Diabetic Medicine最新文献

{"title":"Type 1 Diabetes in care homes: A practical guide on management","authors":"A. J. Sinclair,&nbsp;S. Bellary,&nbsp;A. Middleton,&nbsp;A. Morris,&nbsp;R. Walker,&nbsp;K. Winkley Bryant,&nbsp;U. Dashora,&nbsp;M. Karamat,&nbsp;J. Rayner,&nbsp;S. Tomlinson,&nbsp;G. Maltese","doi":"10.1111/dme.15457","DOIUrl":"10.1111/dme.15457","url":null,"abstract":"<p>The primary purpose of the original NAPCHD project was to develop a national Strategic Document of Diabetes Care for Care Homes which has now been completed and well received as a worthwhile, sustainable, and effective guidance for delivering quality diabetes care in the UK. A Working Group of NAPCHD was established to produce a Position Statement on type 1 diabetes in care homes since this area was recommended as a topic to further develop. There are currently limited data on the prevalence and clinical outcomes associated with type 1 diabetes in care homes and management policies have been non-existent in the UK. Communication among all key stakeholders involved in direct care of residents with type 1 diabetes is generally fragmented and lacks coordination. This is compounded by a slowly growing utilisation of diabetes technology and the absence of a standard/agreed community-based model of interdisciplinary collaboration. The Rationale and Objectives were defined prior to commencing the work and a work plan with individual tasks was initially set out. After multiple correspondences and Team calls over a period of 9 months, the Group successfully generated a first draft in October 2023. This draft was then finalised the following month and circulated among stakeholders for feedback. Nine chapters have been provided including minimum standards of diabetes care, insulin regimens, avoiding hospitalisation and discharge planning. A scheme for a community-based model of care for type 1 diabetes has been included. Eight key messages were developed. In addition, an Appendix has been created which includes key assessments such as nutritional assessment, detection of frailty, sick day rules and foot risk stratification (available online).</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15457","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581686","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":"Pathophysiology of vascular ageing and the effect of novel cardio-renal protective medications in preventing progression of chronic kidney disease in people living with diabetes","authors":"Nikolaos Fountoulakis,&nbsp;Yoshihisa Miyamoto,&nbsp;Meda E. Pavkov,&nbsp;Janaka Karalliedde,&nbsp;Giuseppe Maltese","doi":"10.1111/dme.15464","DOIUrl":"10.1111/dme.15464","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Among people with diabetes those with chronic kidney disease (CKD) have a reduced life expectancy with increased risk of cardiovascular disease (CVD) a major contributor to morbidity and mortality. CKD related to diabetes is growing worldwide and is one of the leading causes of kidney failure globally. Diabetes is associated with accelerated vascular ageing and the related mechanisms and mediators that drive the progression of CKD and CVD disease in people with diabetes may help provide insights into the pathophysiology of cardio-renal complications and guide treatment interventions in people with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a narrative review of the literature using PubMed for English language articles that contained keywords that related to diabetes, chronic or diabetic kidney disease, ageing, cellular senescence, arterial stiffness, Klotho and sirtuins, sodium-glucose co-transporter-2 (SGLT-2) inhibitors, renin angiotensin aldosterone system (RAAS) and glucagon-like peptide-1 (GLP-1) receptor agonists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Progressive kidney disease in diabetes is associated with accelerated ageing driven in part by multiple processes such as cellular senescence, inflammation, oxidative stress and circulating uremic toxins. This accelerated ageing phenotype contributes to increased arterial stiffness, endothelial dysfunction, cognitive decline and muscle wasting, thereby elevating morbidity and mortality in individuals with diabetes and CKD. Deficiency of the kidney-derived anti-ageing hormone Klotho and reduced sirtuin levels play pivotal roles in these ageing pathways. Dietary, lifestyle and pharmacological interventions targeting vascular ageing may help reduce the progression of CKD and associated CVD in people with diabetes. The current standard of care and pillars of treatment for kidney disease such as RAAS inhibitors, SGLT-2 inhibitors and GLP-1 receptor agonists all influence pathways involved in vascular ageing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A multifactorial intervention to prevent the development of CKD by targeting traditional risk factors as well as treatment with novel agents with cardio-renal beneficial effects can prevent accelerated ageing and extend lifespan in people with diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575567","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":"Sensor-derived glycaemic metrics in pregnant women with type 1 diabetes randomised to faster acting insulin aspart or insulin aspart—A secondary analysis of the CopenFast trial","authors":"Julie C. Søholm,&nbsp;Sidse K. Nørgaard,&nbsp;Kirsten Nørgaard,&nbsp;Tine D. Clausen,&nbsp;Peter Damm,&nbsp;Elisabeth R. Mathiesen,&nbsp;Lene Ringholm","doi":"10.1111/dme.15467","DOIUrl":"10.1111/dme.15467","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We compared sensor-derived glycaemic metrics in pregnant women with type 1 diabetes (T1D) randomised to faster acting insulin aspart (faster aspart) or insulin aspart (IAsp).