Diabetes & metabolism最新文献

{"title":"Towards humane diabetes care in the era of technological innovation","authors":"Gérard Reach","doi":"10.1016/j.diabet.2026.101745","DOIUrl":"10.1016/j.diabet.2026.101745","url":null,"abstract":"<div><div>This editorial argues that technological innovation in diabetes, particularly continuous glucose monitoring and hybrid closed-loop systems, must be integrated into a humane medicine centred on both metrics and persons. It was written under the pressure of observing that diabetes distress persists in a substantial proportion of patients who benefit from the most advanced technologies, including hybrid closed‑loop systems. The author describes each patient’s situation as a “mental puzzle” of beliefs, emotions and social constraints and highlights the biographical ruptures caused by disease and technology. The clinical encounter has a double object—the disease and the person—held together through clinical conversation that translates innovation into livable choices for each individual. It is where technicality meets humanity.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101745"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine-based diabetic retinopathy screening in patients over 70 Years: a French cohort study within the OPHDIAT network","authors":"Héloïse Torres-Villaros ,&nbsp;Joseph Albou ,&nbsp;Franck Fajnkuchen ,&nbsp;Aude Couturier ,&nbsp;Audrey Giocanti-Aurégan ,&nbsp;Pascale Massin","doi":"10.1016/j.diabet.2026.101728","DOIUrl":"10.1016/j.diabet.2026.101728","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the outcomes of teleophthalmology-based diabetic retinopathy (DR) screening in individuals over 70 years within the OPHDIAT network and to compare them with those of patients aged 18–69 years.</div></div><div><h3>Methods</h3><div>A cohort of 16,459 diabetic patients, without known DR or with mild non-proliferative DR (NPDR), screened in 2024 in 32 OPHDIAT centers, was included and divided into two groups: &lt; 70 years (<em>n</em> = 13,639) and ≥ 70 years (<em>n</em> = 2,820). Two non-mydriatic retinal photographs per eye were analyzed by certified ophthalmologists.</div></div><div><h3>Results</h3><div>Among patients aged ≥70 years, 21.3% (95% CI: 19.8–22.8) had any DR, and 6.1% (95% CI: 5.2–6.9) were referred to an ophthalmologist for moderate NPDR or a more severe form of the disease, including suspected macular edema. These proportions did not significantly differ from those found in patients &lt; 70 years: 21.9% (95% CI: 21.2–22.6) and 6.1% (95% CI:5.6–6.5), respectively. Severe NPDR or proliferative DR were rare in both groups (1.0%, 95% CI: 0.6–1.4% <em>vs</em>. 1.7%, 95% CI: 1.5–1.9%, <em>P</em> &lt; 0.001). The proportion of ungradable images was higher in the group ≥70 year (14.4%, 95% CI:13.1–15.7% <em>vs</em>. 6.1%, 95% CI: 5.7–6.5%, <em>P</em> &lt; 0.001), particularly in phakic eyes, although 80% of patients had interpretable images for both eyes. Pupil dilation significantly improved image quality in this group. Screening also allowed detecting other ocular disorders, including age-related macular degeneration and glaucoma, which were more common in the group ≥ 70 years (2.1%, 95% CI: 1.5–2.6% <em>vs</em>. 0.6%, 95% CI: 0.4–0.7% <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Teleophthalmology-based DR screening appeared feasible and clinically relevant in patients aged ≥70 years, allowing identifying patients requiring ophthalmologic evaluation, while also detecting other age-related ocular diseases. Pupil dilation is recommended to optimize image quality in this population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101728"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No association between carbohydrate-counting knowledge and disordered eating behaviors in adults with type 1 diabetes","authors":"Laura Albaladejo ,&nbsp;Melissa Ferguene ,&nbsp;Béatrice Genoux ,&nbsp;Lucien Marchand ,&nbsp;Hélène du Boullay ,&nbsp;Sandrine Lablanche ,&nbsp;Céline Vermorel ,&nbsp;Aurélie Gauchet ,&nbsp;Jean-Luc Bosson ,&nbsp;Cécile Bétry","doi":"10.1016/j.diabet.2026.101735","DOIUrl":"10.1016/j.diabet.2026.101735","url":null,"abstract":"<div><h3>Aims</h3><div>Carbohydrate counting enables flexible prandial insulin dosing in type 1 diabetes but remains cognitively demanding. Concerns persist that such sustained attention to food may contribute to disordered eating behaviors. The primary aim of this study was to examine whether carbohydrate-counting knowledge is associated with disordered eating behaviors.