Diabetes & metabolism最新文献

{"title":"Analysis of glycemic control in diabetic patients by monitoring HbA1c levels before, during and after Covid-19 confinement in Auvergne, France","authors":"Anthony Albouy ,&nbsp;Céline Lambert ,&nbsp;Pierre Bernard ,&nbsp;Catherine Laporte ,&nbsp;Frédéric Fortin","doi":"10.1016/j.diabet.2024.101597","DOIUrl":"10.1016/j.diabet.2024.101597","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe glycemic control in diabetic patients monitored by glycated hemoglobin (HbA1c) before, during and after COVID-19 confinement. To identify factors, measured before confinement, associated with HbA1c testing during confinement and those associated with a 1 % increase in HbA1c after confinement.</div></div><div><h3>Method</h3><div>Retrospective, descriptive study of diabetic patients over 18 years old who underwent at least one HbA1c test before and after confinement. The data were collected from medical analysis laboratories in the Auvergne region (France) and included HbA1c measurements between March 17, 2019, and May 11, 2021, age, sex, residential area, and medical specialty of the prescribing physician.</div></div><div><h3>Results</h3><div>70,286 patients were included (54.1 % men, mean age 71.7 ± 13.1 years). The average preconfinement HbA1c level (6.80 % ± 1.16) was similar to the average post-confinement HbA1c level (6.80 % ± 1.14). A larger median reduction of 0.90 % points in HbA1c level in the year following confinement was observed in patients whose preconfinement HbA1c level was ≥ 9 %. Only 24.5 % of the patients had an HbA1c test performed during confinement, the majority of whom were over 80 years of age and had an average HbA1c level between 7 and 9 % before confinement. For 5.1 % of the patients, the average HbA1c level increased by one percentage point or more after confinement. Patients ≤ 64, those with an insufficient number of blood tests before confinement and those with an imbalance in HbA1c before confinement were at risk of glycemic imbalance after confinement.</div></div><div><h3>Conclusion</h3><div>Confinement had no impact on HbA1c levels in diabetic patients.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101597"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793117","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":"Phthalates exposure, biological aging, and increased risks of insulin resistance, prediabetes, and diabetes in adults with metabolic dysfunction-associated steatotic liver disease","authors":"Yueru Yang ,&nbsp;Shuhui Wan ,&nbsp;Linling Yu ,&nbsp;Wei Liu ,&nbsp;Jiahao Song ,&nbsp;Da Shi ,&nbsp;Yongfang Zhang ,&nbsp;Weihong Chen ,&nbsp;Weihong Qiu ,&nbsp;Bin Wang","doi":"10.1016/j.diabet.2024.101602","DOIUrl":"10.1016/j.diabet.2024.101602","url":null,"abstract":"<div><h3>Aim</h3><div>To estimate the individual and combined influences of phthalates and biological aging on insulin resistance (IR), prediabetes, and diabetes in population with metabolic dysfunction-associated steatotic liver disease (MASLD).</div></div><div><h3>Methods</h3><div>Data on 3,045 US adults with MASLD were collected to outline the individual and mixed effects of urinary phthalate metabolites on prevalent IR, prediabetes, and diabetes by survey-weighted logistic regression and weighted quantile sum (WQS) regression, as well as the interaction effects between phthalates and biological aging.</div></div><div><h3>Results</h3><div>We discovered positive relationships – odds ratio (OR) and 95 % confidence interval [CI] – of mono-2-ethyl-5-carboxypentyl phthalate 1.147 [1.041;1.264], mono-(2-ethyl-5-hydroxyhexyl) phthalate 1.175 [1.073;1.288], and mono-(2-ethyl-5-oxohexyl) phthalate 1.140 [1.040;1.250] with IR, and of mono-isobutyl phthalate with prediabetes 1.216 [1.064;1.390] (all FDR-adjusted <em>P</em> &lt; 0.05). WQS analyses indicated significantly mixed effects of phthalate metabolites on the elevated risks of IR 1.166 [1.034;1.315], prediabetes 1.194 [1.006;1.416], and diabetes 1.214 [1.026;1.437]. Biological age (BA) and phenotypic age (PA) were positively associated with IR, prediabetes, and diabetes and further significantly interacted with phthalates on the outcomes; typically, compared to participants with low levels of phthalates mixture and PA, those with high levels of phthalates mixture and PA had the highest risks of IR 2.468 [1.474;4.133] (<em>P</em>_interaction = 0.031), prediabetes 1.975 [1.189;3.278] (<em>P</em>_interaction = 0.009), and diabetes 6.065 [3.210;11.460] (<em>P</em>_interaction = 0.013).