Diabetes & metabolism最新文献

{"title":"Efficacy and safety of pharmacological treatments for gestational diabetes: a systematic review comparing metformin with glibenclamide and insulin","authors":"Louise Bodier ,&nbsp;Maela Le Lous ,&nbsp;Hélène Isly ,&nbsp;Christèle Derrien ,&nbsp;Patricia Vaduva","doi":"10.1016/j.diabet.2025.101622","DOIUrl":"10.1016/j.diabet.2025.101622","url":null,"abstract":"<div><h3>Aim</h3><div>Gestational diabetes, characterized by impaired glucose tolerance occurring or diagnosed during pregnancy, is a significant public health concern. When lifestyle and dietary measures fail (30 % of women), insulin is the standard treatment. Oral antidiabetic agents, such as metformin (Glucophage) and glibenclamide, could provide a promising alternative. The aim here was to evaluate the effectiveness and safety of these treatments in gestational diabetes.</div></div><div><h3>Methods</h3><div>This study is based on a systematic literature review. A keyword search for \"metformin (Glucophage),\" \"glibenclamide,\" \"pregnancy,\" and \"gestational diabetes\" was conducted in the PubMed and Google Scholar databases from 2013 to 2023.</div></div><div><h3>Results</h3><div>A total of 45 studies were selected and analyzed. metformin (Glucophage) appears to offer a combination of effectiveness in glycemic control and maternal and neonatal safety. Compared to insulin, it reduces maternal weight gain, lowers maternal hypoglycemia rates, and shows a tendency to reduce gestational hypertension and preeclampsia. Additionally, infants born to mothers on metformin (Glucophage) are less likely to be macrosomic, experience fewer neonatal hypoglycemic episodes, and require fewer admissions to intensive care units. On the other hand, glibenclamide seems effective in glycemic control but is associated with higher rates of macrosomia and neonatal hypoglycemia.</div></div><div><h3>Conclusion</h3><div>Metformin (Glucophage) appears to be a promising alternative to insulin for treating gestational diabetes, while uncertainties remain regarding the safety of glibenclamide.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101622"},"PeriodicalIF":4.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemia Risk Index (GRI) and international glucose targets before and 6 months after initiation of hybrid closed loop system in the CIRDIA, a French multisite out-of-hospital center","authors":"Sylvie Picard ,&nbsp;Blandine Courbebaisse ,&nbsp;Joëlle Dupont ,&nbsp;Fabienne Amiot-Chapoutot ,&nbsp;Emmanuelle Lecornet-Sokol ,&nbsp;Estelle Personeni ,&nbsp;François Mougel ,&nbsp;Clara Bouché ,&nbsp;Françoise Giroud ,&nbsp;Sandrine Lablanche ,&nbsp;Sophie Borot","doi":"10.1016/j.diabet.2025.101617","DOIUrl":"10.1016/j.diabet.2025.101617","url":null,"abstract":"<div><h3>Aims</h3><div>To analyze in a population of persons with type 1 diabetes (PwT1D) ambulatory glucose profile (AGP) parameters – including glycemia risk index (GRI) – for six months after hybrid closed loop (HCL) initiation in a multisite out-of-hospital French center (CIRDIA). We calculated the percentage of people reaching glucose targets and determined a GRI threshold that could identify patients reaching targets.</div></div><div><h3>Methods</h3><div>This was a retrospective study conducted in the CIRDIA, a multisite (<em>n</em>=7) out-of-hospital HCL initiation center. AGP metrics for the 14 previous days were manually extracted from HCL platforms at initiation (M0), 3 ± 1 months (M3) and 6 ± 1 months (M6). PwT1D were considered as reaching efficacy and safety targets (EST) if time-in-range was &gt; 70 %, GMI was &lt; 7 %, time-below-range (TBR)^&lt;70 was &lt; 4 % and TBR^&lt;54 was &lt; 1 %. GRI was calculated and ROC analyses were performed to set a GRI threshold that could identify patients reaching EST.</div></div><div><h3>Results</h3><div>Six-month data were available for 136 persons. The percentage of PwT1D reaching glucose targets at respectively M0, M3 and M6 were for EST: 6.6 %, 40.4 % and 39.7 %. GRI decreased from 56.0 ± 20.9 to 30.1 ± 14.1 and 30.6 ± 13.8. ROC analyses showed that the best GRI value to detect patients who reached EST was GRI &lt;26. A threshold set at this level had very good specificity (92 %) and negative predictive value (93 %) to identify those who do need further intensive support with HCL.</div></div><div><h3>Conclusion</h3><div>Setting a GRI threshold at 26 could be helpful to detect with a single number, potentially automatically calculated by CGM platforms, PwT1D who require further support.