Diabetes & metabolism最新文献

{"title":"Cardiovascular protection significantly depends on HbA1c improvement with GLP-1RAs but not with SGLT2 is in type 2 diabetes: A narrative review","authors":"André J. Scheen","doi":"10.1016/j.diabet.2023.101508","DOIUrl":"10.1016/j.diabet.2023.101508","url":null,"abstract":"<div><h3>Background</h3><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is), while developed as antihyperglycaemic medications for the treatment of type 2 diabetes, have proven to reduce major cardiovascular adverse events (MACEs) and hospitalization for heart failure (especially for SGLT2is) in dedicated cardiovascular outcome trials. The contribution of the glucose-lowering effect in the cardiovascular protection is uncertain and may differ between the two drug classes.</p></div><div><h3>Methods</h3><p>This narrative review compares the relative effects of glycated hemoglobin (HbA1c) reduction on the cardiovascular protection provided by GLP-1RAs and SGLT2is in placebo-controlled cardiovascular outcome trials by using the results of either post-hoc mediation analyses or meta-regression studies.</p></div><div><h3>Results</h3><p>Both mediation and meta-regression analyses suggest that the lower cardiovascular risk with GLP-1RAs partially but substantially tracks with their glucose-lowering effect, especially when considering the reduction in nonfatal strokes. In contrast, similar analyses fail to demonstrate any significant contribution of the glucose-lowering effect with SGLT2is, not only on MACEs but also on heart failure issues.</p></div><div><h3>Conclusion</h3><p>The contribution of improved glucose control in cardiovascular protection is limited, but is much greater for GLP-1RAs than for SGLT2is. Of note, such mediation or meta-regression analyses are exploratory and can only be viewed as hypothesis generating.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 2","pages":"Article 101508"},"PeriodicalIF":7.2,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139057648","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":"Metformin treatment is associated with improved survival in diabetic patients hospitalized with acute heart failure: A prospective observational study using the Korean acute heart failure registry data","authors":"Kyeong-Hyeon Chun ,&nbsp;Jaewon Oh ,&nbsp;Chan Joo Lee ,&nbsp;Jin Joo Park ,&nbsp;Sang Eun Lee ,&nbsp;Min-Seok Kim ,&nbsp;Hyun-Jai Cho ,&nbsp;Jin-Oh Choi ,&nbsp;Hae-Young Lee ,&nbsp;Kyung-Kuk Hwang ,&nbsp;Kye Hun Kim ,&nbsp;Byung-Su Yoo ,&nbsp;Dong-Ju Choi ,&nbsp;Sang Hong Baek ,&nbsp;Eun-Seok Jeon ,&nbsp;Jae-Joong Kim ,&nbsp;Myeong-Chan Cho ,&nbsp;Shung Chull Chae ,&nbsp;Byung-Hee Oh ,&nbsp;Seok-Min Kang","doi":"10.1016/j.diabet.2023.101504","DOIUrl":"10.1016/j.diabet.2023.101504","url":null,"abstract":"<div><h3>Aims</h3><p>Although the hypothesis that metformin<span> is beneficial for patients with diabetes and heart failure (HF) has been steadily raised, there is limited data on metformin use in patients<span> with acute HF. We analyzed the association of metformin on all-cause mortality in hospitalized patients with type 2 diabetes and acute HF.</span></span></p></div><div><h3>Methods</h3><p><span>The Korean Acute Heart Failure registry prospectively enrolled patients hospitalized for acute HF from 2011 to 2014. Among this cohort, we analyzed patients with diabetes with baseline estimated glomerular filtration rate (eGFR) of 30 ml/min/1.73 m</span>²<span> or more. We analyzed the all-cause mortality and re-hospitalization for HF within 1 year after discharge<span>. Inverse probability treatment weighting method was used to adjust baseline differences on metformin treatment.