Diabetic Medicine最新文献

{"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,&nbsp;Xiaoting Chen,&nbsp;Tingting Hu,&nbsp;Ruqiong Sun,&nbsp;Fangying Zhu,&nbsp;Xiaohong Wu","doi":"10.1111/dme.15491","DOIUrl":"10.1111/dme.15491","url":null,"abstract":"<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&gt;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":"42 6","pages":""},"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,&nbsp;Philip Newland-Jones,&nbsp;Naresh Kanumilli,&nbsp;Rose Stewart,&nbsp;Fiona Regan,&nbsp;Tabitha Randell","doi":"10.1111/dme.15508","DOIUrl":"10.1111/dme.15508","url":null,"abstract":"&lt;p&gt;Type one diabetes (T1D) can be identified before the need for insulin through the measurement of islet autoantibodies.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The presence of a single islet autoantibody indicates risk whereas two or more, even in the absence of hyperglycaemia, is sufficient to define early-stage T1D.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; T1D now can therefore be classified into the early-stage ‘presymptomatic’ and later insulin requiring ‘symptomatic’ stages. Since autoantibodies can appear years before symptomatic presentation and the need for insulin, individuals identified with presymptomatic T1D will need education, support and monitoring leading up to insulin initiation. The recent consensus statement initiated by Breakthrough T1D (formerly the Juvenile Diabetes Research Foundation) with endorsement from other societies (see original publication) provides some guidance on how we should do so.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The aim of this commentary is to highlight this article and explore how it best applies to clinical care in the UK.&lt;/p&gt;&lt;p&gt;Diagnosing T1D early has advantages; it reduces presentation in diabetic ketoacidosis,&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; reduces glycaemic exposure prior to diagnosis and facilitates glucose control in the years that follow,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; and provides time to prepare for a life with insulin and the associated reduction in anxiety.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; Furthermore, the availability of immunotherapy to delay T1D (in the USA and potentially soon in the UK&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt;) is increasing interest in screening programmes to identify patients suitable for clinical intervention. Research screening programmes are now established internationally,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; through the ELSA (Early Surveillance for Autoimmune diabetes, www.elsadiabetes.nhs.uk) and T1DRA (Type 1 Diabetes Risk in Adults, www.t1dra.bristol.ac.uk) in the UK, and through a nationally sanctioned screening programme in Italy.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; Over and above this, many of us have patients identified early through clinical care or through reclassification of adults with dysglycaemia originally thought to be type 2 diabetes. The management of these patients has not previously followed any formal structure, and these consensus guidelines are therefore welcome.&lt;/p&gt;&lt;p&gt;There are four key areas.&lt;/p&gt;&lt;p&gt;First, guidance is provided around the frequency and intensity of follow-up for single Ab as well as multiple Ab individuals, the different stages of early-stage presymptomatic T1D, in adults and children. The pros and cons of the different approaches to glucose monitoring (glycated haemoglobin, continuous glucose monitoring, self monitoring of blood glucose) are outlined and the utility of these different approaches at different stages is discussed. Importantly, advice is also provided around safety. The importance of regular education about symptoms of diabetes and diabetic ketoacidosis is highlighted and all health professionals involve","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15508","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":"OA","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}

{"title":"Hypoglycaemic stimulation of macrophage cytokine release is suppressed by AMP-activated protein kinase activation","authors":"Jiping Zhang,&nbsp;Alice E. Pollard,&nbsp;Eleanor F. Pearson,&nbsp;David Carling,&nbsp;Benoit Viollet,&nbsp;Kate L. J. Ellacott,&nbsp;Craig Beall","doi":"10.1111/dme.15456","DOIUrl":"10.1111/dme.15456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Acute hypoglycaemia promotes pro-inflammatory cytokine production, increasing the risk for cardiovascular events in diabetes. AMP-activated protein kinase (AMPK) is regulated by and influences the production of pro-inflammatory cytokines. We sought to examine the mechanistic role of AMPK in low glucose-induced changes in the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF), which is elevated in people with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Macrophage cell line Raw264.7 cells, primary macrophage bone marrow-derived macrophages obtained from wild-type mice or AMPK γ1 gain-of-function mice, were used, as were AMPKα1/α2 knockout mouse embryonic fibroblasts (MEFs). Allosteric