Rachel Dlugatch, David Rankin, Mark Evans, Nick Oliver, Sze May Ng, Julia Lawton
{"title":"Improving access to diabetes technologies in children and young people with type 1 diabetes: Healthcare professionals' perspectives and views","authors":"Rachel Dlugatch, David Rankin, Mark Evans, Nick Oliver, Sze May Ng, Julia Lawton","doi":"10.1111/dme.70058","DOIUrl":"10.1111/dme.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To understand and explore the strategies, resources, and interventions healthcare professionals are implementing, or recommend implementing, to promote more equitable access to diabetes technology amongst children and young people (CYP) with type 1 diabetes in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Interviews were conducted with (<i>n</i> = 29) healthcare professionals working in paediatric diabetes in England from (<i>n</i> = 15) purposively selected sites. Data were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Healthcare professionals reported many strategies to help address diabetes technology access disparities in CYP, structured under the following themes: ‘Re-evaluating staff levels, roles, and efficiency’; ‘Improving communication’; ‘Promoting peer support and community outreach’; ‘Providing financial and social support for deprived CYP/caregivers’; ‘Encouraging CYP/caregiver choice;’ and ‘Funding, sustainability, and burnout.’ Many of these strategies appeared to be local (e.g., site-specific) solutions, made possible by short-term, one-off funding schemes and innovation by individual team members. While some proposed strategies appeared to improve staff time-efficiencies allowing greater numbers of CYPs to be moved onto technology, others, as interviewees noted, could add to individual team members' workloads and stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Healthcare professionals appeared highly committed to addressing technology access disparities in CYP. While some of their recommendations may be easier to implement than others, our findings underscore the importance of adopting a joined-up, integrated approach to promoting equitable technology access across the UK. This would require closer collaboration and resource-sharing within and across sites, backed by sustainable, long-term funding, with a significant portion dedicated to increasing staffing capacity to support the practical implementation of these strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974534","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}
M. U. Shah, C. L. Cliff, P. E. Squires, K. Lee, C. E. Hills
{"title":"The cardio-renal-metabolic role of the nod-like receptor protein-3 and senescence-associated secretory phenotype in early sodium/glucose cotransporter-2 inhibitor therapy in people with diabetes who have had a myocardial infarction","authors":"M. U. Shah, C. L. Cliff, P. E. Squires, K. Lee, C. E. Hills","doi":"10.1111/dme.70059","DOIUrl":"10.1111/dme.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Following an acute myocardial infarction (AMI), individuals with type 2 diabetes (T2DM) have a 2-to-3 fold increased risk of mortality compared to those without diabetes, and globally cardiorenal complications account for 50% of diabetes-related deaths. The use of sodium/glucose cotransporter-2 inhibitors (SGLT2i) in people with T2DM-AMI is associated with decreased inflammatory burden and improved cardiorenal outcomes. The mechanisms behind this protection are unclear and form the basis of this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single centre, prospective study with randomisation will utilise plasma and monocyte-derived macrophages from patients with T2DM who have recently had an AMI and are prescribed Empagliflozin (SGLT2i) either immediately following the acute cardiac event or at 3 months post-AMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study will test the hypothesis that Empagliflozin provides anti-inflammatory protection by suppressing systemic NOD-like receptor protein-3 (NLRP3) inflammasome activation and the pro-inflammatory senescence-associated secretory phenotype (SASP), perpetrators of sterile (non-pathogen evoked) inflammation linked to poor clinical outcomes in T2DM-AMI patients. The study will also assess the benefits of early intervention on these parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elucidating a role for an SGLT2i in suppressing sterile inflammation will enhance understanding of how they can be used effectively to treat cardiorenal complications and will identify novel pathways for future intervention. Furthermore, the optimal timing of when to initiate SGLT2i therapy post-AMI is unclear. Correlating the level of protection to the onset of therapy in individuals with T2DM, AMI and at cardiovascular risk will establish if Empagliflozin provides greater benefit when intervention is initiated earlier.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984265","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}
