Diabetes/Metabolism Research and Reviews最新文献

{"title":"An 11-Year Study to Predict Major Complications According to Biological Age in Patients With Diabetes: National Health Information Database (NHIS-NHID 2002–2020)","authors":"Chul-young Bae,&nbsp;Bo-seon Kim,&nbsp;In-hee Kim,&nbsp;Min-hee Jeon","doi":"10.1002/dmrr.70170","DOIUrl":"10.1002/dmrr.70170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of diabetes has been increasing, particularly among younger age groups with prolonged survival, and the risk of complications and the burden of healthcare costs are also expected to rise. We investigated the concept of biological age (BA) in patients with diabetes and there by developed a model to predict the risk and time of onset of diabetes complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using NHIS-NHID data, we analysed 686,410 patients with diabetes who had undergone a health examination in 2009–2010. We analysed patients' data until 2020. We developed a BA model for patients with diabetes and predicted the risk of complications and the time of complication onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In both sexes, the incidences of all complications increased significantly with increasing corrected BA (<i>p</i> &lt; 0.05). Similarly, the time until onset of all complications decreased significantly with increasing corrected BA (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study suggests that maintaining a lower BA is associated with a reduced risk of complications and a delayed onset of the disease, which may encourage diabetic patients to manage their health more effectively. This study is the first to apply the concept of BA, reflecting health and ageing status, to patients with diabetes to explore its relationship with the risk and timing of complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700602","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":"Changes in Brain Volumetric Measures Associated With Type 1 Diabetes Depict an Evolutionary Adaptation Process to Developmental Cognitive Demands","authors":"Andrés Antonio González-Garrido,&nbsp;Geisa Bearitz Gallardo-Moreno,&nbsp;José Manuel Gómez-Barba,&nbsp;Yusniel Santos-Rodríguez,&nbsp;Aurora Espinoza-Valdez,&nbsp;Fabiola Reveca Gómez-Velázquez,&nbsp;Vanessa Doreen Ruiz-Stovel","doi":"10.1002/dmrr.70169","DOIUrl":"10.1002/dmrr.70169","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Type 1 diabetes mellitus has been associated with a significant risk of brain volume reduction and cognitive disorders, mainly affecting executive functioning and working memory. Therefore, an early impact of type 1 diabetes can be expected on volumetric measures and anatomic relationships among brain structures underlying these mental processes, as reflecting a process probably driven by developmental cognitive demands. With this aim, we compared volumetric measures and brain anatomical associations in young adults with type 1 diabetes and healthy controls.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Forty-one clinically well-controlled, right-handed type 1 diabetes patients aged 18–30 and with 10 or more years of disease evolution participated, along with forty-one healthy controls matched by age, sex, IQ, and years of schooling. They were all scanned with a 3-T MRI to obtain brain images with a voxel size of 1 mm&lt;sup&gt;3&lt;/sup&gt;. The images were processed, and cortical gray and white matter were used to compute volumetric measures and cortical thickness, which were analyzed according to the corresponding segmentation map. Graph-theoretical analyses were also performed on adjacency resultant matrices.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Global cortical volumes did not significantly differ between the groups. However, subcortical gray matter volume was significantly lower in the diabetes group (&lt;i&gt;M&lt;/i&gt; = 43.4 cm&lt;sup&gt;3&lt;/sup&gt;, SD = 3.3) compared with controls (&lt;i&gt;M&lt;/i&gt; = 45 cm&lt;sup&gt;3&lt;/sup&gt;, SD = 3.8; &lt;i&gt;t&lt;/i&gt;(80) = −2.04, &lt;i&gt;p&lt;/i&gt; = 0.045, &lt;i&gt;d&lt;/i&gt; = 0.45). Patients also showed reduced volumes in cerebellar white matter, vermis, and brainstem, as well as decreased volumes in several frontal and subcortical regions, including the putamen and thalamus. These changes were found to correlate meaningfully with longer diabetes duration and age at disease onset. Graph-theoretical analyses further revealed alterations in brain network topology in the diabetes group.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The results suggest that slight brain alterations affecting both brain microstructural integrity and typical organization early occur even in young patients with free-from-diabetes complications and clinically well-controlled type 1 diabetes. Moreover, these brain morphological changes appear to reflect the illness's distinctive impact on the developing brain, likely representing adaptive changes to address increasing cognitive and environmental demands.