Diabetes & metabolism最新文献

{"title":"GLP-1-derived therapies and sarcopenia: plea for a specific focus on at risk special populations","authors":"André J. Scheen","doi":"10.1016/j.diabet.2025.101708","DOIUrl":"10.1016/j.diabet.2025.101708","url":null,"abstract":"<div><h3>Background</h3><div>A risk of excessive reduction in skeletal muscle mass (SSM), potentially leading to sarcopenia, when using glucagon-like peptide-1 (GLP-1)-based therapies, is currently a matter of debate. While most available results are rather reassuring in the general population, sarcopenia may become a concern in some special subgroups with comorbidities known to be associated with a higher risk of sarcopenia, independently of any GLP-1-based therapy.</div></div><div><h3>Methods</h3><div>An extensive literature search was done to identify studies that investigated the effects of GLP-1-based therapies on changes in SMM and sarcopenia in special populations, i.e. older people, patients with type 2 diabetes, atherosclerotic cardiovascular disease, heart failure, chronic kidney disease, and metabolic dysfunction–associated liver disease.</div></div><div><h3>Results</h3><div>Several publications emphasized the risk of sarcopenia and recommended caution when prescribing GLP-1-based therapies in people with these comorbidities of interest. However, hard data remain scarce in the literature, without any evidence-based demonstration of a significantly increased risk of sarcopenia. Nevertheless, as old age potentiates the risk of sarcopenia, older patients with these comorbidities (especially advanced heart failure or renal disease) deserve more careful attention.</div></div><div><h3>Conclusion</h3><div>While the risk of sarcopenia associated with GLP-1-based therapies remains controversial in the general population, a higher risk in special populations with comorbidities has been repeatedly emphasized despite the lack of evidence-based data in the literature. Because these agents showed major clinical benefits in patients with such comorbidities but sarcopenia could mitigate them, there is an urgent need to implement dedicated studies with appropriate measures of sarcopenia in these special populations.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101708"},"PeriodicalIF":4.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310442","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":"Ulcer topography matters: hindfoot versus forefoot outcomes in first-time diabetic foot ulcer","authors":"Muhammad Mohid Haroon","doi":"10.1016/j.diabet.2025.101707","DOIUrl":"10.1016/j.diabet.2025.101707","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101707"},"PeriodicalIF":4.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277043","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":"Epicardial adipose tissue volume and diabetic retinopathy","authors":"Emmanuel Cosson ,&nbsp;Sopio Tatulashvili ,&nbsp;Marouane Boubaya ,&nbsp;Amir Abdul Khalife ,&nbsp;Imen Rezgani ,&nbsp;Lucie Allard ,&nbsp;Meriem Sal ,&nbsp;Ines Barka ,&nbsp;Mohamed Lamine Mariko ,&nbsp;Mohamed Zerguine ,&nbsp;Omar Nouhou Koutcha ,&nbsp;Bénédicte Gaborit ,&nbsp;Coralie Bloch-Queyrat ,&nbsp;Pierre-Yves Brillet ,&nbsp;Héloïse Torres-Villaros ,&nbsp;Audrey Giocanti-Aurégan ,&nbsp;Hélène Bihan","doi":"10.1016/j.diabet.2025.101706","DOIUrl":"10.1016/j.diabet.2025.101706","url":null,"abstract":"<div><h3>Introduction</h3><div>We explored the association between epicardial adipose tissue (EAT) volume and diabetic retinopathy.</div></div><div><h3>Methods</h3><div>We used clinical data from a monocentric mixed retrospective and prospective observational study of 1093 individuals living with diabetes who had a computed tomography (CT) scan in order to calculate their coronary artery calcium (CAC) score. This scan was also used to compute EAT volume. For the present study, only persons whose diabetic retinopathy status was known (i.e., yes/no) were included.