Diabetes & metabolism最新文献

{"title":"Practical implementation of automated insulin delivery systems in 2025: A French position statement update","authors":"E Bismuth ,&nbsp;M Joubert ,&nbsp;E Renard ,&nbsp;N Tubiana-Rufi ,&nbsp;L Chaillous ,&nbsp;E Bonnemaison ,&nbsp;H Hanaire ,&nbsp;R Coutant ,&nbsp;P Schaepelynck ,&nbsp;J Beltrand ,&nbsp;Y Reznik ,&nbsp;F Authier ,&nbsp;S Borot ,&nbsp;S Brunot ,&nbsp;C Calvez ,&nbsp;G Charpentier ,&nbsp;F Dalla-Vale ,&nbsp;A Delawoevre ,&nbsp;B Delemer ,&nbsp;A Desserprix ,&nbsp;PY Benhamou","doi":"10.1016/j.diabet.2025.101637","DOIUrl":"10.1016/j.diabet.2025.101637","url":null,"abstract":"<div><div>The advent of automated insulin delivery (AID) systems in 2020 marked a disruptive event in managing type 1 diabetes, benefiting children and adults alike. By 2024, advances in real-world data and research motivated an update to the French consensus on AID systems to expand accessibility, refine guidelines, and optimize patient follow-up.</div><div>AID systems have consistently improved glycemic control by reducing HbA1c, increasing time-in-range (TIR), and minimizing hypoglycemia, with significant benefits even for specific populations such as individuals with poor glycemic control, brittle diabetes, children, very young children, pregnant women, those with insulin resistance or gastroparesis, or after bariatric surgery. Recent studies support the broadening of AID indications for these special situations, also demonstrating safe transitions directly from multiple daily injections. A careful selection of the most appropriate system for these special situations is essential to achieve optimal personalization for each patient.</div><div>Training healthcare professionals and patients remains essential for optimizing AID usage. Updated guidelines emphasize multidisciplinary education, telemonitoring, and individualized follow-up to ensure safety and efficacy.</div><div>The potential of fully automated systems and adjunctive therapies, such as GLP-1 receptor agonists, is being explored alongside promising evidence that AID systems improve glycemic control in type 2 diabetes without increasing hypoglycemia. The future of AID systems lies in innovation and expanding their applicability across diverse patient populations.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 3","pages":"Article 101637"},"PeriodicalIF":4.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618025","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 use and effectiveness of tirzepatide among people without evidence of type 2 diabetes in the United States","authors":"Emily R. Hankosky ,&nbsp;Karishma Desai ,&nbsp;Chanadda Chinthammit ,&nbsp;Michael Grabner ,&nbsp;Grace Stockbower ,&nbsp;Xuanyao He ,&nbsp;Donna Mojdami ,&nbsp;Cachet Wenziger ,&nbsp;Theresa Hunter Gibble","doi":"10.1016/j.diabet.2025.101636","DOIUrl":"10.1016/j.diabet.2025.101636","url":null,"abstract":"<div><h3>Aim</h3><div>To understand treatment patterns and effectiveness of tirzepatide among people without type 2 diabetes (T2D) in the US.</div></div><div><h3>Methods</h3><div>This retrospective, observational, descriptive study used the Healthcare Integrated Research Database (index date: first-observed tirzepatide claim; index period: May 13, 2022–May 24, 2023). Key eligibility criteria were: age ≥ 18 years; ≥ 1 tirzepatide claim; no T2D diagnosis codes or glycated hemoglobin ≥ 6.5 %, no anti-diabetes medications (except metformin); and continuous medical/pharmacy enrollment for ≥ 12 months pre-index (Overall cohort). Tirzepatide persistence and utilization (6-months post-index) were assessed among obesity management medication (OMM)-eligible individuals (body mass index [BMI] ≥ 30 kg/m², or ≥ 27 kg/m² with ≥ 1 obesity-related complication [ORC]; OMM-eligible cohort). Tirzepatide effectiveness was assessed among individuals who were OMM-eligible, naive to glucagon-like peptide-1 receptor agonists, and persistent on tirzepatide for ≥6 months (Persistent+GLP-1 naive cohort).