Diabetic Medicine最新文献

{"title":"Continuous glucose monitoring in type 2 diabetes: Evidence for glycaemic metrics and patient-reported outcomes","authors":"Abuzar Watan Pal,&nbsp;Wei Lim Chong,&nbsp;Hasniza Zaman Huri,&nbsp;Jeyakantha Ratnasingam","doi":"10.1111/dme.70360","DOIUrl":"10.1111/dme.70360","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In adults with type 2 diabetes (T2D), continuous glucose monitoring (CGM) provides insights beyond HbA1c. A comprehensive understanding of clinical benefits and patient-reported outcomes (PROs) associated with CGM is needed to inform its integration into routine care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted across PubMed, Scopus, Cochrane Library and CINAHL from inception to June 2025 to identify randomised controlled trials and non-randomised studies including quasi-experimental and observational designs. Outcomes of interest included glycaemic measures (HbA1c, time in range, hypoglycaemia, glycaemic variability) and PROs. Given the heterogeneity in study design and outcome reporting, findings were synthesised narratively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty studies (N ≈ 3275) were included. CGM use was associated with improvement in HbA1c, particularly among insulin-treated individuals and those with higher baseline HbA1c. CGM use also increased time in range by approximately 9–15 percentage points (1.5–3.6 h/day) and was generally associated with reduced hypoglycaemia risk and glycaemic variability, although effects on hypoglycaemia were not uniform. In contrast, diabetes-specific PROs, including treatment satisfaction and diabetes-related distress, showed more consistent improvement, whereas changes in overall quality-of-life measures were less pronounced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CGM use was associated with clinically meaningful improvements in glycaemic metrics and PROs in adults with T2D. Although evidence remains limited for long-term outcomes and special populations, current findings support the clinical value of CGM in diabetes management.</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":"147978433","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":"Sex-specific differences in the prevalence of intermediate hyperglycaemia states: A systematic review and meta-analysis","authors":"Louise Cooper,&nbsp;Ian Porter,&nbsp;Claire Meek,&nbsp;Simon J. Griffin,&nbsp;Amy Ahern","doi":"10.1111/dme.70293","DOIUrl":"10.1111/dme.70293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate the sex-specific prevalence of isolated impaired glucose tolerance, isolated impaired fasting glucose, combined impaired glucose tolerance and impaired fasting glucose and type 2 diabetes diagnosed by isolated glucose states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched MEDLINE, Cochrane Database of Systematic Reviews, Embase and CINAHL from inception to 22.04.25. Title and abstract screening, full-text review, data extraction and risk of bias assessment (Hoy et al.) were conducted by two reviewers using pre-defined eligibility criteria. Sex-stratified prevalence and odds ratio for each intermediate hyperglycaemic state in women compared with men were pooled using a random-effects meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 8 studies suitable for meta-analysis, including 52,256 participants (25,263 women). The pooled prevalences (95% CI) of isolated impaired glucose tolerance, isolated impaired fasting glucose (ADA thresholds) and combined impaired glucose tolerance in women were respectively 8% (7%,9%), 15% (12%,18%) and 7% (5%, 9%) and for men 5% (4%,7%), 21% (12%, 32%) and 7% (5%, 10%). Compared with men, women had higher odds of having isolated impaired glucose tolerance: 1.42 (1.23, 1.65), 0.65 (0.44, 0.96) lower odds of isolated impaired fasting glucose: 0.65 (0.44, 0.96) and similar odds of combined impaired glucose tolerance and impaired fasting glucose: 0.85 (0.46, 1.57). There was moderate certainty evidence for pooled prevalence estimates and high certainty evidence for comparisons of iIGT and iIFG between sexes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are sex-specific disparities in the prevalence of different isolated intermediate hyperglycaemic states, which may contribute to underdiagnosis and undertreatment in primary care and introduce ascertainment bias into research and policy.