Diabetes & metabolism最新文献

{"title":"Epicardial adipose tissue measurement is an interesting biomarker for cardiovascular health in a case control study of patients with familial partial type 2 lipodystrophy","authors":"Mathilde Simonson ,&nbsp;Patricia Ancel ,&nbsp;Romain Mortier ,&nbsp;Mohamed Lamine Mariko ,&nbsp;Bénédicte Fontaine ,&nbsp;Julie Koue-Chon-Lim ,&nbsp;Jules Martel ,&nbsp;Estelle Nobécourt ,&nbsp;Bénédicte Gaborit","doi":"10.1016/j.diabet.2025.101719","DOIUrl":"10.1016/j.diabet.2025.101719","url":null,"abstract":"<div><h3>Aim</h3><div>Clinical cardiovascular risk scoring and Coronary artery calcification evaluation are lacking in Type 2 Familial Partial Lipodystrophy patients who present higher cardiovascular events and risk factors. The epicardial adipose tissue volume - a visceral adipose tissue which is accumulated during lipodystrophy - is higher in type 2 diabetic patients with coronary artery disease. In this case control study, we assessed epicardial adipose tissue volume as a new marker of interest in these patients.</div></div><div><h3>Methods</h3><div>Patients with type 2 Familial Partial Lipodystrophy or control patients, in primary prevention for cardiovascular events, were followed up at the University Hospital of La Réunion. Type 2 Familial Partial Lipodystrophy patients undergoing both coronary artery calcification and clinical cardiovascular risk scoring were retrospectively included and paired with control patients for age, sex and body mass index (NCT07090629). The epicardial adipose tissue volume was measured for each of the 126 subjects, with a semi-automated technique using deep learning and AI. Results: Type 2 Familial Partial Lipodystrophy patients displayed significantly higher adipose tissue volume (77 ± 39 cm³) than control subjects at high cardiovascular risk (60 ± 30 cm³; <em>P</em> = 0.010).</div></div><div><h3>Conclusions</h3><div>we show for the first time patients with Type 2 Familial Partial Lipodystrophy present higher values of epicardial adipose tissue volume, an interesting biomarker to add to coronary artery calcification and clinical scoring.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101719"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688836","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":"\"Usefulness of continuous interstitial glucose in diabetic patient undergoing hemodialysis","authors":"Elise Berchoux ,&nbsp;Ilan Szwarc ,&nbsp;Jean-Baptiste Bonnet ,&nbsp;Joanna Pissarra ,&nbsp;Antoine Avignon ,&nbsp;Sébastien Jugant ,&nbsp;Moglie Le Quintrec ,&nbsp;Ariane Sultan","doi":"10.1016/j.diabet.2025.101720","DOIUrl":"10.1016/j.diabet.2025.101720","url":null,"abstract":"<div><h3>Backgroung</h3><div>In patients with type 2 diabetes (T2D) undergoing hemodialysis (HD), glycemic control is challenging, and glycated hemoglobin (HbA1c) is often unreliable due to altered red blood cell turnover, anemia, and treatments such as erythropoiesis-stimulating agents. Continuous glucose monitoring (CGM) provides additional metrics—such as time in range (TIR), time below range (TBR), and glycemic variability—that may better reflect glucose control in this population. This study aimed to assess the usefulness of 14-day CGM data compared to HbA1c in evaluating glycemic control in T2D patients on HD.</div></div><div><h3>Methods</h3><div>This is a prospective and multicenter study. Patients included were of &gt; 18 years, DM2, and hemodialysis patients. We assessed glycemic control of diabetic hemodialysis patient over 14 days with the CGM freestyle 1 comparing to HbA1c.</div></div><div><h3>Results</h3><div>Forty-one patients were included. While 68 % had HbA1c &lt; 8 %, only 21 % met the CGM targets (<em>P</em> &lt; 0.005). Mean glucose levels were significantly lower on dialysis days (−13 mg/dl, <em>P</em> &lt; 0.0001), without an increase in hypoglycemic episodes. Discrepancies between HbA1c and CGM metrics were associated with diabetes-related nephropathy and longer duration of HD.