Diabetes & metabolism最新文献

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Exploring perceived barriers to physical activity among individuals with type 1 diabetes in the era of new technologies: An analysis from the BETTER registry 探索新技术时代1型糖尿病患者身体活动的感知障碍:来自BETTER注册表的分析
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-07-06 DOI: 10.1016/j.diabet.2025.101677
C. Guédet , L. Alexandre-Heymann , J.E. Yardley , V. Messier , V. Boudreau , T. Chahal , M. Dostie , M-E. Mathieu , A-S. Brazeau , S. Tagougui , R. Rabasa-Lhoret
{"title":"Exploring perceived barriers to physical activity among individuals with type 1 diabetes in the era of new technologies: An analysis from the BETTER registry","authors":"C. Guédet ,&nbsp;L. Alexandre-Heymann ,&nbsp;J.E. Yardley ,&nbsp;V. Messier ,&nbsp;V. Boudreau ,&nbsp;T. Chahal ,&nbsp;M. Dostie ,&nbsp;M-E. Mathieu ,&nbsp;A-S. Brazeau ,&nbsp;S. Tagougui ,&nbsp;R. Rabasa-Lhoret","doi":"10.1016/j.diabet.2025.101677","DOIUrl":"10.1016/j.diabet.2025.101677","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to identify barriers to physical activity for people living with type 1 diabetes (PwT1D) and their relationship with sociodemographic and disease-specific factors.</div></div><div><h3>Methods</h3><div><em>-</em> Cross-sectional study with BETTER registry participants (&gt;14 years) who completed the BAPAD1 (Barriers to Physical Activity in T1D) questionnaire. An item with a score of 5 or more was defined as a barrier. Participants were categorized into 4 subgroups based on their insulin therapy and blood glucose monitoring modality: 1) multiple daily injections (MDI) without continuous glucose monitoring (CGM), 2) MDI with CGM, 3) continuous subcutaneous insulin infusion (CSII) with CGM, and 4) automated insulin delivery system (AID).</div></div><div><h3>Results</h3><div>Among 1117 participants, the main perceived barrier was fear of hypoglycemia. BAPAD1 scores were similar across all subgroups, but more individuals in the AID group perceived \"fear of hypoglycemia\" and \"loss of control over diabetes\" as barriers. Being female, having a low income or education level, being overweight or obese, taking medication for depression, younger diabetes, higher HbA1c, presence of microvascular complications, and lack of confidence in managing hypoglycemia were associated with higher BAPAD1 score.</div></div><div><h3>Conclusion</h3><div>Fear of hypoglycemia remains the main barrier to physical activity for PwT1D. Technological advances alone are not sufficient to reduce perceived barriers to physical activity, highlighting the need for complementary educational and behavioral interventions.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101677"},"PeriodicalIF":4.6,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593307","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}
引用次数: 0
Association between continuous glucose monitoring metrics and metabolic dysfunction-associated steatotic liver disease in adults with type 1 diabetes undergoing vibration-controlled transient elastography: a multicenter cross-sectional study 在接受振动控制的瞬时弹性成像的成人1型糖尿病患者中,连续血糖监测指标与代谢功能障碍相关的脂肪变性肝病之间的关系:一项多中心横断面研究
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-07-05 DOI: 10.1016/j.diabet.2025.101684
Alessandro Mantovani , Stefano Ciardullo , Elena Sani , Alessandro Csermely , Emigela Shtembari , Ilaria Milani , Paolo Sbraccia , Gianluca Perseghin , Frida Leonetti , Giovanni Targher , Valeria Guglielmi , Danila Capoccia
{"title":"Association between continuous glucose monitoring metrics and metabolic dysfunction-associated steatotic liver disease in adults with type 1 diabetes undergoing vibration-controlled transient elastography: a multicenter cross-sectional study","authors":"Alessandro Mantovani ,&nbsp;Stefano Ciardullo ,&nbsp;Elena Sani ,&nbsp;Alessandro Csermely ,&nbsp;Emigela Shtembari ,&nbsp;Ilaria Milani ,&nbsp;Paolo Sbraccia ,&nbsp;Gianluca Perseghin ,&nbsp;Frida Leonetti ,&nbsp;Giovanni Targher ,&nbsp;Valeria Guglielmi ,&nbsp;Danila Capoccia","doi":"10.1016/j.diabet.2025.101684","DOIUrl":"10.1016/j.diabet.2025.101684","url":null,"abstract":"<div><h3>Background</h3><div>There is uncertainty regarding the association between continuous glucose monitoring (CGM), derived glycemic metrics, and metabolic dysfunction-associated steatotic liver disease (MASLD) in individuals with type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>We consecutively enrolled 262 adult individuals with established T1D undergoing vibration-controlled transient elastography (VCTE) with liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). All participants underwent CGM. MASLD was defined as CAP ≥248 dB/m and the presence of at least one cardiometabolic risk factor. Significant liver fibrosis was defined as LSM ≥8 kPa.