</span></span></p></div><div><h3>Results</h3><p>The study analyzed data from 1,309 patients with HF and diabetes (mean age 69 years, 56 % male). Among them, 613 (47 %) patients were on metformin at admission. During the median follow-up period of 11 months, 132 (19 %) and 74 (12 %) patients not receiving and receiving metformin treatment died, respectively. The mortality rate was lower in metformin users than in non-users (hazard ratio 0.616 [0.464–0.819] <em>P</em>&lt;0.001). After adjustment, metformin was significantly associated with a lower risk for the mortality (hazard ratio 0.677 [0.495–0.928] <em>P</em>=0.015). In subgroup analyses, this association remains significant irrespective of baseline kidney function (eGFR &lt;60 or ≥60 ml/min/1.73 m², <em>P</em><span>-for-interaction=0.176) or left ventricular ejection fraction (&lt;40 %, 40–49 %, or ≥50 %, </span><em>P</em>-for-interaction=0.224).</p></div><div><h3>Conclusions</h3><p>Metformin treatment at the time of admission was associated with a lower risk for 1-year mortality in patients with diabetes, hospitalized for acute HF.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101504"},"PeriodicalIF":7.2,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138572627","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":"Reduction of circulating methylglyoxal levels by a Mediterranean diet is associated with preserved kidney function in patients with type 2 diabetes and coronary heart disease: From the CORDIOPREV randomized controlled trial","authors":"Francisco M. Gutierrez-Mariscal ,&nbsp;Alicia Podadera-Herreros ,&nbsp;Juan F. Alcalá-Diaz ,&nbsp;Magdalena P. Cardelo ,&nbsp;Antonio P. Arenas-de Larriva ,&nbsp;Silvia de la Cruz-Ares ,&nbsp;Jose D. Torres-Peña ,&nbsp;Raul M. Luque ,&nbsp;Pablo Perez-Martinez ,&nbsp;Javier Delgado-Lista ,&nbsp;Jose Lopez-Miranda ,&nbsp;Elena M. Yubero-Serrano","doi":"10.1016/j.diabet.2023.101503","DOIUrl":"10.1016/j.diabet.2023.101503","url":null,"abstract":"<div><h3>Aim</h3><p>Advanced glycation end products (AGEs) play a role in kidney disease in type 2 diabetes mellitus (T2DM). However, there have been no prior controlled clinical trials examining the effects of specific diets on AGE metabolism and their impact on kidney function. Our aim was to assess whether modulating AGE metabolism resulting in reduced AGEs levels, after consumption of two healthy diets, could delay kidney function decline in patients with T2DM and coronary heart disease (CHD).</p></div><div><h3>Methods</h3><p>T2DM patients (540 out of 1002 patients from the CORDIOPREV study), with estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m², were classified based on their baseline kidney function: normal eGFR (≥ 90 ml/min/1.73 m²), mildly decreased eGFR (60- &lt; 90 ml/min/1.73 m²) and moderately decreased eGFR (&lt;60 ml/min/1.73 m²). Serum AGE levels, methylglyoxal (MG) and N-carboximethyllysine (CML), and gene expression related to AGE metabolism (<em>AGER1, RAGE</em>, and <em>GloxI</em> mRNA) were measured before and after 5-years of dietary intervention (a Mediterranean diet or a low-fat diet).</p></div><div><h3>Results</h3><p>Mediterranean diet produced a lower declined of eGFR compared to the low-fat diet only in patients with mildly decreased eGFR (<em>P</em> = 0.035). Moreover, Mediterranean diet was able to decrease MG levels and increase <em>GloxI</em> expression in normal and mildly decreased eGFR patients (all <em>P</em> &lt; 0.05). One standard deviation increment of MG levels after dietary intervention resulted in a 6.8-fold (95 % CI 0.039;0.554) higher probability of eGFR decline.</p></div><div><h3>Conclusion</h3><p>Our study showed that lowering circulating AGE levels, specifically MG, after following a Mediterranean diet, might be linked to the preservation of kidney function, evidenced by a decreased decline of eGFR in T2DM patients with CHD. Patients with mildly decreased eGFR could potentially benefit more from AGE reduction in maintaining kidney function.