</div></div><div><h3>Methods</h3><div>This cross-sectional study (NCT07021456) was conducted online. Participants completed questionnaires assessing carbohydrate-counting knowledge (Gluciquizz), disordered eating behaviors (DEPS-R), and likely eating disorders (SCOFF-F). Additional questionnaires evaluated quality of life (ADDQoL), diabetes-related distress (PAID-5), and fear of hypoglycemia (HFS-II short form). Elevated DEPS-R was defined as a score ≥ 20, and likely eating disorders as SCOFF-F ≥ 2.</div></div><div><h3>Results</h3><div>A total of 100 adults with type 1 diabetes were included. No correlation was observed between Gluciquizz and DEPS-R (ρ = −0.03, 95% CI (−0.23 to 0.17), P = 0.73). Similarly, Gluciquizz scores did not differ between participants with SCOFF-F &lt; 2 and ≥ 2 (P = 0.745). Diabetes-related distress was significantly higher among participants with elevated DEPS-R scores (PAID-5 median 15 vs 8; P = 0.006), whereas ADDQoL and HFS-II did not differ significantly.</div></div><div><h3>Conclusion</h3><div>In this selected adult population with type 1 diabetes, carbohydrate-counting knowledge was not associated with disordered eating behaviors. However, positive DEB screening was linked with higher diabetes-related distress, supporting the importance of psychosocial assessment.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101735"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between glucagon-like peptide-1 receptor agonists and colorectal cancer survival: A population-based cohort study","authors":"Arnaud Dosda ,&nbsp;Grégoire Fauchier ,&nbsp;Nadia Sabbah ,&nbsp;Laurent Fauchier ,&nbsp;Thierry Lecomte ,&nbsp;Pierre Henri Ducluzeau","doi":"10.1016/j.diabet.2026.101734","DOIUrl":"10.1016/j.diabet.2026.101734","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the association between glucagon-like peptide-1 receptor agonist (GLP1-RA) use and all-cause mortality in patients with type 2 diabetes treated for colorectal cancer, using a real-world health database.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted using the TriNetX global health records network. Adult patients with type 2 diabetes diagnosed with colorectal cancer between 2010 and 2025 were included. Patients were divided into two cohorts based on GLP1-RA exposure versus other oral antidiabetic drugs. Propensity score matching was applied to balance covariates. Overall survival (primary outcome) and metastasis-free survival (secondary outcome) were analysed using Kaplan-Meier curves and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>After propensity score matching, each cohort included 751 patients. Median follow-up period was 731 days in the GLP1-RA cohort and 779 days in the non-GLP1-RA cohort. GLP1-RA users had a significantly reduced all-cause mortality rate (11.5%) compared with non-users a (20.4%), with a hazard ratio of 0.58 (95%CI: 0.45–0.76; <em>P</em> &lt; 0.001). Metastasis-free survival rate were 5.3% in the GLP1-RA cohort versus 8.9% in the matched non-user cohort, with a hazard ratio of 0.60 (95%CI: 0.40–0.87; <em>P</em> = 0.01). The incidence of major adverse cardiovascular events (MACE) did not differ significantly between cohorts, with a hazard ratio of 0.84 (95%CI: 0.66–1.06; <em>P</em> = 0.16).</div></div><div><h3>Conclusions</h3><div>In this real-world cohort of diabetic patients treated for colorectal cancer, GLP1-RA therapy was associated with a significant improvement in overall survival. These findings support the continued use of GLP1-RA agents in this population and may provide reassurance to clinicians and patients regarding the safety and potential benefit of these agents following a colorectal cancer diagnosis.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101734"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When “good” comes too fast: rapid glycemic correction and the kidney: a “metabolic descent” hypothesis","authors":"Dured Dardari","doi":"10.1016/j.diabet.2026.101737","DOIUrl":"10.1016/j.diabet.2026.101737","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101737"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture risk and treatment thresholds in patients with diabetes","authors":"Jakob Starup-Linde ,&nbsp;Katrine Hygum ,&nbsp;Henrik Støvring ,&nbsp;Jens-Erik Beck Jensen ,&nbsp;Pia Eiken ,&nbsp;Pernille Hermann ,&nbsp;Bente Langdahl ,&nbsp;Torben Harsløf","doi":"10.1016/j.diabet.2026.101722","DOIUrl":"10.1016/j.diabet.2026.101722","url":null,"abstract":"<div><h3>Aims</h3><div>Traditional risk factors underestimate fracture risk in individuals with diabetes. In this population-based case-control study we aimed to determine T-score thresholds for type 1 and 2 diabetes (T1D and T2D) with equivalent risk of fractures as that of individuals without diabetes and a T-score of -2.5.