</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.70293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439052","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":"Mind the gap: Ongoing inequalities in glycaemic levels in young people living with Type 1 diabetes across England and Wales","authors":"Victoria Homer,&nbsp;Cillian Brophy,&nbsp;Robert French,&nbsp;Amani Krayem,&nbsp;Saira Pons Perez,&nbsp;Justin T. Warner,&nbsp;Renuka P. Dias","doi":"10.1111/dme.70283","DOIUrl":"10.1111/dme.70283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Inequalities in glycaemic levels in children and young people (CYP) living with Type 1 diabetes (T1D) across different ethnic and socio-economic groups in England and Wales were first highlighted in 2016. Almost 10 years on, we wanted to know if the gap has been closed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Analysis of 27,919 CYP with T1D from the 2022–2023 National Paediatric Diabetes Audit (NPDA). Multivariable linear regression was used to assess any association between socio-economic status (SES), ethnicity or insulin pump use and HbA1c, adjusting for age, gender and diabetes duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CYP from ethnic minority groups continue to have significantly higher mean HbA1c levels compared to White CYP with the largest difference in Black children (6.8 mmol/mol, [0.6%], 95% CI 5.7, 7.9 mmol/mol). Lower SES remains associated with higher HbA1c levels with the largest difference between the least deprived and most deprived (7.0 mmol/mol; [0.6%], 95% CI: 6.4, 7.6). CYP from ethnic minority groups (Black 34.2% vs. White 49.56%, <i>p</i> &lt; 0.0001) and those living in more deprived neighbourhoods (Least Deprived 54% vs. Most Deprived 41%, <i>p</i> = 0.0001) were less likely to use insulin pumps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ethnicity and SES remained significantly associated with HbA1c levels even after accounting for the use of insulin pumps. Black CYP continue to have the highest glycaemic levels, and lower SES remains associated with poorer HbA1c outcomes. Substantial inequalities persist in the use of insulin pump therapy highlighting the ongoing need for targeted interventions to improve equity in diabetes care and outcomes.</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.70283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597510","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":"Wolfram syndrome and diabetes mellitus in Aotearoa, New Zealand: Phenotype and response to GLP-1 receptor agonist therapy","authors":"Abigail L'Amie,&nbsp;Andrea L. Vincent,&nbsp;Craig A. Jefferies,&nbsp;Geoffrey Braatvedt,&nbsp;Esko Wiltshire,&nbsp;Fran Mouat,&nbsp;Benjamin B. Albert,&nbsp;Rinki Murphy","doi":"10.1111/dme.70405","DOIUrl":"10.1111/dme.70405","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the clinical characteristics of patients with Wolfram syndrome (WFS) and diabetes mellitus (DM) in Aotearoa, New Zealand. Review of response to therapy in those treated with glucagon-like peptide-1 receptor agonists (GLP1RA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study describes 7 patients with WFS1 genetic variants (1 patient with WFS-like syndrome), and DM from 5 New Zealand families (age range 5–33 years, 4 females, 3 males). All are receiving insulin. In 5 patients receiving GLP1RA therapy, we described their pre- and post-treatment biometric parameters, glycaemic control and visual acuity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Genetic testing identified compound heterozygous variants in the <i>WFS1</i> gene (inherited from each parent) in five patients. Another two were heterozygous carriers of a single <i>WFS1</i> missense variant, one of which was associated with uniparental disomy. Among patients receiving GLP1RA therapy, reductions were seen in HbA1c (mean 11.6 mmol/mol) and total daily insulin dose (mean 0.25 units/kg/day).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We report genotypic and phenotypic variability in association with clinical features, including age of onset and severity. GLP1RA therapy was associated with improvements in diabetic control. Longer-term follow-up is required to monitor for sustained benefit and for progression or improvement in other WFS clinical features.