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101503"},"PeriodicalIF":7.2,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S126236362300085X/pdfft?md5=90da1a438dd19cd356bb2859e6308063&pid=1-s2.0-S126236362300085X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138572591","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":"Monitoring gestational diabetes mellitus patients with myDiabby Healthcare® smartphone application vs classical diary. Results from the non-inferiority TELESUR-GDM study","authors":"Poncelet C ,&nbsp;Bouamoud L ,&nbsp;Michel P ,&nbsp;Campinos C","doi":"10.1016/j.diabet.2023.101502","DOIUrl":"10.1016/j.diabet.2023.101502","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of the TELESUR-GDM study was to demonstrate the non-inferiority of the onset of maternal, fœtal, and neonatal complications for patients with gestational diabetes mellitus (GDM) monitored by myDiabby HealthcareⓇ (app group) compared to patients with a classical glycaemic blood monitoring by diary (control group).</p></div><div><h3>Materials and methods</h3><p>TELESUR-GDM was a retrospective, monocentric, and non-inferiority study including 349 patients in the app group and 295 patients in the control group. The primary outcome was a composite score based on maternal, foetal, and neonatal complications. The statistical analysis used chi square or Student <em>t</em> tests for categorical or continuous variables, and Dunnett–Gent test for non-inferiority.</p></div><div><h3>Results</h3><p><span>In the app and control groups, 46.3 % and 53.7 % of the patients respectively, observed complications. Non-inferiority of telemonitoring by application vs diary was confirmed (odds ratio=0.79 [95 % CI 0.58;1.07], </span><em>P</em><span><span> &lt; 0.001). Caesarean section, labour induction, and </span>insulin treatment rates were: 20 vs 23 % (</span><em>P</em> = 0.4), 36 vs 28 % (<em>P</em> = 0.047), and 22 vs 23 % (<em>P</em><span> = 0.8) in the app vs control group, respectively. Macrosomia<span>, intrauterine growth restriction<span><span>, neonatal hypoglycaemia, and </span>neonatal jaundice rates were: 4.3 vs 6.1 % (</span></span></span><em>P =</em> 0.4), 6.9 vs 3.1 % (<em>P =</em> 0.04), 1.7 vs 14 % (<em>P</em> &lt; 0.001), and 8.6 vs 1.0 % (<em>P</em> &lt; 0.001), in the app versus control group, respectively.</p></div><div><h3>Conclusion</h3><p>GDM glycaemic telemonitoring compared to patients with classic glycaemic monitoring by diary was not inferior in terms of maternal, fœtal, and neonatal complications. Neonatal hypoglycaemia, a life-threatening event, was significantly reduced despite the observation of more neonatal jaundice cases.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101502"},"PeriodicalIF":7.2,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138537206","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":"Real-world safety and effectiveness of dapagliflozin in people living with type 1 diabetes in Spain: The Dapa-ON multicenter retrospective study","authors":"María Durán-Martínez ,&nbsp;Sharona Azriel ,&nbsp;Viyey Kishore Doulatram-Gamgaram ,&nbsp;Óscar Moreno-Pérez ,&nbsp;Pedro J. Pinés-Corrales ,&nbsp;Cristina Tejera-Pérez ,&nbsp;Juan Francisco Merino-Torres ,&nbsp;Miguel Brito-Sanfiel ,&nbsp;Ana Chico ,&nbsp;Amparo Marco ,&nbsp;Elena García-Fernández ,&nbsp;José Ignacio Martínez-Montoro ,&nbsp;on behalf of the Diabetes Area of the Spanish Society of Endocrinology and Nutrition (SEEN)","doi":"10.1016/j.diabet.2023.101501","DOIUrl":"10.1016/j.diabet.2023.101501","url":null,"abstract":"<div><h3>Objective</h3><p>To assess real-world safety and effectiveness of dapagliflozin in people living with type 1 diabetes mellitus (T1DM).