Alagu Sankareswaran, Pooja Kunte, Diane P. Fraser, Mobeen Shaik, Dimple Lavanuru, Michael N. Weedon, Richard A. Oram, Chittaranjan S. Yajnik, Giriraj R. Chandak
{"title":"HLA haplotype diversity, islet autoantibody status and discriminative ability of type 1 diabetes genetic risk score in Indians","authors":"Alagu Sankareswaran, Pooja Kunte, Diane P. Fraser, Mobeen Shaik, Dimple Lavanuru, Michael N. Weedon, Richard A. Oram, Chittaranjan S. Yajnik, Giriraj R. Chandak","doi":"10.1111/dme.70041","DOIUrl":"10.1111/dme.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We have reported that a 9SNPs type 1 diabetes (T1D) Genetic Risk Score (GRS) developed from European data had a lower power in Indians to distinguish T1D from type 2 diabetes (T2D). We explore the performance of an improved (67SNPs) T1DGRS and also the potential reasons for lower discriminative ability to classify types of diabetes in Indians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied the discriminative ability of a 67SNPs European T1DGRS in 611 clinically diagnosed T1D and 1153 T2D patients, and 321 non-diabetic controls, using receiver operating characteristic (ROC) area under the curve (AUC). We also compared the frequency and effect sizes of HLA risk haplotypes between Indians and Europeans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The T1DGRS was discriminative of T1D from T2D and controls. However, the ability is lower in Indians than Europeans (AUC, Europeans 0.92, Indians all T1D 0.83, AA-positive 0.86). The T1DGRS was higher in AA-positive than in AA-negative persons [13.01 (12.79–13.23) vs. 12.09 (11.64–12.56)], <i>p</i> < 0.0001. The association of common HLA-DQA1 ~ HLA-DQB1 haplotypes was broadly similar; however, important differences were noted in the frequency, direction and magnitude of effect for some haplotypes between Indians and Europeans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We confirm broad applicability of European 67SNPs T1DGRS to Indian T1D persons. However, differences in HLA allele frequencies, magnitude and directional differences reduced the predictive value. Our results stress the need to generate ancestry-specific GRS, which we plan to do in the near future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977540","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}
Suresh Rama Chandran, Karen Jui Lin Choo, Hong Chang Tan, May Zin Oo, Celine Yu Hui Wong, Wei Mian Ang, Daphne Gardner
{"title":"Skin reactions to Freestyle Libre Pro among individuals with and without diabetes","authors":"Suresh Rama Chandran, Karen Jui Lin Choo, Hong Chang Tan, May Zin Oo, Celine Yu Hui Wong, Wei Mian Ang, Daphne Gardner","doi":"10.1111/dme.70062","DOIUrl":"10.1111/dme.70062","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985679","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}
Emma Lund, Dorte Vistisen, Jannet Svensson, Niels H. Birkebaek, Pernille F. Rønn
{"title":"Age- and sex-dependent lipid trajectories in children and adolescents with type 1 diabetes—A Danish nationwide registry-based study","authors":"Emma Lund, Dorte Vistisen, Jannet Svensson, Niels H. Birkebaek, Pernille F. Rønn","doi":"10.1111/dme.70055","DOIUrl":"10.1111/dme.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To examine age and sex differences in lipid trajectories in paediatric type 1 diabetes. Secondly, to examine the effect of HbA<sub>1c</sub> and BMI on low-density lipoprotein (LDL-C) trajectories and the proportion of children meeting the LDL-C threshold for intervention according to ISPAD guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Information on children and adolescents with type 1 diabetes was retrieved from DanDiabKids from 2005 to 2019. All individuals <19 years with at least two lipid measurements were included. Linear mixed effects models were used to model lipid trajectories over age with adjustment for potential confounders. Sex differences were examined as interactions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analysed 1188 girls and 1,288 boys with a total of 8563 lipid measurements and a median (Q1-Q3) diabetes duration of 6.4 years (4–9.6 years) at last visit. Total cholesterol (TC), LDL-C and triglycerides increased across all ages for girls, while high-density lipoprotein (HDL-C) declined slightly. In boys, TC, LDL-C and HDL-C decreased from around 12 years, while triglycerides increased over the entire age scale. Higher HbA<sub>1c</sub> and BMI <i>z</i>-scores were associated with higher LDL-C. Depending on age and sex, 19%–42% of individuals had LDL-C values above the limit for intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TC, LDL-C, HDL-C and triglycerides vary with age and sex in children and adolescents with type 1 diabetes. In addition, a high proportion of adolescents, particularly girls, have LDL-C levels above the intervention threshold. The results call for more research on age- and sex-specific levels of LDL-C that should lead to intervention to prevent future cardiovascular events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959165","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}
