Diabetes & metabolism最新文献

{"title":"Glucagon-like peptide-1 receptor agonists and acute pancreatitis","authors":"Kuan-Fu Liao , Shih-Wei Lai","doi":"10.1016/j.diabet.2025.101666","DOIUrl":"10.1016/j.diabet.2025.101666","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101666"},"PeriodicalIF":4.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153184","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":"What the diabetologist needs to know about the risk of non-arteritic anterior ischaemic optic neuropathy and GLP-1 receptor agonist use in patients with type 2 diabetes","authors":"Sylvie Feldman-Billard","doi":"10.1016/j.diabet.2025.101664","DOIUrl":"10.1016/j.diabet.2025.101664","url":null,"abstract":"<div><h3>Aim</h3><div>Recent findings have raised concern about a potential association between semaglutide use and non-arteritic anterior ischaemic optic neuropathy (NAION), a rare form of permanent vision loss. This report provides a critical analysis of the current knowledge of GLP-1 receptor agonist (RA) use and risk of NAION in patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>A literature search strategy was conducted for all English-language literature with a systematic review of key references up to April 2025.</div></div><div><h3>Results</h3><div>Across studies including patients with T2D, the relative increase in NAION risk associated with the use of a GLP-1 RA, mainly semaglutide, ranged from nonsignificant to fourfold, while the absolute number of affected patients remained low. Given the retrospective design of the main studies, no causal link could be established between the use of GLP-1RAs and NAION. Some mechanistic hypotheses have been put forward without any being formally demonstrated to date. The profound metabolic and haemodynamic changes induced by GLP-1RAs might be the trigger of NAION in predisposed patients with an optic “disc-at-risk”, a potent anatomical risk factor easily detected by ocular examination.</div></div><div><h3>Conclusion</h3><div>Pending studies clarifying this risk, these findings call for cautious use of GLP-1 RAs, particularly in patients with ocular risk factors. Given the widespread use of GLP-1RAs, clinicians should be aware of this potential risk, without overshadowing the remarkable benefit of GLP-1RAs in patients with type 2 diabetes.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101664"},"PeriodicalIF":4.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096646","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":"SGLT2 inhibitor, GLP-1 receptor agonist, and dementia risk","authors":"Shih-Wei Lai","doi":"10.1016/j.diabet.2025.101663","DOIUrl":"10.1016/j.diabet.2025.101663","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101663"},"PeriodicalIF":4.6,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016200","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":"Global Burden of type 2 diabetes in non-elderly individuals 1990 to 2021 and projections for 2050: a systematic analysis of the 2021 Global Burden of Disease","authors":"Qian He ,&nbsp;Wenjing Wu ,&nbsp;Junnian Chen ,&nbsp;Haofeng Zhou ,&nbsp;Gangyu Ding ,&nbsp;Shuiqing Lai ,&nbsp;AndyY.T. Kuo ,&nbsp;Heng Wan ,&nbsp;Beisi Lin ,&nbsp;Hongjiang Wu ,&nbsp;AliceP.S. Kong ,&nbsp;Haixia Guan ,&nbsp;Huanyi Cao","doi":"10.1016/j.diabet.2025.101660","DOIUrl":"10.1016/j.diabet.2025.101660","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes (T2D) is increasingly becoming a major global health challenge. However, research on T2D in non-elderly populations remains insufficient.</div></div><div><h3>Methods</h3><div>We analyzed data from the Global Burden of Disease (GBD) study in 2021, focusing on diabetes-related indicators among individuals aged 15 to 59 across 204 countries and regions. This included prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs), categorized into 21 GBD regions according to the Sociodemographic Index (SDI). We employed join-point regression and Bayesian Age-Period-Cohort models to assess trends from 1990 to 2021 and forecast from 2021 to 2050.