Diabetes & metabolism最新文献

{"title":"Effect of dietary reinforcement combined or not with GLP-1 receptor agonist therapy on histological outcomes in MASLD among patients with type 2 diabetes","authors":"Bruno Guerci , Michael Joubert , Ghassan Riachi , Marie-Lauren Antoine , Delphine Clabaut , Renaud Fay , Gaetan Prevost","doi":"10.1016/j.diabet.2025.101679","DOIUrl":"10.1016/j.diabet.2025.101679","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101679"},"PeriodicalIF":4.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340737","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":"Mitochondrial heteroplasmy-phenotype correlation and response to glucose lowering therapy in subjects with m.3243A>G mutations","authors":"N Ng ,&nbsp;B Sanchez-Lechuga ,&nbsp;CJ McCarrick ,&nbsp;C Mangan ,&nbsp;M Burke ,&nbsp;J.A. Ioana ,&nbsp;C Gavin ,&nbsp;R O’Byrne ,&nbsp;JJ O’Byrne ,&nbsp;MM Byrne","doi":"10.1016/j.diabet.2025.101678","DOIUrl":"10.1016/j.diabet.2025.101678","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a paucity of evidence to guide pharmacological treatment for mitochondrial diabetes. Metformin is generally contraindicated due to the high risk of lactic acidosis, Sulphonylurea (SU) therapy has been used as 1st line therapy but most progress to insulin. The aim of this study is to investigate the glucose-insulin secretory response to oral glucose, the response to glucose lowering therapy, and the heteroplasmy phenotype correlation in subjects with a confirmed m.3243A&gt;G mutation.</div></div><div><h3>Methods</h3><div>49 subjects were phenotyped in detail. A 2 hr OGTT was performed to establish insulin-secretory response. Heteroplasmy was measured and they had bi-annual clinical follow-up.</div></div><div><h3>Results</h3><div>34 of 49 m.3243A&gt;G subjects had diabetes mellitus (DM) with an onset at 38 (31–44) years, 7 had impaired glucose tolerance or impaired fasting glucose, and 8 had normal glucose tolerance (NGT). DM subjects had reduced insulin secretion (AUC C-peptide 2009.0[1710.0–3156.0] vs. 4693.75[3768.25–5609.38] pmol/l/120 min, <em>P</em> = 0.002) and insulin sensitivity (OGIS 283.0[209.0–324.0] vs. 437.0 [416.0–524.0]ml min⁻¹m⁻², <em>P</em> &lt; 0.001]) compared to NGT subjects. Heteroplasmy was higher in DM subjects compared to NGT (20[11–26] vs. 6[5–10] %, <em>P</em> = 0.014). 5 of 8 subjects on metformin had raised lactate and 65 % of subjects required insulin to improve glycaemic control. Only 1/6 subjects transitioned from insulin to SU. Two subjects on SGLT2i and GLP-1 agonists progressed to insulin.</div></div><div><h3>Conclusion</h3><div>β-cell dysfunction and insulin resistance contribute to mitochondrial diabetes development. 65 % of subjects required insulin to improve glycaemic control. Early insulin initiation may be necessary to improve glycaemic control in the long term.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101678"},"PeriodicalIF":4.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337326","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":"The significance of ophthalmological evaluation in the correct diagnosis of pediatric insulin-dependent diabetes mellitus: lessons from novel WFS1 variants","authors":"Eleni Papageorgiou ,&nbsp;Panagiotis N. Toumasis ,&nbsp;Aspasia Tsezou ,&nbsp;Emmanouil Manolakos ,&nbsp;Georgia Gazeti ,&nbsp;Efthimios Dardiotis ,&nbsp;Eleni Arnaoutoglou ,&nbsp;Aggeliki Alagianni ,&nbsp;Argyro Petsiti ,&nbsp;Polyxeni Stamati ,&nbsp;Zisis Tsouris ,&nbsp;Aspasia Michoula ,&nbsp;Sofia Androudi ,&nbsp;Ioanna Grivea ,&nbsp;Dimitrios T. Papadimitriou","doi":"10.1016/j.diabet.2025.101676","DOIUrl":"10.1016/j.diabet.2025.101676","url":null,"abstract":"<div><div>Wolfram syndrome 1 is an autosomal recessive disorder often commencing as insulin dependent diabetes, but with inherent progressive ultimately fatal neurodegeneration. We report two pediatric cases, referred as unregulated insulin dependent diabetes mellitus, initially misdiagnosed as type 1 diabetes, in whom whole exome sequencing confirmed the clinical diagnosis of Wolfram syndrome with novel Wolfram syndrome gene 1 variants. An 11-year-old Asian male refugee with presumed type 1 diabetes since the age of 6 years, acknowledged progressive visual decline the last 6 months, but only after ophthalmological evaluation revealing bilateral optic atrophy, confirmed by optical coherence tomography and retinal nerve fiber layer thinning, leading to genetic testing and revealing a novel homozygous missense variant (c.1598C&gt;<em>T</em>, p.Pro533Leu). A 15-year-old male with severely progressive autism spectrum disorder since the age of 3 years, and poorly regulated presumed type 1 diabetes since the age of 9 years, had signs of a progressive neurodegenerative disorder at presentation. Bilateral optic nerve pallor and sensorineural hearing loss were documented. Genetic testing revealed the pathogenic Wolfram syndrome gene 1 variant c.1523_1524delTA; p.Tyr508CysfsTer34 (frameshift deletion) in trans with the previously undescribed missense variant c.497T&amp;gt;C; p.Leu166Pro, reclassified now as likely pathogenic. Both cases highlight the importance of ophthalmological evaluation in the early diagnostic workup of pediatric insulin dependent diabetes when autoimmunity is not confirmed. Although not mandated by current guidelines, early ophthalmologic assessment, at least in insulin dependent diabetes with non-previously established autoimmunity, can enable timely diagnosis of Wolfram syndrome, enabling prompt multidisciplinary intervention and potential enrollment in emerging disease-modifying therapies.