</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":"148298615","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":"Exploring the gap between sensor-detected (SDH) and person-reported hypoglycaemia (PRH): The voice of people living with diabetes","authors":"Monika Cigler,&nbsp;Omaima El-Hakouni,&nbsp;Renald Mecani,&nbsp;François Pouwer,&nbsp;Evertine J. Abbink,&nbsp;Michaela Moser,&nbsp;Bastiaan E. de Galan,&nbsp;Eric Renard,&nbsp;Mark Evans,&nbsp;Julie Maria Bøggild Brøsen,&nbsp;Ulrik Pedersen-Bjergaard,&nbsp;Rory J. McCrimmon,&nbsp;Simon Heller,&nbsp;Petra M. Baumann,&nbsp;Uffe Søholm,&nbsp;Silvia Basta,&nbsp;Patrick Divilly,&nbsp;Natalie Zaremba,&nbsp;Stephanie A. Amiel,&nbsp;Pratik Choudhary,&nbsp;Julia K. Mader,&nbsp;the Hypo-RESOLVE consortium","doi":"10.1111/dme.70301","DOIUrl":"10.1111/dme.70301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>In people with insulin-treated diabetes experiencing hypoglycaemia, the multicentre Hypo-METRICS study found that 60% of sensor-detected hypoglycaemic episodes (SDH) were asymptomatic, and over 40% of person-reported hypoglycaemia (PRH) occurred at glucose levels ≥70 mg/dL (3.9 mmol/L). This subanalysis explored participants' experiences of these episodes to identify possible clinical implications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-eight Austrian participants received a 15-item questionnaire on their experience of asymptomatic hypoglycaemia and symptoms at glucose levels ≥70 mg/dL (3.9 mmol/L).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rate was 86% (<i>n</i> = 50). Among all participants, 56% (<i>n</i> = 28) reported experiencing hypoglycaemic symptoms at glucose levels ≥70 mg/dL (3.9 mmol/L) “sometimes” or “often.” They attributed this to a combination of a threshold shift due to chronic hyperglycaemia, rapid glucose decline and fear of hypoglycaemia. 68% of all SDH &lt; 70 mg/dL and 59% of those below the clinically critical level of 54 mg/dL were asymptomatic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results demonstrate that SDH and PRH each capture different, yet equally important, dimensions of the hypoglycaemia experience. Relying on only one source of information inevitably provides an incomplete picture. By integrating the patient's voice, diabetes professionals can provide appropriate support and tailor continuous glucose monitoring (CGM) alarm settings and treatment plans to truly meet individual needs.</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.70301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577526","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":"Diabetes care through video consultations: Insights from people using insulin pump therapy and healthcare professionals—A longitudinal qualitative study","authors":"Anders Nikolai Ørsted Schultz,&nbsp;Leah Sejrup Christensen,&nbsp;Eithne Hayes Bauer,&nbsp;Kristian Kidholm,&nbsp;Georg Bollig,&nbsp;Frans Brandt,&nbsp;Karin Brochstedt Dieperink","doi":"10.1111/dme.70319","DOIUrl":"10.1111/dme.70319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore expectations and experiences with video consultations of people with type 1 diabetes using insulin pump therapy and healthcare professionals (HCPs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An interpretive description approach was used in a longitudinal design. Semi-structured interviews were conducted with people with diabetes and HCPs at two time points (T1 and T2). T1 interviews explored expectations prior to a randomised controlled trial. T2 interviews explored experiences with intervention group participants and HCPs. A reflexive thematic data analysis was employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 33 interviews were conducted. Two themes for people with diabetes at T1 were: ‘<i>Is video inferior?</i>—<i>The fear of missing something</i>’ and ‘<i>Allows me to stay in my everyday life</i>’. At follow-up interviews (T2): ‘<i>It is fine for smaller issues</i>—<i>but not for larger issues</i>’ and ‘<i>Are video consultations worth it?</i>’. HCPs' themes at T1 were: ‘<i>Can video consultations increase empowerment?</i>’ and ‘<i>What can be done?</i>—<i>Something in-between a phone and an in-person consultation</i>’. At follow-up interviews (T2): ‘<i>If carried out right, a lot can be done</i>’ and ‘<i>Obstacles for moving forward</i>’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Video consultations can potentially be a less disruptive form of consultation, allowing people with diabetes to stay in their everyday lives, especially for minor issues or minor treatment adjustments. Challenges, in terms of pre-visit preparation, might outweigh the benefits. Adjustment of clinical work is required to address people with diabetes' preferences for video consultations, guidance on preparation and requirements for participants.