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 &lt;/d","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700567","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":"Gene-Lifestyle Interplay in Type 1 Diabetes: Joint Effects and Interactions From Cross-Sectional and Longitudinal Cohort Analyses","authors":"Chunran Lai,&nbsp;Qinyi Li,&nbsp;Xingchen Geng,&nbsp;Jiahui Cao,&nbsp;Xiaomin Zeng,&nbsp;Zijing Du,&nbsp;Shan Wang,&nbsp;Chenxiao Shen,&nbsp;Ying Fang,&nbsp;Yijun Hu,&nbsp;Xianwen Shang,&nbsp;Zhuoting Zhu,&nbsp;Xiayin Zhang,&nbsp;Honghua Yu","doi":"10.1002/dmrr.70168","DOIUrl":"10.1002/dmrr.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Type 1 diabetes (T1D) is a complex autoimmune disorder heavily influenced by heritable traits. However, the interplay between modifiable lifestyle factors and genetic susceptibility remains insufficiently characterised. This study sought to elucidate how genetic background and lifestyle determinants jointly affect T1D liability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilising the UK Biobank cohort, we performed both cross-sectional and longitudinal assessments. A polygenic risk score (PRS) was computed to quantify genetic predisposition to T1D across 403,778 subjects. Concurrently, a composite lifestyle index was generated based on six domains: adiposity, smoking status, alcohol intake, physical exertion, diet quality, and sleep duration. We evaluated cross-sectional relationships using multivariable logistic regression and assessed longitudinal outcomes using Cox proportional hazard models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In a 15-year longitudinal study (median follow-up: 12.3 years) of 402,005 participants, 1474 cases of T1D were identified. Stratified by genetic risk, participants in the intermediate (hazard ratio [HR] = 1.17; 95% CI: 1.00–1.37) and highest (HR = 2.89; 95% CI: 2.46–3.39) risk groups demonstrated significantly elevated risks of incident T1D compared to the lowest risk group, independent of lifestyle factors. Conversely, when categorised by lifestyle patterns, both intermediate (HR = 0.61; 95% CI: 0.52–0.71) and healthy (HR = 0.43; 95% CI: 0.37–0.52) lifestyle groups exhibited substantially reduced risks of T1D compared to the unhealthy lifestyle group, irrespective of genetic predisposition. A significant interaction between genetic risk and lifestyle on the risk of T1D was found in both cross-sectional and longitudinal analyses (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The data reveal a robust inverse relationship between adherence to a healthy lifestyle and T1D incidence across all genetic strata, even among those with elevated hereditary risk. These results underscore the critical role of lifestyle modification in mitigating T1D susceptibility, distinct from genetic inheritance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693075","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":"Intersecting Molecular Pathways in Cardiovascular Disease and Diabetes Mellitus: Emerging Roles of Inflammation and Therapeutics","authors":"Lilian Anagnostopoulou,&nbsp;Nikolaos Ktenopoulos,&nbsp;Anastasios Apostolos,&nbsp;Christos Fragoulis,&nbsp;Panayotis Vlachakis,&nbsp;Paschalis Karakasis,&nbsp;Marios Sagris,&nbsp;Nikias Milaras,&nbsp;Maria Drakopoulou,&nbsp;Andreas Synetos,&nbsp;Ioannis Kyriazis,&nbsp;Ioannis Ioannidis,&nbsp;Costas Tsioufis,&nbsp;Konstantinos Toutouzas","doi":"10.1002/dmrr.70167","DOIUrl":"10.1002/dmrr.70167","url":null,"abstract":"<p>Diabetes mellitus (DM) and cardiovascular diseases (CVD) remain leading contributors to global morbidity and mortality, imposing a substantial burden on healthcare systems worldwide. The pathophysiological mechanisms underlying these conditions are complex and closely interconnected, with chronic low-grade inflammation, oxidative stress, endothelial dysfunction, insulin resistance and dysregulated lipid metabolism serving as pivotal shared pathways. Persistent hyperglycaemia and metabolic imbalance in DM accelerate vascular injury and atherosclerotic progression, thereby significantly increasing cardiovascular risk. Consequently, therapeutic strategies that concurrently target both metabolic and cardiovascular dysfunction may offer meaningful clinical advantages and improved long-term outcomes. In recent years, novel antidiabetic agents such as sodium–glucose co-transporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have demonstrated not only glycaemic control but also substantial cardiovascular protection, including reductions in major adverse cardiovascular events, heart failure hospitalisations and renal disease progression. These pleiotropic effects extend beyond