</div></div><div><h3>Results</h3><div>The global age-standardized incidence rate increased from 196.3 per 100,000 (95 % UI, 145.2–257.4) in 1990 to 361.1 per 100,000 (95 % UI, 275.2–458.4) in 2021. The prevalence, mortality rate, and DALYs exhibit a similar upward trend. Although both men and women have experienced rises in prevalence, incidence, mortality rate, and DALYs, men continue to lead these metrics across nearly all age groups. Low-middle SDI countries bear the most severe disease burden. A high body mass index is a major risk factor in this population. It is estimated that by 2050, approximately 1.195 billion non-elderly individuals worldwide will have T2D, with epidemiological changes being the primary driver of this disease burden.</div></div><div><h3>Conclusions</h3><div>This study on the burden of T2D reveals that its prevalence among non-elderly individuals is steadily increasing and is projected to affect over a billion people worldwide by 2050. Targeted measures are crucial to tackle this global health challenge for this population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101660"},"PeriodicalIF":4.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016564","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":"Diabetes prevalence, awareness, and control in the United States, 2017-2023","authors":"Jessica L Harding ,&nbsp;Chengcheng Hu ,&nbsp;Jithin Sam Varghese ,&nbsp;Rodrigo M Carrillo-Larco ,&nbsp;Mohammed K Ali","doi":"10.1016/j.diabet.2025.101659","DOIUrl":"10.1016/j.diabet.2025.101659","url":null,"abstract":"<div><h3>Introduction</h3><div>We compared diabetes prevalence, awareness, and control pre versus post the Covid-19 pandemic.</div></div><div><h3>Methods</h3><div>This was a cross-sectional analysis of the U.S. National Health and Nutrition Examination Surveys pre (2017–2020) and post (2021–2023) the pandemic. We included all non-pregnant adults (aged ≥ 20 years) who had undergone biomedical testing. Diagnosed and undiagnosed diabetes was defined as self-reported diabetes and no self-reported diabetes with HbA1c &gt;6.5 % or fasting plasma glucose ≥126 mg/dL, respectively. Among diagnosed diabetes, we estimated proportions achieving glycemic (HbA1c &lt; 7.0 %), blood pressure (&lt; 130/80 mmHg), and cholesterol control (non-high-density lipoprotein &lt; 130mg/dl), and use of blood pressure and lipid lowering medications.</div></div><div><h3>Results</h3><div>The prevalence of total diabetes, diagnosed diabetes, undiagnosed diabetes, and proportion of diabetes that was undiagnosed remained stable between pre and post pandemic periods: from 16.2 % [95 %CI: 14.3–18.1] to 15.8 % [13.7–17.9], from 11.7 % [10.1–13.2] to 11.3 % [9.4–13.2], from 4.6 % [3.8–5.3]) to 4.5 % [3.4–5.6]), and from 28.1 % [24.3–31.8] to 28.4 % [21.9–35.0], respectively. Among those with diagnosed diabetes, glycemia, blood pressure, lipid control, and use of blood pressure or lipid medication did not significantly change.</div></div><div><h3>Conclusions</h3><div>Between 2017–2020 and 2021–2023, there were no significant changes in diabetes prevalence, awareness, and control in the U.S. population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101659"},"PeriodicalIF":4.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942475","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":"Glucose management indicator: Do we need device-specific equations?","authors":"Tamás Jávorfi ,&nbsp;Győző Kocsis ,&nbsp;Márk M. Svébis ,&nbsp;Viktória Ferencz ,&nbsp;Beatrix A. Domján ,&nbsp;Árpád Kézdi ,&nbsp;Hanna Hankó ,&nbsp;Zsuzsanna Putz ,&nbsp;Ádám G. Tabák","doi":"10.1016/j.diabet.2025.101661","DOIUrl":"10.1016/j.diabet.2025.101661","url":null,"abstract":"<div><h3>Aim</h3><div>Glucose management indicator (GMI) may not perform equally well for different continuous glucose monitoring (CGM) systems. Thus, we aimed to develop device-specific GMI for the Guardian 3 and 4 sensors, compare them to the original GMI, and investigate the association between the glycaemic gap (=HbA1c-GMI) and HbA1c.