</div></div><div><h3>Research Design and Methods</h3><div>We collected dual energy x-ray absorptiometry (DXA) data (2000–2019), information on diagnoses (1977–2019) and redeemed medications (1997–2019) from the National Danish Registries which are linked by a unique identifier. Cases were individuals with the first incident major osteoporotic fracture (MOF) within two years before or one year after a DXA and controls were fracture free and matched on age, gender, and time period of the DXA. Logistic regression modelling was used in the case-control analysis.</div></div><div><h3>Results</h3><div>We identified 17,703 cases and 17,703 controls. T1D and T2D were associated with an increased risk of MOF (odds ratio: 1.8, 95 % CI:1.4;2.3 and 1.2, 95 % CI:1.1;1.3, respectively) adjusted for hip BMD. T1D and T2D patients had a similar risk of MOF at T-scores (total hip) = -1.4 and -2.1, respectively, as patients without diabetes with a T-score of -2.5. For hip fracture, the equivalent risk was correspondingly reached with T-scores of -1.9 and -1.6. Similar findings apply for femoral neck and lumbar spine BMD.</div></div><div><h3>Conclusions</h3><div>Compared to individuals without diabetes, fracture risk was increased in patients with T1D and T2D independent of BMD. Our study suggests that the T-score thresholds for treatment initiation in T1D and T2D should be increased.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101722"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Views and understanding of metabolic dysfunction-associated steatotic liver disease in patients with diabetes","authors":"David M Williams ,&nbsp;Jagadish Nagaraj ,&nbsp;Laura Wilkinson ,&nbsp;Jeffrey W Stephens ,&nbsp;Thinzar Min","doi":"10.1016/j.diabet.2026.101723","DOIUrl":"10.1016/j.diabet.2026.101723","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101723"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent reflux underlying GLP-1RA–associated chronic cough","authors":"Huijun Zheng ,&nbsp;Lijuan Ma ,&nbsp;Hao Liu","doi":"10.1016/j.diabet.2026.101739","DOIUrl":"10.1016/j.diabet.2026.101739","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101739"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing the role of GLP-1 receptor agonists in colorectal cancer Care","authors":"Baodong Wang ,&nbsp;Jiayuan Huang ,&nbsp;Zhiyun Chen","doi":"10.1016/j.diabet.2026.101742","DOIUrl":"10.1016/j.diabet.2026.101742","url":null,"abstract":"<div><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used in type 2 diabetes, yet their management after colorectal cancer diagnosis remains uncertain. A recent population-based cohort study reported lower mortality and fewer metastatic events among GLP-1 RA users than among patients receiving other glucose-lowering therapies. However, causal inference is limited by potential immortal time bias from the exposure definition, incomplete reporting of key prognostic and treatment factors (stage, surgery, systemic therapy, performance status), and unclear cohort entry and follow-up windows. In addition, reliance on routine administrative codes may misclassify outcomes. Time-varying exposure models, active-comparator new-user or landmark designs, and registry linkage/validation would strengthen the evidence.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101742"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe hyperglycemia after initiation of long-acting cabotegravir in two antiretroviral treatment-controlled people with HIV","authors":"Nadia Valin ,&nbsp;Pauline Campa ,&nbsp;Thibault Chiarabini ,&nbsp;Joëlle Michot ,&nbsp;Carole Collet-Gaudillat ,&nbsp;Stéphanie Kury Paulin ,&nbsp;Jacqueline Capeau ,&nbsp;Karine Lacombe","doi":"10.1016/j.diabet.2026.101744","DOIUrl":"10.1016/j.diabet.2026.101744","url":null,"abstract":"<div><div>We report two cases of normoglycemic people with HIV well-controlled by antiretroviral therapy who were switched to a dual long-acting therapy consisting of cabotegravir (CAB), an integrase strand transfer inhibitor, and rilpivirine (RIL), a non-nucleoside analog reverse transcriptase inhibitor, administred intramuscularly once a month then every two months. Both cases developed shortly acute severe hyperglycemia with ketoacidosis or insulinopenia requiring intravenous insulin therapy. Anti-pancreatic autoantibodies were absent. The hyperglycemic episode resumed after stopping CAB/RIL and/or initiating metformin. To our knowledge these are the first reported cases of severe CAB/RIL-induced hyperglycemia. Up to now, long-acting CAB/RIL has not been associated with metabolic outcomes. These cases serve as a warning to clinicians to monitor glycemia when initiating long-acting CAB/RIL therapy.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101744"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}