{"title":"Pregnancy-Specific Glucose Management Index Predicts Preterm Birth and Pre-Eclampsia Superior to HbA1c in Women With Type 1 Diabetes Mellitus","authors":"Daizhi Yang, Ping Ling, Chaofan Wang, Xueying Zheng, Hongrong Deng, Xubin Yang, Jinhua Yan, Wen Xu, Sihui Luo, Jianping Weng","doi":"10.1002/dmrr.70048","DOIUrl":"https://doi.org/10.1002/dmrr.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to evaluate the predictive accuracy of HbA1c and pregnancy-specific Glucose Management Index (GMI) in forecasting adverse pregnancy outcomes for pregnancies with T1DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this pre-specified secondary analysis of the CARNATION study, one hundred pregnancies with T1DM who used continuous glucose monitoring systems (CGMS) and had pregnancy outcomes were included. We compared the predictive performance of HbA1c and GMI in identifying composite adverse pregnancy outcomes (CAPO, including maternal death, pre-eclampsia, miscarriage, preterm birth, neonatal death, large for gestational age, congenital malformations, neonatal hypoglycemia, and admission to the neonatal intensive care unit (NICU)) among them. Log-bin regression and receiver operating characteristic curves were utilised for the analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The participants had a mean diabetes duration of 8.0 ± 6.2 years and experienced HbA1c of 6.1 ± 0.7% and GMI of 6.4 ± 0.6% during pregnancy. Among them, 2 (2.0%) had a pregnancy loss, 51 (51.0%) experienced CAPO, 29 (29.6%) foetuses were admitted to the NICU, 15 (15.3%) had a preterm birth, and 5 (5.1%) were pre-eclampsia. HbA1c and GMI were consistent predictors of NICU admission (AUC 0.72 vs. 0.67, <i>p</i> = 0.508) and CAPO (AUC 0.66 vs. 0.61, <i>p</i> = 0.385). GMI was more advantageous in predicting pre-eclampsia (AUC 0.80 vs. 0.49, <i>p</i> = 0.009) and preterm birth (AUC 0.67 vs. 0.54, <i>p</i> = 0.030) compared to HbA1c.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GMI, a measure reflecting shorter-term blood glucose control, has emerged as a significant biomarker for adverse perinatal outcomes in pregnancies with T1DM. Notably, GMI provides a more pronounced advantage in predicting pre-eclampsia and preterm birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ChiCTR1900025955</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171657","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}
Celestino Sardu, Nunzia D'Onofrio, Maria Consiglia Trotta, Maria Luisa Balestrieri, Giovanni Francesco Nicoletti, Giovanbattista D'Amico, Carlo Fumagalli, Carla Contaldi, Giuseppe Pacileo, Lucia Scisciola, Maddalena Nicoletti, Ludovica Vittoria Marfella, Matilde Sbriscia, Ferdinando Carlo Sasso, Giuseppe Signoriello, Giuseppe Paolisso, Raffaele Marfella
{"title":"Could Ghrelin Expression Regulate Diastolic Cardiac Function in Type 2 Diabetic Obese Patients?","authors":"Celestino Sardu, Nunzia D'Onofrio, Maria Consiglia Trotta, Maria Luisa Balestrieri, Giovanni Francesco Nicoletti, Giovanbattista D'Amico, Carlo Fumagalli, Carla Contaldi, Giuseppe Pacileo, Lucia Scisciola, Maddalena Nicoletti, Ludovica Vittoria Marfella, Matilde Sbriscia, Ferdinando Carlo Sasso, Giuseppe Signoriello, Giuseppe Paolisso, Raffaele Marfella","doi":"10.1002/dmrr.70049","DOIUrl":"https://doi.org/10.1002/dmrr.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Adipose tissue expresses cytokines, sirtuin-1 (SIRT1), and microRNAs (miRs), regulating left ventricle (LV)-diastolic function (LV-DF). Ghrelin could modulate these pathways in patients with type 2 diabetes mellitus (T2DM) and obesity. We investigated ghrelin expression in T2DM obese patients after abdominal fat excision, and in those with LV-DF normalisation at 1 year of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Two-hundred and two T2DM obese patients enroled for abdominoplastic surgery were divided into those with normal LV-DF (group 1: E/E′ < 9, <i>n</i> 76) and those with altered LV-DF: group 2 (9 < E/E′ < 14; <i>n</i> 96) and group 3 (E/E′ > 14, <i>n</i> 28).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with LV-diastolic dysfunction had over-inflammation, lower SIRT1 and higher abdominal fat sodium-glucose-transporter-two (SGLT2) expression (<i>p</i> < 0.05). They did not differ for ghrelin expression (<i>p</i> > 0.05). They evidenced different tissue/serum expression of miR-21, miR-92 and miR-126 (<i>p</i> < 0.05). Group 2 versus group 1 over-expressed tissue inflammatory markers and SGLT2 (<i>p</i> < 0.05), with higher extent in group 3 versus group 1 (<i>p</i> < 0.01) and versus group 2 (<i>p</i> < 0.025). SIRT1 was downregulated in group 2 versus group 1 (<i>p</i> < 0.05), and versus group 3 (<i>p</i> < 0.01). At the follow-up end, patients with lower LV-diastolic dysfunction had lower inflammation and SGLT2, and higher serum ghrelin (<i>p</i> < 0.05). They increased miR-126, and reduced serum miR-21 and miR-92 expression. At the follow-up end, 50 patients experienced LV-DF normalisation, which was predicted by tissue miR-126 (HR 1.344, CI 95% 1.126–1.937), and ghrelin (HR 1.123, CI 95% 1.016–1.310).