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101676"},"PeriodicalIF":4.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319118","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":"Can diabetic peripheral neuropathy predict lacunar stroke in patients with diabetes?","authors":"Nathalie Deschamps ,&nbsp;Nadia Sabbah ,&nbsp;Amina Nasri ,&nbsp;Michel Haba ,&nbsp;Mathieu Nacher ,&nbsp;Bertrand De Toffol","doi":"10.1016/j.diabet.2025.101675","DOIUrl":"10.1016/j.diabet.2025.101675","url":null,"abstract":"<div><div>Stroke is the leading-cause of death in women and motor-disability in adults. In patients with diabetes, diabetic peripheral neuropathy (DPN) increases the risk of ischemic stroke. The aim of this work was to test the hypothesis that an etiological pattern of ischemic stroke in patients with DPN can be recognized. This was a single-center retrospective observational study of patients hospitalized in Cayenne general-hospital with ischemic stroke. The primary endpoint was to determine if there is an association between the mechanism of stroke and the presence of DPN. We included 226 patients: mean age 64.14 ± 15.2 years; male predominance (62.4 %); and 5.8 % with DPN, i.e., 14.9 % of patients with diabetes. DPN was significantly associated with small-vessel disease (SVD): adjusted odds ratio=5.08 [1.17;22.14]. These findings highlight a common pathophysiology between DPN and SVD. DPN can provide a window of opportunity to detect SVD and prevent its complications like stroke or dementia.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101675"},"PeriodicalIF":4.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277282","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":"The association between hip fractures and type 2 diabetes in the elderly","authors":"Shu Yuan ,&nbsp;Zi-Lin Li ,&nbsp;Jing Hu","doi":"10.1016/j.diabet.2025.101673","DOIUrl":"10.1016/j.diabet.2025.101673","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101673"},"PeriodicalIF":4.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251691","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":"Cardiorenal outcomes and safety of SGLT2 inhibitors in patients with diabetes secondary to disorders of the exocrine pancreas: a nationwide population-based study","authors":"Kyoung Hwa Ha ,&nbsp;Minae Park ,&nbsp;Yujin Lee ,&nbsp;Dae Jung Kim ,&nbsp;Seung Jin Han","doi":"10.1016/j.diabet.2025.101668","DOIUrl":"10.1016/j.diabet.2025.101668","url":null,"abstract":"<div><h3>Aims</h3><div>Limited data are available on the effectiveness of pharmacological treatments for diabetes secondary to disorders of the exocrine pancreas (DEP). This study evaluated the real-world effectiveness and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in individuals with DEP.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from the Korean National Health Insurance Service database. Data on 66,120 individuals with DEP who initiated glucose-lowering drugs (GLDs) between September 2014 and December 2022 were analyzed. Patients initiating SGLT2 inhibitors were matched 1:1 with patients initiating other GLDs using propensity-score matching. The effectiveness outcomes included major adverse cardiovascular events (MACEs), heart failure, end-stage kidney disease (ESKD), and all-cause mortality. The safety outcomes included hypoglycemia, diabetic ketoacidosis, genital infections, urinary tract infections, fractures, pancreatitis, and pancreatic cancer.</div></div><div><h3>Results</h3><div>After matching, 4,128 SGLT2 inhibitor-other GLD user pairs were included in the analysis, with a mean follow-up of 2.3 years. Compared with use of other GLDs, use of SGLT2 inhibitors was associated with a significantly lower risk of MACE (hazard ratio [HR]: 0.69; 95% confidence interval [CI]: 0.51–0.93), hospitalization for heart failure (HR: 0.70; 95% CI: 0.51–0.95), ESKD (HR: 0.19; 95% CI: 0.06–0.61), and all-cause mortality (HR: 0.38; 95% CI: 0.27–0.53). SGLT2 inhibitor use was associated with a reduced risk of urinary tract infections (HR: 0.87; 95% CI: 0.78–0.96) and pancreatitis (HR 0.71; 95% CI 0.58–0.87).</div></div><div><h3>Conclusions</h3><div>SGLT2 inhibitors were associated with a reduced risk of adverse cardiorenal outcomes and all-cause mortality and were safely used in patients with DEP.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101668"},"PeriodicalIF":4.