Diabetes/Metabolism Research and Reviews最新文献

{"title":"Sarcopenia and Its Impact on Sexual Health: A Systematic Review","authors":"Giuseppe Defeudis,&nbsp;Rossella Mazzilli,&nbsp;Olivia Di Vincenzo,&nbsp;Marianna Minnetti,&nbsp;Eleonora Poggiogalle,&nbsp;Daniele Gianfrilli,&nbsp;Andrea M. Isidori,&nbsp;Lorenzo M. Donini,&nbsp;Silvia Migliaccio","doi":"10.1002/dmrr.70067","DOIUrl":"https://doi.org/10.1002/dmrr.70067","url":null,"abstract":"<p>Sarcopenia is increasingly recognised for its detrimental effects on functional status and quality of life. When combined with obesity, in a condition known as sarcopenic obesity, these effects are further exacerbated by metabolic and hormonal dysfunctions. In this scenario, emerging evidence suggests that these conditions may also negatively impact sexual health. To explore this relationship, we conducted a systematic review (PROSPERO registration: CRD42025646427). Out of 943 identified articles, only seven met the eligibility criteria. The majority of studies, mainly cross-sectional studies conducted in older men, except one, reported a strong association between sarcopenia (or its components) and sexual dysfunctions, particularly erectile dysfunction. However, significant heterogeneity in diagnostic criteria and the limited number of studies focusing on women lead to non-conclusive results. Further longitudinal studies with larger, standardised cohorts are needed to clarify the underlying mechanisms, establish causal relationships, and develop tailored interventions for optimised treatment. Finally, this systematic review allows more attention to be paid to a topic that has really been little discussed and lays the groundwork for soliciting new insights, particularly in women.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573290","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 Burden of Female Breast Cancer Attributable to High Fasting Plasma Glucose From 1990 to 2021 and Projections to 2046: An Analysis for the Global Burden of Disease Study 2021","authors":"Donglin Jiang,&nbsp;Siyao Ma,&nbsp;Yangxue Wu,&nbsp;Jicun Zhu,&nbsp;Qian Yang,&nbsp;Ling Liu,&nbsp;Tiandong Li,&nbsp;Yin Lu,&nbsp;Yuqi Liu,&nbsp;Peng Wang,&nbsp;Keyan Wang,&nbsp;Jianxiang Shi,&nbsp;Hua Ye","doi":"10.1002/dmrr.70063","DOIUrl":"https://doi.org/10.1002/dmrr.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High fasting plasma glucose (HFPG) plays an important role in the progression of breast cancer. This study aims to assess the global time trends of female breast cancer attributable to HFPG from 1990 to 2021 and projections to 2046.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study obtained the number and age-standardised rate of deaths and disability-adjusted life years (DALYs) of female breast cancer burden attributable to HFPG by age, region, country, and socio-demographic index (SDI) from 1990 to 2021. Average Annual Percentage Change (AAPC) was analysed to assess time trends in female breast cancer burden attributable to HFPG. The age-period-cohort model was used to project the global burden by 2046.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, 4.62% of female breast cancer deaths (30,000) and 4.04% of DALYs (820,000) globally were attributed to HFPG. Compared with 1990, the age-standardised mortality rate (ASMR) and age-standardised DALY rate (ASDR) increased, with AAPCs of 0.76 (95% CI: 0.71, 0.89) and 0.86 (95% CI: 0.84, 0.98), respectively. The burden of breast cancer attributable to HFPG was higher in the elderly and low SDI regions. Additionally, the burden of female breast cancer attributable to HFPG is projected to continue to increase through 2046.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The burden of female breast cancer attributable to HFPG has increased over the past three decades and will continue to increase over the next 25 years. Therefore, it is important to control blood sugar to reduce the burden of breast cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519870","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":"Concomitant Diabetes and Atrial Fibrillation: Epicardial Fat and Macrophage-Related Mechanisms","authors":"Saja Al-rubaye,&nbsp;Moisés Rodríguez-Mañero,&nbsp;José Ramón González-Juanatey,&nbsp;Sonia Eiras","doi":"10.1002/dmrr.70065","DOIUrl":"https://doi.org/10.1002/dmrr.70065","url":null,"abstract":"<p>Type 2 diabetes mellitus (T2DM) is present in 25% of patients with atrial fibrillation (AF), the most prevalent arrhythmia in the world. This concomitant disorder enhances thromboembolic events, length of hospital stay after AF ablation, renal impairment after anticoagulation, heart rate variability after glucose-lowering treatment, and cardiac mortality. These patients accumulate inflamed epicardial fat (EAT) with paracrine consequences on β-oxidation of mitochondria, cytosolic Ca²⁺ fluxes, and sarcomere shortening. Knowing these specific targets will improve the efficacy of personalised preventive and curative therapies since AF leads to AF and EAT accumulation. This review tries to clarify the interplay among epicardial fat accumulation and macrophages with concomitant T2DM and AF to provide a summary of current known mechanisms and therapeutic strategies.