</div></div><div><h3>Conclusion</h3><div>HbA1c alone may substantially underestimate glycemic burden in patients on hemodialysis. CGM provides a more accurate assessment of glucose control and reveals undetected hypo- and hyperglucose levels. Incorporating CGM into routine care may improve diabetes management and therapeutic decision-making in this high-risk population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101720"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696550","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":"Pancreatic polypeptide in patients with type 1 diabetes and exocrine failure or chronic pancreatitis. The DIAPP study","authors":"Lea Dehghani ,&nbsp;Fideline Bonnet-Serrano ,&nbsp;Hendy Abdul ,&nbsp;Laure Alexandre-Heymann ,&nbsp;Jean Guibourdenche ,&nbsp;Etienne Larger","doi":"10.1016/j.diabet.2025.101712","DOIUrl":"10.1016/j.diabet.2025.101712","url":null,"abstract":"<div><h3>Introduction</h3><div><em>.</em> <strong>-</strong> Exocrine dysfunction can occur in type 1 diabetes (T1D). When exocrine function is impaired, it is unclear whether alterations also involve other endocrine cell types beyond beta cells. Pancreatic polypeptide (PP) is, besides insulin, the sole hormone that is specific to islets of Langerhans. The aim of the DIAPP study was to evaluate if PP secretion is also altered when T1D is complicated by exocrine failure.</div></div><div><h3>Materials and Methods</h3><div><em>. -</em> Seven patients with T1D and normal pancreatic function (T1DN), 9 patients with T1D and exocrine failure (T1DEF) were compared to 13 patients with type 3c diabetes; i. e. with chronic pancreatitis (CP). All of them had a mixed meal test (MMT), C-peptide and PP being determined before and at 60, 90 and 120 minutes.</div></div><div><h3>Results</h3><div><em>. –</em> The area under the curve of C-peptide during MMT (AUC_Cpep) was significantly greater in the CP group than in both T1D groups (<em>P</em> &lt; 0.0001 vs. the T1DEF group and <em>P</em> &lt; 0.001 vs. the T1D group) while the area under the curve of PP (AUC_PP) was significantly smaller in the CP group than in both T1D groups (<em>P</em> &lt; 0.01 vs. both groups). The AUC_PP / AUC_Cpep ratio was higher in the CP group than in both T1D groups (<em>P</em> &lt; 0.0001 vs. both groups).</div></div><div><h3>Conclusion</h3><div><em>. -</em> PP secretion was altered specifically in patients with CP, not in T1D, even when associated with pancreatic exocrine failure.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101712"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497968","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":"Handgrip strength cut-off points for identifying French adults at risk of type 2 diabetes","authors":"Thi Chi Phuong Nguyen ,&nbsp;Jean-Michel Oppert ,&nbsp;Laurent Bourhis ,&nbsp;Alice Bellicha ,&nbsp;Bernard Srour ,&nbsp;Emmanuelle Kesse-Guyot ,&nbsp;Serge Hercberg ,&nbsp;Pilar Galan ,&nbsp;Mathilde Touvier ,&nbsp;Léopold K Fezeu ,&nbsp;Jérémy Vanhelst","doi":"10.1016/j.diabet.2025.101713","DOIUrl":"10.1016/j.diabet.2025.101713","url":null,"abstract":"<div><h3>Aim</h3><div>To identify cut-off points for handgrip strength (HGS) detecting T2D risk among adults in France, and to examine the relationships between absolute and relative HGS and the incidence of T2D.</div></div><div><h3>Methods</h3><div>Data from 18,519 adults (5096 men) in the NutriNet-Santé cohort, were analyzed. HGS was measured using dynamometry on both hands. Nine indicators were derived, including absolute values and those relative to body weight and BMI. Receiver Operating Characteristic curves and cubic splines were used to assess predictive performance, as well as cut-off points for HGS that maximize this performance. Cox proportional hazards models were used to evaluate associations between reduced HGS and T2D.</div></div><div><h3>Results</h3><div>Over 9.8 years, 329 incident T2D cases were validated. Absolute HGS showed not associated with T2D risk, whereas higher relative HGS was associated with lower risk (e.g. HR for HGS relative to body weight: 1.30, 95 % CI: 1.07–1.58). Relative HGS showed better discrimination (AUC 0.623–0.675) than absolute HGS (≤ 0.44). Optimal cut-offs were 0.446 kg/kg and 1.086 kg/kg/m² (dominant hand), and 0.397 kg/kg and 1.033 kg/kg/m² (non-dominant). Low relative HGS was associated with increased risk (HRs 1.42–1.68), consistent across sensitivity, sex, and age analyses.</div></div><div><h3>Conclusions</h3><div>Relative, but not absolute, handgrip strength is independently associated with T2D incidence and shows modest discriminative ability. Given its simplicity and cost-effectiveness, grip strength may be a useful screening tool in clinical and public health settings.