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101617"},"PeriodicalIF":4.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143369769","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":"Lp(a) concentration and polymorphic size are not associated with new onset diabetes in individuals with prediabetes","authors":"Maxime Carpentier ,&nbsp;Matthieu Wargny ,&nbsp;Mikaël Croyal ,&nbsp;Cédric Le May ,&nbsp;Sarra Smati ,&nbsp;Edith Bigot-Corbel ,&nbsp;Samy Hadjadj ,&nbsp;Bertrand Cariou","doi":"10.1016/j.diabet.2025.101621","DOIUrl":"10.1016/j.diabet.2025.101621","url":null,"abstract":"<div><h3>Aim</h3><div>Observational studies in the general population suggest that low concentrations of lipoprotein (a) [Lp(a)] are associated with an increased risk of type 2 diabetes. Here, we aim to determine whether Lp(a) plasma concentration and Kringle-IV (K-IV) repeat polymorphism were associated with new-onset diabetes (NOD) in individuals with prediabetes.</div></div><div><h3>Methods</h3><div>IT-DIAB is an observational, prospective study including 303 participants with impaired fasting glucose (fasting plasma glucose [FPG]: 110–125 mg/dl) followed annually for 5 years. The primary endpoint was the development of NOD, defined as a first FPG value ≥ 126 mg/dl during follow-up. Lp(a) concentrations were measured by immunoturbidimetry, apo(a) concentrations and the number of K-IV domains by mass spectrometry. Survival analyses for NOD were modeled using Kaplan-Meier curves and a multivariable Cox model, after binarization on threshold values of Lp(a) or K-IV.</div></div><div><h3>Results</h3><div>Among the participants, 113 (37%) developed NOD during follow-up. The concentrations of Lp(a) and the number of K-IV domains were not significantly different according to NOD status. Similarly, the percentage of patients with a non-detectable (≤ 7 nmol/l) or elevated (&gt;125 nmol/l) Lp(a) concentration was similar between those with or without NOD: 68.1 vs 63.7% (<em>P</em> = 0.46) and 8.8 vs 8.9% (<em>P</em> &gt; 0.99), respectively. Kaplan-Meier curves and Cox models did not show any association between Lp(a) concentration (threshold 7 nmol/l and 125 nmol/l) or number of K-IV domain (threshold 23) and the risk of NOD.</div></div><div><h3>Conclusion</h3><div>In a high-risk population, Lp(a) concentration or polymorphic size do not appear to be substantially associated with type 2 diabetes risk.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101621"},"PeriodicalIF":4.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257756","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":"Early use of hybrid closed-loop following total pancreaticoduodenectomy","authors":"Alice Larroumet ,&nbsp;Arthur Marichez ,&nbsp;Marion Camoin ,&nbsp;Laurence Baillet-Blanco ,&nbsp;Jean-Philippe Adam ,&nbsp;Christophe Laurent ,&nbsp;Vincent Rigalleau ,&nbsp;Kamel Mohammedi ,&nbsp;Laurence Chiche","doi":"10.1016/j.diabet.2025.101619","DOIUrl":"10.1016/j.diabet.2025.101619","url":null,"abstract":"<div><div>Diabetes secondary to total pancreaticoduodenectomy (TP) is challenging to manage due to high glycemic variability and risk of hypoglycemia, in a frail population. We report the case of four patients with no prior diabetes who underwent TP. Three of four patients needed artificial nutritional support. Hybrid closed-loop (HCL) insulin therapy was initiated within 12 weeks of surgery. After 90 days of HCL treatment, continuous glucose measurement showed a 70.4 ± 11.8 % time in range (versus 43 ± 6.5 % before HCL); 0.2 ± 0.2 % time below range (versus 0.6 ± 0.5 % before HCL); 23.8 ± 9.1 % time above range 180–250 mg/dl (versus 22.9 ± 6.1 % before HCL); 4.2 ± 2.5 % time above range &gt; 250 mg/dl (versus 33.8 ± 3.9 % before HCL). The glucose management indicator improved from 8.5 ± 0.6 % to 6.9 ± 0.6 %. There was no severe hypoglycemia or need for unplanned medical attention. Early post-operative use of HCL allowed our patients to achieve safely optimal glycemic control after TP.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101619"},"PeriodicalIF":4.6,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191654","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":"Physical frailty, genetic predisposition, and type 2 diabetes mellitus","authors":"Zhenyi Xu ,&nbsp;Ruilang Lin ,&nbsp;Xueying Ji ,&nbsp;Chen Huang ,&nbsp;Ce Wang ,&nbsp;Yongfu Yu ,&nbsp;Zhijun Bao","doi":"10.1016/j.diabet.2025.101618","DOIUrl":"10.1016/j.diabet.2025.101618","url":null,"abstract":"<div><h3>Aim</h3><div>To examine the association between frailty and incident type 2 diabetes mellitus (T2DM), considering the joint effect of multimorbidity and genetic risk.