</p></div><div><h3>Methods</h3><p>We conducted a multicenter retrospective study in Spain including data from 250 people living with T1DM receiving dapagliflozin as add-on therapy to insulin (80.8 % on-label use). The number of diabetic ketoacidosis (DKA) events was calculated over a 12-month follow-up (primary outcome). Changes in body weight, HbA1c, total daily insulin dose, and continuous glucose monitoring (CGM) metrics from baseline (at dapagliflozin prescription) to 12 months were also evaluated.</p></div><div><h3>Results</h3><p>A total of five DKA events (2.4 % [95 % CI 0.3;4.5] were reported in patients with a 12-month follow-up, <em>n</em> = 207): two events related to insulin pump malfunction, two events related to concomitant illnesses, and one event related to insulin dose omission. DKA events were more frequent among insulin pump users than among participants on multiple daily injections (7.7 % versus 1.2 %). Four of the reported DKA events occurred within the first six months after initiation of dapagliflozin. No deaths or persistent sequelae due to DKA were reported. No severe hypoglycemia episodes were reported. Significant reductions in mean body weight (−3.3 kg), HbA1c (−0.6 %), and total daily insulin dose (−8.6 %), <em>P</em> &lt; 0.001, were observed 12 months after dapagliflozin prescription. Significant improvements in TIR (+9.3 %), TAR (−7.2 %), TBR (−2.5 %), and coefficient of variation (−5.1 %), <em>P</em> &lt; 0.001, were also observed in the subgroup of patients with available CGM data. Finally, an improvement in urinary albumin-to-creatinine ratio (UACR) was found among participants with UACR ≥ 30 mg/g at baseline (median decrease of 99 mg/g in UACR, <em>P</em> = 0.001).</p></div><div><h3>Conclusion</h3><p>The use of dapagliflozin in people living with T1DM has an appropriate safety profile after careful selection of participants and implementation of strategies to reduce the risk of DKA (i.e., prescribed according to the recommendations of the European Medicines Agency), and also leads to clinical improvements in this population.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101501"},"PeriodicalIF":7.2,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1262363623000836/pdfft?md5=f497d2cdffc752a5332ec84a0b1e3552&pid=1-s2.0-S1262363623000836-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138537172","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":"Effects of SGLT2 inhibitors on clinical cancer survival in patients with type 2 diabetes","authors":"Yen-Min Huang ,&nbsp;Wan-Ming Chen ,&nbsp;An-Tzu Jao ,&nbsp;Mingchih Chen ,&nbsp;Ben-Chang Shia ,&nbsp;Szu-Yuan Wu","doi":"10.1016/j.diabet.2023.101500","DOIUrl":"10.1016/j.diabet.2023.101500","url":null,"abstract":"<div><h3>Purpose</h3><p>According to the preclinical data, sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2is) may exert anticancer effects. Here, we clarified the cancer-specific mortality (primary outcome) and all-cause mortality (secondary outcome) of SGLT2is and their dose-dependency in patients<span> with cancer undergoing standard curative treatments.</span></p></div><div><h3>Methods</h3><p><span>We analyzed data from patients with type 2 diabetes mellitus (T2DM) diagnosed with cancer between January 1, 2016, and December 31, 2018, enrolled from the Taiwan Cancer Registry database. Kaplan-Meier method was used to estimate all-cause mortality and cancer-specific mortality, comparing survival curves between SGLT2i users and nonusers using the stratified log-rank test. Cox </span>proportional hazards regression was conducted to identify independent predictors for all-cause and cancer-specific mortality among the covariates.