Elizabeth Holmes-Truscott, Joanne Jordan, Leonid Churilov, Wendy Davis, Sarah Glastras, Marlena Klaic, Meaghan Read, An Tran-Duy, David O'Neal, Elif Ekinci
{"title":"Accelerating diabetes innovation for real-world community impact through interdisciplinary research: Who is at the table?","authors":"Elizabeth Holmes-Truscott, Joanne Jordan, Leonid Churilov, Wendy Davis, Sarah Glastras, Marlena Klaic, Meaghan Read, An Tran-Duy, David O'Neal, Elif Ekinci","doi":"10.1111/dme.70057","DOIUrl":"10.1111/dme.70057","url":null,"abstract":"<p>Diabetes represents a range of conditions characterised by hyperglycaemia, impacting β-cell function and insulin action, and requiring daily self management in the form of tailored pharmacological and behavioural interventions. This heterogeneity is further compounded by the broad spectrum of acute and chronic diabetes-related complications which may compromise the function of every organ in the body and, ultimately, impact quality and quantity of life. It is therefore not surprising that generating innovative solutions to support the physical, emotional and social well-being for people living with diabetes is correspondingly complex and cannot be addressed successfully by a single academic discipline.<span><sup>1</sup></span> This commentary article represents a call to action for comprehensive interdisciplinary diabetes research to become the standard to accelerate diabetes innovation and realise research advancements into ‘real-world’ community impacts. The authors are members of the Australian Centre for Accelerating Diabetes Innovation (ACADI)—a collaborative interdisciplinary national diabetes centre uniting over 70 different partners, including academic, advocacy, health service, industry and community partners. Importantly, the authors represent diverse disciplines (Figure 1) and lived experience (of gestational diabetes, EHT; and type 1 diabetes, MR).</p><p>While there is a substantial body of work dedicated to the meaning of <i>interdisciplinary research</i>,<span><sup>2</sup></span> for this commentary, it is defined as the integration of knowledge, techniques and perspectives ‘from two or more disciplines to advance fundamental understanding or to solve problems whose solutions are beyond the scope of a single discipline’.<span><sup>3</sup></span> Interdisciplinary diabetes research offers several benefits. Combining different areas of expertise and innovative thinking is of central influence in scientific achievements and breakthroughs.<span><sup>4</sup></span> Interdisciplinary research can bring novel insights, overcome feasibility or logistical constraints by pooling available resources to increase capacity and enhance complexity and sophistication of research outputs.<span><sup>5</sup></span> Thus, interdisciplinary research can reduce duplication, and ensures that the best approach and methods are used to assess outcomes, thereby increasing the appropriate allocation and efficient use of research funding to the needs and priorities of diverse communities.</p><p>Methodologies and frameworks have been developed specifically to assist researchers to engage in and understand the process of interdisciplinary research,<span><sup>6</sup></span> including making disciplinary perspectives explicit to assist mutual understanding.<span><sup>7</sup></span> Figure 1 provides a high-level outline of a range of disciplines (and example disciplinary questions) that can contribute to the diabetes research table to increase the likelihood of t","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968288","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}
Venus R. Michaels, Alisa Boucsein, Yongwen Zhou, Shirley D. Jones, Ryan G. Paul, Esko Wiltshire, Craig Jefferies, Martin I. de Bock, Benjamin J. Wheeler