</div></div><div><h3>Methods</h3><div>The study included 429,022 individuals in the UK Biobank. We used Cox regression with hazard ratio (HR) and 95 % confidence interval (CI) to 1) evaluate the associations of frailty with incident T2DM, 2) explore whether frailty and multimorbidity would have a joint effect, and 3) assess whether the associations were modified by genetic risk.</div></div><div><h3>Results</h3><div>Compared with non-frail individuals, prefrail and frail individuals were at higher risk of T2DM: HR[95 %CI] = 1.42 [1.38;1.47] for prefrailty and 1.81[1.70;1.92] for frailty. Five frailty components were associated with increased risk of T2DM: HR[95 %CI] = 1.21[1.17;1.26] for weight loss, 1.35[1.30;1.40] for exhaustion, 1.31[1.26;1.37] for low physical activity, 1.27[1.20;1.33] for low grip strength, and 1.47[1.41;1.52] for slow gait speed. The increased risks were more pronounced among frail individuals with more than three morbidities: HR[95 %CI] = 4.10[3.76;4.46]. Frail individuals at high genetic risk had a four and a half-fold greater risk of T2DM compared with non-frail individuals at low genetic risk: HR[95 %CI] = 4.54[4.14;4.97].</div></div><div><h3>Conclusion</h3><div>Frailty was associated with increased risk of T2DM, especially in individuals with higher number of morbidities and high genetic risk. Frailty may be an independent risk factor for T2DM and targeted strategies to prevent and manage frailty would contribute to reducing the risk of T2DM.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101618"},"PeriodicalIF":4.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096878","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":"Dynamics of diabetes prevalence, incidence and mortality in France: A nationwide study, 2013–2021","authors":"Sandrine Fosse-Edorh ,&nbsp;Marie Guion ,&nbsp;Sarah Goria ,&nbsp;Laurence Mandereau-Bruno ,&nbsp;Emmanuel Cosson","doi":"10.1016/j.diabet.2025.101615","DOIUrl":"10.1016/j.diabet.2025.101615","url":null,"abstract":"<div><h3>Aim</h3><div>To estimate the time trends of treated diabetes incidence, prevalence and mortality in France from 2013 to 2019 and to compare with the Covid-19 pandemic period (2020–2021).</div></div><div><h3>Methods</h3><div>Using the French National Health Data System, people with treated diabetes ≥ 45 years-old were identified based on their medications. Annual time trends over 2013–2019 were estimated using Poisson log-linear model controlled for age, year and region for prevalence (aPTT), incidence (aITT) and mortality (aMTT). Numbers of incident cases and deaths in 2020–2021 were estimated from these trends, and compared with those observed.</div></div><div><h3>Results</h3><div>Over 2013–2019, incidence and mortality declined significantly in men, aITT=-0.61 % (-0.95;-0.26); aMTT=-0.52 % (-0.81;-0.22), leading to a stable prevalence, aPTT=0.18 % (-0.03;0.40). In women, the fall in incidence was more marked, aITT=-1.45 % (-1.95;-0.95), mortality was stable, aMTT=-0.19 % (-0.54;0.15), leading to a significant decrease in prevalence, aPTT=-0.31 % (-0.60;-0.02). Compared with people not treated for diabetes, the relative risk of mortality increased significantly in men over the 2013–2019 period, from 1.38 (1.37;1.39) to 1.42 (1.41;1.43), while the risk remained stable in women, from 1.45 (1.44;1.46) to 1.46 (1.45;1.47).</div><div>In 2020, there were 7,458 and 4,404 additional deaths and 3,550 and 4,919 new cases in respectively men and women. In 2021, there were 11,576 and 6,371 additional deaths and 30,057 and 26,169 new cases in respectively men and women.</div></div><div><h3>Conclusion</h3><div>This study reports a favorable dynamic of diabetes over 2013–2019 followed by a sharp increase in incidence and mortality in 2020 and 2021. Continued monitoring is necessary to identify long-term trend and potential indirect effect of the pandemic.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101615"},"PeriodicalIF":4.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082099","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 Type 2 Diabetes onset age and risk of cardiovascular disease and mortality: Two cohort studies from United Kingdom and Hong Kong","authors":"Boyuan Wang ,&nbsp;Ivy Lynn Mak ,&nbsp;Kiki Sze Nga Liu ,&nbsp;Edmond Pui Hang Choi ,&nbsp;Cindy Lo Kuen Lam ,&nbsp;Eric Yuk Fai Wan","doi":"10.1016/j.diabet.2025.101607","DOIUrl":"10.1016/j.diabet.2025.101607","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the association between type 2 diabetes mellitus (T2DM) onset age and risk of cardiovascular disease (CVD) and mortality.