</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.70319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038954","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":"Type 2 diabetes in Norway 2009–2021: Have declining incidence rates continued?","authors":"Lars Bakke Hindenes,&nbsp;Paz Lopez-Doriga Ruiz,&nbsp;German Tapia,&nbsp;Inger Johanne Bakken,&nbsp;Elisabeth Qvigstad,&nbsp;Hanne L. Gulseth,&nbsp;Lars C. Stene","doi":"10.1111/dme.70225","DOIUrl":"10.1111/dme.70225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To describe updated trends in the incidence and prevalence of diagnosed type 2 diabetes in Norway by age, sex, country of birth and education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A nationwide cohort study using registries on primary and specialist healthcare, dispensed drugs and demographic factors in Norway. We analysed incidence trends 2009–2021 using Poisson regression and JoinPoint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During 2009–2021, 195,935 incident type 2 diabetes cases were identified. After a decline in incidence 2009–2014, the incidence was largely stable over time, with a suggestive upward trend 2019–2021. The overall incidence rates were 651 per 100,000 person-years in 2009 and 530 per 100,000 in 2021. There were 165,432 prevalent cases of type 2 diabetes in 2009 (5.5% of the population), consistently increasing throughout the study period to a peak at 259017 (7.6%) in 2021. The time trends were largely consistent across age, sex, country of birth and education. Inhabitants with lower education and born in Asia or Africa had substantially higher incidence and prevalence than those with higher education and born in Norway or other continents, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The previously described decline in incidence of diagnosed type 2 diabetes during 2009–2014 was not sustained, and prevalence continued to increase throughout 2009–2021.</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":"146145391","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":"Improved prediction of symptomatic type 1 diabetes using a luciferase-based assay to measure (pro)insulin autoantibodies","authors":"Rebecca C. Wyatt,&nbsp;Cristina Brigatti,&nbsp;Sian L. Grace,&nbsp;Claire L. Williams,&nbsp;Ilaria Marzinotto,&nbsp;Ben T. Gillard,&nbsp;Elena Bazzigaluppi,&nbsp;Deborah Shoemark,&nbsp;Michela A.-M. Chandler,&nbsp;Peter Achenbach,&nbsp;Lorenzo Piemonti,&nbsp;BOX Study Group,&nbsp;AWAF,&nbsp;Kathleen M. Gillespie,&nbsp;Vito Lampasona,&nbsp;Alistair J. K. Williams,&nbsp;Anna E. Long","doi":"10.1111/dme.70277","DOIUrl":"10.1111/dme.70277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Insulin autoantibodies (IAA) are key predictors of type 1 diabetes, particularly in young children. Micro-radiobinding assays (RBA) are the gold standard for IAA measurement but have limitations. We assessed whether a luciferase immunoprecipitation system (LIPS) assay improved diabetes risk assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To validate LIPS compared with RBA, samples from people with new-onset type 1 diabetes (<i>n</i> = 150) and first-degree relatives (FDRs) (<i>n</i> = 619), of whom 91 had developed diabetes during follow-up, were used. This cross-sectional observational data was analysed using the area under the receiver operator characteristic curve and cox-proportional hazard models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In new-onset diabetes, RBA and LIPS showed 88% agreement in IAA status. Positive IAA LIPS was more common in 89 FDRs with high-moderate affinity IAA (61%) compared with 22 FDRs with low-affinity IAA (18%) (<i>p</i> &lt; 0.001). In FDRs positive for multiple other islet autoantibodies, 20-year diabetes risk was 80% for those positive compared with 30% for those negative for IAA by LIPS (<i>p</i> = 0.013). IAA LIPS added to diabetes risk independently of status/level of IAA by RBA, other autoantibodies and sampling age (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The IAA LIPS low-blood-volume, high-throughput technique identifies more individuals with the highest risk of diabetes. The ability to identify high-affinity IAA makes LIPS an ideal method for future clinical trials and population screening strategies to predict the risk of 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":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795134","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":"Efficacy and safety of switching to iGlarLixi from premixed insulin therapy in patients with type 2 diabetes: A real-world experience","authors":"Chun-Jui Huang,&nbsp;Shun-Jie Yang,&nbsp;Cheng-Pin Cheng,&nbsp;Chun-Hsing Lin,&nbsp;Ya-Chun Lee,&nbsp;Harn-Shen Chen","doi":"10.1111/dme.70275","DOIUrl":"10.1111/dme.