</p></div><div><h3>Results</h3><p><span>We performed 1:2 propensity score matching of our data, which yielded a final cohort of 50,133 patients with cancer; of them, 16,711 and 33,422 were in the SGLT2i user and nonuser groups, respectively. The adjusted hazard ratio (aHR) for cancer-specific and all-cause mortality in SGLT2i users compared with nonusers was 0.21 (95 % confidence interval [CI]: 0.20–0.22) and 0.22 (95 % CI: 0.21–0.23). We divided the patients into four subgroups stratified by quartiles (Q) of cumulative defined daily doses per year (cDDDs), and all-cause and cancer-specific mortality was noted to significantly decrease with increases in dosage (from Q1 to Q4 cDDDs) in SGLT2i users compared with in nonusers (</span><em>P</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>SGLT2is increase overall survival and cancer-specific survival in patients with cancer in a dose-dependent manner.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101500"},"PeriodicalIF":7.2,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465369","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":"A healthful plant-based diet is associated with lower type 2 diabetes risk via improved metabolic state and organ function: A prospective cohort study","authors":"Alysha S. Thompson ,&nbsp;Catharina J. Candussi ,&nbsp;Anna Tresserra-Rimbau ,&nbsp;Amy Jennings ,&nbsp;Nicola P. Bondonno ,&nbsp;Claire Hill ,&nbsp;Solomon A. Sowah ,&nbsp;Aedín Cassidy ,&nbsp;Tilman Kühn","doi":"10.1016/j.diabet.2023.101499","DOIUrl":"10.1016/j.diabet.2023.101499","url":null,"abstract":"<div><h3>Background</h3><p>Plant-based diets are becoming increasingly popular due to favourable environmental footprints and have been associated with lower risk of type 2 diabetes mellitus (T2DM). Here, we investigated the potential mechanisms to explain the lower T2DM risk observed among individuals following plant-based diets.</p></div><div><h3>Methods</h3><p>Prospective data from the UK Biobank, a cohort study of participants aged 40 to 69 years at baseline, was evaluated. Associations between healthful and unhealthful plant-based indices (hPDI and uPDI) and T2DM risk were analysed by multivariable Cox regression models, followed by causal mediation analyses to investigate which cardiometabolic risk factors explained the observed associations.</p></div><div><h3>Results</h3><p>Of 113,097 study participants 2,628 developed T2DM over 12 years of follow-up. Participants with the highest hPDI scores (Quartile 4) had a 24 % lower T2DM risk compared to those with the lowest scores (Quartile 1) [Hazard Ratio (HR): 0.76, 95 % Confidence Interval (CI): 0.68–0.85]. This association was mediated by a lower BMI (proportion mediated: 28 %), lower waist circumference (28 %), and lower concentrations of HBA1c (11 %), triglycerides (9 %), alanine aminotransferase (5 %), gamma glutamyl transferase (4 %), C-reactive protein (4 %), insulin-like growth factor 1 (4 %), cystatin C (4 %) and urate (4 %). Higher uPDI scores were associated with a 37 % higher T2DM risk [HR: 1.37, 95 % CI:1.22- 1.53], with higher waist circumference (proportion mediated: 17 %), BMI (7 %), and higher concentrations of triglycerides (13 %) potentially playing mediating roles.</p></div><div><h3>Conclusion</h3><p>Healthful plant-based diets may protect against T2DM via lower body fatness, but also via normoglycaemia, lower basal inflammation as well as improved kidney and liver function.