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In T2DM obese patients, abdominal fat excision could reduce inflammation, up-regulating serum ghrelin and inducing miRs implied in LV-DF normalisation at 1 year of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical research trial number</h3>\u0000 \u0000 <p>NCT05988346.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905285","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":"Seasonal Variations in HbA1c and Body Composition: A Sex-Specific Analysis in Adolescents With Type 1 Diabetes","authors":"Hussein Zaitoon, Hadel Khalil, Eyal Cohen-Sela, Ori Eyal, Hagar Interator, Asaf Oren, Irina Laurian, Anna Dorfman, Efrat Chorna, Yael Lebenthal, Avivit Brener","doi":"10.1002/dmrr.70047","DOIUrl":"https://doi.org/10.1002/dmrr.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Circannual fluctuations in glycated haemoglobin (HbA1c) levels are recognized among adults, but comparable changes and contributing factors in adolescents with type 1 diabetes (T1D) have not been investigated in depth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the seasonal changes in HbA1c and their association with body composition in youth with T1D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study included adolescents with T1D followed at our paediatric diabetes centre (2021–2023). Seasonal means were calculated for two periods (winter-spring: December to May and summer-autumn: June to November), and ΔHbA1c was calculated as the difference between the values. The patients' body composition (via bioelectrical impedance analysis (BIA)) data were reviewed, and correlation analyses were performed between sex- and age-adjusted <i>z</i>-scores of body composition components [appendicular muscle mass (ASMM) and fat mass (FATM)] and ΔHbA1c.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The seasonal means of HbA1c calculated for 259 adolescents with T1D (56% male, mean age: 16.01 ± 2.23 years) were significantly higher during winter-spring compared to summer-autumn (7.75% vs. 7.24%, <i>p</i> < 0.001, CI: 0.42–0.57), (61.16 mmol/mol vs. 55.72 mmol/mol, respectively <i>p</i> < 0.001, CI: 4.64–6.23). ΔHbA1c displayed a sex-specific association with body composition components in 102 patients (50% males) who underwent BIA. The correlation was significant for only ASMM <i>z</i>-scores in boys (<i>r</i> = 0.277, <i>p</i> = 0.049), while both the ASMM and FATM <i>z</i>-scores significantly correlated with ΔHbA1c (<i>r</i> = 0.301, <i>p</i> = 0.032 and <i>r</i> = 0.284, <i>p</i> = 0.043, respectively) in girls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is a seasonal variation in HbA1c levels in adolescents with T1D, with higher values during winter-spring. The link between seasonal variability and body composition components varied by sex, indicating a need for sex-specific strategies in adolescent diabetes management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880043","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":"The Impact of Cardiometabolic Index on Cardiovascular Disease Risk Among Diabetic Patients: Evidence From Two National Cohorts","authors":"Changxing Liu, Zhirui Zhang, Tianwei Meng, Boyu Wang, Chengjia Li, Ximing Yu, Xulong Zhang","doi":"10.1002/dmrr.70044","DOIUrl":"https://doi.org/10.1002/dmrr.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigates the relationship between the Cardiometabolic Index (CMI) and cardiovascular disease (CVD) risk in diabetic populations using data from the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS). Understanding the predictive role of CMI in assessing CVD risk is essential for enhancing preventive strategies in diabetic patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis was conducted on diabetic participants from NHANES (2005–2018) and CHARLS (2011). CMI was calculated based on the waist-to-height ratio and the triglyceride-to-HDL-C ratio. Multivariable logistic regression models and restricted cubic spline analyses were utilised to evaluate the associations between CMI and CVD risk, adjusting for demographic and clinical covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the NHANES cohort (<i>n</i> = 2044), a higher CMI was significantly associated with an increased risk of CVD after adjusting for confounding factors (OR = 2.01, <i>p</i> = 0.0074). Similarly, in the CHARLS cohort (<i>n</i> = 3964), a higher CMI was linked to an elevated CVD risk (OR = 1.45, <i>p</i> = 0.009). Subgroup analyses demonstrated consistent results across various age, gender and health status subgroups. The restricted cubic spline analysis revealed significant non-linear trends between CMI and CVD risk in both cohorts (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CMI is a robust and independent predictor of CVD risk among diabetic individuals across different populations. These findings highlight the potential clinical value of incorporating CMI into routine assessments to identify high-risk diabetic patients. Future longitudinal studies are needed to further validate these findings and explore the underlying mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880142","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}