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Fixed-ratio combinations such as iGlarLixi are recommended over premixed insulin as first-line injectable therapy for type 2 diabetes mellitus (T2DM), yet real-world evidence on transitions from premix to iGlarLixi remains limited. This study aimed to evaluate the efficacy and safety of switching from premixed insulin to iGlarLixi in a real-world clinical setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort included adults with T2DM who transitioned from premixed insulin to iGlarLixi between July 2020 and July 2023 at Taipei Veterans General Hospital. Glycaemic parameters were collected at baseline, 3 and 6 months after transition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty patients (mean age 67.6 ± 10.5 years) were included. Among those with baseline HbA_1c &gt;58 mmol/mol (7.5%, <i>n</i> = 28), HbA_1c decreased from 79 ± 18 (9.4% ± 1.7%) to 67 ± 18 mmol/mol (8.2% ± 1.6%) at 6 months (<i>p</i> = 0.01) and 23.1% achieved HbA_1c ≤53 mmol/mol (7.0%). The largest HbA_1c reduction was observed in those previously on 40–50 units/day of premix insulin (from 83 ± 21 [9.8% ± 1.9%] to 65 ± 15 mmol/mol [8.1% ± 1.4%], <i>p</i> = 0.037). Total insulin dose and injection frequency significantly decreased (<i>p</i> &lt; 0.001), while hypoglycaemia incidence dropped from 60.0% to 12.5% (<i>p</i> &lt; 0.001). Among patients with pre-existing hypoglycaemia, glycaemic control remained stable despite reductions in insulin dose and injection frequency (<i>p</i> = 0.001, <i>p</i> = 0.032, respectively). Higher HOMA-IR was significantly associated with suboptimal glycaemic response in multivariate model (<i>p</i> = 0.037).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Switching from premixed insulin to iGlarLixi is a safe and effective strategy to simplify therapy and improve glycaemic management. Insulin resistance may influence response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 7","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597529","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":"Feasibility and benefits of continuous glucose monitoring for type 1 diabetes in Rwanda: A real-world 12-month continuation phase","authors":"Sandhya Narayanan,&nbsp;Jason Baker,&nbsp;John B. Welsh,&nbsp;Giacomo Cappon,&nbsp;Jean Claude Habineza,&nbsp;Simon P. Niyonsenga","doi":"10.1111/dme.70284","DOIUrl":"10.1111/dme.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Continuous glucose monitoring (CGM) remains underutilized in low- and middle-income countries (LMICs). We extend earlier observations on the feasibility and impact of CGM among people living with type 1 diabetes (T1D) in Rwanda in a real-world continuation phase study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a 1-year continuation phase of a single-arm, mixed-methods, prospective observational study conducted in Kigali, Rwanda, from August 2022 to September 2024. Completers of the 12-month Phase I were transitioned to a current-generation CGM device and, in months 19–24, reduced frequency of clinic visits reflecting routine care. The primary outcomes were change in haemoglobin A1c (HbA1c) and the CGM-based metrics time in range (TIR, 3.9–10 mmol/L), and time below range (TBR, &lt;3.9 mmol/L). Secondary outcomes included self-reported hospitalizations, incidences of severe hypoglycaemia and diabetic ketoacidosis, as well as diabetes-related questionnaire results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the end of Phase I, 40 of the original 50 participants entered Phase II with mean HbA1c, TIR and TBR of 44 mmol/mol (6.2%), 44.9% and 5.6%, respectively, all metrics being significantly different from study start. These did not change significantly by the end of the study (48 mmol/mol [6.6%], 46.5% and 7.9%, respectively). No hospitalizations, three episodes of severe hypoglycaemia and two episodes of diabetic ketoacidosis were reported. Most respondents were satisfied with the device, used it consistently and trusted the values provided.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CGM-related improvements in HbA1c and TIR among Rwandans living with T1D were maintained for at least 24 months. CGM should be considered as an important tool to improve diabetes self-management in LMICs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"43 7","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380478","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}