</div></div><div><h3>Methods</h3><div>In a single-centre, observational study of adult type 1 diabetes patients using Guardian Sensor 3 (G3) and 4 (G4) CGM devices, we estimated HbA1c using CGM-derived mean glucose for both CGMs using linear mixed models. We compared the estimates and their residuals (G3-gap and G4-gap) to the original GMI and its residuals (Bergenstal-gap) using regression and Bland-Altman plots.</div></div><div><h3>Results</h3><div>We included 120 adult type 1 diabetes patients (90 with G3 and 30 with G4) and 194 measurement points. We found that for G3 and G4 sensors, GMI significantly underestimated glycaemia in high HbA1c ranges, reaching the clinically significant 0.5 %[4.4 mmol/mol] difference at 7.6 % [60 mmol/mol] for G3 and 8.3 % [67 mmol/mol] for G4 sensors. For G4, GMI significantly overestimated glycaemia in the lower HbA1c range. We found a strong relationship between all 3 gaps and HbA1c, and the slope was steeper for the Bergenstal-gap versus the sensor-specific G3 and G4 gaps. The G3-gap was approximately half as large as the Bergenstal-gap for HbA1c &gt; 7 % [53 mmol/mol], and the G4-gap is approximately half of the Bergenstal-gap for the whole HbA1c range.</div></div><div><h3>Conclusion</h3><div>Device-specific GMI equations could reduce the risk of clinically significant under- and overestimation of HbA1c, improving clinical decision-making.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101661"},"PeriodicalIF":4.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060262","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":"Methylamine metabolites and progression to kidney failure in type 2 diabetes: An Asian and European prospective study","authors":"Pierre-Jean Saulnier ,&nbsp;Jian-Jun Liu ,&nbsp;Mikael Croyal ,&nbsp;Joe de Keizer ,&nbsp;Jiexun Wang ,&nbsp;Huili Zheng ,&nbsp;Robert G. Nelson ,&nbsp;Stéphanie Ragot ,&nbsp;Sylvia Liu ,&nbsp;Jean-Michel Halimi ,&nbsp;Bertrand Cariou ,&nbsp;Su Chi Lim ,&nbsp;Samy Hadjadj ,&nbsp;Singapore KTPH-DKD study group,&nbsp;France SURDIAGENE study group","doi":"10.1016/j.diabet.2025.101658","DOIUrl":"10.1016/j.diabet.2025.101658","url":null,"abstract":"<div><h3>Aim</h3><div>Unlike trimethylamine N-oxide (TMAO), the role of methylamine pathway metabolites in diabetic kidney disease (DKD) remains unclear. We investigated the association of circulating methylamines with progression of DKD in a prospective cohort study of patients with type 2 diabetes of two different ethnic backgrounds.</div></div><div><h3>Methods</h3><div>We analyzed two independent cohorts: a European-origin cohort (SURDIAGENE France; n = 1,357) and an Asian-origin cohort (Khoo Teck Puat Hospital-DKD [KTPH-DKD] Singapore, n = 1,868). The primary composite renal outcome in SURDIAGENE was sustained doubling of serum creatinine or kidney failure with replacement therapy (KFRT), while the secondary outcome was 40% renal function loss (RFL40). In KTPH-DKD, KFRT was the primary outcome. Baseline betaine, carnitine, choline, trimethylamine and TMAO concentrations were measured in plasma by mass-spectrometry. Cox regression models were used to estimate the risk of DKD progression, adjusting for demographics, clinical parameters, and comorbidities.</div></div><div><h3>Results</h3><div>Over a median follow-up of 7.1 years (IQR 4.5-10.7), we registered 75 composite renal outcomes in SURDIAGENE and over 10.7 years (IQR 7.0-11.8), 149 KFRT in KTPH-DKD. Choline was the only consistently associated with progression of DKD in both cohorts: HR [95%CI] per 1 SD = 1.29 [1.02;1.62], <em>P</em> = 0.033 for composite renal outcome, 1.11 [1.01;1.23], <em>P</em> = 0.028 for RFL40 in SURDIAGENE, and 1.84 [1.30;2.61], <em>P</em> &lt; 0.001 for KFRT in KTPH-DKD.