Tianyuan Jiang, Dandan Wang, Ruoting Chai, Yanyun Hu, Liying Zhu, Fang Fang, Na Li, Chunling Wan, Fang Liu
{"title":"Attenuated Niacin Skin Flushing Response in Diabetic Peripheral Neuropathy Patients: A Novel Clinical Diagnostic Tool","authors":"Tianyuan Jiang, Dandan Wang, Ruoting Chai, Yanyun Hu, Liying Zhu, Fang Fang, Na Li, Chunling Wan, Fang Liu","doi":"10.1002/dmrr.70042","DOIUrl":"https://doi.org/10.1002/dmrr.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The diagnosis of diabetic peripheral neuropathy (DPN) remains challenging because of the lack of objective biomarkers. In this study, we explored the niacin-induced skin flushing response (NSFR) as a novel diagnostic biomarker for DPN on the basis of its association with microangiopathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We recruited 114 patients with type 2 diabetes (51 with DPN, 59 without DPN, and 4 with unclear neuropathy status) and 91 healthy controls. Peripheral neuropathy was assessed through clinical symptoms and signs, vibration threshold testing and electromyography. NSFR was measured using a six-chamber sandwich patch and six concentrations of aqueous methyl nicotinate. Demographic and clinical data were collected via questionnaires and medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The NSFR was significantly lower in patients with type 2 diabetes than in healthy controls (1613 ± 1130.1 vs. 2494.6 ± 1071.9, <i>p</i> < 0.001) and was further reduced in DPN patients than in those without DPN (1105.4 ± 950.93 vs. 2063.7 ± 1119.3, <i>p</i> < 0.001). The association between the NSFR and the risk of developing DPN remained significant after adjusting for potential confounding factors (OR 0.848, 95% CI 0.757–0.949; <i>p</i> = 0.004). A nomogram illustrated the role of the NSFR in predicting DPN occurrence. The ROC curve for the NSFR had an AUC of 0.740, with 72.55% sensitivity and 66.10% specificity. For the combined model, the AUC improved to 0.898, with 89.58% sensitivity and 78.85% specificity. Decision curve analysis confirmed the practical clinical value of the NSFR for predicting DPN risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NSFR is significantly associated with the risk of developing peripheral neuropathy in diabetic patients and shows promise as a diagnostic tool for DPN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871744","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}
Benedetta Maria Bonora, Andrea Giaccari, Agostino Consoli, Fabio Broglio, Angelo Avogaro, Gian Paolo Fadini, for the GLIMPLES Study Investigators
{"title":"Long-Term Effectiveness of Once-Weekly Semaglutide in Patients With Type 2 Diabetes Previously Treated With Insulin. A Multicentre Real-World Study","authors":"Benedetta Maria Bonora, Andrea Giaccari, Agostino Consoli, Fabio Broglio, Angelo Avogaro, Gian Paolo Fadini, for the GLIMPLES Study Investigators","doi":"10.1002/dmrr.70045","DOIUrl":"https://doi.org/10.1002/dmrr.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The introduction of glucagon-like peptide 1 receptor agonists (GLP-1RAs) has provided new avenues for managing type 2 diabetes (T2D), aiming to achieve optimal glycaemic control while minimising treatment burden. We conducted a multicentre retrospective real-world study to assess the effectiveness of semaglutide once-weekly (OW) in patients previously treated with insulin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included individuals with T2D who were on insulin (basal and/or bolus) and initiated OW semaglutide at 18 specialist care centres. We collected retrospective data on baseline clinical characteristics and updated values of HbA1c and body weight. The primary outcome was the change in HbA1c analysed using the mixed model for repeated measures. Secondary outcomes included the changes in body weight, insulin discontinuation and the change in insulin doses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 674 individuals. At baseline, participants were 61.7 years old, with a mean diabetes duration of 11.5 years and an HbA1c of 8.2%. During a median follow-up of 18 months, OW semaglutide initiation led to a significant reduction in HbA1c (−0.9%) and body weight (−4.3 kg), with 60% of patients achieving HbA1c < 7%. 32.8% of patients discontinued insulin therapy, 72.5% of whom achieved an HbA1c < 7%. Among patients on basal-bolus insulin, 75% completely discontinued bolus, 62% of whom achieved an HbA1c < 7%. Predictors of insulin discontinuation included shorter diabetes duration, lower baseline HbA1c, and lower insulin doses. Among patients who remained on insulin, initiation of OW semaglutide was associated with a decrease in total daily insulin requirement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study highlights OW semaglutide as a valuable addition to a T2D regimen based on insulin, offering effective glycaemic and weight control with the potential for insulin deintensification or discontinuation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871745","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}