</div></div><div><h3>Conclusion</h3><div>Phthalates exposure of MASLD adults was related to increased risks of IR, prediabetes, and diabetes, which were interactively aggravated by biological aging. Controlling phthalates exposure and biological aging probably hold significant relevance for the prevention of diabetes in the MASLD population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101602"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815453","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":"Obesity rather than diabetes impacted severe Covid-19 on reunion island: A retrospective cohort study from a frontline hospital, 2020–2021","authors":"Yann Brousse ,&nbsp;Patrick Gérardin ,&nbsp;Dina Filali ,&nbsp;Victorine Lenclume ,&nbsp;Hind Aissaoui ,&nbsp;Marie-Christine Jaffar Bandjee ,&nbsp;Estelle Nobecourt ,&nbsp;Léa Bruneau","doi":"10.1016/j.diabet.2024.101601","DOIUrl":"10.1016/j.diabet.2024.101601","url":null,"abstract":"<div><h3>Aim</h3><div>2019-Coronavirus reached the French island of Reunion, which is marked by a very high prevalence of metabolic disorders such as obesity and type 2 diabetes mellitus (T2DM), in March 2020. The objective was to determine the metabolic factors associated with the severity of SARS-CoV-2 infection in Reunion Island.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study enrolled patients who were hospitalized on the island from March 11th, 2020 to August 4th, 2021. Severe Covid-19 was defined according to the WHO's definition, including deaths. A multilevel logistic model with the circulation period of the variants as a random effect was performed.</div></div><div><h3>Results</h3><div>The median age of the 681 patients enrolled was 56 years [42–68] and 54% were men. Obese patients and patients who were both diabetic and obese had an increased risk of developing severe Covid-19: 2.64 [1.46;4.78] and 2.96 [1.47;5.93], aOR [CI95%] respectively. Diabetic inpatients did not when adjusting for individual characteristics and accounting the period of circulation of variants: 1.24 [0.68;2.24] (<em>P</em> = 0.471).</div></div><div><h3>Conclusion</h3><div>This study reveals an unexpected prominence of obesity on T2DM (without precision) in the development of severe Covid-19. Despite a high prevalence of T2DM, this finding may partially explain why Covid-19 did not have an even greater impact on the island. Further studies should also consider the treatment of diabetes, diabetic complications, glycemic imbalance or stratify by the novel subgroups of T2DM to better understand the link between T2DM and severe Covid-19 in the Reunionese population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101601"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804244","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 and care for preclinical stage 1–2 type 1 diabetes in first-degree relatives: French expert position statement","authors":"Roberto Mallone ,&nbsp;Elise Bismuth ,&nbsp;Charles Thivolet ,&nbsp;Pierre-Yves Benhamou ,&nbsp;Nadine Hoffmeister ,&nbsp;François Collet ,&nbsp;Marc Nicolino ,&nbsp;Rachel Reynaud ,&nbsp;Jacques Beltrand ,&nbsp;SFD, SFEDP and AJD","doi":"10.1016/j.diabet.2024.101603","DOIUrl":"10.1016/j.diabet.2024.101603","url":null,"abstract":"<div><div>The natural history of type 1 diabetes (T1D) evolves from stage 1 (islet autoimmunity with normoglycemia; ICD-10 diagnostic code E10.A1) to stage 2 (autoimmunity with dysglycemia; E10.A2) and subsequent clinical stage 3 (overt hyperglycemia), which is commonly the first time of referral. Autoantibody testing can diagnose T1D at its preclinical stages 1–2 and lead to earlier initiation of care, particularly for first-degree relatives of people living with T1D, who are at higher genetic risk. Preclinical T1D screening and monitoring aims to avoid inaugural ketoacidosis and prolong preservation of endogenous insulin secretion, thereby improving glycemic control and reducing long-term morbidity. Moreover, early management can help coping with T1D and correct modifiable risk factors (obesity, sedentary lifestyle). New treatments currently under clinical deployment or trials also offer the possibility of delaying clinical progression. All these arguments lead to the proposition of a national screening and care pathway open to interested first-degree relatives. This pathway represents a new expertise to acquire for healthcare professionals. By adapting international consensus guidance to the French specificities, the proposed screening strategy involves testing for ≥ 2 autoantibodies (among IAA, anti-GAD, anti-IA-2) in relatives aged 2–45 years. Negative screening (∼95 % of cases) should be