{"title":"Impact of Simplera Sync™ sensors and Extended™ Wear Infusion Sets on glycaemia and system performance of the MiniMed™ 780G system in children and young adults with previously high HbA1c","authors":"Venus R. Michaels, Alisa Boucsein, Yongwen Zhou, Shirley D. Jones, Ryan G. Paul, Esko Wiltshire, Craig Jefferies, Martin I. de Bock, Benjamin J. Wheeler","doi":"10.1111/dme.70048","DOIUrl":"10.1111/dme.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The MiniMed™ 780G improves glycaemia and reduces burden in type 1 diabetes. We investigated how new all-in-one “Simplera Sync™” sensors and 7-day Extended™ Wear Infusion Sets (EIS) affect glycaemia and system performance in young people with previously elevated HbA1c levels (≥69 mmol/mol [≥8%]) after transitioning from 780G with Guardian 4™ sensors and 3-day infusion sets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an extension phase analysis in 75 participants (aged 7–25 years) initially enrolled in the CO-PILOT randomised controlled trial. For this analysis, baseline was defined as the period following the use of 780G with Guardian 4™ sensors and 3-day infusion sets. Participants then transitioned to 780G with Simplera Sync™ and EIS. We compared glycaemic and system performance outcomes from baseline to those after the transition to 780G with Simplera Sync™ and EIS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline HbA1c was 66.1 mmol/mol ± 14.2 mmol/mol and remained stable at 66.7 mmol/mol ± 11.2 mmol/mol after the transition (<i>p</i> = 0.38). Time in range (3.9–10.0 mmol/L [70–180 mg/dL]) at baseline was 58.5% ± 14.9% and 60.4% ± 15.7% after transition (<i>p</i> = 0.09). Time in tight range (3.9–7.8 mmol/L [70–140 mg/dL]) increased from 38.1% ± 13.1% at baseline to 40.5% ± 13.6% after the transition (<i>p</i> = 0.04). While using 780G with Simplera Sync™ and EIS, automation time increased from baseline 79.2% ± 25.9% to 85.8% ± 21.8% (<i>p</i> = 0.007), and sensor wear time from 80.7% ± 22.4% at baseline to 88.4% ± 17.2% (<i>p</i> < 0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Simplera Sync™ and EIS improved time in automation and sensor wear time when using 780G AHCL in this high-risk young population. This was associated with incremental improvement in time in tight range despite the challenges of this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973604","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}
Rathi Ravindrarajah, Matt Sutton, Peter Bower, Evangelos Kontopantelis
{"title":"Variation in effectiveness of the NHS Diabetes Prevention Programme in people diagnosed with non-diabetic hyperglycaemia by age, sex, BMI, and deprivation: A matched cohort analysis of 69,801 people","authors":"Rathi Ravindrarajah, Matt Sutton, Peter Bower, Evangelos Kontopantelis","doi":"10.1111/dme.70037","DOIUrl":"https://doi.org/10.1111/dme.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The NHS Diabetes Prevention Programme (DPP) is a behaviour-change programme aimed at adults diagnosed with non-diabetic hyperglycaemia (NDH), who are at higher risk of developing type 2 diabetes mellitus (Diabetes). This paper explores the heterogeneity in the effectiveness of the DPP by age, sex, BMI, and practice location deprivation (IMD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Matched cohort analysis with random-effects parametric survival models, evaluating the association between referral to the DPP and conversion to diabetes, with interactions fitted for age, sex, BMI, and IMD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>18,470 patients referred to the programme were matched to 51,331 controls. None of the interactions of patient characteristics with referrals were statistically significant. For women, the difference in the HR of conversion to diabetes, compared to men, was HR = 0.94 (95% CI: 0.81, 1.08, <i>p</i> = 0.38); For those aged [18–34], HR = 0.79 (95% CI: 0.34, 1.84, <i>p</i> = 0.58) and aged [75–84] HR = 0.86 (95% CI:0.66, 1.12, <i>p</i> = 0.26) compared to those aged [55–64]. The HR for conversion was 0.88 (95% CI:0.62, 1.26, <i>p</i> = 0.49) for those with a BMI ≥ (25–29.9) kg/m<sup>2</sup> and HR = 0.76 (95% CI:0.54, 1.06, <i>p</i> = 0.10) in those with a BMI ≥ 30 kg/m<sup>2</sup> compared to BMI < 25 kg/m<sup>2</sup>. Finally, for the most deprived IMD quintile, compared to the least deprived, the difference in the conversion was HR = 1.31 (95% CI: 0.98, 1.73, <i>p</i> = 0.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The DPP was effective in reducing conversion rates from NDH to diabetes as shown in our previous study results. The intervention appeared to be similarly effective by age, sex, BMI, and deprivation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 7","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255963","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}
Esraa A. Makhdom, Alisha Maher, Ryan Ottridge, Mathew Nicholls, Asad Ali, Brendan G. Cooper, Ramzi A. Ajjan, Srikanth Bellary, Wasim Hanif, Fahmy Hanna, David Hughes, Vijay Jayagopal, Rajni Mahto, Mayank Patel, James Young, Ananth U. Nayak, Mimi Z. Chen, Julie Kyaw-Tun, Susana Gonzalez, Ravikanth Gouni, Anuradhaa Subramanian, Nicola J. Adderley, Abd A. Tahrani