Xiaoying Zhou, Wenjuan Wang, Yang Yuan, Shanhu Qiu, Yandong Cheng, Zilin Sun
{"title":"Long-Term Anti-SARS-CoV-2 IgG Antibody Levels in Vaccinated Diabetes Patients After Recovery From COVID-19","authors":"Xiaoying Zhou, Wenjuan Wang, Yang Yuan, Shanhu Qiu, Yandong Cheng, Zilin Sun","doi":"10.1002/dmrr.70043","DOIUrl":"https://doi.org/10.1002/dmrr.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Long-term persistence of anti-SARS-CoV-2 IgG antibodies is critical to protect against SARS-CoV-2 infection or to alleviate the severity of COVID-19. However, the persistence of anti-SARS-CoV-2 IgG after infection in vaccinated diabetes patients is unclear. This study aimed to investigate levels of anti-SARS-CoV-2 IgG 1 year after SARS-CoV-2 infection in diabetes patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted between December 2023 and January 2024. Participants with SARS-CoV-2 infection during December 2022 to January 2023 were included, and were classified into the diabetes group and non-diabetes group. Anti-N/S IgG antibodies were measured with chemiluminescence immunoassay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 500 participants, 265 diabetes and 235 non-diabetes patients, were included. Anti-N/S IgG levels in the diabetes group were significantly lower than those in the non-diabetes group (1.92 ± 0.58 vs. 2.08 ± 0.42 log<sub>10</sub> AU/mL, <i>p</i> = 0.001). In vaccinated subjects, antibody levels in diabetes patients were also lower than those in non-diabetic patients. After adjustment for sex, age, body mass index, estimated glomerular filtration rate, hypertension, and heart disease, diabetes was negatively correlated with antibody titres (<i>β</i> = −0.16, 95% confidence interval (CI) −0.26 to −0.06, <i>p</i> = 0.002). In the diabetes group, after adjustment for confounders, use of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) was positively associated with high antibody levels (odds ratio 3.84, 95% CI 1.70–8.65, <i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vaccinated diabetes patients have lower anti-N/S IgG antibodies than non-diabetic patients 12 months after infection. SGLT-2i is associated with higher anti-N/S IgG antibody levels in diabetes patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861898","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}
Maja Cigrovski Berkovic, Felice Strollo, Antonio Ceriello
{"title":"Is Now the Time to Review the Diabetes Diagnostic Criteria?","authors":"Maja Cigrovski Berkovic, Felice Strollo, Antonio Ceriello","doi":"10.1002/dmrr.70046","DOIUrl":"https://doi.org/10.1002/dmrr.70046","url":null,"abstract":"<p>The prevention of prediabetes and type 2 diabetes mellitus (T2DM) remains a significant challenge for health systems worldwide. New technology and its expanding spread within the general population can be a helpful tool for healthcare professionals to identify those at risk for diabetes and develop effective and personalized interventions. Recent advancements in continuous glucose monitoring (CGM) technology have provided new insights into interstitial glucose levels, even among healthy individuals. An increasing number of athletes, especially in endurance sports, utilize CGM data during training and competitions to optimize their energy levels. This data-driven approach has led to significant improvements, such as reducing race times by critical seconds—often enough to secure medals. Furthermore, non-athletes are utilizing CGM to make healthier food choices and mitigate postprandial glucose excursions, which can help them achieve the desired body weight. Therefore, use of CGM has the potential to enhance the early detection of dysglycemia (prediabetes and diabetes) and refine the current diagnostic criteria to help individualised interventions and prevent long-term complications.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857090","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":"Body Composition and Regional Adiposity in Adolescents With Type 1 Diabetes: Relation to Insulin Resistance, Glycaemic Control and Vascular Complications","authors":"Safinaz Adel Elhabashy, Bassma Abdelnasser Abdelhaleem, Sherihane Saieed Madkour, Christein Monir Kamal, Nouran Yousef Salah","doi":"10.1002/dmrr.70041","DOIUrl":"https://doi.org/10.1002/dmrr.