</div></div><div><h3>Conclusion</h3><div>Plasma choline is an independent risk factor for DKD progression in two independent type 2 diabetes populations. Interventional trials are needed to assess whether reducing dietary choline intake could mitigate severe renal outcomes in type 2 diabetes.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101658"},"PeriodicalIF":4.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996871","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":"Musculoskeletal disorders in type 1 diabetes: Clinical phenotyping and associations with quality of life and glucose control - The French SFDT1 cohort study","authors":"Noémie Topalian ,&nbsp;Sylvie Picard ,&nbsp;Jean-Pierre Riveline ,&nbsp;Dulce Canha ,&nbsp;Jean-Baptiste Julla ,&nbsp;Sandrine Lablanche ,&nbsp;Laurence Salle ,&nbsp;Emmanuel Sonnet ,&nbsp;Aurélie Berot ,&nbsp;Didier Gouet ,&nbsp;Kalliopi Bilariki ,&nbsp;Chloé Amouyal ,&nbsp;Lucien Marchand ,&nbsp;Sophie Borot ,&nbsp;Nicolas Chevalier ,&nbsp;Isabela Banu ,&nbsp;Emmanuelle Sokol ,&nbsp;Emmanuel Cosson ,&nbsp;Guy Fagherazzi ,&nbsp;Gloria Aguayo","doi":"10.1016/j.diabet.2025.101647","DOIUrl":"10.1016/j.diabet.2025.101647","url":null,"abstract":"<div><h3>Background</h3><div>Musculoskeletal disorders (MSDs) are common, but overlooked, complications of type 1 diabetes mellitus (T1DM). This study aims to describe MSD phenotypes (clinical, lifestyle, socio-economic) in adults with T1DM.</div></div><div><h3>Methods</h3><div>We analyzed adult participants in the SFDT1 cohort study. We assessed the following MSDs: stress fractures, non-traumatic upper-limb disorders, and entrapment syndromes. We performed a cross-sectional analysis of the association between MSDs and various factors. After applying multiple imputations for missing data, we computed logistic regression models with progressive adjustments on confounding factors.</div></div><div><h3>Results</h3><div>Of 1832 participants (53 % men, median age 38 (IQR 22) years), 34 % reported at least one personal history of MSD: 8 % for stress fractures, 24 % for upper-limb disorders and 15 % for entrapment syndromes. A higher prevalence of MSDs was found in women, with aging and with diabetes duration. In a fully adjusted model, we observed a positive association between current smoking (OR [95 %CI] = 1.50 [1.14;1.97]), non-excessive alcohol consumption (1.45 [1.14;1.85]), neuropathy (1.70 [1.35;2.15]), retinopathy (1.30 [1.02;1.65]), use of automated insulin delivery systems (1.53 [1.06;2.21]) and MSDs. MSDs were associated with reduced global quality of life (0.97 [0.95;0.98]). MSDs were not associated with HbA1c, social vulnerability or physical activity.</div></div><div><h3>Conclusion</h3><div>We have shown that MSDs are found in 1 in 3 people with T1DM. They are associated with several lifestyle factors, diabetes complications and the use of automated insulin delivery systems. MSDs should be considered in the T1DM assessment to optimize quality of life.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101647"},"PeriodicalIF":4.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891365","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":"Comparative study of SGLT2 inhibitors and metformin: Evaluating first-line therapies for dementia prevention in type 2 diabetes","authors":"Mingyang Sun ,&nbsp;Xiaoling Wang ,&nbsp;Zhongyuan Lu ,&nbsp;Yitian Yang ,&nbsp;Shuang Lv ,&nbsp;Mengrong Miao ,&nbsp;Wan-Ming Chen ,&nbsp;Szu-Yuan Wu ,&nbsp;Jiaqiang Zhang","doi":"10.1016/j.diabet.2025.101655","DOIUrl":"10.1016/j.diabet.2025.101655","url":null,"abstract":"<div><h3>Background</h3><div><em>-</em> Type 2 diabetes (T2D) increases the risk of dementia by 1.5 to 2.5 times. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) and metformin, widely used antidiabetic therapies, have demonstrated potential neuroprotective effects. Their comparative effectiveness in dementia prevention remains unknown.