glucose lowering and involve modulation of inflammatory pathways, improvement of endothelial function, attenuation of oxidative stress and favourable haemodynamic changes. Additionally, emerging evidence highlights the role of the gut microbiota as a critical mediator in the bidirectional relationship between DM and CVD. Alterations in microbial composition and diversity, collectively termed dysbiosis, have been associated with systemic inflammation, impaired metabolic homoeostasis, increased intestinal permeability and the production of pro-atherogenic metabolites such as trimethylamine N-oxide. Understanding these microbiome-related mechanisms may open new avenues for preventive and therapeutic interventions targeting the gut–metabolic–cardiovascular axis. This narrative review provides an updated and comprehensive overview of the molecular and cellular mechanisms linking DM and CVD, with particular emphasis on inflammatory signalling, metabolic dysregulation and the emerging influence of the gut microbiome in their shared pathogenesis and therapeutic modulation.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640344","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":"Long-Term Metabolic Effects and Weight Loss Outcomes of Bariatric Surgery in Patients With Super-Super Obesity","authors":"Sergio Susmallian,&nbsp;Irena Babis,&nbsp;Asnat Raziel","doi":"10.1002/dmrr.70165","DOIUrl":"10.1002/dmrr.70165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate long-term weight trajectories and metabolic outcomes after bariatric surgery in patients with extreme obesity (BMI ≥ 60 kg/m²).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with BMI ≥ 60 kg/m² represent a high-risk subgroup with a substantial cardiometabolic burden, yet long-term outcome data remain limited, particularly beyond 5 years and in cohorts including revisional surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study included patients with BMI ≥ 60 kg/m² who underwent bariatric surgery between April 2008 and August 2019. Outcomes included percentage total weight loss (%TWL), BMI change, and remission or improvement of metabolic comorbidities derived from structured medical records, with follow-up of up to 10 years. Early postoperative complications and mortality were also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty patients were included (mean age 41.5 years; mean baseline BMI 63.8 kg/m²; 67% female), 80% had obesity-related comorbidities and 23% underwent revisional surgery. Mean %TWL declined from 37.99% at ≤ 2 years to 37.36% at 2–5 years, 22.37% at 5–10 years, and 19.38% at &gt; 10 years (<i>p</i> = 0.054). At the last follow-up (mean 72 months), mean BMI decreased to 45.11 kg/m² and mean %TWL was 29.4%. Remission or improvement occurred in NAFLD (73.9%), type 2 diabetes (77.8%), obstructive sleep apnoea (85.7%), and hyperlipidaemia (70.0%), whereas hypertension improved in 29.1%. Two deaths occurred (3.33%): one perioperative death due to an anastomotic leak after revisional surgery and one late death unrelated to surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In BMI ≥ 60 kg/m², bariatric surgery delivers durable metabolic benefits despite frequent long-term weight regain, supporting its role as a metabolic intervention beyond weight loss and underscoring the need for strategies that preserve metabolic health over time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595654","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":"Global Trends and Inequalities in Diabetes Prevalence and Treatment Coverage Among Adults Aged ≥ 45 Years, 1990–2040: Insights From the NCD-RisC Database","authors":"Jinli Liu,&nbsp;Yanan Wang,&nbsp;Lei Zhang,&nbsp;Shaonong Dang","doi":"10.1002/dmrr.70164","DOIUrl":"10.1002/dmrr.70164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess the global burden, trends, and inequalities of diabetes prevalence and treatment coverage among adults aged ≥ 45 years from 1990 to 2040.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Diabetes prevalence and treatment coverage data were obtained from the NCD-RisC database. Average annual percentage changes (AAPC) were estimated using join point regression, and a Bayesian age–period–cohort model was used to project diabetes prevalence and treatment coverage from 2023 to 2040. Cross-national health inequalities were measured using the slope index of inequality (SII) and the relative concentration index (RCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Globally, diabetes prevalence rose from 12.85% in 1990 to 23.57% in 2022 (AAPC = 1.90%), and is projected to reach 37.44% by 2040 (AAPC = 2.59%). Treatment coverage grew from 33.22% to 45.88% (AAPC = 1.02%) and is projected to surge to 51.64% by 2040 (AAPC = 0.65%). Diabetes prevalence grew fastest in middle-income countries, whereas treatment coverage improved most in higher-income countries. The SII for prevalence burden decreased from −0.25% in 1990 to −14.86% in 2022, and is projected to further decline to −18.32% by 2040. For treatment coverage, the SII increased from 24.57% in 1990 to 43.91% in 2022, with a projected rise to 54.22% by 2040. The relative inequality measured by the RCI showed a similar pattern.