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pre-planned secondary analysis of the CopenFast trial included women with T1D using intermittently scanned continuous glucose monitoring (isCGM) during pregnancy. Glycaemic metrics, including time in range (TIRp, 3.5–7.8 mmol/L) and time below range in pregnancy (TBRp, &lt;3.5 mmol/L), were evaluated in the intervals: from randomisation (median 9.5 weeks, interquartile range 9.0–11.0) to 21 weeks, from 22 to 33 weeks and from 34 to 37 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 113 (91%) of 124 women using isCGM in the original trial were included. At randomisation, glycaemic metrics were comparable in both groups. Women randomised to faster aspart achieved higher TIRp from 22 to 33 weeks (estimated treatment difference 5.1% [95% confidence interval 0.3; 9.7], <i>p</i> = 0.04) and mean TIRp &gt;70% from randomisation to 21 weeks onwards, while this was achieved after 34 weeks in women randomised to IAsp. TBRp remained stable around 4% throughout pregnancy in both groups. One (2%) versus 5 (9%) experienced ≥1 severe hypoglycaemic event (odds ratio 0.93 [−0.2; −0.01], <i>p</i> = 0.04). Infant birthweight standard deviation score was lower in the faster aspart group (estimated treatment difference −0.5 [−0.9; −0.03], <i>p</i> = 0.04); however, this attenuated when adjusting for parity (<i>p</i> = 0.10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Women using faster aspart achieved more TIRp and experienced less severe hypoglycaemia compared to women using IAsp. Infant birthweight was lower and thereby more appropriate in the faster aspart group; however, this attenuated when adjusting for parity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575571","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":"Omnipod 5 outcomes comparing Dexcom G6 and Freestyle Libre 2 plus users in adults with type 1 diabetes","authors":"Roland H. Stimson,&nbsp;Anna R. Dover,&nbsp;Marcus J. Lyall,&nbsp;Catriona J. Kyle,&nbsp;Rohana J. Wright,&nbsp;Gayle McRobert,&nbsp;Mark W. J. Strachan,&nbsp;Fraser W. Gibb","doi":"10.1111/dme.15465","DOIUrl":"10.1111/dme.15465","url":null,"abstract":"&lt;p&gt;Omnipod 5 (OP5) is a tubeless automated insulin delivery (AID) system that was, until recently, only compatible with Dexcom G6 sensors (G6). Currently, all published evidence attesting to the efficacy of OP5 relates specifically to use with G6 sensors.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; In mid-2024, OP5 compatibility with Freestyle Libre 2 Plus CGM (L2+) was launched in the United Kingdom. This study aimed to compare early glycaemic outcomes, and time spent in AID mode, between those using G6 and L2+ sensors.&lt;/p&gt;&lt;p&gt;This was a retrospective analysis of 77 adults (45 G6 and 32 L2+) with type 1 diabetes at a single centre in the UK. Baseline CGM data were collected in the 28 days prior to converting from Omnipod DASH (standalone CSII) to OP5 and compared with data from the first 28 days of AID use. CGM data were obtained from LibreView and Glooko. Clinical and demographic data were obtained from SCI Diabetes (national diabetes register). As a service evaluation of routinely collected data, this project did not require ethical approval. Paired data were compared with Wilcoxon-signed rank tests and unpaired data with Wilcoxon rank-sum test. Correlations were assessed by the Spearman correlation coefficient. Categorical data were compared by chi-squared test. Logistic regression analysis assessed independent predictors of reduction in TBR and improvement in TIR (defined as &gt;10%). &lt;i&gt;p&lt;/i&gt; values &lt;0.05 were considered statistically significant. Statistical analyses were performed using R Studio (version 2023.12.1).&lt;/p&gt;&lt;p&gt;Forty-nine (64%) were female. Median age was 43 years (IQR 32–56) and diabetes duration was 23 years (14–33). Age (&lt;i&gt;p&lt;/i&gt; = 0.872), duration (&lt;i&gt;p&lt;/i&gt; = 0.371), sex (&lt;i&gt;p&lt;/i&gt; = 0.947), socio-economic deprivation (&lt;i&gt;p&lt;/i&gt; = 0.912) and BMI (&lt;i&gt;p&lt;/i&gt; = 0.161) did not differ between L2+ and G6 users at baseline. Baseline CGM metrics were not significantly different between G6 and L2+ users (all &lt;i&gt;p&lt;/i&gt; &gt; 0.05).