. Pearson","doi":"10.1111/dme.15469","DOIUrl":"10.1111/dme.15469","url":null,"abstract":"<p>Type 2 diabetes (T2D) is a complex condition characterised by the interaction between insulin resistance and beta cell dysfunction. C-peptide, a key biomarker of endogenous insulin secretion, has a role in diagnosing type 1 diabetes (T1D). However, its utility in T2D has not been extensively studied. This review provides an overview of the progression of C-peptide levels over time in T2D and discuss its interpretation in clinical settings. We reviewed current evidence on the relationship between C-peptide levels and response to antidiabetic drugs, as well as the utility of C-peptide testing in T2D treatment strategies. We also reviewed available evidence for C-peptide in predicting future outcomes in T2D. In this review, we hoped to clarify the value of C-peptide testing in understanding and managing T2D and to highlight areas where further research is needed.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964249","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":"Protocol for a 1-year randomised, controlled, parallel group, open-label trial on the effects and feasibility of time-restricted eating in individuals with type 2 diabetes- The REStricted Eating Time in the treatment of type 2 diabetes (RESET2) trial","authors":"Anne-Ditte Termannsen,&nbsp;Annemarie Varming,&nbsp;Natasja Bjerre,&nbsp;Helena Z. Wodschow,&nbsp;Gitte S. Hansen,&nbsp;Nicole J. Jensen,&nbsp;Frederik Persson,&nbsp;Jonatan I. Bagger,&nbsp;Satchidananda Panda,&nbsp;Graham Finlayson,&nbsp;Bettina Ewers,&nbsp;Dorte L. Hansen,&nbsp;Kirsten Nørgaard,&nbsp;Jørgen Rungby,&nbsp;Louise G. Grunnet,&nbsp;Martin B. Blond,&nbsp;Nana F. Hempler,&nbsp;Kristine Færch,&nbsp;Jonas S. Quist","doi":"10.1111/dme.15506","DOIUrl":"10.1111/dme.15506","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Time-restricted eating (TRE) limits the time for food intake to typically 6–10 h/day without other dietary restrictions. The aim of the RESET2 (the REStricted Eating Time in the treatment of type 2 diabetes) trial is to investigate the effects on glycaemic control (HbA_1c) and the feasibility of a 1-year TRE intervention in individuals with overweight/obesity and type 2 diabetes. The aim of the present paper is to describe the protocol for the RESET2 trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RESET2 is a randomised, controlled, parallel-group, open-label trial. One hundred and sixty individuals with type 2 diabetes (HbA_1c &gt;53 mmol/mol (&gt;7.0%)), and Body Mass Index ≥25 kg/m² will be randomised to standard care plus TRE, or to standard care and habitual living. Both the intervention and control group will follow standard diabetes care including regular clinical visits 3–4 times/year. The intervention is divided into two periods: (1) a 3-month TRE period with a fixed eating window with a self-selected timing to obtain data from the participants' experiences with TRE and (2) a 9-month individually adjusted TRE period. Participants in the TRE group will be instructed to reduce their eating window by a minimum of 3 h/day compared to the habitual eating window and with an eating window of 8–10 h/day. Test days will be scheduled at baseline, after 3 months and after 1 year. The primary outcome is HbA_1c (evaluated 3 months and 1 year after randomisation) and secondary outcomes are body weight, fat mass, continuous glucose monitoring derived time-in-range and use of antidiabetic medicine (evaluated 1 year after randomisation). Additionally, we will conduct a process evaluation to assess whether the TRE intervention functioned as hypothesised.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964250","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 novel BLK heterozygous mutation (p.Met121lle) in maturity-onset diabetes mellitus: A case report and literature review.","authors":"Fenjuan Xu, Xiaoting Chen, Tingting Hu, Ruqiong Sun, Fangying Zhu, Xiaohong Wu","doi":"10.1111/dme.15491","DOIUrl":"https://doi.org/10.1111/dme.15491","url":null,"abstract":"<p><p>Maturity onset diabetes of the young (MODY) is a highly heterogeneous monogenic disease that occurs due to β-cell dysfunction. It is divided into different types depending on the gene mutated, and a total of 16 genes have been found to be associated with MODY. However, due to the current lack of understanding of monogenic diabetes, 90% of MODY is currently misdiagnosed and ignored in clinical practice. In this paper, we report the clinical data of a patient diagnosed with diabetes. Genetic testing revealed a novel BLK heterozygous mutation (c.363G>A) in the patient and in his father and son. He had no islet-specific autoantibodies and showed a reduced meal-induced response of insulin. Precise diagnosis of MODY individuals is important to the treatment.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15491"},"PeriodicalIF":3.2,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926562","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":"Highlighting the new consensus guidelines for managing people at risk of, and with early-stage type 1 diabetes-Relevance to clinical care in the UK.","authors":"Parth Narendran, Philip Newland-Jones, Naresh Kanumilli, Rose Stewart, Fiona Regan, Tabitha Randell","doi":"10.1111/dme.15508","DOIUrl":"https://doi.org/10.1111/dme.15508","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15508"},"PeriodicalIF":3.2,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902721","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 automated insulin delivery system use on diabetes distress in people with type 1 diabetes and their caregivers: A systematic review and meta-analysis","authors":"Dulce Canha,&nbsp;Virginia McMahon,&nbsp;Susanne Schmitz,&nbsp;Carine De Beaufort,&nbsp;Fawaz Alzaid,&nbsp;Yves Reznik,&nbsp;Jean-Pierre Riveline,&nbsp;Guy Fagherazzi,&nbsp;Gloria A. Aguayo","doi":"10.1111/dme.15503","DOIUrl":"10.1111/dme.15503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetes distress (DD) is prevalent among people with diabetes. While automated insulin delivery systems (AIDs) improve glycaemic control, their impact on DD is unclear. We aimed to investigate the effect of AIDs on DD in people with diabetes and their caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We focused on people with diabetes using AIDs versus other insulin delivery systems, with DD as the outcome. We included randomised controlled trials (RCTs), before-after studies (BAS) and observational studies until 4 April 2024. After screening, 40 studies were included in the systematic review, comprising 5426 participants (3210 adults, 1131 paediatric and 1085 caregivers). Twenty-seven studies were selected for the meta-analysis (focusing solely on type 1 diabetes). We used random effects models by population and study design. We also conducted a subgroup analysis by age group (children vs. teenagers).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In adults, eight BAS and five RCTs indicated a significant small DD reduction post-AID initiation (standardised mean difference [95% confidence intervals] −0.32 [95% CI: −0.40, −0.24] and [−0.19 (−0.27, −0.11)]). No significant changes were observed in the paediatric population. In caregivers, eleven BAS and five RCTs indicated a significant moderate DD reduction (−0.48 [95% CI: −0.78, −0.18] and (−0.22 [−0.38, −0.06])). Subgroup analysis revealed an increased benefit in parents of children compared to parents of teenagers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This work suggests that AIDs is associated with a DD reduction in adults and caregivers but not in children/teenagers with type 1 diabetes. More longitudinal studies and better systematic DD assessments are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892873","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}