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Between 1990 and 2040, diabetes prevalence is projected to increase significantly, while treatment coverage shows only limited improvement. Over the same period, the diabetes prevalence burden is increasingly concentrated in resource-limited regions, while treatment accessibility is becoming progressively more concentrated in economically developed areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582896","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":"Reassessment of the Diagnostic Accuracy of HbA1c and Glucose for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Observational Studies","authors":"Christina Baechle,&nbsp;Ferdinand V. Stoye,&nbsp;Nafiseh Shokri-Mashhadi,&nbsp;Anna-Therese Klötzsch,&nbsp;Brenda Bongaerts,&nbsp;Annika Hoyer,&nbsp;Oliver Kuss,&nbsp;Rüdiger Landgraf,&nbsp;Wolfgang Rathmann,&nbsp;Sabrina Schlesinger","doi":"10.1002/dmrr.70160","DOIUrl":"10.1002/dmrr.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This systematic review and meta-analysis evaluated the diagnostic performance of HbA_1c, fasting plasma glucose (FPG), and 1-h plasma glucose (1hPG) against the 2-h plasma glucose standard (≥ 11.1 mmol/L) in adults without previously diagnosed diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of Medline and CENTRAL (until 09.2025) identified population-based studies considering all available cutoff values for these markers. Diagnostic accuracy was estimated using bivariate random-effects models. Summary ROC curves and optimal cutoff values were derived using a Weibull accelerated failure time approach and the Youden index. Subgroup analyses explored potential differences across continents. The certainty of evidence (CoE) was evaluated using the GRADE approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-eight studies including 276,203 participants were synthesised. Overall, FPG showed higher diagnostic accuracy than HbA_1c, with an optimal cutoff of 6.3 mmol/L [95% confidence interval 6.0 mmol/L; 6.5 mmol/L], yielding 73% [68%; 78%] sensitivity and 91% [89%; 94%] specificity. The optimal HbA_1c cutoff was 47 [42; 49] mmol/mol (i.e., 6.5% [6.0%; 6.6%]), with 62% [51%; 80%] sensitivity and 92% [77%; 96%] specificity. The CoE was low. Across all regions, FPG consistently outperformed HbA_1c. Optimal FPG cutoff values ranged from 5.3 mmol/L in North America to 6.5 mmol/L in Asian countries, and from 41 mmol/mol (5.9%) in Asian countries to 45 mmol/mol (6.3%) in North America for HbA_1c.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results suggest that FPG is a more reliable diagnostic marker than HbA_1c and that uniform global thresholds may not fully reflect population-specific differences. Further high-quality studies are needed to refine diagnostic performance and examine factors influencing accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522510","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":"Not All GLP-1 Receptor Agonists Are Alike: Real-World Evidence of Differential Endocrine and Dermatologic Safety","authors":"Nai Lee,&nbsp;Yun Kim","doi":"10.1002/dmrr.70163","DOIUrl":"10.1002/dmrr.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for metabolic disorders, but emerging safety concerns include alopecia and reproductive or endocrine-related adverse events (AEs). This study investigated the association between specific GLP-1 RAs and these endocrine-related AEs using a large-scale pharmacovigilance database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This study analysed the U.S. FDA Adverse Event Reporting System (FAERS) data (Q2 2022–Q2 2025) for six GLP-1 Ras (exenatide, lixisenatide, liraglutide, dulaglutide, semaglutide, and tirzepatide) to identify alopecia- and reproductive or endocrine–related a AEs. Disproportionality analyses were conducted using crude and adjusted reporting odds ratios (cROR and aROR) from logistic regression controlling for potential confounding factors. Sensitivity analyses with positive and negative controls were used to validate the signal robustness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1276 alopecia-related and 759 reproductive or endocrine–related cases were identified. Semaglutide showed significant positive associations with alopecia (aROR 1.23 [1.11–1.35]) and reproductive/hormonal disorders, including polycystic ovary syndrome (aROR 6.59 [3.73–11.64]) and menstrual abnormalities. In contrast, dulaglutide and tirzepatide demonstrated negative associations for