&lt;/p&gt;&lt;p&gt;Time in automode did not differ between groups (G6: 99% [96–100] vs. L2+: 99 [98–100], &lt;i&gt;p&lt;/i&gt; = 0.551) and this was also true of time in limited automode (G6: 2% [2–3] vs. L2+: 2 [1–3], &lt;i&gt;p&lt;/i&gt; = 0.826). Changes in glucose metrics from baseline are presented in Table 1. Correlation (R) between baseline TIR and change in TIR was −0.91 for L2+ and −0.56 for G6 (both &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Logistic regression analysis identified only baseline TIR (OR 0.93 per % [95% CI 0.88–0.97], &lt;i&gt;p&lt;/i&gt; &lt; 0.001) but not sensor type (&lt;i&gt;p&lt;/i&gt; = 0.723) as an independent predictor of &gt;10% improvement in TIR. Any fall in TBR was independently associated with baseline TBR (OR 3.4 per % [95% CI 2.0–7.1], &lt;i&gt;p&lt;/i&gt; &lt; 0.01) and also the use of G6 sensors (OR 5.8 [95% CI 1.4–34], &lt;i&gt;p&lt;/i&gt; = 0.027).&lt;/p&gt;&lt;p&gt;There do not appear to be any important differences in time spent in automode between G6 and L2+. Similarly, early CGM outcomes are comparable between the two CGM options with respect to average glucose, TIR and high glucose metrics. ","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15465","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575548","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":"Acceptability and psychometric properties of four scales assessing the impact of Type 2 diabetes on quality of life—Results of ‘YourSAY: Quality of Life’","authors":"Elizabeth Holmes-Truscott,&nbsp;Melanie M. Broadley,&nbsp;Uffe Søholm,&nbsp;Debbie D. Cooke,&nbsp;Christel Hendrieckx,&nbsp;Elizabeth J. Coates,&nbsp;Simon R. Heller,&nbsp;Jane Speight","doi":"10.1111/dme.15461","DOIUrl":"10.1111/dme.15461","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess and compare the psychometric properties and acceptability of four diabetes-specific quality of life (QoL) scales among adults with Type 2 diabetes (T2D).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults (≥18 years) with T2D living in the United Kingdom (<i>n</i> = 1465) or Australia (<i>n</i> = 248) completed a cross-sectional, online survey including the following: ADDQoL, DCP, DIDP and Diabetes QoL-Q (presented in randomised order), followed by rating scales to assess clarity, relevance, ease of completion, length and comprehensiveness of each scale. Demographic, clinical and psychosocial characteristics were collected. Acceptability (scale completeness and user ratings), response patterns, structure (exploratory and confirmatory factor analyses) and validity (convergent, confirmatory, divergent and known-groups) were examined. Data were analysed by country to assess cross-country reproducibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>High completion rates (≥89%) and positive user ratings were observed across scales indicating broad acceptability. The DIDP was the strongest performing scale: highest completion rate (97%), user ratings (≥84% positive) and most satisfactory psychometric properties (highest variance explained, consistent factor loadings &gt;0.5 on all items and most permissible model fit parameters). Scale-level floor effects may suggest domain omissions for the brief DIDP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current study provides novel insights into the acceptability, validity and reliability of diabetes-specific QoL measures for adults with T2D. Consistent with the published Type 1 diabetes cohort findings, the DIDP is recommended as a brief, acceptable and psychometrically sound measure. However, selection needs to be considered in the context of the specific research or clinical aims and further evidence (e.g. responsiveness) may be required before it can be recommended for use in trials or prospective studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544334","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":"An audit and feedback-based intervention to improve diabetes management in the year after transfer to adult type 1 diabetes care: A multi-center quasi-experimental study","authors":"Rayzel Shulman,&nbsp;Ian Zenlea,&nbsp;Noah Ivers,&nbsp;Peter C. Austin,&nbsp;Ping Li,&nbsp;Cheril Clarson,&nbsp;Alanna Landry,&nbsp;Jennifer Harrington,&nbsp;Geetha Mukerji,&nbsp;Mark R. Palmert,&nbsp;Janet Parsons,&nbsp;Zubin Punthakee,&nbsp;Baiju R. Shah","doi":"10.1111/dme.15444","DOIUrl":"10.1111/dme.15444","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To test whether an audit and feedback-based intervention improved HbA1c 12 months after transfer to type 1 diabetes adult care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multi-centre, quasi-experimental pre-post study of an AF-based intervention targeting paediatric diabetes teams, which encouraged the implementation of an evidence-informed structured transition process at five paediatric diabetes centres in Ontario, Canada. Participants entered the study at their final paediatric visit. A parallel control cohort was ascertained using population-based administrative datasets. The primary outcome was HbA1c 