repeated every 4 years until the age of 12. A management workflow is proposed for relatives screening positive (∼5 % of cases), with immuno-metabolic monitoring by autoantibody testing, OGTT, glycemia and/or HbA1c of variable frequency, depending on T1D stage, age, patient preference and available resources, as well as the definition of expert centers for preclinical T1D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101603"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831638","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":"Impact of pre- and post-exercise strategies on hypoglycemic risk for two modalities of aerobic exercise among adults and adolescents living with type 1 diabetes using continuous subcutaneous insulin infusion: A randomized controlled trial","authors":"Joséphine Molveau ,&nbsp;Étienne Myette-Côté ,&nbsp;Capucine Guédet ,&nbsp;Sémah Tagougui ,&nbsp;Roxane St-Amand ,&nbsp;Corinne Suppère ,&nbsp;Elsa Heyman ,&nbsp;Virginie Messier ,&nbsp;Valérie Boudreau ,&nbsp;Laurent Legault ,&nbsp;Rémi Rabasa-Lhoret","doi":"10.1016/j.diabet.2024.101599","DOIUrl":"10.1016/j.diabet.2024.101599","url":null,"abstract":"<div><h3>Objective</h3><div>We investigated strategies to mitigate hypoglycemic risk during and after different aerobic exercises in people with type 1 diabetes (pwT1D) using continuous subcutaneous insulin infusion.</div></div><div><h3>Research design and methods</h3><div>Thirty-seven pwT1D (21 adults, 16 adolescents; HbA1c = 7.5 ± 1.0 %) participated in two post-absorptive (4-h post-meal) exercise sessions (60-min continuous moderate intensity [CONT] vs. intermittent [INT]). Pre-exercise basal rate reduction (BRR) was either 40 % or 80 %, 90 min before exercise. Post-exercise, participants undertook either a 20 % BRR for 10 h with 20 % reduced dinner bolus (INS) or a 45 g post-exercise carbohydrate (CHO) snack with a 50 % insulin bolus, and a 30 g bedtime CHO snack without bolus (snack).</div></div><div><h3>Results</h3><div>While a similar number of hypoglycemic events (31 vs. 28) were observed between exercise modalities, CONT led to a greater decrease in blood glucose during exercise compared to INT (-3.1 ± 2.3, CONT vs. -2.7 ± 2.2 mmol/l, INT, <em>P</em> = 0.005). Changes in blood glucose during exercise (-3.0 ± 2.4, 40 %BRR vs. -2.8 ± 2.1 mmol/l, 80 %BRR, <em>P</em> = 0.076) and the number of hypoglycemic events (35 vs. 24) were similar between 40 % and 80 %BRR. Time in hyperglycemia was lower with INS compared to snack in the first 30 min after exercise, but no differences were observed for late recovery period or nighttime.</div></div><div><h3>Conclusion</h3><div>Compared to INT, CONT led to greater blood glucose decline without increasing hypoglycemia risk. A larger pre-exercise BRR did not further reduce hypoglycemia risk during exercise. Post-exercise INS and snack strategies led to comparable glucose profiles in pwT1D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101599"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804237","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":"Effects of smoking behavior change on diabetes incidence after cancer development: A nationwide cohort study","authors":"MI Hee Cho ,&nbsp;Jinhyung Jung ,&nbsp;Hye Yeon Koo ,&nbsp;Wonyoung Jung ,&nbsp;Kyungdo Han ,&nbsp;In Young Cho ,&nbsp;Dong Wook Shin","doi":"10.1016/j.diabet.2024.101604","DOIUrl":"10.1016/j.diabet.2024.101604","url":null,"abstract":"<div><h3>Aim</h3><div>Cigarette smoking and diabetes mellitus (DM) increase risks of cardiovascular diseases and all-cause mortality in cancer survivors. An increased risk of DM incidence in cancer survivors has been observed and smoking is an important modifiable risk factor for DM development in the general population. Thus, we investigated the association between smoking behavior change after cancer diagnosis and DM incidence in cancer survivors.</div></div><div><h3>Methods</h3><div>This retrospective cohort study using the Korean National Health Insurance System database included patients with newly diagnosed cancers between 2010 and 2016. Smoking behavior changes after cancer diagnosis were categorized as never smoker, ex-smoker, quitter, smoking starter, and persistent smoker. The associations between smoking behavior changes and DM incidence in overall and specific cancers were investigated using Cox regression analyses.