</div></div><div><h3>Results</h3><div>Participants had a mean age of 54±13 years, a mean body mass index (BMI) of 25.8 ± 5.6 kg/m<sup>2</sup> and a mean HbA1c of 7.7 ± 1.4 %. The prevalence of MASLD and significant liver fibrosis was 35.1 % (<em>n</em> = 92) and 4.6 % (<em>n</em> = 12), respectively. Using quantile regression analysis, time above range 180–250 mg/dl (TAR1) was significantly associated with increased CAP values (coefficient: 1.037; 95 % confidence interval [0.216;1.858]; <em>P</em> = 0.013). This association remained significant even after adjusting for age, sex, BMI, HbA1c, and total daily insulin dose. Other variables independently associated with CAP were older age, male sex, BMI, and total daily insulin dose. Using a random forest regression model, BMI was found to be the most important factor, followed by age, total daily insulin dose, and TAR1.</div></div><div><h3>Conclusions</h3><div>TAR1 was independently associated with increased CAP values, even after adjustment for age, BMI, sex, HbA1c, and total daily insulin dose, suggesting a potential role for glycemic variability in hepatic fat accumulation in adults with T1D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101684"},"PeriodicalIF":4.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581419","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}
引用次数: 0
Post-translational modifications of apolipoproteins as promising biomarkers for diabetes-related cardiovascular diseases: A comprehensive review 载脂蛋白翻译后修饰作为糖尿病相关心血管疾病有前景的生物标志物:综述
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-07-05 DOI: 10.1016/j.diabet.2025.101683
Chloé Chevalier , Arsênio Rodrigues Oliveira , Valentin Blanchard , Cédric Le May , Bertrand Cariou , Samy Hadjadj , Mikaël Croyal
{"title":"Post-translational modifications of apolipoproteins as promising biomarkers for diabetes-related cardiovascular diseases: A comprehensive review","authors":"Chloé Chevalier ,&nbsp;Arsênio Rodrigues Oliveira ,&nbsp;Valentin Blanchard ,&nbsp;Cédric Le May ,&nbsp;Bertrand Cariou ,&nbsp;Samy Hadjadj ,&nbsp;Mikaël Croyal","doi":"10.1016/j.diabet.2025.101683","DOIUrl":"10.1016/j.diabet.2025.101683","url":null,"abstract":"<div><div>Lipoproteins are biochemical complexes of apolipoproteins and lipids that primarily mediate the transport of lipids through the circulation, from sites of absorption or synthesis to those of use, storage, or excretion. In type 2 diabetes (T2D), disruptions in lipoprotein metabolism are key drivers of complications and strongly contribute to atherosclerotic cardiovascular disease (ASCVD). As a result, ASCVD remains the leading cause of death in T2D, with significantly higher prevalence than in non-diabetic individuals. Protein post-translational modifications (PTMs) have emerged as key contributors to organ failure mechanisms, with specific PTMs closely linked to the pathogenesis of T2D. Several reports also emphasized the value of plasma apolipoproteins for the early prediction of ASCVD in cardiometabolic diseases. Thus, apolipoproteins, and especially their structurally post-translational modified forms, offer new insights into the molecular mechanisms of lipoprotein dysfunction and may enhance the specificity of ASCVD risk stratification in T2D. This review outlines major apolipoprotein PTMs identified in T2D, many of which can now be quantified in biological samples, particularly via mass spectrometry. We also discuss their role in lipoprotein metabolism dysfunction and their potential value in assessing ASCVD risk in T2D, highlighting their growing potential as clinical biomarkers in population-based cohort studies.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101683"},"PeriodicalIF":4.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586054","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}