AMPK activators PF-06409577 and BI-9774 were used in conjunction with inhibitor SBI-0206965. We examined changes in protein phosphorylation/expression using western blotting and protein localisation using immunofluorescence. Metabolic function was assessed using extracellular flux analyses and luciferase-based ATP assay. Cytokine release was quantified by enzyme-linked immunosorbent assay (ELISA). Oxidative stress was detected using a fluorescence-based reactive oxygen species (ROS) assay, and cell viability was examined using flow cytometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Macrophages exposed to low glucose showed a transient and modest activation of AMPK and a metabolic shift towards increased oxidative phosphorylation. Moreover, low glucose increased oxidative stress and augmented the release of macrophage MIF. However, pharmacological activation of AMPK by PF-06409577 and BI-9774 attenuated low glucose-induced MIF release, with a similar trend noted with genetic activation using AMPKγ1 gain-of-function (D316A) mice, which produced a mild effect on low glucose-induced MIF release. Inhibition of NFĸB signalling diminished MIF release and AMPK activation modestly but significantly reduced low glucose-induced nuclear translocation of NFĸB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Taken together, these data indicate that pharmacological AMPK activation suppresses the release of MIF from macrophages caused by energy stress, suggesting that AMPK activation could be a useful strategy for mitigating hypoglycaemia-induced inflammation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881594","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":"Effect of the SGLT2 inhibitor ipragliflozin on the expression of genes that regulate skin function.","authors":"Nobutomo Ikarashi, Keito Tabata, Yui Shinozaki, Risako Kon, Hiroyasu Sakai, Tomoo Hosoe","doi":"10.1111/dme.15505","DOIUrl":"https://doi.org/10.1111/dme.15505","url":null,"abstract":"<p><strong>Aims: </strong>Skin disorders occur more frequently with sodium-dependent glucose cotransporter type 2 (SGLT2) inhibitors than with other antidiabetic drugs. We conducted basic research using ipragliflozin, with the aim of identifying new measures to prevent skin disorders caused by SGLT2 inhibitors.</p><p><strong>Methods: </strong>db/db type 2 diabetes model mice were orally administered ipragliflozin (10 mg/kg or 30 mg/kg) once a day for 28 days and skin function genes were analysed by real-time RT-PCR or Western blotting.</p><p><strong>Results: </strong>No difference in the expression level of collagen (Col1a1 and Col1a2) in the skin was detected between the ipragliflozin treatment group and the control group. On the other hand, the expression levels of enzymes involved in the synthesis and decomposition of hyaluronic acid (Has2 and Hayl1) and enzymes involved in the synthesis and decomposition of ceramide (Sptlc1, Sptlc2, Asah1, and Acer1) were significantly decreased by the administration of ipragliflozin. Furthermore, the expression levels of filaggrin (Flg), loricrin (Lor), elastin (Eln), and aquaporin-3 (Aqp3) in the skin were lower in the ipragliflozin treatment group than in the control group.</p><p><strong>Conclusions: </strong>It was revealed that ipragliflozin reduces the expression of genes involved in skin barrier and moisturizing functions, which this may be one of the mechanisms through which this drug causes skin disorders.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15505"},"PeriodicalIF":3.2,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876561","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":"Disordered eating attitudes and behaviours among older adults with type 1 diabetes: An exploratory study","authors":"Gabriella T. Ercolino,&nbsp;Jessica Sprinkles,&nbsp;Angela Fruik,&nbsp;Rashmi Muthukkumar,&nbsp;Nikhita Gopisetty,&nbsp;Xiaorui Qu,&nbsp;Laura A. Young,&nbsp;Elizabeth J. Mayer-Davis,&nbsp;Angelica Cristello Sarteau,&nbsp;Anna R. Kahkoska","doi":"10.1111/dme.15504","DOIUrl":"10.1111/dme.15504","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We explored the prevalence of disordered eating behaviours (DEBs) and attitudes among older adults with type 1 diabetes (T1D) and associations with demographic and clinical variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults aged ≥65 years with T1D from a university-affiliated hospital system completed an electronic survey (September to November 2023) including the Diabetes Eating Problem Survey-Revised (DEPS-R). Clinical data were extracted from medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-seven older adults (mean [SD] age: 71.8 [4.1]; mean [SD] HbA1c [mmol/mol]: 51 [12]; BMI [kg/m²]: 27.3 [4.7]) with T1D completed the DEPS-R. Mean DEPS-R score was 11.5 (6.0), with 5.2% (<i>n</i> = 4) having clinically significant DEBs (score ≥ 20). We found a positive linear association between DEPS-R score and BMI (adjusted <i>p</i> = 0.002). There was no significant association with HbA1c.