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201265","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":"Glucagon-like peptide-1 receptor agonists and acute pancreatitis","authors":"Kuan-Fu Liao ,&nbsp;Shih-Wei Lai","doi":"10.1016/j.diabet.2025.101666","DOIUrl":"10.1016/j.diabet.2025.101666","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101666"},"PeriodicalIF":4.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What the diabetologist needs to know about the risk of non-arteritic anterior ischaemic optic neuropathy and GLP-1 receptor agonist use in patients with type 2 diabetes","authors":"Sylvie Feldman-Billard","doi":"10.1016/j.diabet.2025.101664","DOIUrl":"10.1016/j.diabet.2025.101664","url":null,"abstract":"<div><h3>Aim</h3><div>Recent findings have raised concern about a potential association between semaglutide use and non-arteritic anterior ischaemic optic neuropathy (NAION), a rare form of permanent vision loss. This report provides a critical analysis of the current knowledge of GLP-1 receptor agonist (RA) use and risk of NAION in patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>A literature search strategy was conducted for all English-language literature with a systematic review of key references up to April 2025.</div></div><div><h3>Results</h3><div>Across studies including patients with T2D, the relative increase in NAION risk associated with the use of a GLP-1 RA, mainly semaglutide, ranged from nonsignificant to fourfold, while the absolute number of affected patients remained low. Given the retrospective design of the main studies, no causal link could be established between the use of GLP-1RAs and NAION. Some mechanistic hypotheses have been put forward without any being formally demonstrated to date. The profound metabolic and haemodynamic changes induced by GLP-1RAs might be the trigger of NAION in predisposed patients with an optic “disc-at-risk”, a potent anatomical risk factor easily detected by ocular examination.</div></div><div><h3>Conclusion</h3><div>Pending studies clarifying this risk, these findings call for cautious use of GLP-1 RAs, particularly in patients with ocular risk factors. Given the widespread use of GLP-1RAs, clinicians should be aware of this potential risk, without overshadowing the remarkable benefit of GLP-1RAs in patients with type 2 diabetes.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101664"},"PeriodicalIF":4.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 inhibitor, GLP-1 receptor agonist, and dementia risk","authors":"Shih-Wei Lai","doi":"10.1016/j.diabet.2025.101663","DOIUrl":"10.1016/j.diabet.2025.101663","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101663"},"PeriodicalIF":4.6,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of type 2 diabetes in non-elderly individuals 1990 to 2021 and projections for 2050: a systematic analysis of the 2021 Global Burden of Disease","authors":"Qian He ,&nbsp;Wenjing Wu ,&nbsp;Junnian Chen ,&nbsp;Haofeng Zhou ,&nbsp;Gangyu Ding ,&nbsp;Shuiqing Lai ,&nbsp;AndyY.T. Kuo ,&nbsp;Heng Wan ,&nbsp;Beisi Lin ,&nbsp;Hongjiang Wu ,&nbsp;AliceP.S. Kong ,&nbsp;Haixia Guan ,&nbsp;Huanyi Cao","doi":"10.1016/j.diabet.2025.101660","DOIUrl":"10.1016/j.diabet.2025.101660","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes (T2D) is increasingly becoming a major global health challenge. However, research on T2D in non-elderly populations remains insufficient.</div></div><div><h3>Methods</h3><div>We analyzed data from the Global Burden of Disease (GBD) study in 2021, focusing on diabetes-related indicators among individuals aged 15 to 59 across 204 countries and regions. This included prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs), categorized into 21 GBD regions according to the Sociodemographic Index (SDI). We employed join-point regression and Bayesian Age-Period-Cohort models to assess trends from 1990 to 2021 and forecast from 2021 to 2050.</div></div><div><h3>Results</h3><div>The global age-standardized incidence rate increased from 196.3 per 100,000 (95 % UI, 145.2–257.4) in 1990 to 361.1 per 100,000 (95 % UI, 275.2–458.4) in 2021. The prevalence, mortality rate, and DALYs exhibit a similar upward trend. Although both men and women have experienced rises in prevalence, incidence, mortality rate, and DALYs, men continue to lead these metrics across nearly all age groups. Low-middle SDI countries bear the most severe disease burden. A high body mass index is a major risk factor in this population. It is estimated that by 2050, approximately 1.195 billion non-elderly individuals worldwide will have T2D, with epidemiological changes being the primary driver of this disease burden.</div></div><div><h3>Conclusions</h3><div>This study on the burden of T2D reveals that its prevalence among non-elderly individuals is steadily increasing and is projected to affect over a billion people worldwide by 2050. Targeted measures are crucial to tackle this global health challenge for this population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 4","pages":"Article 101660"},"PeriodicalIF":4.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}