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101499"},"PeriodicalIF":7.2,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465368","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":"Low frequency of albuminuria testing among diabetic patients in France: Real-world data from clinical laboratories","authors":"Fabrice Bonnet ,&nbsp;Léa Longepierre ,&nbsp;Dinh-Phong Nguyen ,&nbsp;Imène Sedrati ,&nbsp;Alegria Marcilla","doi":"10.1016/j.diabet.2023.101498","DOIUrl":"10.1016/j.diabet.2023.101498","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101498"},"PeriodicalIF":7.2,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138435582","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":"MASLD, hepatic steatosis and fibrosis are associated with the prevalence of chronic kidney disease and retinopathy in adults with type 1 diabetes mellitus","authors":"Alessandro Mantovani ,&nbsp;Mario Luca Morieri ,&nbsp;Raffaella Aldigeri ,&nbsp;Luisa Palmisano ,&nbsp;Maria Masulli ,&nbsp;Katia Bonomo ,&nbsp;Marco Giorgio Baroni ,&nbsp;Efisio Cossu ,&nbsp;Flavia Agata Cimini ,&nbsp;Gisella Cavallo ,&nbsp;Raffaella Buzzetti ,&nbsp;Carmen Mignogna ,&nbsp;Frida Leonetti ,&nbsp;Simonetta Bacci ,&nbsp;Roberto Trevisan ,&nbsp;Riccardo Maria Pollis ,&nbsp;Alessandra Dei Cas ,&nbsp;Saula Vigili de Kreutzenberg ,&nbsp;Giovanni Targher","doi":"10.1016/j.diabet.2023.101497","DOIUrl":"10.1016/j.diabet.2023.101497","url":null,"abstract":"<div><h3>Aim</h3><p>We examined whether metabolic dysfunction-associated steatotic liver disease (MASLD) with or without significant fibrosis (assessed by validated non-invasive biomarkers) was associated with an increased risk of prevalent chronic kidney disease (CKD) or diabetic retinopathy in people with type 1 diabetes mellitus (T1DM).</p></div><div><h3>Methods</h3><p>We performed a retrospective multicenter cross-sectional study involving 1,409 adult outpatients with T1DM, in whom hepatic steatosis index (HSI) and fibrosis (FIB)-4 index were calculated for non-invasively detecting hepatic steatosis (defined by HSI &gt; 36), with or without coexisting significant fibrosis (FIB-4 index ≥ 1.3 or &lt; 1.3). CKD was defined as an estimated glomerular filtration rate (eGFR) &lt; 60 mL/min/1.73 m² or urine albumin/creatinine ratio ≥ 3.0 mg/mmol. The presence of diabetic retinopathy was also recorded in all participants.</p></div><div><h3>Results</h3><p>Patients with MASLD and significant fibrosis (<em>n</em> = 93) had a remarkably higher prevalence of CKD and diabetic retinopathy than their counterparts with MASLD without fibrosis (<em>n</em> = 578) and those without steatosis (<em>n</em> = 738). After adjustment for sex, diabetes duration, hemoglobin A1c, hypertension, and use of antihypertensive or lipid-lowering medications, patients with SLD and significant fibrosis had a higher risk of prevalent CKD (adjusted-odds ratio 1.76, 95 % confidence interval 1.05–2.96) than those without steatosis. Patients with MASLD without fibrosis had a higher risk of prevalent retinopathy (adjusted-odds ratio 1.49, 95 % CI 1.13–1.46) than those without steatosis.</p></div><div><h3>Conclusion</h3><p>This is the largest cross-sectional study showing that MASLD with and without coexisting significant fibrosis was associated, independently of potential confounders, with an increased risk of prevalent CKD and retinopathy in adults with T1DM.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101497"},"PeriodicalIF":7.2,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1262363623000794/pdfft?md5=9e7a417b1b7fa2f43bfe913f0d62c510&pid=1-s2.0-S1262363623000794-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296891","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":"Glucometrics knowledge and its relationship to glycemic control in people living with type 1 diabetes: The GluKometrics study","authors":"Rebeca Reyes ,&nbsp;Oscar Moreno-Perez ,&nbsp;Cristina Tejera-Perez ,&nbsp;Miguel Brito-Sanfiel ,&nbsp;Pedro Pines ,&nbsp;Eva Aguilera ,&nbsp;Manuel Gargallo ,&nbsp;Pedro Rozas-Moreno ,&nbsp;Javier Escalada San Martin","doi":"10.1016/j.diabet.2023.101496","DOIUrl":"10.1016/j.diabet.2023.101496","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"50 1","pages":"Article 101496"},"PeriodicalIF":7.2,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138049126","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}