</div></div><div><h3>Results</h3><div>We included 1037 individuals living with diabetes (type 2 79.1 %, type 1 14.8 %, other types 6.2 %) for 14.6 ± 9.9 years. Mean body mass index was 29.4 ± 5.9 kg/m², HbA1c was 8.7 ± 2.2 %, 38.2 % had diabetic retinopathy, and EAT volume was 93 ± 40 cm³. Diabetic retinopathy was positively associated with North African ethnicity, type 1 diabetes, longer diabetes duration, higher HbA1c levels, and more hypertension and diabetes-related complications (nephropathy, neuropathy, macroangiopathy and a high CAC score). EAT volume was lower in patients with diabetic retinopathy than in those without (87 ± 37 vs 97 ± 42 cm³, <em>P</em> &lt; 0.0001), independently of confounders (per 10cm³ increase: odds ratio 0.89 [95 % confidence interval 0.84;0.93], <em>P</em> &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>We found an unexpected negative association between the volume of EAT—a proinflammatory tissue—and diabetic retinopathy prevalence. This finding warrants further mechanistic investigation.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101706"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277026","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":"Comment on “Association between smoking status and suicide mortality in patients with type 2 diabetes: A nationwide population-based cohort study”","authors":"Hamza Khan","doi":"10.1016/j.diabet.2025.101705","DOIUrl":"10.1016/j.diabet.2025.101705","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101705"},"PeriodicalIF":4.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116077","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":"Glycemic and renal effects of SGLT2 Inhibitors in Prader-Willi syndrome: Benefits and risks","authors":"Juliette Jacquot-Thierry ,&nbsp;Sarah Chalopin ,&nbsp;Héléna Mosbah ,&nbsp;Émilie Montastier ,&nbsp;Fabien Mourre ,&nbsp;Blandine Gatta-Cherifi ,&nbsp;Julien Bourry ,&nbsp;Eléonore Guichard ,&nbsp;Pauline Faucher ,&nbsp;Christine Poitou ,&nbsp;Chloé Amouyal","doi":"10.1016/j.diabet.2025.101704","DOIUrl":"10.1016/j.diabet.2025.101704","url":null,"abstract":"<div><h3>Objective</h3><div>Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely used in type 2 diabetes (T2D) management, but their efficacy and tolerance in Prader-Willi syndrome (PWS) remains unknown. Given the early onset of diabetes and treatment challenges, evaluating SGLT2is in this population is essential.</div></div><div><h3>Research and methods</h3><div>In this retrospective, multicenter study, 48 adults with PWS and T2D, among whom 24 patients receiving SGLT2is, were followed over 6 months. Glycemic and renal parameters were analyzed at baseline and 6 months.</div></div><div><h3>Results</h3><div>HbA1c was higher in the SGLT2i group and significantly improved (<em>P</em> &lt; 0.05) while it remained stable in controls. The albumin-to-creatinine ratio also decreased significantly<strong>.</strong> No significant weight change was noted. Adverse events occurred in 37.5 % of treated patients, including acute kidney injury in 8.3 %.</div></div><div><h3>Conclusions</h3><div>SGLT2is improve glycemic control and renal markers in PWS with no weight loss. Close safety monitoring is warranted, particularly regarding renal function in PWS and more generally towards all complex obesity with neurodevelopmental disorders.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101704"},"PeriodicalIF":4.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102692","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":"Diabetic retinopathy remission in patients using an automated insulin delivery system: A prospective controlled study","authors":"Beatriz Barquiel ,&nbsp;Daniel Álvarez ,&nbsp;Óscar Moreno Domínguez ,&nbsp;Elena García-Pérez de Sevilla ,&nbsp;Natalia Hillman ,&nbsp;Ricardo Romero ,&nbsp;Ruth Gaspar ,&nbsp;Montserrat Arévalo ,&nbsp;Noemí González-Perez de Villar","doi":"10.1016/j.diabet.2025.101703","DOIUrl":"10.1016/j.diabet.2025.101703","url":null,"abstract":"<div><h3>Aims</h3><div>Diabetic retinopathy (DR) is a complication of chronic hyperglycemia in people living with type 1 diabetes (PLWT1D). The use of automated insulin delivery (AID) systems may modify this course. In this prospective observational study, we evaluated whether the MiniMed 780G AID system was associated with remission or improvement in the severity of DR.</div></div><div><h3>Methods</h3><div>The study included PLWT1D with DR treated either with the AID system or with multiple daily insulin injections (MDI) combined with intermittent glucose monitoring. The follow-up period was two years. DR was graded annually, and HbA1c levels were recorded. Glucose monitoring parameters were also assessed to evaluate the impact of glucose ranges and variability on retinopathy. Group comparisons were performed using univariate and multivariate statistical analyses.