引用次数: 0
GLP-1 receptor agonists, body composition, skeletal muscle and risk of sarcopaenia: from promising findings in animal models to debated concern in human studies GLP-1受体激动剂,身体成分,骨骼肌和肌少症的风险:从动物模型的有希望的发现到人类研究中有争议的问题
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-06-24 DOI: 10.1016/j.diabet.2025.101681
André J. Scheen
{"title":"GLP-1 receptor agonists, body composition, skeletal muscle and risk of sarcopaenia: from promising findings in animal models to debated concern in human studies","authors":"André J. Scheen","doi":"10.1016/j.diabet.2025.101681","DOIUrl":"10.1016/j.diabet.2025.101681","url":null,"abstract":"<div><div>Background. - Glucagon-like peptide-1 (GLP-1)-based therapies induce a clinically relevant weight loss, which is associated with overall better prognosis in people with type 2 diabetes and/or clinical obesity. However, a risk of excessive reduction in fat-free mass (FFM) and skeletal muscle mass (SSM), potentially leading to sarcopaenia in at-risk patients, is currently a matter of debate as this negative effect could minimize their benefit/risk balance. <em>Methods.</em> - An extensive literature search to detect animal and human studies that investigated the effects of GLP-1-based therapies on changes in body composition (FFM and SMM), muscle strength, structure, and function. <em>Results.</em> - Favourable effects on SMM, intramuscular lipid deposition, inflammation and mitochondrial health were consistently reported in different rodent models with GLP-based therapies. However, mixed results were reported in human studies, some reported an excessive FFM/SMM loss while others arguing for a protective effect against sarcopaenia (including less myosteatosis). This controversy may result from misinterpretation of SMM derived from FFM changes and a lack of studies that properly investigate SMM, muscle function and structure in humans. <em>Conclusion</em>. - Maximizing fat loss while preserving lean (muscle) tissue mass and function is a central goal of modern obesity pharmacological treatments. Currently, available data preclude to have a definite conclusion about positive/negative effects of GLP-1-based therapies on muscle. Further investigations using accurate methodologies to assess not only SMM but also muscle structure, function (strength) and performance are needed to better analyse the effects of GLP-1-based therapies, especially among individuals at higher risk of sarcopaenia, older patients and frail people.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101681"},"PeriodicalIF":4.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502045","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}
引用次数: 0
Prediction of cardiovascular events by skin auto-fluorescence: the DIABAGE follow-up study 皮肤自身荧光预测心血管事件:DIABAGE随访研究
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-06-23 DOI: 10.1016/j.diabet.2025.101682
Jorys Bueno , Alpha M. Diallo , Stéphane Jaisson , Jenny Fontaine , Céline Lukas , Romain Barriquand , Géraldine Vitellius , Philippe Gillery , Brigitte Delemer , Sara Barraud
{"title":"Prediction of cardiovascular events by skin auto-fluorescence: the DIABAGE follow-up study","authors":"Jorys Bueno ,&nbsp;Alpha M. Diallo ,&nbsp;Stéphane Jaisson ,&nbsp;Jenny Fontaine ,&nbsp;Céline Lukas ,&nbsp;Romain Barriquand ,&nbsp;Géraldine Vitellius ,&nbsp;Philippe Gillery ,&nbsp;Brigitte Delemer ,&nbsp;Sara Barraud","doi":"10.1016/j.diabet.2025.101682","DOIUrl":"10.1016/j.diabet.2025.101682","url":null,"abstract":"<div><h3>Aim</h3><div>Advanced glycation end-products (AGEs) are known to play a role in the pathophysiology of type 1 diabetes (T1D) complications. The aim of this study was to assess the predictive value of AGEs indirectly evaluated by skin auto-fluorescence (SAF) on the occurrence of cardiovascular events (CVEs) in T1D.</div></div><div><h3>Methods</h3><div>We measured baseline SAF in T1D patients with at least 10 years history of diabetes and assessed incident CVEs. An optimum threshold of SAF was determined using ROC curve, and its predictive value was assessed by Cox proportional regression.</div></div><div><h3>Results</h3><div>The study included 179 patients, 53 % of whom were women. At baseline, the mean age was 47.7 ± 15.9 years, the mean duration of diabetes was 26.4 ± 12.2 years. Median HbA<sub>1c</sub> was 7.7 % (7.3–8.7) and median LDL cholesterol was 2.58 mmol/l (2.14–3.07). Median follow-up was 7.4 years (6.85 - 7.7) with 34 CVEs in 24 patients.