</div></div><div><h3>Results</h3><div>The overall cohort included 4,177 individuals with mean age 46.0 years, 75.6 % female, and mean BMI 37.1 kg/m². At baseline, 73.8 % of individuals had ≥ 1 ORC while 51.0 % had ≥ 2 ORCs. Persistence in the OMM-eligible cohort was 73.8 %; by the sixth prescription fill, 56.2 % were receiving &lt; 10 mg tirzepatide. Individuals in the Persistent+GLP-1 naive cohort with pre- and post-index weight and BMI measurements (<em>n</em> = 200) achieved mean weight reduction of 12.9 % at 6-months post-index (≥ 5 %: 88.5 %; ≥ 10 %: 69.0 %).</div></div><div><h3>Conclusion</h3><div>Real-world evidence suggests multimorbidity among tirzepatide initiators, slower tirzepatide dose escalation than in clinical trials, and clinically meaningful weight reduction among people persisting on tirzepatide for ≥ 6 months.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 3","pages":"Article 101636"},"PeriodicalIF":4.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589161","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":"Association of daily sleep duration with risk of metabolic dysfunction-associated steatotic liver disease and adverse liver outcomes","authors":"Qian Wang ,&nbsp;Huiyi Chen ,&nbsp;Huiling Deng ,&nbsp;Minyi Zhang ,&nbsp;Haoyue Hu ,&nbsp;Haotong Ouyang ,&nbsp;Lien Ma ,&nbsp;Ruiyan Liu ,&nbsp;Jian Sun ,&nbsp;Guifang Hu ,&nbsp;Kaifeng Wang","doi":"10.1016/j.diabet.2025.101628","DOIUrl":"10.1016/j.diabet.2025.101628","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease worldwide, leading to substantial disease burden globally. Whether sleep duration is associated with the risk of MASLD, cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality remains underexplored.</div></div><div><h3>Methods</h3><div>A total of 489,261 middle-aged and older adults from the UK Biobank without prior liver diseases were included. The primary outcome was MASLD, with secondary outcomes, including cirrhosis, HCC, and liver-related mortality ascertained through linked hospital records and death registries. Sleep duration was self-reported at baseline survey and categorized into ≤ 5, 6, 7, 8 and ≥ 9 hours.</div></div><div><h3>Results</h3><div>During a median (IQR) follow-up of 13.8 (1.5) years, 7,133 MASLD, 5,527 cirrhosis, 1,126 HCC, and 1,125 liver-related mortality cases were identified. After adjusting for potential confounders, the HRs [95% CIs] of MASLD were 1.44 [1.32;1.57], 1.17 [1.09;1.24], 1.00 (reference), 1.05 [0.99;1.11] and 1.35 [1.24;1.46] for ≤ 5, 6, 7, 8 and ≥ 9 hours of sleep duration, respectively. Similar trends were also observed for cirrhosis, HCC, and liver-related mortality. In addition, the U-shaped association between sleep duration and MASLD was more pronounced among participants without abnormal body mass index (overweight and obese), hypertension or insomnia (<em>P</em> for interaction &lt;0.05).</div></div><div><h3>Conclusions</h3><div>Both short and long sleep duration are associated with an increased risk of MASLD, cirrhosis, HCC, and liver-related mortality. Maintaining a moderate sleep duration of 7 to 8 hours per day could be crucial to prevent against this escalating public health concern.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 3","pages":"Article 101628"},"PeriodicalIF":4.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472733","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":"Screening for autoimmune atrophic gastritis by serum gastrin measurement in subjects with type 1 diabetes","authors":"Aude Pacheco ,&nbsp;Marc Diedisheim ,&nbsp;Claire Goulvestre ,&nbsp;Laure Alexandre-Heymann ,&nbsp;Roberto Mallone ,&nbsp;Danièle Dubois-Laforgue ,&nbsp;Etienne Larger","doi":"10.1016/j.diabet.2025.101640","DOIUrl":"10.1016/j.diabet.2025.101640","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite associated risk of anemia and gastric cancer, screening for autoimmune atrophic gastritis (AAG) is underperformed in subjects with type 1 diabetes mellitus (T1DM). We measured the predictive value of serum gastrin as a biomarker of gastric atrophy in subjects with T1DM and parietal cell autoantibodies (PCA).