</div></div><div><h3>Method</h3><div>Two retrospective cohort studies were conducted using the electronic health records from the United Kingdom (UK) and Hong Kong (HK) on adults without CVD. During 2008-2013, 128,918 and 185,646 patients with new-onset T2DM were assigned to the T2DM group, and 5,052,770 and 3,159,396 patients without T2DM were included as controls in the UK and HK cohort, respectively. Patients were stratified into six age groups. Multivariable Cox regression, adjusted for baseline characteristics and fine stratification weights, was used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for each outcome.</div></div><div><h3>Results</h3><div>New-onset T2DM was associated with increased CVD and mortality risk, but the risks decreased with age. Compared to those without T2DM in the same age groups, the HR (95 % CI) for CVD in the UK cohort was 3.22 (2.80, 3.71), 1.21 (1.15, 1.26), and 0.99 (0.93, 1.05) for T2DM individuals at ages 18–39, 60–69, and ≥ 80, respectively. Similarly, the HR (95 % CI) for mortality among new-onset T2DM patients was 2.41 (2.06, 2.83) for age 18–39, 1.40 (1.34, 1.46) for age 60–69, and 1.12 (1.08, 1.16) for age ≥ 80. Results from the HK cohort showed a similar pattern.</div></div><div><h3>Conclusion</h3><div>Young onset of T2DM is associated with a significant impact on cardiovascular health later in life. This highlights the importance of the prevention of DM in young adults.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101607"},"PeriodicalIF":4.6,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018722","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":"Use of glucagon-like peptide-1 receptor agonists in people with history of acute pancreatitis: TriNetX analysis","authors":"Mahmoud Nassar ,&nbsp;Hazem Abosheaishaa ,&nbsp;Anoop Misra ,&nbsp;Paresh Dandona ,&nbsp;Husam Ghanim ,&nbsp;Ajay Chaudhuri (Prof.)","doi":"10.1016/j.diabet.2025.101613","DOIUrl":"10.1016/j.diabet.2025.101613","url":null,"abstract":"<div><h3>Introduction</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used in subjects with type 2 diabetes (T2D) and obesity. However, concerns over their association with acute pancreatitis (AP) have emerged. Our aim was to evaluate the risk of recurrence of AP in subjects on GLP-1RAs with a history of AP.</div></div><div><h3>Methods</h3><div>This retrospective study deployed the TriNetX platform. We identified adult cohorts of subjects with a history of AP and analyzed the impact of individual medications (GLP-1RAs, SGLT2i, or DPP4i) on the risk of recurrence of AP. To adjust for baseline differences, propensity score matching was done in cohorts with and without risk factors for AP.</div></div><div><h3>Results</h3><div>Our analysis of 672,069 patients with a history of AP and T2D revealed significant risk reductions associated with GLP-1RAs compared to other treatments. Over one to five years, GLP-1RAs consistently showed a lower risk of AP recurrence compared to SGLT2i and DPP-4i. Specifically, over a one-year period, GLP-1RAs users had a risk reduction of -0.071 (95 % CI:0.085 to -0.057) (p &lt; 0.001) compared to SGLT2i, and -0.064 (95 % CI:0.080 to -0.048) (p&lt; 0.001) compared to DPP-4i. These trends persisted, with the risk differences further widening by the fifth year to -0.086 and -0.094, respectively.</div></div><div><h3>Conclusion</h3><div>Based on our findings, we conclude that GLP-1RAs may be safely used in subjects with a history of acute pancreatitis. While our analysis showed that there was a significantly lower risk of AP recurrence in subjects on GLP-1compared to DPP-IV inhibitors and SGLT2 inhibitors, as this is a retrospective analysis we suggest that these findings need to be confirmed in prospective studies.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101613"},"PeriodicalIF":4.