</div></div><div><h3>Methods</h3><div><em>-</em> This retrospective cohort study used the TriNetX global federated network, analyzing de-identified records from over 98 healthcare organizations. Adults with T2D initiating SGLT2i or metformin as first-line therapy were propensity score-matched (1:1). The primary outcome was overall dementia incidence, including vascular dementia, Alzheimer’s disease, and other subtypes. Secondary outcomes included all-cause mortality. Time-to-event outcomes were assessed using Kaplan-Meier curves and Cox models.</div></div><div><h3>Results</h3><div><em>-</em> Among 74,975 matched patients in each cohort, SGLT2i use was associated with a lower incidence of overall dementia: 2.7 % vs. 6.9 %: adjusted hazard ratio (aHR) 0.80 [95 % CI 0.76;0.84]. Reductions were observed in vascular dementia (0.8 % vs. 2.0 %; aHR 0.87), Alzheimer’s dementia (1.1 % vs. 3.2 %; aHR, 0.76), and all-cause mortality (6.8 % vs. 15.4 %; aHR, 0.92). Benefits were pronounced in older adults, particularly those aged ≥80 years.</div></div><div><h3>Conclusions</h3><div><em>-</em> SGLT2is significantly reduced dementia risk and mortality compared to metformin in T2D patients. These findings suggest SGLT2is may offer superior neuroprotective benefits, underscoring their potential as a first-line therapy for T2D. Further randomized trials are needed to confirm these results.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101655"},"PeriodicalIF":4.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899449","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":"Automated insulin delivery after beta-cell replacement failure in people living with type 1 diabetes","authors":"Quentin Perrier ,&nbsp;Sandrine Lablanche ,&nbsp;Luc Rakotoarisoa ,&nbsp;Orianne Villard ,&nbsp;Jean-Pierre Riveline ,&nbsp;Jean-Baptiste Julla ,&nbsp;Fanny Buron ,&nbsp;Sophie Reffet ,&nbsp;Eric Renard ,&nbsp;Laurence Kessler ,&nbsp;Pierre-Yves Benhamou","doi":"10.1016/j.diabet.2025.101654","DOIUrl":"10.1016/j.diabet.2025.101654","url":null,"abstract":"<div><h3>Aims</h3><div>Patients living with highly unstable type 1 diabetes (T1D) are eligible for beta-cell replacement (βCR) therapy (islet or pancreas transplantation). This study aimed to evaluate glycemic control in patients treated with automated insulin delivery (AID) following failed βCR therapy, defined as secondary graft failure or marginal function.</div></div><div><h3>Material and Methods</h3><div>A national, multicenter, retrospective study was conducted with 23 patients who had βCR failure treated with AID for at least three months. The primary outcome was the proportion of patients achieving recommended glucose targets (time in 70–180mg/dl range [TIR] &gt; 70 %, time below range [TBR] &lt; 4 % and HbA1c &lt; 7 %). Secondary outcomes included TIR, glycemia risk index (GRI), HbA1c, coefficient of variation (CV), body weight, insulin doses, severe hypoglycemia and AID discontinuation.</div></div><div><h3>Results</h3><div>The proportion of patients achieving recommended glucose targets under AID increased from 5.0 % to 57.1 % after 12 months. TIR increased from 54.2 ± 18.0 % to 75.5 ± 9.6 % after 12-month AID, while GRI decreased from 45.8 ± 22.2 % to 25.6 ± 10.3 %. HbA1c levels decreased from 7.5 ± 0.9 % to 7.0 ± 1.1 % after 12-month AID. CV, body weight and insulin doses did not change. All patients were free from severe hypoglycemia under AID, including those who had experienced severe hypoglycemia after βCR failure. No patient discontinued the AID.</div></div><div><h3>Conclusions</h3><div>This study highlights the effectiveness of AID in achieving glucose control targets and preventing severe hypoglycemia in patients with T1D following βCR failure. AID may serve as a valuable therapeutic option to improve glucose control when graft function declines.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101654"},"PeriodicalIF":4.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877476","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}