</div></div><div><h3>Results</h3><div>DR remission occurred in 15/30 (50 %) participants treated with the AID system, compared with 0/30 (0 %) in the MDI group (<em>P</em> &lt; 0.001). Improvement in DR stage was observed in 15/30 (50 %) participants in the AID group, compared with 2/30 (6.7 %) in the MDI group (<em>P</em> &lt; 0.001). These outcomes were associated with lower HbA1c, reduced time above range (TAR), and a lower coefficient of variation (CV) in the remission group.</div></div><div><h3>Conclusion</h3><div>Remission or improvement of DR was observed in patients with type 1 diabetes treated with an AID system.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101703"},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067011","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":"Peripheral neuropathy as a bedside marker for cerebral microangiopathy","authors":"Muhammad Mohid Haroon","doi":"10.1016/j.diabet.2025.101702","DOIUrl":"10.1016/j.diabet.2025.101702","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101702"},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066978","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":"Modelled substitution of meat with dairy products and the 20-year cumulative incidence of type 2 diabetes: Insights from the ATTICA cohort study (2002–2022)","authors":"Ioanna Kechagia ,&nbsp;Mary Yannakoulia ,&nbsp;Fotios Barkas ,&nbsp;Evangelos Liberopoulos ,&nbsp;Petros P. Sfikakis ,&nbsp;Christos Pitsavos ,&nbsp;Demosthenes Panagiotakos","doi":"10.1016/j.diabet.2025.101701","DOIUrl":"10.1016/j.diabet.2025.101701","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the association between modelled substitution of total, red, and white meat with dairy subtypes (low-fat, full-fat, and fermented) and the 20-year cumulative incidence of type 2 diabetes (T2D), among apparently healthy adults.</div></div><div><h3>Methods</h3><div>The present analysis included data from 2000 individuals free of atherosclerotic cardiovascular disease and T2D at baseline (age 43 ± 13 years; 51% women), participating in the ATTICA cohort study (2002–2022). Food intake was assessed using a validated semi-quantitative food-frequency questionnaire.</div></div><div><h3>Results</h3><div>The 20-year cumulative incidence of T2D was 26.3% (95%CI [24.4, 28.3%]). Participants who developed T2D during follow-up reported significantly higher red meat consumption compared to those who did not (5.0 vs. 4.5 times/week; <em>P</em> = 0.016). Modelled substitution of one daily serving of total meat per 1000 kcal with full-fat dairy, in fully adjusted models, suggested a trend (at <em>P</em> &lt; 0.10) of lowering 20-year T2D risk (OR 0.38, 95%CI [0.14, 1.05]); similarly, substitution of one daily serving/1000 kcal of total meat with fermented dairy showed a trend of lowering T2D risk (OR 0.39, 95%CI [0.15, 1.07]). Substituting red meat with full-fat dairy was not associated with T2D risk (OR per one daily serving/1000 kcal = 0.37, 95%CI [0.11, 1.19]); similarly, substitutions with low-fat, fermented dairy or white meat showed not significant associations with T2D risk.</div></div><div><h3>Conclusion</h3><div>Substituting total and red/processed meat with full-fat or fermented dairy products in modeled analyses indicated potentially favorable, though largely non-significant, associations with long-term risk of T2D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101701"},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056556","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":"Incidence of death and amputation in patients with a first diabetic foot ulcer: results from the CODIA cohort","authors":"Julla Jean-Baptiste ,&nbsp;Jolivet Théo ,&nbsp;Estellat Candice ,&nbsp;Varoquaux Gaël ,&nbsp;Carlier Aurélie ,&nbsp;Gautier Jean-François ,&nbsp;Alberge Julie ,&nbsp;Abouleka Yawa ,&nbsp;Bergès Audrey ,&nbsp;Liu Elise ,&nbsp;Abecassis Judith ,&nbsp;Tubach Florence ,&nbsp;Potier Louis","doi":"10.1016/j.diabet.2025.101700","DOIUrl":"10.1016/j.diabet.2025.101700","url":null,"abstract":"<div><h3>Aim</h3><div><em>-</em> To investigate the incidences of death and lower limb amputation (LLA) among patients hospitalized with a first diabetic foot ulcer and to identify the associated risk factors.