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019242","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":"Weight loss therapy and addiction: Increased risk after bariatric surgery but reduced risk with GLP-1 receptor agonists","authors":"André J. Scheen","doi":"10.1016/j.diabet.2025.101612","DOIUrl":"10.1016/j.diabet.2025.101612","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is an increasing public health problem because of its high prevalence and associated morbidity and mortality. Two weight-loss strategies are currently used, either bariatric surgery or pharmacological therapy with glucagon-like peptide-1 receptor agonists (GLP-1RAs). Preclinical studies in rodents suggested an increased risk of additive disorders after bariatric surgery contrasting with a reduced risk with GLP-1RAs.</div></div><div><h3>Methods</h3><div>An extensive literature search to detect clinical studies that investigated the prevalence of addictive disorders (food addiction, alcohol abuse, smoking, cannabis, cocaine, opioid use) following bariatric surgery or GLP-1RA therapy in obese patients.</div></div><div><h3>Results</h3><div>In observational cohort studies, the prevalence of alcohol use disorder was twofold higher after &gt; 2 years following surgery (eleven studies, mainly with gastric bypass) whereas it was reduced roughly by half with GLP-1RA therapy (five studies, mainly with semaglutide). Similar findings were reported with other addictive disorders. An addiction transfer from food addiction to other addictive disorders is hypothesized to explain the increased risk after bariatric surgery. Several mechanisms are proposed to explain the favorable findings reported with GLP-1RAs, i.e. effects on the dopamine reward pathway, central GABA (gamma-aminobutyric acid) release, negative emotional stress associated with food/drug restriction and/or neuronal inflammation.</div></div><div><h3>Conclusion</h3><div>Available data from observational cohort studies confirm an increased risk of addictive disorders following bariatric surgery, contrasting with a reduced risk with GLP-1RA therapy. Both physicians and patients should be informed of the higher risk post-surgery whereas available promising results with GLP-1RAs should be confirmed in ongoing dedicated randomized controlled trials before any official indication.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101612"},"PeriodicalIF":4.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019160","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":"Epidemiology of major amputation following diabetic foot ulcer: Insights from recent nationwide data in the french national health registry (SNDS)","authors":"Jean-Baptiste Bonnet ,&nbsp;Claire Duflos ,&nbsp;Helena Huguet ,&nbsp;Antoine Avignon ,&nbsp;Ariane Sultan","doi":"10.1016/j.diabet.2025.101606","DOIUrl":"10.1016/j.diabet.2025.101606","url":null,"abstract":"<div><h3>Objective</h3><div>The out-of-hospital care pathways of people with DFU have been little studied. We used the French National Health Data System (SNDS) to collect refund and care pathway data for all French residents. The aim of this study was to determine the incidence of major lower limb amputation (MA) and associated risk factors in a population with an incident DFU.</div></div><div><h3>Research Design and Methods</h3><div>We included any person living with diabetes and incident DFU. The primary endpoint was the occurrence of MA within one year. We considered the course and consumption of care one year before and one year after the initial event.</div></div><div><h3>Results</h3><div>In 2018, 133,791 people were included, and during the follow-up, MA was performed in 4,733 (3.5 %). Among these people with MAs, 16.4 % were included via the out-of-hospital part of the protocol, and their first contact with the hospital led to MA. Factors associated (hazard ratio, HR [95 % confidence interval, CI]) with MA were: being male (1.92 [1.78;2.08]), arteriopathy of the lower limb (10.16 [9.36;11.03]), psychiatric disease (1.10 [1.01;1.20]) and end-stage renal disease (2.12 [1.93;2.33]).</div><div>Regarding the care pathway, associations (HR [95 %CI]) were observed between lower MA rates and people with more general practitioner (0.83 [0.75–0.91]), private nurse (0.88 [0.81–0.95]) and diabetologist (0.88 [0.81–0.95]) visits.</div><div>Living in the most disadvantaged municipalities was associated (HR [95 %CI]) with a higher MA rate (1.17[1.06–1.29]).</div></div><div><h3>Conclusion</h3><div>This is the first national study of the care pathways followed by people with DFU. Failures in the care pathway, precariousness and several comorbidities were identified, with an impact on the MA risk.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101606"},"PeriodicalIF":4.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}