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older adults with T1D endorsed variable degrees of DEBs. Greater DEBs were associated with higher BMI; more research is needed to characterise this relationship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876556","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 impact of residual diabetic toe osteomyelitis at the conservative surgical resection margins on prognosis.","authors":"Haojie Sun, Weidong Deng, Shanwen Si, Xuekui Liu, Houfa Geng, Jun Liang","doi":"10.1111/dme.15502","DOIUrl":"https://doi.org/10.1111/dme.15502","url":null,"abstract":"<p><strong>Aims: </strong>The study is to investigate how residual osteomyelitis at conservative surgical resection margins affects the prognosis of diabetic toe osteomyelitis.</p><p><strong>Methods: </strong>In this retrospective study, 67 participants with diabetic toe osteomyelitis who underwent conservative surgery were evaluated. The diagnosis of osteomyelitis was based on histopathology, and bone histopathology was done on the resection bone. After discharge, a 16-week follow-up was conducted, focusing on the wound healing time as the primary outcome. Cox regression analysis was employed as the primary method to analyse the risk factors that influence wound healing.</p><p><strong>Results: </strong>Among the 67 participants, 48 (71.6%) had positive bone margins, while 19 (28.4%) had negative bone margins. Participants with positive bone margins experienced an average healing time of 60.78 ± 18.50 days, whereas those with negative bone margins had an average healing time of 55.19 ± 14.60 days (p = 0.285). Bone margins (positive vs. negative) did not have an impact on wound healing (HR, 1.195 [95% CI, 0.668-2.136]; p = 0.549). Ankle-brachial index was identified as a factor influencing wound healing (HR, 5.399 [95% CI, 1.145-25.455]; p = 0.033). There was no statistical difference between the two groups in terms of wound healing rates (40 of 48 [83.3%] vs. 16 of 19 [84.2%], p = 0.93), inpatient days (19.48 ± 5.25 vs. 18.26 ± 4.79 days, p = 0.385) and duration of antibiotics (32.33 ± 5.64 vs. 30.53 ± 6.93 days, p = 0.272).</p><p><strong>Conclusion: </strong>The residual osteomyelitis in diabetic toe osteomyelitis post-conservative surgery does not impact the wound healing.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15502"},"PeriodicalIF":3.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853507","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":"Towards standardization of person-reported outcomes (PROs) in pediatric diabetes research: A consensus report","authors":"Katharine Barnard-Kelly,&nbsp;David Marrero,&nbsp;Maartje de Wit,&nbsp;Frans Pouwer,&nbsp;Kamlesh Khunti,&nbsp;Norbert Hermans,&nbsp;Jessica S. Pierce,&nbsp;Lori Laffel,&nbsp;Richard I. G. Holt,&nbsp;Tadej Battelino,&nbsp;Diana Naranjo,&nbsp;Jacqueline Fosbury,&nbsp;Lawrence Fisher,&nbsp;William Polonsky,&nbsp;Jill Weissberg-Benchell,&nbsp;Korey K. Hood,&nbsp;Oliver Schnell,&nbsp;Laurel H. Messer,&nbsp;Thomas Danne,&nbsp;Revital Nimri,&nbsp;Soren Skovlund,&nbsp;Julia K. Mader,&nbsp;Jennifer L. Sherr,&nbsp;Desmond Schatz,&nbsp;Simon O'Neill,&nbsp;Emma Doble,&nbsp;Marissa Town,&nbsp;Karin Lange,&nbsp;Carine de Beaufort,&nbsp;Linda Gonder-Frederick,&nbsp;Sarah S. Jaser,&nbsp;Alon Liberman,&nbsp;David Klonoff,&nbsp;Nuha A. Elsayed,&nbsp;Raveendhara R. Bannuru,&nbsp;Ramzi Ajjan,&nbsp;Christopher Parkin,&nbsp;Frank J. Snoek","doi":"10.1111/dme.15484","DOIUrl":"10.1111/dme.15484","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetes ranks among the most common chronic conditions in childhood and adolescence. It is unique among chronic conditions, in that clinical outcomes are intimately tied to how the child or adolescent living with diabetes and their parents or carers react to and implement good clinical practice guidance. It is widely recognized that the individual's perspective about the impact of trying to manage the disease together with the burden of self-management should be addressed to achieve optimal health outcomes. Standardized, rigorous assessment of behavioural and mental health outcomes is crucial to aid understanding of person-reported outcomes alongside, and in interaction with, physical health outcomes. Whilst tempting to conceptualize person-reported outcomes as a focus on perceived quality of life, the reality is that health-related quality of life is multi-dimensional and covers indicators of physical or functional health status, psychological well-being and social well- being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this context, this Consensus Statement has been developed by a collection of experts in diabetes to summarize the central themes and lessons derived in the assessment and use of person-reported outcome measures in relation to children and adolescents and their parents/carers, helping to provide a platform for future standardization of these measures for research studies and routine clinical use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This consensus statement provides an exploration of person-reported outcomes and how to routinely assess and incorporate into clincial research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845996","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}