</div></div><div><h3>Subjects and Methods</h3><div>PCA measurements were retrospectively retrieved in 1,425 consecutive subjects with T1DM between 2014 and 2018. Screening for AAG was conducted in PCA+ subjects by measuring blood counts, serum ferritin, vitamin B12 and gastrin; and by performing gastroduodenal fibroscopy, with fundic biopsies for histology and <em>Helicobacter pylori</em>. The performance of blood biomarkers of gastric atrophy was analyzed in comparison with the histopathological gold standard.</div></div><div><h3>Results</h3><div>PCA were found in 185/1,425 subjects (13 %). PCA positivity was associated with female sex, older age, longer T1DM duration, and co-occurrence of anti-GAD and anti-thyroperoxydase autoantibodies. Of the 185 PCA+ subjects, 122 (66 %) participated in screening. AAG was found in 69/122 (57 %) subjects and <em>Helicobacter pylori</em> infection in 20/122 (16 %). Compared to PCA+ subjects without gastric atrophy, those with gastric atrophy had more frequently iron deficiency (65 % vs. 18 %, <em>P</em> &lt; 0.0001), and/or vitamin B12 deficiency (57 % vs. 7 %, <em>P</em> &lt; 0.0001); 44/69 (64 %) presented a pre-tumoral lesion and 6 % a tumor. Using a cut-off of 1.2-fold above the upper normal limit, serum gastrin concentration displayed 91 % sensitivity and 82 % specificity at predicting gastric atrophy.</div></div><div><h3>Conclusion</h3><div>In subjects with T1DM and PCA, serum gastrin is a reliable biomarker of gastric atrophy that can be used to select subjects requiring gastroduodenal fibroscopy.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 3","pages":"Article 101640"},"PeriodicalIF":4.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672166","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":"Management of diabetes in patients hospitalized for acute cardiac events: Joint position paper from the French Society of Cardiology and the French-speaking Diabetes Society","authors":"Patrick Henry ,&nbsp;Sophie Jacqueminet ,&nbsp;Gilles Lemesle ,&nbsp;Gaetan Prevost ,&nbsp;Franck Boccara ,&nbsp;Emmanuel Cosson ,&nbsp;Etienne Puymirat ,&nbsp;Denis Angoulvant ,&nbsp;François Roubille ,&nbsp;Serge Kownator ,&nbsp;Paul Valensi ,&nbsp;Victor Aboyans ,&nbsp;Bruno Vergès","doi":"10.1016/j.diabet.2025.101645","DOIUrl":"10.1016/j.diabet.2025.101645","url":null,"abstract":"<div><div>Patients with type 2 diabetes, but also older patients with type 1 diabetes, are at major risk of cardiovascular morbidity and death. After an acute cardiac event, the prognosis of patients with diabetes is impaired, with clear increases in in-hospital and long-term morbidity and deaths. Both hyper- and hypoglycaemia are deleterious after an acute cardiac event, and the decision to start intravenous insulin is often challenging. Moreover, some antidiabetic treatments have cardioprotective effects, and the onset of an acute cardiac event provides an opportunity to shift to these treatments. The objective of this position statement is to offer practical tools to cardiologists seeking to improve the care of patients with diabetes hospitalized for an acute cardiac event, and to optimize collaboration between cardiologists and diabetologists. After a summary of the evidence for antidiabetic treatments in patients with acute cardiac events, we propose an algorithm to start and adapt intravenous insulin in the most severe patients, and conclude with standard insulin protocols or oral treatments at discharge. We also discuss appropriate antidiabetic treatment of these patients at discharge, based on the main cardiological diagnosis, kidney function and antidiabetic strategies. Finally, situations in which the diabetologist must be consulted are discussed.