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Obesity is increasingly recognized among people with type 1 diabetes mellitus (T1DM). Little is known about the body composition of adolescents with T1DM and its metabolic outcomes. Hence, this study assessed the body composition of adolescents with T1DM and its relationship with glycaemic control, insulin resistance and vascular complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>One hundred twenty adolescents with T1DM were assessed for anthropometric measures, insulin therapy, bioelectrical impedance analysis (BIA), fasting lipids, glycated haemoglobin, with estimated glucose disposal rate (eGDR) calculation. Regional body fat quantification was performed via Magnetic resonance imaging (MRI) 3-T.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-three adolescents with T1DM were overweight (27.5%), and 8 were obese (6.6%). Adolescents with T1DM having insulin resistance were found to have significantly higher BMI <i>z</i> score, total body fat %, and visceral/subcutaneous fat % than those without insulin resistance (<i>p</i> < 0.05). Moreover, adolescents with T1DM having microvascular complications showed significantly higher total fat % and visceral/subcutaneous fat % than those without microvascular complications (<i>p</i> < 0.05). Visceral fat % and visceral/subcutaneous fat ratio were positively correlated with waist/hip ratio, eGDR and LDL level (<i>p</i> < 0.05). Waist/hip ratio and eGDR were the most significant independent variables associated with visceral fat % and visceral/subcutaneous fat ratio among adolescents with T1DM using multivariate regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overweight and visceral adiposity are frequently encountered among the studied adolescents with T1DM. Visceral adiposity is associated with insulin resistance, hyperlipidaemia and microvascular complications among adolescents with T1DM independent of glycaemic control and insulin dosage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770254","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}
Jingjing Liu, Zhangdaihong Liu, Chang Liu, Hong Sun, Xiaoguang Li, Yang Yang
{"title":"Integrating Artificial Intelligence in the Diagnosis and Management of Metabolic Syndrome: A Comprehensive Review","authors":"Jingjing Liu, Zhangdaihong Liu, Chang Liu, Hong Sun, Xiaoguang Li, Yang Yang","doi":"10.1002/dmrr.70039","DOIUrl":"https://doi.org/10.1002/dmrr.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic syndrome (MetS) is a progressive chronic pathophysiological state characterised by abdominal obesity, hypertension, hyperglycaemia, and dyslipidaemia. It is recognised as one of the major clinical syndromes affecting human health, with approximately one-quarter of the global population impacted. MetS increases the risk of developing cardiovascular diseases (CVDs), stroke, type 2 diabetes mellitus (T2DM), and diverse metabolic diseases. Early diagnosis of MetS could potentially reduce the prevalence of these diseases. However, care for the MetS population faces significant challenges due to (i) a lack of comprehensive understanding of the full spectrum of associated diseases, stemming from unclear pathophysiological mechanisms and (ii) frequent underdiagnosis or misdiagnosis of MetS in clinical settings due to inconsistent screening guidelines, limited medical resources, time constraints in clinical practice, and insufficient awareness and training. The increasing availability of healthcare and medical data presents opportunities to apply and innovate with artificial intelligence (AI) in addressing these challenges. This review aims to (i) summarise the spectrum of diseases associated with MetS and (ii) review the diverse AI models applied to MetS and metabolic syndrome-related diseases (MetSRD), where MetSRD collectively refers to diseases and conditions directly associated with MetS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our review consists of two phases. Initially, we conducted a literature review on MetS to narrow down the spectrum of MetSRD based on the strength of clinical evidence. We then used the terms ‘Metabolic Syndrome’ and ‘Machine Learning’ in combination with the identified MetSRD for further refinement. In total, we identified 52 related diseases in the first phase and 36 articles in the second phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified a total of 52 MetSRD after the first phase, with T2DM, CVDs, and cancer being the top three. Among the 36 articles obtained in the second phase, we observed the following: (i) The criteria for MetS were inconsistent across the studies. (ii) The primary purpose of AI applications was to identify risk factors for diseases, thereby improving predictions for MetS or MetSRD. Traditional machine learning models, such as Random Forest and Logistic Regression, were found to be the most effective. (iii) In addition to the MetS criteria, AI models explored other factors, including demographic and physiological variables, dietary influences, lipidomic and proteomic indicators, and more.</p>\u0000 </section>\u0000 \u0000 ","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 4","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707636","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}