Diabetes & metabolism最新文献

{"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":"Hip fractures and type 2 diabetes in the elderly: Risk factors analysis of the Nedices cohort","authors":"Federico Hawkins Carranza ,&nbsp;Cristina Martín-Arriscado Arroba ,&nbsp;Arturo Corbatón-Anchuelo ,&nbsp;Guillermo Martínez Díaz-Guerra ,&nbsp;Félix Bermejo Pareja","doi":"10.1016/j.diabet.2025.101656","DOIUrl":"10.1016/j.diabet.2025.101656","url":null,"abstract":"<div><h3>Aim</h3><div><em>-</em> To analyze the association between type 2 diabetes (T2D) and the incidence of hip fractures in the elderly, while also considering the influence of socioeconomic status (SES), and other risk factors (RFs).</div></div><div><h3>Methods</h3><div><em>-</em> Data were collected from 5278 participants aged ≥ 65 years. The study included a baseline and a follow-up survey 3 years later. Participants completed a questionnaire, anthropometric measurements, blood tests, and physical and cognitive tools. The research was conducted in three Spanish communities with different socioeconomic backgrounds.</div></div><div><h3>Results</h3><div><em>-</em> At baseline, there were 874 T2D and 4494 controls. Body mass index (BMI) was slightly higher in individuals with hip fractures. Significant differences were observed in BMI, education level, physical activity, osteoporosis, cataracts, and osteoarthritis. In the follow-up survey, 96 newly, 615 previously T2D, and 2985 controls were compared. Those with hip fractures were associated with lower educational attainment, sedentary life, and higher diagnoses of osteoporosis, cataracts, and osteoarthritis. Charlson index was higher in individuals with hip fractures. A higher proportion of fractures occurred in urban areas. The rate of incidence of T2D between individuals with and without fractures was not different.</div></div><div><h3>Conclusion</h3><div><em>-</em> RFs for hip fractures in T2D are similar to those in the general population. Osteoporosis, being female, and advancing age were independent RFs for hip fractures. There was an inverse association between educational level, community allocation, and physical activity which may further contribute to hip fracture risk. These highlights the need for research to better understand the role of T2D and these RFs in hip fracture incidence.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101656"},"PeriodicalIF":4.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047744","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}

{"title":"Increased fatty acid-binding protein 4 levels are associated with the risk of developing retinopathy in type 2 diabetes mellitus patients","authors":"Yan Liu ,&nbsp;Kaihui Ma ,&nbsp;Aiying Zhang ,&nbsp;Yun Cui ,&nbsp;Hui Zhao ,&nbsp;Xinhua Li ,&nbsp;Ke Zhao","doi":"10.1016/j.diabet.2025.101653","DOIUrl":"10.1016/j.diabet.2025.101653","url":null,"abstract":"<div><h3>Aim</h3><div>Fatty acid-binding protein 4 (FABP4) is associated with the risk of developing diabetes and its microvascular complications. We aimed to explore the association between serum FABP4 levels and the risk of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>Serum FABP4 levels were measured via enzyme-linked immunosorbent assay in 275 individuals (78 healthy controls, 197 T2DM patients). DR severity was determined via fundus fluorescence angiography. Multivariate analyses were performed via logistic regression models. The diagnostic value of these measures was assessed via receiver operating characteristic curve analysis.</div></div><div><h3>Results</h3><div>Serum FABP4 levels were significantly greater in the proliferative DR (PDR) group than in the ZeroDR (ZDR) and non-proliferative DR (NPDR) groups, and the FABP4 levels positively with DR severity (<em>r</em> = 0.328, <em>P</em> &lt; 0.001). Logistic regression analysis revealed that after adjusting for potential confounders, increased FABP4, fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were risk factors for DR development, and FABP4 was an independent risk factor for PDR development. A multivariate logistic regression model that included FABP4 as a categorical binary variable with a cutoff value of 20.57 ng/ml revealed that a level of FABP4 above the cutoff value increased the DR risk (OR=6.394; 95 % CI=3.18;13.58; <em>P</em> &lt; 0.001). Similarly, a FABP4 concentration above the cutoff value of 24.40 ng/ml increased the PDR risk (OR=4.686; 95 % CI=1.907;12.34; <em>P</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>The FABP4 level is associated with DR severity and has the potential as a serum biomarker for DR prediction.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101653"},"PeriodicalIF":4.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870631","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":"2025-04-15","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":"Impact of SGLT-2i on COPD exacerbations in patients with type 2 diabetes mellitus: A systematic review and meta-analysis","authors":"Prakasini Satapathy ,&nbsp;Abhay M Gaidhane ,&nbsp;Nasir Vadia ,&nbsp;Soumya V Menon ,&nbsp;Kattela Chennakesavulu ,&nbsp;Rajashree Panigrahi ,&nbsp;Jayaraj Patil ,&nbsp;Ganesh Bushi ,&nbsp;Mahendra Singh ,&nbsp;Awakash Turkar ,&nbsp;Sanjit Sah ,&nbsp;S. Govinda Rao ,&nbsp;Khang Wen Goh ,&nbsp;Muhammed Shabil","doi":"10.1016/j.diabet.2025.101646","DOIUrl":"10.1016/j.diabet.2025.101646","url":null,"abstract":"<div><h3>Background</h3><div>Chronic Obstructive Pulmonary Disease (COPD) and Type 2 Diabetes Mellitus (T2DM) often coexist, leading to compounded morbidity, mortality, and healthcare burden. COPD exacerbations significantly impact patients with T2DM, with increased frequency and severity. Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) have demonstrated promising benefits in managing both glycemic control and respiratory health. This systematic review and meta-analysis aim to assess the impact of SGLT-2 inhibitors on COPD exacerbations in T2DM patients.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis following PRISMA guidelines, evaluating studies published until March 2025. A broad search strategy across PubMed, Embase, and Web of Science identified relevant studies comparing SGLT-2 inhibitors with other antidiabetic agents. Studies meeting predefined eligibility criteria, including those providing quantitative data on COPD exacerbation frequency and hospitalization rates, were included in the analysis.</div></div><div><h3>Results</h3><div>Eight studies involving 4,64,542 participants were included. The pooled hazard ratio (HR) for the impact of SGLT-2 inhibitors on COPD exacerbations was 0.646 (95 % CI: 0.470–0.889), demonstrating a 35 % decrease in exacerbations compared to other antidiabetic agents. SGLT-2 inhibitors demonstrated superior efficacy over DPP-4 inhibitors (HR: 0.618, 95 % CI: 0.462–0.827) and sulfonylureas (HR: 0.620, 95 % CI: 0.526–0.731). However, the reduction in severe exacerbations was not statistically significant (HR: 0.715, 95 % CI: 0.403–1.269). Subgroup analysis indicated that SGLT-2 inhibitors had a modest but significant advantage over GLP-1 receptor agonists (HR: 0.940, 95 % CI: 0.890–0.993).</div></div><div><h3>Conclusions</h3><div>SGLT-2 inhibitors significantly reduce COPD exacerbations in T2DM patients, offering dual benefits in managing both glycemic control and respiratory health. These findings support the integration of SGLT-2 inhibitors into treatment regimens for T2DM-COPD overlap. Further randomized controlled trials and long-term studies are needed to confirm the lasting efficacy and explore the underlying mechanisms.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101646"},"PeriodicalIF":4.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843437","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}