</div></div><div><h3>Methods</h3><div><em>-</em> We leveraged medical records from 08/2017 to 10/2023 in the clinical data warehouse of the Greater Paris Hospitals. The primary outcome was the cumulative incidence of death estimated at 12 months. We used Kaplan-Meier and Aalen-Johansen estimators to assess the incidence of death and LLA (identified through ICD-10 codes). We used multivariate Cox regression and Fine and Gray models to estimate risk factors (clinical/biological data, medications, and comorbidities at baseline) for death and LLA, accounting for death as a competing event.</div></div><div><h3>Results</h3><div><em>-</em> 3102 patients were included; the median age was 70.66 years and there were 67.64% males. The cumulative incidence of death at 12 months was 21.64% [95%CI 20.11;23.26]. Mortality risk was associated with older age, chronic cardiac, hepatic, or renal diseases, cancer history, and systemic inflammation, whereas being overweight was linked to lower mortality. The cumulative incidence of LLA at 12 months was 24.15% [22.54;25.79]. Risk factors for LLA included male sex, history of peripheral artery disease, emergency admission, and systemic inflammation markers, while dementia was associated with a lower risk.</div></div><div><h3>Conclusion</h3><div><em>-</em> Cumulative incidences of all-cause mortality and LLA during the months following hospitalization with a first diabetic foot ulcer were alarmingly high. Mortality risk was primarily associated with patient comorbidities, while amputation risk was closely associated with systemic inflammation and history of peripheral artery disease.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101700"},"PeriodicalIF":4.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017021","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":"Prevalence and predictive factors of computed tomography-detected pancreatopathy in a cohort of adult patients hospitalized for newly diagnosed or uncontrolled non-auto-immune diabetes","authors":"Noëmie Lemétayer ,&nbsp;Lucille Quénéhervé ,&nbsp;Jean-Romain Risson ,&nbsp;Charlotte Nachtergaele ,&nbsp;Geneviève Crouzeix ,&nbsp;Emmanuel Sonnet ,&nbsp;Nathalie Roudaut ,&nbsp;Véronique Kerlan ,&nbsp;Vianney Deméocq ,&nbsp;Philippe Thuillier","doi":"10.1016/j.diabet.2025.101699","DOIUrl":"10.1016/j.diabet.2025.101699","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the prevalence of pancreatic lesions in patients hospitalized for newly diagnosed or uncontrolled diabetes mellitus and identify potential predictive factors for pancreatic pathology.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, single-center observational study at Brest University Hospital between February 2016 and February 2022. Adult patients hospitalized for newly diagnosed diabetes or uncontrolled diabetes mellitus who underwent a computed tomography (CT) scan within six months of admission were included. Patients with type 1 diabetes, prior pancreatectomy, or a known history of pancreatic adenocarcinoma were excluded. Clinical, biological, and imaging data were analyzed.</div></div><div><h3>Results</h3><div>Among 412 patients analyzed, 53 (12.9 %) presented pancreatic abnormalities (PA), including 11 cases (2.7 %) of malignant pancreatic lesion. Predictive factors for PA (<em>P</em> &lt; 0.05) included (odds ratio [95 % confidence interval]): age ≥ 65 years (2.00 [1.52;5.27]); body mass index ≤ 26.4 kg/m² (2.65 [1.1;4.98]); LDL/HDL ratio ≤ 3.0 (4.75 [2.03;11.10]); and presence of at least one clinical warning sign (alcoholic use, steatorrhea, abdominal pain) (2.29 [1.21;4.33]). Using all four criteria together, 68 of 412 CT scans would have been avoided, with no missed cases.</div></div><div><h3>Conclusions</h3><div>The prevalence of pancreatic lesions in patients hospitalized for diabetes-related glycemic imbalance was significant although malignancy remained low. Age ≥ 65 years, low body mass index, and altered lipid profile may help identify patients requiring pancreatic imaging. Future prospective studies should refine these criteria to develop screening strategies for early pancreatic cancer detection in high-risk selected diabetic populations.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101699"},"PeriodicalIF":4.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985185","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}