12 months after transfer. The main exposure was the study period: pre-implementation (June 2018–May 2019); early-implementation (June 2019–September 2020); and late-implementation (October 2020–September 2021). Multivariable linear regression models were fit separately in each cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 449 and 2844 individuals in the intervention and control cohorts, respectively. Twelve months after transfer, participants in the late-implementation intervention cohort had an HbA1c that was, on average, 0.41% lower than participants in the pre-implementation period (<i>p</i> = 0.016). Among the control cohort, there was no significant difference in the HbA1c 12 months after transfer between study periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found an effect of the intervention on glycaemic management one year following transfer to adult care. Future work will focus on refining and testing the effectiveness of the intervention in an expanded number of study sites and in collaboration with adult diabetes care providers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544335","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 high-fibre diets on glycaemic control in women with diabetes in pregnancy: A systematic review and meta-analysis","authors":"Danielle Jones,&nbsp;Anna Kyriakidou,&nbsp;Louise Cooper,&nbsp;Nooria Atta,&nbsp;Patrycja Tobolska,&nbsp;Suzanne Smith,&nbsp;Elizabeth Turner,&nbsp;Clive Petry,&nbsp;Clare Gillies,&nbsp;Claire L. Meek","doi":"10.1111/dme.15435","DOIUrl":"10.1111/dme.15435","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Dietary fibre improves glycaemic control in type 2 diabetes, but its therapeutic role in women with diabetes in pregnancy is unclear. We assessed the effect of dietary fibre on markers of glycaemic control in women with diabetes in pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched four databases (Cochrane Library, MEDLINE, Embase and Web of Science) to identify RCTs exploring the effect of dietary fibre, high-fibre diets or fibre supplementation on fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG) and requirement for insulin therapy, among other glycaemic makers in pregnant women with diabetes. Data were pooled for each outcome to calculate change from baseline mean (SD) and overall mean difference (MD) between control and intervention groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1462 identified studies, data from 20 eligible trials containing 1061 participants were pooled. On meta-analysis, a higher fibre intake was associated with reduced FBG (MD: −0.35 mmol/L, 95% CI: −0.53, −0.18, <i>p</i> &lt; 0.01), PBG (MD: −0.90 mmol/L, 95% CI: −1.39, −0.40, <i>p</i> &lt; 0.01) and requirement for insulin (OR: 0.24, 95% CI: 0.13, 0.46, <i>p</i> &lt; 0.01). There was significant heterogeneity for FBG and PBG (&gt;90%), attributable to differences in Intervention type for PBG (Dietary Approach to Stop Hypertension [DASH] diet, low glycaemic index, supplement; <i>p</i> &lt; 0.01) and study duration (for FBG: <i>p</i> = 0.002; not for PBG). Studies were mostly scored as high risk of bias due to lack of blinding (Cochrane Risk of Bias Tool v.2.0).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>High-quality dietary intervention studies in pregnancy are lacking. Our results suggest that high-fibre diets improve fasting and postprandial glycaemia and reduce the likelihood of requiring insulin in women with diabetes in pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544336","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":"Comparison of ultrasound scanning and clinical examination for detecting insulin injection related Lipohypertrophy and construction of Lipohypertrophy classification table","authors":"Hongmei Xu,&nbsp;Zhengnan Cheng,&nbsp;Xiaohui Li,&nbsp;Chun Mu,&nbsp;Di Bao,&nbsp;Qiuling Xing","doi":"10.1111/dme.15458","DOIUrl":"10.1111/dme.15458","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore an cost-effective, convenient method for lipohypertrophy (LH) detection with a high detection rate, and to construct a classification table for LH, so as to provide reference for LH screening and management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From December 2021 to November 2022, 395 hospitalized patients with diabetes from a Tianjin tertiary hospital were enrolled. The LH was detected through ultrasound scanning (USS), structured visual palpation (SVP), and ordinary visual palpation (OVP), and the detection rates were compared. A classification table for LH (LH-LNT table) was constructed based on SVP characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Under USS, SVP, and OVP, the detection of LH was 89.6%, 78.0%, and 66.6% respectively, with site detection at 92.3%, 71.2%, and 57.8% respectively, showcasing statistically significant differences among the three methods. SVP had a lower misdiagnosis rate than OVP, with upper arm and thighs being common misdiagnosed sites. LH was mostly found in the lower