</div></div><div><h3>Results</h3><div>Of the 263,940 cancer survivors, 67.6 % were never smokers, 16.0 % were ex-smokers, 9.3 % were quitters, 1.0 % were smoking starters, and 6.2 % were persistent smokers. During a mean follow-up of 4.0 years, 12,175 patients were diagnosed with DM after cancer development. Compared to the never smokers, the adjusted hazard ratios (95 % confidential interval) of DM incidence were 1.06 (1.00–1.13) for ex-smokers, 1.45 (1.35–1.54) for quitters, 1.46 (1.25–1.71) for starters, and 1.57 (1.45–1.69) for persistent smokers.</div></div><div><h3>Conclusion</h3><div>Compared with never smokers, cancer survivors who engaged smoking at any point before or after cancer diagnosis showed an increased risk of DM incidence after cancer diagnosis. Cancer survivors should be advised to quit smoking promptly and to maintain abstinence throughout cancer survivorship.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101604"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873821","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":"One-hour post-load glucose is associated with biopsy-proven metabolic dysfunction-associated steatotic liver disease in obese individuals","authors":"Fangqin Yuan ,&nbsp;Da Fang ,&nbsp;Hao Xu ,&nbsp;Yuanyuan Nie ,&nbsp;Wen Cai ,&nbsp;Tianwei Gu","doi":"10.1016/j.diabet.2024.101588","DOIUrl":"10.1016/j.diabet.2024.101588","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the association between one-hour post-load plasma glucose (1h-PG) levels and metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic-associated steatohepatitis (MASH).</div></div><div><h3>Methods</h3><div>Clinical data were collected from 538 obese participants who underwent oral glucose tolerance tests (OGTT) and liver biopsy in the Drum Tower Hospital affiliated with the Nanjing University Medical School. Participants were categorized into normal glucose tolerance (NGT), prediabetes (pre-DM), and type 2 diabetes (T2DM) groups, with further stratification of the NGT group into 1h-PG Low and 1h-PG High. The diagnosis of MASLD and MASH was performed using the NASH Clinical Research Network scoring system. Logistic regression analyses were performed to determine the association between each category and MASLD/ MASH.</div></div><div><h3>Results</h3><div>The prevalence of MASLD and MASH progressively increased across NGT 1h-PG Low, NGT 1h-PG High, pre-DM and T2DM groups. Compared to the NGT 1h-PG Low group, the NGT 1h-PG High group had a significantly higher risk of MASLD (OR 3.27 [95 % CI 1.32;8.09]) and MASH (OR 3.08 [1.55;6.11]), which is similar to the pre-DM group. Additionally, elevated 1h-PG levels were associated with hepatic steatosis, lobular inflammation, and fibrosis. Mediation analysis indicated that Matsuda insulin sensitivity index and disposition index played a sequential mediating role between 1h-PG and hepatic steatosis, accounting for 14.23 % of total effect (β 0.014 [95 % CI 0.002;0.035]).</div></div><div><h3>Conclusion</h3><div>Elevated 1h-PG levels increase the risk of MASLD and MASH in obese individuals. Early screening and management of MASLD are necessary, even in NGT individuals when 1h-PG levels are ≥8.6 mmol/l.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101588"},"PeriodicalIF":4.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793119","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":"Cardiovascular and renal effects of the combination therapy of a GLP-1 receptor agonist and an SGLT2 inhibitor in observational real-life studies","authors":"André J. Scheen","doi":"10.1016/j.diabet.2024.101594","DOIUrl":"10.1016/j.diabet.2024.101594","url":null,"abstract":"<div><h3>Background</h3><div>Combining a glucagon-like peptide-1 receptor agonist (GLP-1RA) and an sodium-glucose cotransporter 2 inhibitor (SGLT2i) improved cardiovascular (and renal) prognosis compared to either monotherapy in several post-hoc exploratory analyses of randomized controlled trials (RCTs) versus placebo carried out in patients with type 2 diabetes (T2DM) and high cardiovascular/renal risk. The aim of the present work is to verify if such a benefit of the combined therapy is also present in real-life clinical practice.</div></div><div><h3>Methods</h3><div>An extended search of the literature was performed to select observational retrospective studies that compared cardiovascular and/or renal outcomes in patients with T2DM treated with a GLP-1RA/SGLT2i combination versus patients treated with either GLP-1RA monotherapy or SGLT2i monotherapy, in addition to standard of care therapy.