several reproductive outcomes (e.g., dysmenorrhoea, amenorrhoea, heavy menstrual bleeding), indicating lower reporting odds in this dataset. Sensitivity analyses using control drugs confirmed the consistency and specificity of these findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This real-world pharmacovigilance study identified agent-specific differences in the endocrine and dermatologic safety profiles of GLP-1 RAs. While semaglutide exhibited disproportionate reporting for alopecia and hormonal imbalance, dulaglutide and tirzepatide showed lower or non-significant disproportionality signals for these events. These results highlight the need for personalised agent selection and continued pharmacovigilance to optimise long-term patient safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522425","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":"Illuminating Glucose: How to Unveil Organ-Specific Insulin Resistance and Guide Metabolic Strategies in Diabetes","authors":"Shawn Gugliandolo,&nbsp;Cassandra Morciano,&nbsp;Lucia Leccisotti,&nbsp;Umberto Capece,&nbsp;Gianfranco Di Giuseppe,&nbsp;Teresa Mezza,&nbsp;Gea Ciccarelli,&nbsp;Laura Soldovieri,&nbsp;Michela Brunetti,&nbsp;Adriana Avolio,&nbsp;Amelia Splendore,&nbsp;Alfredo Pontecorvi,&nbsp;Andrea Giaccari,&nbsp;Francesca Cinti","doi":"10.1002/dmrr.70162","DOIUrl":"10.1002/dmrr.70162","url":null,"abstract":"<p>Recent evidence has shown that muscle insulin resistance is not the only factor contributing to type 2 diabetes (T2D). Organ-specific insulin resistance is increasingly recognised as a significant contributor to the metabolic changes that lead to hyperglycemia, although the precise extent of its impact remains unclear. The qualitative and quantitative aspects of regional insulin-resistance in determining whole body insulin resistance and glucose uptake can be explored through positron emission tomography (PET) combined with computerised tomography images, using specific radio tracers like 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG). This approach provides new insight into organ-specific glucose uptake allowing the visualisation of glucose metabolism. This review article seeks to highlight key findings from dynamic imaging, in terms of glucose uptake, focussing on the specific compartments (muscle, liver, adipose organ, heart, kidney and brain) in different metabolic conditions, such as insulin resistance and T2D, and during metabolic treatment. In essence, mapping these distinct organ contributions in the orchestra of glucose metabolism is forging a new frontier in personalised diabetes management, allowing for treatments uniquely tailored to individual metabolic needs.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 3","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516162","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":"State of the Art and Future Perspectives of Continuous Glucose Monitoring in Intensive and Non-Intensive Care Settings","authors":"Lorenzo Lucaccini Paoli,&nbsp;Alessandro Rizzi,&nbsp;Linda Tartaglione,&nbsp;Daniele D'Amore,&nbsp;Laila Vinti,&nbsp;Annarita Barberio,&nbsp;Gianmario Sciaraffia,&nbsp;Luca Viti,&nbsp;Mauro Di Leo,&nbsp;Alfredo Pontecorvi,&nbsp;Dario Pitocco","doi":"10.1002/dmrr.70154","DOIUrl":"10.1002/dmrr.70154","url":null,"abstract":"<div>\u0000 \u0000 <p>The development of advanced diabetes technology, such as continuous glucose monitoring (CGM) systems, has permitted in outpatient setting to significantly improve metabolic control by reducing hypoglycemia, ameliorating glycated haemoglobin and reducing glycaemic variability. CGM has emerged as a promising tool to improve glycaemic control in hospitalised patients, potentially reducing the incidence of severe hypoglycemia and hyperglycemia. The availability of real-time glucose data enables more informed clinical decision-making and facilitates prompt adjustments to therapeutic regimens, which is particularly valuable in a dynamic hospital environment. Despite these potential advantages, the implementation of CGM in general ward settings faces several barriers, including a lack of familiarity and experience among healthcare providers as well as the relatively high cost of CGM sensors and associated equipment. Further research is warranted to evaluate the feasibility, clinical benefits, cost-effectiveness, and potential limitations of CGM deployment in general hospital wards. Therefore, the purpose of this review is to provide a comprehensive overview of the current implementation and future potential of CGM in non-Intensive Care Unit (non-ICU) and Intensive Care Unit (ICU) settings for adults with diabetes mellitus or hyperglycemia.</p>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 3","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516134","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}