Diabetes & metabolism最新文献

{"title":"Association between continuous glucose monitoring metrics and metabolic dysfunction-associated steatotic liver disease in adults with type 1 diabetes undergoing vibration-controlled transient elastography: a multicenter cross-sectional study","authors":"Alessandro Mantovani ,&nbsp;Stefano Ciardullo ,&nbsp;Elena Sani ,&nbsp;Alessandro Csermely ,&nbsp;Emigela Shtembari ,&nbsp;Ilaria Milani ,&nbsp;Paolo Sbraccia ,&nbsp;Gianluca Perseghin ,&nbsp;Frida Leonetti ,&nbsp;Giovanni Targher ,&nbsp;Valeria Guglielmi ,&nbsp;Danila Capoccia","doi":"10.1016/j.diabet.2025.101684","DOIUrl":"10.1016/j.diabet.2025.101684","url":null,"abstract":"<div><h3>Background</h3><div>There is uncertainty regarding the association between continuous glucose monitoring (CGM), derived glycemic metrics, and metabolic dysfunction-associated steatotic liver disease (MASLD) in individuals with type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>We consecutively enrolled 262 adult individuals with established T1D undergoing vibration-controlled transient elastography (VCTE) with liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). All participants underwent CGM. MASLD was defined as CAP ≥248 dB/m and the presence of at least one cardiometabolic risk factor. Significant liver fibrosis was defined as LSM ≥8 kPa.</div></div><div><h3>Results</h3><div>Participants had a mean age of 54±13 years, a mean body mass index (BMI) of 25.8 ± 5.6 kg/m² and a mean HbA1c of 7.7 ± 1.4 %. The prevalence of MASLD and significant liver fibrosis was 35.1 % (<em>n</em> = 92) and 4.6 % (<em>n</em> = 12), respectively. Using quantile regression analysis, time above range 180–250 mg/dl (TAR1) was significantly associated with increased CAP values (coefficient: 1.037; 95 % confidence interval [0.216;1.858]; <em>P</em> = 0.013). This association remained significant even after adjusting for age, sex, BMI, HbA1c, and total daily insulin dose. Other variables independently associated with CAP were older age, male sex, BMI, and total daily insulin dose. Using a random forest regression model, BMI was found to be the most important factor, followed by age, total daily insulin dose, and TAR1.</div></div><div><h3>Conclusions</h3><div>TAR1 was independently associated with increased CAP values, even after adjustment for age, BMI, sex, HbA1c, and total daily insulin dose, suggesting a potential role for glycemic variability in hepatic fat accumulation in adults with T1D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101684"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581419","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":"Post-translational modifications of apolipoproteins as promising biomarkers for diabetes-related cardiovascular diseases: A comprehensive review","authors":"Chloé Chevalier ,&nbsp;Arsênio Rodrigues Oliveira ,&nbsp;Valentin Blanchard ,&nbsp;Cédric Le May ,&nbsp;Bertrand Cariou ,&nbsp;Samy Hadjadj ,&nbsp;Mikaël Croyal","doi":"10.1016/j.diabet.2025.101683","DOIUrl":"10.1016/j.diabet.2025.101683","url":null,"abstract":"<div><div>Lipoproteins are biochemical complexes of apolipoproteins and lipids that primarily mediate the transport of lipids through the circulation, from sites of absorption or synthesis to those of use, storage, or excretion. In type 2 diabetes (T2D), disruptions in lipoprotein metabolism are key drivers of complications and strongly contribute to atherosclerotic cardiovascular disease (ASCVD). As a result, ASCVD remains the leading cause of death in T2D, with significantly higher prevalence than in non-diabetic individuals. Protein post-translational modifications (PTMs) have emerged as key contributors to organ failure mechanisms, with specific PTMs closely linked to the pathogenesis of T2D. Several reports also emphasized the value of plasma apolipoproteins for the early prediction of ASCVD in cardiometabolic diseases. Thus, apolipoproteins, and especially their structurally post-translational modified forms, offer new insights into the molecular mechanisms of lipoprotein dysfunction and may enhance the specificity of ASCVD risk stratification in T2D. This review outlines major apolipoprotein PTMs identified in T2D, many of which can now be quantified in biological samples, particularly via mass spectrometry. We also discuss their role in lipoprotein metabolism dysfunction and their potential value in assessing ASCVD risk in T2D, highlighting their growing potential as clinical biomarkers in population-based cohort studies.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101683"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586054","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":"2025-09-01","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":"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 ,&nbsp;Michael Joubert ,&nbsp;Ghassan Riachi ,&nbsp;Marie-Lauren Antoine ,&nbsp;Delphine Clabaut ,&nbsp;Renaud Fay ,&nbsp;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":"2025-09-01","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":"Prediction of cardiovascular events by skin auto-fluorescence: the DIABAGE follow-up study","authors":"Jorys Bueno ,&nbsp;Alpha M. Diallo ,&nbsp;Stéphane Jaisson ,&nbsp;Jenny Fontaine ,&nbsp;Céline Lukas ,&nbsp;Romain Barriquand ,&nbsp;Géraldine Vitellius ,&nbsp;Philippe Gillery ,&nbsp;Brigitte Delemer ,&nbsp;Sara Barraud","doi":"10.1016/j.diabet.2025.101682","DOIUrl":"10.1016/j.diabet.2025.101682","url":null,"abstract":"<div><h3>Aim</h3><div>Advanced glycation end-products (AGEs) are known to play a role in the pathophysiology of type 1 diabetes (T1D) complications. The aim of this study was to assess the predictive value of AGEs indirectly evaluated by skin auto-fluorescence (SAF) on the occurrence of cardiovascular events (CVEs) in T1D.</div></div><div><h3>Methods</h3><div>We measured baseline SAF in T1D patients with at least 10 years history of diabetes and assessed incident CVEs. An optimum threshold of SAF was determined using ROC curve, and its predictive value was assessed by Cox proportional regression.