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101713"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497877","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":"Is Omnipod 5 cost effective for the management of type 1 diabetes among adults in France?","authors":"Jean-Pierre Riveline ,&nbsp;Colin Hopley ,&nbsp;Anamaria-Vera Olivieri ,&nbsp;Gabriel Guigand ,&nbsp;Melanie Littlewood ,&nbsp;Alfred Penfornis","doi":"10.1016/j.diabet.2025.101721","DOIUrl":"10.1016/j.diabet.2025.101721","url":null,"abstract":"<div><h3>Aim</h3><div><em>-</em>To compare long-term cost-effectiveness between the Omnipod® 5 Automated Insulin Delivery System and continuous subcutaneous insulin infusion + continuous glucose monitoring for type 1 diabetes among adults in France.</div></div><div><h3>Methods</h3><div><em>-</em> The analysis used the IQVIA Core Diabetes Model (v9.5) and considered both the French healthcare system and societal perspective. The study population and treatment effects were from the OP5–003 randomized controlled trial. Life-years, quality-adjusted life-years, incremental cost-effectiveness ratios and incremental cost-utility ratios, modeled over a 50-year horizon (base case), were analyzed. Sensitivity analyses were conducted to test treatment effects with different time horizons and discounting. Utility values were based on Omnipod 5 EuroQoL 3-Dimensions data and literature sources.</div></div><div><h3>Results</h3><div><em>-</em> In the base case, Omnipod 5 showed better clinical outcomes and lower diabetes-related complication rates than continuous subcutaneous insulin infusion + continuous glucose monitoring, gaining 0.373 life-years and 1.568 quality-adjusted life-years (incremental cost-utility ratio considering direct costs from a healthcare perspective = €791 per quality-adjusted life-year). With Omnipod 5, although direct healthcare costs were €1240 higher, there were savings from reduced complications, and total costs including societal productivity were €3071 lower. Sensitivity analyses confirmed lower total costs with Omnipod 5 across time horizons and discounting, and the direct cost-utility ratio was €2438 per quality-adjusted life-year when the treatment effect on glycosylated hemoglobin was halved.</div></div><div><h3>Conclusion</h3><div><em>-</em> Considering the reported benefits on glycemic control and health-related quality of life, Omnipod 5 is a cost-effective alternative to continuous subcutaneous insulin infusion + continuous glucose monitoring for adults with type 1 diabetes in France.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101721"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784216","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":"Patient-reported outcome measures (PROMs) are differently associated with treatment modalities, household income, and diabetes-related events in children with type 1 diabetes, their mothers, and their fathers: a French nationwide survey","authors":"Emmanuelle Labarre ,&nbsp;Laurent Poiroux ,&nbsp;Marc De Kerdanet ,&nbsp;Line Lobel ,&nbsp;Bétina Porcel ,&nbsp;Aurélie Donzeau ,&nbsp;Carine Choleau ,&nbsp;Jacques Beltrand ,&nbsp;Regis Coutant","doi":"10.1016/j.diabet.2025.101711","DOIUrl":"10.1016/j.diabet.2025.101711","url":null,"abstract":"<div><h3>Aim</h3><div>To conduct a population-based study on the quality of life (QoL) in families (mothers, fathers, and children) of children using closed loop (CL) compared to those using multiple daily injections (MDI), open loop (OL), and low glucose suspend (LGS) systems.</div></div><div><h3>Methods</h3><div>A nationwide French survey of children with type 1 diabetes (T1D) and their parents was conducted through the national family association, <em>Familles AJD</em>, in 2024. Six validated questionnaires were used for assessing QoL, anxiety, time spent managing diabetes, and sleep quality. Multivariate analyses were performed.</div></div><div><h3>Results</h3><div>We collected 1593 surveys (1093 from mothers, 242 from fathers, and 258 from children &gt; 8 years). T1D children were aged 11.3 ± 4 years, had diabetes for 4.7 ± 3.8 years; 18% used MDI, 41% OL, 13% LGS, and 29% CL. HbA1c was 7.3 ± 0.6% with CL, vs. 7.7 ± 1.0% for other treatments (<em>P</em> &lt; 0.05). CL was associated with improved QoL scores in parents (compared to OL and MDI), and children (compared to OL, not MDI). Time spent managing diabetes was lower with CL in parents, not children. Anxiety and sleep quality were not improved with CL. Child age (in parents) and household income (in all) were associated with improved QoL. HbA1c and a history of ketoacidosis (in mothers), or a history of severe hypoglycemia (in children), had a deleterious effect. Mothers experienced lower QoL, but scores correlated within the household.