</div></div><div><h3>Results</h3><div>Nine observational studies showed that a GLP-1RA/SGLT2i combination is associated with a greater reduction in major adverse cardiovascular events (MACEs), hospitalization for heart failure and all-cause-mortality when compared to either GLP-1RA alone or SGLT2i alone, without obvious differences between the two monotherapies, including regarding heart failure. Results were obtained in different populations, including patients with atherosclerotic cardiovascular disease and/or heart failure. Only three observational studies gave information on renal outcomes, with a greater benefit when the GLP-1RA/SGLT2i combination was compared with GLP-1RA alone or SGLT2i alone.</div></div><div><h3>Conclusion</h3><div>In real-life conditions, the GLP-1RA/SGLT2i combination reduced cardiovascular and renal outcomes compared with both GLP-1RA monotherapy and SGLT2i monotherapy. Overall, observational studies confirm the results reported in post-hoc exploratory analyses of RCTs versus placebo.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101594"},"PeriodicalIF":4.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752504","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":"Prevent hypoglycaemia when using automated insulin delivery systems in type 1 diabetes requires near normal glycaemic variability","authors":"Louis Monnier ,&nbsp;Claude Colette ,&nbsp;Eric Renard ,&nbsp;Pierre-Yves Benhamou ,&nbsp;Safa Aouinti ,&nbsp;Nicolas Molinari ,&nbsp;David Owens","doi":"10.1016/j.diabet.2024.101589","DOIUrl":"10.1016/j.diabet.2024.101589","url":null,"abstract":"<div><h3>Aim</h3><div>Although newer technologies of insulin delivery in type 1 diabetes have facilitated an improvement in glycaemic control the risk of hypoglycaemia remains a threat. Therefore, it is important to define the thresholds of glycaemic variability below which the risk of hypoglycaemia can be eliminated or at least minimized.</div></div><div><h3>Methods</h3><div>Randomized controlled trials conducted from 2017 to 2023 comparing Sensor-Augmented-Pumps and Augmented Insulin Delivery Systems (<em>n</em> = 16 and 22 studies, respectively) were selected. A weighted linear model of regression was used to compute the relationship between glycaemic variability and times spent below glucose range. The intercepts of regression lines with the abscissa axis (time below range = 0 %) defined the glycaemic variability thresholds.</div></div><div><h3>Results</h3><div>Positive relationships were observed between the 2 metrics. The scatter plots indicated that the times spent below range never reached the value of 0 % and that the glycaemic variability never fell below 28 %. By extrapolating the regression lines, the glycaemic variability at intercepts with time below range &lt; 70 mg/dL of 0 % was 30.1 % with sensor augmented pumps and 18.9 % with automated insulin delivery. For a time below range &lt; 54 mg/dL of 0 % the respective glycaemic variability values were 32.7 % and 19.9 % (with sensor augmented pumps and automated insulin delivery, respectively).</div></div><div><h3>Conclusions</h3><div>Importantly, glycaemic variability targets and ambient hyperglycaemia are interdependent. Users of automated insulin delivery need to reach a glycaemic variability of 18 % to 20 % to minimize or eradicate the risk of hypoglycaemia. Such values are those observed in healthy non-diabetic people.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101589"},"PeriodicalIF":4.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712350","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":"Medial arterial calcification of the lower limbs in diabetes: Time for awareness? A short narrative review","authors":"Jean-Michel Davaine ,&nbsp;Damien Denimal ,&nbsp;Pauline Treca ,&nbsp;Hugo Francon ,&nbsp;Franck Phan ,&nbsp;Agnès Hartemann ,&nbsp;Olivier Bourron","doi":"10.1016/j.diabet.2024.101586","DOIUrl":"10.1016/j.diabet.2024.101586","url":null,"abstract":"<div><div>In patients with diabetes, peripheral arterial disease, particularly below the knee, is associated with medial arterial calcification. This is a frequent and potentially serious complication, affecting all types of diabetes. In recent years, our understanding of the pathophysiology and clinical significance of medial arterial calcification has improved considerably. Here, we offer a short narrative review of the epidemiology, clinical consequences, and pathophysiology of this complication. Now that medial arterial calcification of the lower limbs is better understood, we also focus on the prospect of treatments targeting arterial calcification.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 1","pages":"Article 101586"},"PeriodicalIF":4.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635418","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}