</div><div>The median SAF level was 2.7 (2.3–3.1) in patients with incident CVEs and 2.1 (1.8–2.6) in patients without CVEs. The optimum threshold of SAF to differentiate patients with or without incident CVEs was 2.2. The occurrence of CVE was predicted by the optimum SAF threshold in the unadjusted model (HR 6.46), but also after adjustment with different models (HR 3.15–5.05).</div></div><div><h3>Conclusion</h3><div>SAF level is higher in people living with T1D who will present CVEs. Furthermore, SAF threshold of 2.2 predicted the occurrence of CVE. If these results are confirmed, SAF could be a useful marker in cardiovascular risk stratification in T1D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101682"},"PeriodicalIF":4.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500028","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}
引用次数: 0
The impact of chiglitazar, a pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes: a real-world study chiglitazar(一种泛ppar激动剂)对2型糖尿病患者代谢功能障碍相关脂肪变性肝病的影响:一项现实世界研究
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-06-21 DOI: 10.1016/j.diabet.2025.101680
Yijiong Tan , Wenjun Qu , Jiehua Zhao , Yunqin Ma , Qidi Zhang , Hong Gao , Qin Zhen , Yufan Wang , Yongde Peng , Fang Liu , Nengguang Fan
{"title":"The impact of chiglitazar, a pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes: a real-world study","authors":"Yijiong Tan ,&nbsp;Wenjun Qu ,&nbsp;Jiehua Zhao ,&nbsp;Yunqin Ma ,&nbsp;Qidi Zhang ,&nbsp;Hong Gao ,&nbsp;Qin Zhen ,&nbsp;Yufan Wang ,&nbsp;Yongde Peng ,&nbsp;Fang Liu ,&nbsp;Nengguang Fan","doi":"10.1016/j.diabet.2025.101680","DOIUrl":"10.1016/j.diabet.2025.101680","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the efficacy of chiglitazar, a novel pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes (T2D) in a real-world clinical setting.</div></div><div><h3>Materials and methods</h3><div>This prospective cohort study included T2D patients with MASLD who received either chiglitazar or other glucose-lowering medications over a 24-week period. To minimize selection bias, 1:1 propensity score matching (PSM) was implemented. The primary outcomes were changes in controlled attenuation parameter (CAP, measuring hepatic steatosis) and liver stiffness measurement (LSM, assessing fibrosis). Secondary outcomes included glycemic parameters and liver enzymes.</div></div><div><h3>Results</h3><div>A total of 235 T2D patients were enrolled (40 chiglitazar users, 195 non-chiglitazar users), and 31 matched pairs were derived after 1:1 PSM. The adjusted mean reduction in CAP from baseline to 24 weeks was significantly greater in the chiglitazar group (-28.38 dB/m [95 % CI:36.11;-20.65]) compared to the non-chiglitazar group (-16.74 dB/m [-24.47;-9.01]), with a between-group difference of -11.64 dB/m (-22.38;-0.90, <em>P</em> = 0.038). LSM changes were similar between groups (difference in LS mean:0.11 [-1.04;0.82], <em>P</em> = 0.813). Subgroup analyses indicated that the beneficial effect of chiglitazar was consistent across variables such as sex, age, body mass index, and concomitant use of SGLT-2 inhibitors or GLP-1 receptor agonists (all <em>P</em> for interaction &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Chiglitazar administration is associated with a significant reduction in CAP values in T2D patients with MASLD, suggesting its potential as a dual therapeutic approach for both conditions.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101680"},"PeriodicalIF":4.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370031","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}
引用次数: 0
Effect of dietary reinforcement combined or not with GLP-1 receptor agonist therapy on histological outcomes in MASLD among patients with type 2 diabetes 膳食强化联合或不联合GLP-1受体激动剂治疗对2型糖尿病MASLD患者组织学结局的影响
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-06-19 DOI: 10.1016/j.diabet.2025.101679
Bruno Guerci , Michael Joubert , Ghassan Riachi , Marie-Lauren Antoine , Delphine Clabaut , Renaud Fay , Gaetan Prevost