</div></div><div><h3>Conclusion</h3><div>CL enhanced the QoL in families of children with T1D. Socioeconomic factors and diabetes-related events influence QoL differently depending on the respondent group.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101711"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474837","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":"GLP-1-derived therapies and sarcopenia: plea for a specific focus on at risk special populations","authors":"André J. Scheen","doi":"10.1016/j.diabet.2025.101708","DOIUrl":"10.1016/j.diabet.2025.101708","url":null,"abstract":"<div><h3>Background</h3><div>A risk of excessive reduction in skeletal muscle mass (SSM), potentially leading to sarcopenia, when using glucagon-like peptide-1 (GLP-1)-based therapies, is currently a matter of debate. While most available results are rather reassuring in the general population, sarcopenia may become a concern in some special subgroups with comorbidities known to be associated with a higher risk of sarcopenia, independently of any GLP-1-based therapy.</div></div><div><h3>Methods</h3><div>An extensive literature search was done to identify studies that investigated the effects of GLP-1-based therapies on changes in SMM and sarcopenia in special populations, i.e. older people, patients with type 2 diabetes, atherosclerotic cardiovascular disease, heart failure, chronic kidney disease, and metabolic dysfunction–associated liver disease.</div></div><div><h3>Results</h3><div>Several publications emphasized the risk of sarcopenia and recommended caution when prescribing GLP-1-based therapies in people with these comorbidities of interest. However, hard data remain scarce in the literature, without any evidence-based demonstration of a significantly increased risk of sarcopenia. Nevertheless, as old age potentiates the risk of sarcopenia, older patients with these comorbidities (especially advanced heart failure or renal disease) deserve more careful attention.</div></div><div><h3>Conclusion</h3><div>While the risk of sarcopenia associated with GLP-1-based therapies remains controversial in the general population, a higher risk in special populations with comorbidities has been repeatedly emphasized despite the lack of evidence-based data in the literature. Because these agents showed major clinical benefits in patients with such comorbidities but sarcopenia could mitigate them, there is an urgent need to implement dedicated studies with appropriate measures of sarcopenia in these special populations.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 1","pages":"Article 101708"},"PeriodicalIF":4.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310442","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":"Body weight trends in individuals with type 1 diabetes using automated insulin delivery vs. traditional insulin pumps","authors":"Charles Thivolet ,&nbsp;Zoé Henry ,&nbsp;Nathalie Bendelac ,&nbsp;Sylvie Villar Fimbel","doi":"10.1016/j.diabet.2025.101693","DOIUrl":"10.1016/j.diabet.2025.101693","url":null,"abstract":"<div><h3>Objective</h3><div>This study analyzed the determinants of weight gain among participants initiating an automated insulin delivery (AID) system.</div></div><div><h3>Research design and methods</h3><div>In this observational study, we evaluated 928 persons with type 1 diabetes initiating an insulin pump therapy, including 467 with AID, 98 with pumps with predictive low-glucose suspend (PLGS) algorithm and 363 initiating a sensor-augmented pump (SAP).</div></div><div><h3>Results</h3><div>After 3 months, median (95CI) TIR increased from 50.69 % [49.2–52.3] to 67.9 % [66.7–69.1] in the AID group and HbA1c levels showed a mean reduction of 0.82 %. AID resulted in equivalent body weight gain to SAP and PLGS despite significant improvements in glucose control. Multivariable analysis revealed that weight gain was linked to baseline HbA1C (<em>P</em> &lt; 0.001) and age but not to the type of pump system. During follow-up, percentage increase in body weight at 12 months were similar between groups</div></div><div><h3>Conclusions</h3><div>In persons with T1D, AID did not increase weight gain in comparison to other pump systems.