</div></div><div><h3>Results</h3><div>The study included 179 patients, 53 % of whom were women. At baseline, the mean age was 47.7 ± 15.9 years, the mean duration of diabetes was 26.4 ± 12.2 years. Median HbA_1c was 7.7 % (7.3–8.7) and median LDL cholesterol was 2.58 mmol/l (2.14–3.07). Median follow-up was 7.4 years (6.85 - 7.7) with 34 CVEs in 24 patients.</div><div>The median SAF level was 2.7 (2.3–3.1) in patients with incident CVEs and 2.1 (1.8–2.6) in patients without CVEs. The optimum threshold of SAF to differentiate patients with or without incident CVEs was 2.2. The occurrence of CVE was predicted by the optimum SAF threshold in the unadjusted model (HR 6.46), but also after adjustment with different models (HR 3.15–5.05).</div></div><div><h3>Conclusion</h3><div>SAF level is higher in people living with T1D who will present CVEs. Furthermore, SAF threshold of 2.2 predicted the occurrence of CVE. If these results are confirmed, SAF could be a useful marker in cardiovascular risk stratification in T1D.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101682"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500028","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 impact of chiglitazar, a pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes: a real-world study","authors":"Yijiong Tan ,&nbsp;Wenjun Qu ,&nbsp;Jiehua Zhao ,&nbsp;Yunqin Ma ,&nbsp;Qidi Zhang ,&nbsp;Hong Gao ,&nbsp;Qin Zhen ,&nbsp;Yufan Wang ,&nbsp;Yongde Peng ,&nbsp;Fang Liu ,&nbsp;Nengguang Fan","doi":"10.1016/j.diabet.2025.101680","DOIUrl":"10.1016/j.diabet.2025.101680","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the efficacy of chiglitazar, a novel pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes (T2D) in a real-world clinical setting.</div></div><div><h3>Materials and methods</h3><div>This prospective cohort study included T2D patients with MASLD who received either chiglitazar or other glucose-lowering medications over a 24-week period. To minimize selection bias, 1:1 propensity score matching (PSM) was implemented. The primary outcomes were changes in controlled attenuation parameter (CAP, measuring hepatic steatosis) and liver stiffness measurement (LSM, assessing fibrosis). Secondary outcomes included glycemic parameters and liver enzymes.</div></div><div><h3>Results</h3><div>A total of 235 T2D patients were enrolled (40 chiglitazar users, 195 non-chiglitazar users), and 31 matched pairs were derived after 1:1 PSM. The adjusted mean reduction in CAP from baseline to 24 weeks was significantly greater in the chiglitazar group (-28.38 dB/m [95 % CI:36.11;-20.65]) compared to the non-chiglitazar group (-16.74 dB/m [-24.47;-9.01]), with a between-group difference of -11.64 dB/m (-22.38;-0.90, <em>P</em> = 0.038). LSM changes were similar between groups (difference in LS mean:0.11 [-1.04;0.82], <em>P</em> = 0.813). Subgroup analyses indicated that the beneficial effect of chiglitazar was consistent across variables such as sex, age, body mass index, and concomitant use of SGLT-2 inhibitors or GLP-1 receptor agonists (all <em>P</em> for interaction &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Chiglitazar administration is associated with a significant reduction in CAP values in T2D patients with MASLD, suggesting its potential as a dual therapeutic approach for both conditions.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101680"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370031","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":"2025-09-01","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":"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":"2025-09-01","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":"Exploring perceived barriers to physical activity among individuals with type 1 diabetes in the era of new technologies: An analysis from the BETTER registry","authors":"C. Guédet ,&nbsp;L. Alexandre-Heymann ,&nbsp;J.E. Yardley ,&nbsp;V. Messier ,&nbsp;V. Boudreau ,&nbsp;T. Chahal ,&nbsp;M. Dostie ,&nbsp;M-E. Mathieu ,&nbsp;A-S. Brazeau ,&nbsp;S. Tagougui ,&nbsp;R. Rabasa-Lhoret","doi":"10.1016/j.diabet.2025.101677","DOIUrl":"10.1016/j.diabet.2025.101677","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to identify barriers to physical activity for people living with type 1 diabetes (PwT1D) and their relationship with sociodemographic and disease-specific factors.</div></div><div><h3>Methods</h3><div><em>-</em> Cross-sectional study with BETTER registry participants (&gt;14 years) who completed the BAPAD1 (Barriers to Physical Activity in T1D) questionnaire. An item with a score of 5 or more was defined as a barrier. Participants were categorized into 4 subgroups based on their insulin therapy and blood glucose monitoring modality: 1) multiple daily injections (MDI) without continuous glucose monitoring (CGM), 2) MDI with CGM, 3) continuous subcutaneous insulin infusion (CSII) with CGM, and 4) automated insulin delivery system (AID).</div></div><div><h3>Results</h3><div>Among 1117 participants, the main perceived barrier was fear of hypoglycemia. BAPAD1 scores were similar across all subgroups, but more individuals in the AID group perceived \"fear of hypoglycemia\" and \"loss of control over diabetes\" as barriers. Being female, having a low income or education level, being overweight or obese, taking medication for depression, younger diabetes, higher HbA1c, presence of microvascular complications, and lack of confidence in managing hypoglycemia were associated with higher BAPAD1 score.</div></div><div><h3>Conclusion</h3><div>Fear of hypoglycemia remains the main barrier to physical activity for PwT1D. Technological advances alone are not sufficient to reduce perceived barriers to physical activity, highlighting the need for complementary educational and behavioral interventions.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101677"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593307","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":"2025-07-01","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}