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 3","pages":"Article 101645"},"PeriodicalIF":4.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883128","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":"Persistent gaps in the implementation of lipid-lowering therapy in patients with established atherosclerotic cardiovascular disease: A French nationwide study","authors":"Matthieu Wargny ,&nbsp;Thomas Goronflot ,&nbsp;Pierre-Guillaume Piriou ,&nbsp;Mathilde Pouriel ,&nbsp;Alexandre Bastien ,&nbsp;Julie Prax ,&nbsp;Christophe Leux ,&nbsp;Valéry-Pierre Riche ,&nbsp;Jean-Noël Trochu ,&nbsp;Sophie Béliard ,&nbsp;Nadège Costa ,&nbsp;Jean Ferrières ,&nbsp;Stéphanie Duret ,&nbsp;Bertrand Cariou","doi":"10.1016/j.diabet.2025.101638","DOIUrl":"10.1016/j.diabet.2025.101638","url":null,"abstract":"<div><h3>Background</h3><div>According to international guidelines, lowering LDL-cholesterol is the cornerstone of atherosclerotic cardiovascular disease (ASCVD) prevention. However, observational studies have identified current gaps in the implementation of lipid-lowering therapy (LLT). This whole-population study aimed to evaluate the prevalence and determinants of LLT use in ASCVD patients.</div></div><div><h3>Methods</h3><div>Using the national health data system, all French adults with established ASCVD between 2012 and 2021 were identified using specific ICD-10 and/or procedure codes. LLT use was defined as ≥1 dispensing in the last quarter of 2021. Logistic regression was used to identify factors associated with the absence of LLT use.</div></div><div><h3>Findings</h3><div>In 2021, 2,206,305 individuals (4.89 % among 45,082,270 adults) had established ASCVD (mean age: 72.2 years; 36.9 % women), including 56.1 % with coronary artery disease, 40.4 % with cerebrovascular disease, and 14.5 % with revascularized peripheral artery disease (PAD). Among the 2,056,354 patients alive on 31st December 2021, 32.5 % did not receive any LLT, while 64.8 % received a statin (27.0 % a high-intensity statin), 13.0 % a combination of statin and ezetimibe, and 0.25 % a PCSK9 inhibitor. The absence of LLT use was significantly associated with female sex (adjusted odds ratio [aOR]:1.42, 95 %CI, 1.41–1.43); lowest/highest ages: &lt; 50 years (aOR (/65–74 years): 2.23, 95 %CI 2.20–2.27) and ≥ 85 years (aOR: 2.10, 95 %CI 2.08–2.13); and stroke and PAD, compared to myocardial infarction (aOR: 2.21, 95 %CI 2.19–2.23 and 1.88, 95 %CI 1.86–1.91, respectively).</div></div><div><h3>Interpretation</h3><div>In real life, one-third of French ASCVD patients was not regularly treated with LLT, highlighting the urgent need to develop implementation strategies for lipid management.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 3","pages":"Article 101638"},"PeriodicalIF":4.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660197","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":"Acute kidney injury is associated with liver-related events in patients with metabolic dysfunction-associated fatty liver disease","authors":"Caoxiang She ,&nbsp;Zhixin Guo ,&nbsp;Yaduan Lin ,&nbsp;Shiyu Zhou ,&nbsp;Mingzhen Pang ,&nbsp;Jiao Liu ,&nbsp;Lisha Cao ,&nbsp;Licong Su ,&nbsp;Yinfang Sun ,&nbsp;Chuyao Fang ,&nbsp;Xian Shao ,&nbsp;Sheng Nie","doi":"10.1016/j.diabet.2025.101639","DOIUrl":"10.1016/j.diabet.2025.101639","url":null,"abstract":"<div><h3>Background</h3><div>Evidence regarding the role of acute kidney injury (AKI) in long-term development of metabolic dysfunction-associated fatty liver disease (MAFLD) is limited. We aimed to investigate the associations between AKI and liver-related events in patients with MAFLD.