{"title":"Effect of dietary reinforcement combined or not with GLP-1 receptor agonist therapy on histological outcomes in MASLD among patients with type 2 diabetes","authors":"Bruno Guerci ,&nbsp;Michael Joubert ,&nbsp;Ghassan Riachi ,&nbsp;Marie-Lauren Antoine ,&nbsp;Delphine Clabaut ,&nbsp;Renaud Fay ,&nbsp;Gaetan Prevost","doi":"10.1016/j.diabet.2025.101679","DOIUrl":"10.1016/j.diabet.2025.101679","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101679"},"PeriodicalIF":4.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340737","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}
引用次数: 0
Mitochondrial heteroplasmy-phenotype correlation and response to glucose lowering therapy in subjects with m.3243A>G mutations m.3243A > G突变受试者的线粒体异质性-表型相关性和对降糖治疗的反应
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-06-18 DOI: 10.1016/j.diabet.2025.101678
N Ng , B Sanchez-Lechuga , CJ McCarrick , C Mangan , M Burke , J.A. Ioana , C Gavin , R O’Byrne , JJ O’Byrne , MM Byrne
{"title":"Mitochondrial heteroplasmy-phenotype correlation and response to glucose lowering therapy in subjects with m.3243A>G mutations","authors":"N Ng ,&nbsp;B Sanchez-Lechuga ,&nbsp;CJ McCarrick ,&nbsp;C Mangan ,&nbsp;M Burke ,&nbsp;J.A. Ioana ,&nbsp;C Gavin ,&nbsp;R O’Byrne ,&nbsp;JJ O’Byrne ,&nbsp;MM Byrne","doi":"10.1016/j.diabet.2025.101678","DOIUrl":"10.1016/j.diabet.2025.101678","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a paucity of evidence to guide pharmacological treatment for mitochondrial diabetes. Metformin is generally contraindicated due to the high risk of lactic acidosis, Sulphonylurea (SU) therapy has been used as 1st line therapy but most progress to insulin. The aim of this study is to investigate the glucose-insulin secretory response to oral glucose, the response to glucose lowering therapy, and the heteroplasmy phenotype correlation in subjects with a confirmed m.3243A&gt;G mutation.</div></div><div><h3>Methods</h3><div>49 subjects were phenotyped in detail. A 2 hr OGTT was performed to establish insulin-secretory response. Heteroplasmy was measured and they had bi-annual clinical follow-up.</div></div><div><h3>Results</h3><div>34 of 49 m.3243A&gt;G subjects had diabetes mellitus (DM) with an onset at 38 (31–44) years, 7 had impaired glucose tolerance or impaired fasting glucose, and 8 had normal glucose tolerance (NGT). DM subjects had reduced insulin secretion (AUC C-peptide 2009.0[1710.0–3156.0] vs. 4693.75[3768.25–5609.38] pmol/l/120 min, <em>P</em> = 0.002) and insulin sensitivity (OGIS 283.0[209.0–324.0] vs. 437.0 [416.0–524.0]ml min<sup>−1</sup>m<sup>−2</sup>, <em>P</em> &lt; 0.001]) compared to NGT subjects. Heteroplasmy was higher in DM subjects compared to NGT (20[11–26] vs. 6[5–10] %, <em>P</em> = 0.014). 5 of 8 subjects on metformin had raised lactate and 65 % of subjects required insulin to improve glycaemic control. Only 1/6 subjects transitioned from insulin to SU. Two subjects on SGLT2i and GLP-1 agonists progressed to insulin.</div></div><div><h3>Conclusion</h3><div>β-cell dysfunction and insulin resistance contribute to mitochondrial diabetes development. 65 % of subjects required insulin to improve glycaemic control. Early insulin initiation may be necessary to improve glycaemic control in the long term.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101678"},"PeriodicalIF":4.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337326","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}
引用次数: 0
The significance of ophthalmological evaluation in the correct diagnosis of pediatric insulin-dependent diabetes mellitus: lessons from novel WFS1 variants 眼科评估在小儿胰岛素依赖型糖尿病正确诊断中的意义:来自新型WFS1变异的经验教训。
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-06-15 DOI: 10.1016/j.diabet.2025.101676
Eleni Papageorgiou , Panagiotis N. Toumasis , Aspasia Tsezou , Emmanouil Manolakos , Georgia Gazeti , Efthimios Dardiotis , Eleni Arnaoutoglou , Aggeliki Alagianni , Argyro Petsiti , Polyxeni Stamati , Zisis Tsouris , Aspasia Michoula , Sofia Androudi , Ioanna Grivea , Dimitrios T. Papadimitriou