abdomen, flat, and soft on palpation. L1N2T1 (two soft LH on abdomen) was the main type, accounting for 35.4%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SVP is useful for detecting LH and deserves clinical promotion. The LH-LNT table constructed here effectively summarizes patient LH status, aiding doctor-nurse–patient communication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496921","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":"Integrated multiomic analyses: An approach to improve understanding of diabetic kidney disease","authors":"Claire Hill,&nbsp;Amy Jayne McKnight,&nbsp;Laura J. Smyth","doi":"10.1111/dme.15447","DOIUrl":"10.1111/dme.15447","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Diabetes is increasing in prevalence worldwide, with a 20% rise in prevalence predicted between 2021 and 2030, bringing an increased burden of complications, such as diabetic kidney disease (DKD). DKD is a leading cause of end-stage kidney disease, with significant impacts on patients, families and healthcare providers. DKD often goes undetected until later stages, due to asymptomatic disease, non-standard presentation or progression, and sub-optimal screening tools and/or provision. Deeper insights are needed to improve DKD diagnosis, facilitating the identification of higher-risk patients. Improved tools to stratify patients based on disease prognosis would facilitate the optimisation of resources and the individualisation of care. This review aimed to identify how multiomic approaches provide an opportunity to understand the complex underlying biology of DKD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review explores how multiomic analyses of DKD are improving our understanding of DKD pathology, and aiding in the identification of novel biomarkers to detect disease earlier or predict trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Effective multiomic data integration allows novel interactions to be uncovered and empathises the need for harmonised studies and the incorporation of additional data types, such as co-morbidity, environmental and demographic data to understand DKD complexity. This will facilitate a better understanding of kidney health inequalities, such as social-, ethnicity- and sex-related differences in DKD risk, onset and progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multiomics provides opportunities to uncover how lifetime exposures become molecularly embodied to impact kidney health. Such insights would advance DKD diagnosis and treatment, inform preventative strategies and reduce the global impact of this disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496922","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 development and progression of albuminuria in South Asians with type 2 diabetes compared with Western Europeans. Results from the HinDu the Hague diabetes study","authors":"Judith van Niel,&nbsp;Nel Geelhoed-Duijvestijn,&nbsp;Janet Kist,&nbsp;Mattijs Numans,&nbsp;Rimke Vos","doi":"10.1111/dme.15454","DOIUrl":"10.1111/dme.15454","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Although South Asians have an increased risk to develop diabetes, data on the difference in development and progression of diabetic nephropathy between ethnic groups are not consistent. The aim of this study was to evaluate possible differences in the development and progression of albuminuria in South Asians and Western Europeans (WE) with type 2 diabetes in a large closed cohort of South Asians with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on 1269 South Asians and 2272 Dutch adults with type 2 diabetes who were treated in our diabetes clinic in 2006 or referred thereafter were extracted from electronic medical records. Microalbuminuria and macroalbuminuria were defined separately for men and women based on albumin/creatinine ratios in early morning urine samples. We defined 3 outcomes: (1) no albuminuria, (2) persistent microalbuminuria and (3) macroalbuminuria at the end of follow-up. Cox proportional hazard models were used to discriminate differences in time from diabetes diagnosis until development and progression of albuminuria between the two ethnic groups, adjusted for retinopathy, hypertension, smoking and age at diabetes diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>South Asians have a higher adjusted risk for developing microalbuminuria: HR 1.4, (95% CI 1.2, 1.6) and macroalbuminuria: HR: 1.2 (1.0, 1.4) compared to Western Europeans. However, mean time to progress from micro- to macroalbuminuria was not different between the ethnic groups (3.9 ± 4.0 yrs vs. 3.4 ± 3.9 yrs respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>South Asians have a higher adjusted risk to develop micro- and macroalbuminuria compared with Western Europeans. When microalbuminuria is present, time to progression from micro- to macroalbuminuria is not different between the two groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496923","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}