</div></div><div><h3>Methods</h3><div>This study involved 50,499 Chinese adults with MAFLD from the China Renal Data System (CRDS) database. We identified AKI using patient-level serum creatinine data according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The primary outcome was a composite of liver-related mortality and major adverse liver outcomes. The secondary outcome was an escalation of fibrosis-4 (FIB-4) risk scores. Cox proportional hazard models were performed to assess the association between AKI and the study outcomes.</div></div><div><h3>Results</h3><div>The median age of the patients was 59.17 years, with 54.7% being male. There were 3,711 (7.3%) patients who experienced AKI during hospitalization. A total of 1,660 (3.3%) patients experienced composite liver outcome. Patients with AKI during hospitalization had higher risk of composite liver outcomes (adjusted hazard ratio (aHR) 1.83 [95% confidence interval 1.38;2.41] <em>P</em> &lt; 0.001), especially among those with severe AKI (stage 2/3) (aHR 2.36 [1.57;3.54] <em>P</em> &lt; 0.001). Regarding the secondary outcome, AKI was also associated with an increased risk of escalation of FIB-4 risk scores (aHR 1.28 [1.14;1.44] <em>P</em> &lt; 0.001). These associations remained consistent across various subgroups and sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>AKI was significantly associated with an increased risk of liver-related events among patients with MAFLD. These findings suggest that enhanced vigilance toward AKI may be justifiable in MAFLD patients.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 3","pages":"Article 101639"},"PeriodicalIF":4.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of glucagon-like peptide-1 receptor agonists in people with history of acute pancreatitis: TriNetX analysis","authors":"Mahmoud Nassar ,&nbsp;Hazem Abosheaishaa ,&nbsp;Anoop Misra ,&nbsp;Paresh Dandona ,&nbsp;Husam Ghanim ,&nbsp;Ajay Chaudhuri (Prof.)","doi":"10.1016/j.diabet.2025.101613","DOIUrl":"10.1016/j.diabet.2025.101613","url":null,"abstract":"<div><h3>Introduction</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used in subjects with type 2 diabetes (T2D) and obesity. However, concerns over their association with acute pancreatitis (AP) have emerged. Our aim was to evaluate the risk of recurrence of AP in subjects on GLP-1RAs with a history of AP.</div></div><div><h3>Methods</h3><div>This retrospective study deployed the TriNetX platform. We identified adult cohorts of subjects with a history of AP and analyzed the impact of individual medications (GLP-1RAs, SGLT2i, or DPP4i) on the risk of recurrence of AP. To adjust for baseline differences, propensity score matching was done in cohorts with and without risk factors for AP.</div></div><div><h3>Results</h3><div>Our analysis of 672,069 patients with a history of AP and T2D revealed significant risk reductions associated with GLP-1RAs compared to other treatments. Over one to five years, GLP-1RAs consistently showed a lower risk of AP recurrence compared to SGLT2i and DPP-4i. Specifically, over a one-year period, GLP-1RAs users had a risk reduction of -0.071 (95 % CI:0.085 to -0.057) (p &lt; 0.001) compared to SGLT2i, and -0.064 (95 % CI:0.080 to -0.048) (p&lt; 0.001) compared to DPP-4i. These trends persisted, with the risk differences further widening by the fifth year to -0.086 and -0.094, respectively.</div></div><div><h3>Conclusion</h3><div>Based on our findings, we conclude that GLP-1RAs may be safely used in subjects with a history of acute pancreatitis. While our analysis showed that there was a significantly lower risk of AP recurrence in subjects on GLP-1compared to DPP-IV inhibitors and SGLT2 inhibitors, as this is a retrospective analysis we suggest that these findings need to be confirmed in prospective studies.