{"title":"The significance of ophthalmological evaluation in the correct diagnosis of pediatric insulin-dependent diabetes mellitus: lessons from novel WFS1 variants","authors":"Eleni Papageorgiou ,&nbsp;Panagiotis N. Toumasis ,&nbsp;Aspasia Tsezou ,&nbsp;Emmanouil Manolakos ,&nbsp;Georgia Gazeti ,&nbsp;Efthimios Dardiotis ,&nbsp;Eleni Arnaoutoglou ,&nbsp;Aggeliki Alagianni ,&nbsp;Argyro Petsiti ,&nbsp;Polyxeni Stamati ,&nbsp;Zisis Tsouris ,&nbsp;Aspasia Michoula ,&nbsp;Sofia Androudi ,&nbsp;Ioanna Grivea ,&nbsp;Dimitrios T. Papadimitriou","doi":"10.1016/j.diabet.2025.101676","DOIUrl":"10.1016/j.diabet.2025.101676","url":null,"abstract":"<div><div>Wolfram syndrome 1 is an autosomal recessive disorder often commencing as insulin dependent diabetes, but with inherent progressive ultimately fatal neurodegeneration. We report two pediatric cases, referred as unregulated insulin dependent diabetes mellitus, initially misdiagnosed as type 1 diabetes, in whom whole exome sequencing confirmed the clinical diagnosis of Wolfram syndrome with novel Wolfram syndrome gene 1 variants. An 11-year-old Asian male refugee with presumed type 1 diabetes since the age of 6 years, acknowledged progressive visual decline the last 6 months, but only after ophthalmological evaluation revealing bilateral optic atrophy, confirmed by optical coherence tomography and retinal nerve fiber layer thinning, leading to genetic testing and revealing a novel homozygous missense variant (c.1598C&gt;<em>T</em>, p.Pro533Leu). A 15-year-old male with severely progressive autism spectrum disorder since the age of 3 years, and poorly regulated presumed type 1 diabetes since the age of 9 years, had signs of a progressive neurodegenerative disorder at presentation. Bilateral optic nerve pallor and sensorineural hearing loss were documented. Genetic testing revealed the pathogenic Wolfram syndrome gene 1 variant c.1523_1524delTA; p.Tyr508CysfsTer34 (frameshift deletion) in trans with the previously undescribed missense variant c.497T&amp;gt;C; p.Leu166Pro, reclassified now as likely pathogenic. Both cases highlight the importance of ophthalmological evaluation in the early diagnostic workup of pediatric insulin dependent diabetes when autoimmunity is not confirmed. Although not mandated by current guidelines, early ophthalmologic assessment, at least in insulin dependent diabetes with non-previously established autoimmunity, can enable timely diagnosis of Wolfram syndrome, enabling prompt multidisciplinary intervention and potential enrollment in emerging disease-modifying therapies.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101676"},"PeriodicalIF":4.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319118","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}
引用次数: 0
Can diabetic peripheral neuropathy predict lacunar stroke in patients with diabetes? 糖尿病周围神经病变能否预测糖尿病患者的腔隙性卒中?
IF 4.6 2区 医学
Diabetes & metabolism Pub Date : 2025-06-09 DOI: 10.1016/j.diabet.2025.101675
Nathalie Deschamps , Nadia Sabbah , Amina Nasri , Michel Haba , Mathieu Nacher , Bertrand De Toffol
{"title":"Can diabetic peripheral neuropathy predict lacunar stroke in patients with diabetes?","authors":"Nathalie Deschamps ,&nbsp;Nadia Sabbah ,&nbsp;Amina Nasri ,&nbsp;Michel Haba ,&nbsp;Mathieu Nacher ,&nbsp;Bertrand De Toffol","doi":"10.1016/j.diabet.2025.101675","DOIUrl":"10.1016/j.diabet.2025.101675","url":null,"abstract":"<div><div>Stroke is the leading-cause of death in women and motor-disability in adults. In patients with diabetes, diabetic peripheral neuropathy (DPN) increases the risk of ischemic stroke. The aim of this work was to test the hypothesis that an etiological pattern of ischemic stroke in patients with DPN can be recognized. This was a single-center retrospective observational study of patients hospitalized in Cayenne general-hospital with ischemic stroke. The primary endpoint was to determine if there is an association between the mechanism of stroke and the presence of DPN. We included 226 patients: mean age 64.14 ± 15.2 years; male predominance (62.4 %); and 5.8 % with DPN, i.e., 14.9 % of patients with diabetes. DPN was significantly associated with small-vessel disease (SVD): adjusted odds ratio=5.08 [1.17;22.14]. These findings highlight a common pathophysiology between DPN and SVD. DPN can provide a window of opportunity to detect SVD and prevent its complications like stroke or dementia.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101675"},"PeriodicalIF":4.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277282","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}
引用次数: 0
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