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101693"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762965","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 epicardial adipose tissue is part of the phenotype of LMNA-associated partial lipodystrophy and could contribute to increased cardiovascular risk","authors":"Sophie Lamothe ,&nbsp;Patricia Ancel ,&nbsp;Inès Belalem ,&nbsp;Leïla Lecaque ,&nbsp;Joris Fournel ,&nbsp;Alexis Jacquier ,&nbsp;Zouhair Houhou ,&nbsp;Jean-Baptiste Julla ,&nbsp;Jean-François Gautier ,&nbsp;Corinne Vigouroux ,&nbsp;Bénédicte Gaborit ,&nbsp;Camille Vatier","doi":"10.1016/j.diabet.2025.101710","DOIUrl":"10.1016/j.diabet.2025.101710","url":null,"abstract":"<div><div><em>LMNA</em>-associated familial partial lipodystrophy (FPLD2) is characterized by limb lipoatrophy, cervicofacial and visceral abdominal lipohypertrophy, insulin resistance-related complications and early coronary artery disease (CAD), but epicardial adipose tissue (EAT) is poorly described. We aimed to characterize EAT as a potential new marker of cardiovascular risk in patients with FPLD2. Using a validated deep-learning algorithm, we measured EAT volume from cardiac CT-scans routinely performed for coronary artery calcium (CAC) scoring in patients with FPLD2 (<em>n</em> = 26, 24 women, 65 % with diabetes, median age 49 [32;57] years) compared to patients with type-2 diabetes (T2D) (<em>n</em> = 44, 40 women, age 49 [41;59], <em>p</em> = 0.18). Although lower BMI (23.3 [21;26.6] vs. 27.2 [24.7;29.6], <em>P</em> = 0.03) and HbA1c (6.5 [5.8;7.7] vs. 7.8 [7;8.5] %, <em>P</em> = 0.003) in patients with FPLD2 vs. T2D, EAT volume (110 [72;150] vs. 60 [42;78] ml, <em>P</em> &lt; 0.001) and prevalence of CAD (19 vs. 2 %, <em>P</em> = 0.003) were higher. EAT was positively related to CAC score in the FPLD2 group. Our findings support that EAT is increased in patients with FPLD2 and represents a specific ectopic adipose tissue which could contribute to the increased cardiovascular risk.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101710"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of death and amputation in patients with a first diabetic foot ulcer: results from the CODIA cohort","authors":"Julla Jean-Baptiste ,&nbsp;Jolivet Théo ,&nbsp;Estellat Candice ,&nbsp;Varoquaux Gaël ,&nbsp;Carlier Aurélie ,&nbsp;Gautier Jean-François ,&nbsp;Alberge Julie ,&nbsp;Abouleka Yawa ,&nbsp;Bergès Audrey ,&nbsp;Liu Elise ,&nbsp;Abecassis Judith ,&nbsp;Tubach Florence ,&nbsp;Potier Louis","doi":"10.1016/j.diabet.2025.101700","DOIUrl":"10.1016/j.diabet.2025.101700","url":null,"abstract":"<div><h3>Aim</h3><div><em>-</em> To investigate the incidences of death and lower limb amputation (LLA) among patients hospitalized with a first diabetic foot ulcer and to identify the associated risk factors.</div></div><div><h3>Methods</h3><div><em>-</em> We leveraged medical records from 08/2017 to 10/2023 in the clinical data warehouse of the Greater Paris Hospitals. The primary outcome was the cumulative incidence of death estimated at 12 months. We used Kaplan-Meier and Aalen-Johansen estimators to assess the incidence of death and LLA (identified through ICD-10 codes). We used multivariate Cox regression and Fine and Gray models to estimate risk factors (clinical/biological data, medications, and comorbidities at baseline) for death and LLA, accounting for death as a competing event.</div></div><div><h3>Results</h3><div><em>-</em> 3102 patients were included; the median age was 70.66 years and there were 67.64% males. The cumulative incidence of death at 12 months was 21.64% [95%CI 20.11;23.26]. Mortality risk was associated with older age, chronic cardiac, hepatic, or renal diseases, cancer history, and systemic inflammation, whereas being overweight was linked to lower mortality. The cumulative incidence of LLA at 12 months was 24.15% [22.54;25.79]. Risk factors for LLA included male sex, history of peripheral artery disease, emergency admission, and systemic inflammation markers, while dementia was associated with a lower risk.</div></div><div><h3>Conclusion</h3><div><em>-</em> Cumulative incidences of all-cause mortality and LLA during the months following hospitalization with a first diabetic foot ulcer were alarmingly high. Mortality risk was primarily associated with patient comorbidities, while amputation risk was closely associated with systemic inflammation and history of peripheral artery disease.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101700"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}