Diabetes & metabolism最新文献

{"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}

{"title":"SGLT2 inhibitors and the risk of hepatocellular carcinoma in patients with MASLD and Type 2 diabetes","authors":"Ruey-Shyang Soong ,&nbsp;Wan-Ming Chen ,&nbsp;An-Tzu Jao ,&nbsp;Ming-Che Lee ,&nbsp;Szu-Yuan Wu ,&nbsp;Chih-Lang Lin","doi":"10.1016/j.diabet.2025.101698","DOIUrl":"10.1016/j.diabet.2025.101698","url":null,"abstract":"<div><h3>Background</h3><div>- Hepatocellular carcinoma (HCC) is increasingly driven by non-viral causes, especially metabolic dysfunction–associated steatotic liver disease (MASLD), which is common in type 2 diabetes mellitus (T2D). No pharmacologic agent is currently approved for HCC chemoprevention.</div></div><div><h3>Objective</h3><div>- To evaluate the association between sodium–glucose cotransporter-2 inhibitor (SGLT2i) use and risks of HCC and all-cause mortality in patients with MASLD and T2D.</div></div><div><h3>Design</h3><div><em>-</em> Multinational, retrospective cohort study using the TriNetX federated electronic health record network (2005–2025). Adults aged 18–90 years with non-viral MASLD and pre-existing T2D were identified. We applied a 1-year washout, used an active-comparator design, and performed 1:1 propensity score matching. Adjusted hazard ratios (aHRs) were estimated with Cox models.</div></div><div><h3>Results</h3><div>- After matching, 93,930 SGLT2i users were compared with 93,930 active comparators with excellent covariate balance. Median follow-up was 3.24 years (IQR 1.72–5.09) in the SGLT2i group and 3.25 years (IQR 1.72–5.08) in comparators. HCC occurred in 43 (0.05 %) SGLT2i users vs 74 (0.08 %) comparators (aHR 0.43; 95 % CI 0.29–0.63). All-cause mortality was 5.32 % vs 10.50 % (aHR 0.34; 95 % CI 0.33–0.35). Results were consistent across subgroups and sensitivity analyses, including time-anchored landmark analyses. Risk reductions were also observed for liver fibrosis/cirrhosis and hepatic nodules.</div></div><div><h3>Conclusions</h3><div>- Among patients with MASLD and T2D, SGLT2 inhibitor use was associated with lower risks of HCC and all-cause mortality compared with active comparators. While residual confounding cannot be excluded, these findings support prospective evaluation of SGLT2 inhibitors for liver-related risk reduction in this population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101698"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916305","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":"Ketoacidosis associated with type 2 sodium-glucose cotransporter inhibitors (SGLT2i) in patients aged 65 and older: Evidence from the French national pharmacovigilance database","authors":"Nathanaël Bassas Letissier ,&nbsp;Nassir Mirfendereski ,&nbsp;Marie-Laure Laroche ,&nbsp;Jean- Luc Faillie ,&nbsp;Marc Paccalin ,&nbsp;Pierre-Jean Saulnier ,&nbsp;Marion Allouchery ,&nbsp;Helena Mosbah","doi":"10.1016/j.diabet.2025.101697","DOIUrl":"10.1016/j.diabet.2025.101697","url":null,"abstract":"<div><h3>Background</h3><div>Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have been widely used in the management of type 2 diabetes, with proven cardiovascular and renal benefits. However, their use has been associated with a risk of diabetic ketoacidosis (DKA).</div></div><div><h3>Aim</h3><div>This study aims to describe the characteristics of DKA cases associated with SGLT2i use in patients aged 65 and over, based on data from the French pharmacovigilance database.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on all cases of DKA reported with SGLT2i in patients aged 65 years and older. Cases were retrieved from 2020 onward; 55 were analyzed. Patient characteristics, drug exposure, adverse drug reaction (ADR) reports, hospitalization details, and precipitating factors were examined.</div></div><div><h3>Results</h3><div>Median patient age was 74.0 years (IQR: 69.0; 77.5), with a predominance of males (63.4 %). The median Charlson comorbidity index was 8.0 (IQR: 6.0; 10.0), and polypharmacy was common, with a median of nine drugs per patient. Infections (36.4 %), dehydration (20.0 %), and fasting (18.2 %) were the main precipitating factors. All cases required hospitalization, with 36.4 % admitted to an intensive care unit (ICU). Among ICU patients, 35.0 % required orotracheal intubation and/or vasopressor therapy. One case (1.8 %) resulted in death. Factors significantly associated with ICU admission included younger age (71.3 vs. 75.4 years, <em>P</em> = 0.009), lower pH at admission (<em>P</em> = 0.003), and infection as a precipitating factor (<em>P</em> = 0.007).</div></div><div><h3>Conclusion</h3><div>This study highlights the clinical characteristics and risk factors of SGLT2i-associated DKA in older adults. Infections and severe acidosis were key predictors of ICU admission. The findings underscore the importance of careful patient selection and monitoring to mitigate DKA risk in older patients receiving SGLT2i therapy.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101697"},"PeriodicalIF":4.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884785","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":"Are GLP-1 receptor agonists and diabetic retinopathy foes or friends?","authors":"Kai Liu ,&nbsp;Shu Liu ,&nbsp;Dong Wang ,&nbsp;Hong Qiao","doi":"10.1016/j.diabet.2025.101696","DOIUrl":"10.1016/j.diabet.2025.101696","url":null,"abstract":"<div><div>With the increasing number of patients with diabetes worldwide, the number of patients with diabetic retinopathy (DR) is also increasing, which affects the lives of patients. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are anti-diabetic drugs that mimic the action of endogenous glucagon-like peptide-1, which significantly improve glycemic control in patients with type 2 diabetes. GLP-1RAs can repair the blood-retinal barrier function by activating the GLP-1 receptor in retinal endothelial cells and nerve cells, inhibiting the RhoA/ROCK signaling pathway, up-regulating the tight junction protein occludin and ZO-1, and inhibiting the activation of microglia, reducing the release of pro-inflammatory factors, and reducing neuroinflammation and vascular leakage. However, some GLP-1RAs may increase the risk of DR, such as diabetic macular edema and proliferative DR, and may increase the risk of DR deterioration, especially during rapid glucose lowering. Although the new GLP-1/GIP dual-receptor agonists and GLP-1/GIP/glucagon tri-receptor agonists show comprehensive benefit potential by effectively improving body metabolism, the short-term negative effect of sudden blood glucose drop still needs to be paid attention to. For patients with moderate to severe DR, it is necessary to strengthen ophthalmic monitoring to avoid rapid blood glucose decline in the initial treatment. In the long-term treatment, metabolic benefits and retinal risks need to be weighed, and the patient's condition needs to be evaluated before treatment. Therefore, GLP-1RAs has a duality of \"mechanism protection and clinical risk\" on DR, and individualized treatment strategy should take into consideration drug characteristics, DR severity and glucose control.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101696"},"PeriodicalIF":4.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879015","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}