{"title":"Association between sleep duration and obesity in patients with type 2 diabetes: A longitudinal study","authors":"Esraa A. Makhdom, Alisha Maher, Ryan Ottridge, Mathew Nicholls, Asad Ali, Brendan G. Cooper, Ramzi A. Ajjan, Srikanth Bellary, Wasim Hanif, Fahmy Hanna, David Hughes, Vijay Jayagopal, Rajni Mahto, Mayank Patel, James Young, Ananth U. Nayak, Mimi Z. Chen, Julie Kyaw-Tun, Susana Gonzalez, Ravikanth Gouni, Anuradhaa Subramanian, Nicola J. Adderley, Abd A. Tahrani","doi":"10.1111/dme.70051","DOIUrl":"10.1111/dme.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Obesity is prevalent in patients with type 2 diabetes (T2D) and negatively impacts diabetes outcomes. While studies in the general population have established a link between sleep duration and obesity, this relationship in T2D remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the association between sleep duration and adiposity in patients with T2D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study of adults enrolled in the SLEEP T2D study from 13 UK NHS Trusts. Sleep duration was self-reported using the Pittsburgh Sleep Quality Index (PSQI) and categorized as short (≤ 6 h/ night), long (> 9 h/night) or (normal > 6-9 h/night). Adiposity was assessed using body mass index (BMI) and waist circumference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 229 patients (61% male, mean age 61.2 (<span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <mo>±</mo>\u0000 </mrow>\u0000 </semantics></math>11.7) years, 63.7% with BMI ≥ 30 kg/m<sup>2</sup>). At baseline, sleep duration negatively correlated with BMI (<i>r</i> = −0.27, <i>p</i> < 0.001) and waist circumference (<i>r</i> = −0.25, <i>p</i> = 0.001). After adjusting for potential confounders in different models, short sleep duration was associated with higher BMI (β = −1.01; <i>p</i> = 0.006) and waist circumference (β = −1.91; <i>p</i> = 0.01). Following a median follow-up of 26.5 months, short sleep at baseline was associated with a 5% or more gain in BMI (adjusted OR 10.03; 95% CI 1.55–64.84; <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Short sleep duration is associated with higher adiposity measures (BMI and waist circumference) and weight gain in patients with T2D. Addressing sleep duration may reduce the burden of obesity in T2D, and future studies in this area are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997156","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}
Madeline C. Pearson, Huan Wang, Colin E. Murdoch, Alexander S. F. Doney
{"title":"Clinical implications of a history of pre-eclampsia in women with type two diabetes mellitus","authors":"Madeline C. Pearson, Huan Wang, Colin E. Murdoch, Alexander S. F. Doney","doi":"10.1111/dme.70046","DOIUrl":"10.1111/dme.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The consequences of pre-eclampsia (PE) are not limited to pregnancy; a single episode predisposes mothers to serious future health outcomes. Little is known about how PE impacts the course of type 2 diabetes (T2D) and associated microvascular diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Scottish Care Information for Diabetes data for individuals with diabetes in NHS Tayside and Fife was linked with Scottish maternity morbidity records. A nested case–control study compared BMI, HDL cholesterol, systolic blood pressure(SBP) and HbA1c measures at T2D diagnosis between women with prior pregnancies from 1921 to 2022 affected or unaffected by PE using linear regression and adjusted for the other aforementioned variables. Cox regression models assessed how a PE history influenced the risk of future microvascular complications following T2D diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 6055 women were eligible: 726 (12%) had a PE-pregnancy and 5329 (88%) had only PE-free pregnancies, with ~20 years between pregnancy and T2D diagnosis. At T2D diagnosis, women with a PE history had higher BMI (38.3 kg/m<sup>2</sup> vs. 35.7 kg/m<sup>2</sup>, <i>p</i> < 0.001), higher SBP (139 mmHg vs. 135 mmHg, <i>p</i> < 0.001), lower HDL cholesterol (1.18 mmol/L vs. 1.21 mmol/L, <i>p</i> = 0.002) and were diagnosed 3.2 years earlier (<i>p</i> < 0.001). A PE history was associated with increased microvascular disease risk (HR 1.26 95% CI 1.12–1.42, <i>p</i> < 0.001): diabetic retinopathy (HR 1.22 95% CI 1.07–1.38, <i>p</i> = 0.003); chronic kidney disease (HR 1.35 95% CI 1.06–1.71, <i>p</i> = 0.016); diabetic proteinuric kidney disease (HR 2.45 95% CI 1.03–5.81, <i>p</i> < 0.001). Women with a PE history were ~5 years younger when they developed cardiovascular disease (55.7 years vs. 60.6 years, <i>p</i> < 0.001) and all-cause death (60.1 years vs. 65.6 years, <i>p</i> < 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>At T2D diagnosis, women with a PE history are younger, with more severe clinical presentations and increased risk of developing T2D microvascular complications. This highlights the crucial need for changes to the long-term care of this high-risk group, with aggressive risk-factor management and continued clinical assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997158","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}