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101613"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early use of hybrid closed-loop following total pancreaticoduodenectomy","authors":"Alice Larroumet ,&nbsp;Arthur Marichez ,&nbsp;Marion Camoin ,&nbsp;Laurence Baillet-Blanco ,&nbsp;Jean-Philippe Adam ,&nbsp;Christophe Laurent ,&nbsp;Vincent Rigalleau ,&nbsp;Kamel Mohammedi ,&nbsp;Laurence Chiche","doi":"10.1016/j.diabet.2025.101619","DOIUrl":"10.1016/j.diabet.2025.101619","url":null,"abstract":"<div><div>Diabetes secondary to total pancreaticoduodenectomy (TP) is challenging to manage due to high glycemic variability and risk of hypoglycemia, in a frail population. We report the case of four patients with no prior diabetes who underwent TP. Three of four patients needed artificial nutritional support. Hybrid closed-loop (HCL) insulin therapy was initiated within 12 weeks of surgery. After 90 days of HCL treatment, continuous glucose measurement showed a 70.4 ± 11.8 % time in range (versus 43 ± 6.5 % before HCL); 0.2 ± 0.2 % time below range (versus 0.6 ± 0.5 % before HCL); 23.8 ± 9.1 % time above range 180–250 mg/dl (versus 22.9 ± 6.1 % before HCL); 4.2 ± 2.5 % time above range &gt; 250 mg/dl (versus 33.8 ± 3.9 % before HCL). The glucose management indicator improved from 8.5 ± 0.6 % to 6.9 ± 0.6 %. There was no severe hypoglycemia or need for unplanned medical attention. Early post-operative use of HCL allowed our patients to achieve safely optimal glycemic control after TP.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101619"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of SGLT2 inhibitors and GLP-1 receptor agonists in preventing Alzheimer's disease, vascular dementia, and other dementia types among patients with 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.2025.101623","DOIUrl":"10.1016/j.diabet.2025.101623","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes mellitus (T2DM) is associated with an elevated risk of dementia, including Alzheimer's disease (AD) and vascular dementia (VaD). While sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have shown neuroprotective potential, comparative data on their efficacy in dementia prevention remain scarce.</div></div><div><h3>Methods</h3><div><em>-</em> We conducted a retrospective cohort study using the TriNetX database, including 307,103 SGLT2 inhibitor users and 348,686 GLP-1 receptor agonist users with T2DM. Propensity score matching yielded 221,883 pairs with balanced baseline characteristics. The primary outcome was overall dementia incidence, with secondary outcomes including AD, VaD, and all-cause mortality. Hazard ratios (HRs) were calculated using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>SGLT2 inhibitors were associated with a significantly lower incidence of overall dementia compared to GLP-1 receptor agonists (2.7 % vs. 3.6 %; HR, 0.92; 95 % CI, 0.89–0.95). The risk of VaD (HR, 0.89; 95 % CI, 0.84–0.95) and AD (HR, 0.90; 95 % CI, 0.86–0.94) was also reduced with SGLT2 inhibitors. All-cause mortality was lower in the SGLT2 group (3.6 % vs. 4.6 %; HR, 0.95; 95 % CI, 0.92–0.98). No significant difference was observed in other dementia subtypes (HR, 0.96; 95 % CI, 0.91–1.01).</div></div><div><h3>Conclusions</h3><div>In this large, real-world cohort, SGLT2 inhibitors demonstrated superior efficacy over GLP-1 receptor agonists in reducing the risks of overall dementia, VaD, and AD among patients with T2DM. These findings support the preferential use of SGLT2 inhibitors in mitigating dementia risk in this population, though randomized controlled trials are warranted for confirmation.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 2","pages":"Article 101623"},"PeriodicalIF":4.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426683","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}