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520156","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":"Diabetes and Bone Health: A Comprehensive Review of Impacts and Mechanisms","authors":"Prabhat Upadhyay,&nbsp;Sudhir Kumar","doi":"10.1002/dmrr.70062","DOIUrl":"https://doi.org/10.1002/dmrr.70062","url":null,"abstract":"<p>Diabetic bone disease, a form of secondary osteoporosis, is characterised by reduced bone strength and increased fracture risk, particularly in patients with type 2 diabetes (T2D). Over 35% of T2D patients experience bone loss, with approximately 20% meeting diagnostic criteria for osteoporosis. This review highlights the complex mechanisms underlying diabetic bone disease, emphasising the need to reduce fracture risk and improve clinical outcomes. Key factors such as hyperglycemia, insulin resistance, insulin-like growth factors (IGFs), advanced glycation end products (AGEs), and proinflammatory cytokines disrupt bone turnover by impairing osteoblast and osteoclast function, leading to imbalanced bone formation and resorption. We explore the role of bone turnover and mineralisation in both cortical and trabecular bone, and the impact of microvascular complications on bone microarchitecture. Gut hormones, including Glucagon-like peptide-1 (GLP-1), Glucose-dependent insulinotropic polypeptide (GIP), and Parathyroid hormone (PTH), and the gut microbiota also play crucial roles in the pathogenesis of diabetic bone disease. Specific bacterial species, such as <i>Akkermansia muciniphila</i> and <i>Bacteroides fragilis</i>, are implicated in modulating the gut-bone axis through short-chain fatty acids (SCFAs) and other signalling pathways. These changes, along with altered gut hormone responses, affect bone density, microstructure, and material properties. Despite normal or increased bone mineral density (BMD) in some T2D patients, the material quality of bone is compromised, leading to greater fragility. This review integrates current knowledge of molecular, hormonal, and microbial interactions that contribute to diabetic bone disease, offering insights into potential therapeutic strategies and improving patient care.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473235","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":"Albumin-To-Creatinine Ratio Underestimates True 24-Hour Albuminuria in Obesity: Clinical Relevance for Vascular Risk Stratification","authors":"D. Moriconi,&nbsp;M. Nannipieri,&nbsp;M. Jadoon,&nbsp;A. Solini,&nbsp;R. M. Bruno","doi":"10.1002/dmrr.70064","DOIUrl":"https://doi.org/10.1002/dmrr.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Albuminuria is a recognized marker of endothelial dysfunction and early cardiovascular risk. The albumin-to-creatinine ratio (ACR) is widely used to estimate urinary albumin excretion, but in individuals with high fat-free mass (FFM), such as those with obesity, elevated urinary creatinine may lead to underestimation of albuminuria. We aimed to investigate the concordance between ACR and 24-h urinary albumin excretion (UAE) in adults with obesity and examine whether discrepancies affect the detection of vascular dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>140 individuals affected by severe obesity were enrolled. Albuminuria was assessed using both spot ACR and 24-h UAE. A subgroup of 70 participants underwent vascular testing, including carotid-femoral pulse wave velocity (cf-PWV) and allometrically scaled flow-mediated dilation (FMD). Multivariable linear models were used to evaluate associations between albuminuria markers and vascular parameters, adjusting for age, sex, blood pressure, and HbA1c.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>24h-UAE ≥ 30 mg was more frequent in males (35%) than females (20%), while ACR ≥ 30 mg/g showed no sex difference; 21 individuals (15%) exhibited elevated 24 h-UAE (≥ 30 mg/24 h) despite a normal ACR (&lt; 30 mg/g), a discordant pattern predominantly observed in males with high FFM and urinary creatinine levels. Interestingly, both ACR and UAE were independently associated with reduced FMD (st.<i>β</i> = −0.27 and −0.24; <i>p</i> &lt; 0.05). No sex-based interactions were observed in the vascular models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In individuals with obesity, ACR may underestimate albuminuria, especially in males. Despite this, both markers are associated with early endothelial dysfunction. UAE may provide added value in cardiovascular risk stratification where ACR underperforms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472780","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":"Association of Albuminuria Within the Normoalbuminuric Range With All-Cause Mortality in People With Type 2 Diabetes","authors":"Monia Garofolo,&nbsp;Giuseppe Penno,&nbsp;Anna Solini,&nbsp;Emanuela Orsi,&nbsp;Martina Vitale,&nbsp;Veronica Resi,&nbsp;Enzo Bonora,&nbsp;Cecilia Fondelli,&nbsp;Roberto Trevisan,&nbsp;Monica Vedovato,&nbsp;Antonio Nicolucci,&nbsp;Giuseppe Pugliese,&nbsp;Renal Insufficiency And Cariovascular Events (RIACE) Study Group","doi":"10.1002/dmrr.70061","DOIUrl":"https://doi.org/10.1002/dmrr.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To investigate the independent association of albuminuria within the normoalbuminuric range with all-cause mortality in normoalbuminuric people with type 2 diabetes with and without chronic kidney disease (CKD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This observational, prospective, multicentre, cohort study enroled 15,773 individuals with type 2 diabetes in 2006–2008. At baseline, albumin excretion rate (AER) and estimated glomerular filtration rate (eGFR) were assessed together with cardiometabolic risk profile, treatments, complications, and comorbidities. All-cause mortality was verified on 31 October 2015.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 15,656 participants (99.3%) with valid information on vital status, 11,460 (71.2%) were normoalbuminuric, 9984 (87.1%) without and 1476 (12.9%) with CKD. Normoalbuminuric individuals were stratified into three (&lt; 5, 5–15, and &gt; 15 mg·day⁻¹) or two (&lt; 10 and 10–29 mg·day⁻¹) AER subcategories. When adjusting for age, sex, eGFR, prior cardiovascular disease, cardiovascular risk factors, and treatments, mortality risk was higher in participants with AER 10–29 versus &lt; 10 mg·day⁻¹ (hazard ratio, 1.120 [95% confidence interval, 1.028–1.221], <i>p</i> = 0.009) and 15–29 versus &lt; 5 mg·day⁻¹ (1.243 [1.099–1.406], <i>p</i> &lt; 0.0001). When stratifying by CKD status, the adjusted risk remained significantly increased only for AER 15–29 versus  &lt; 5 mg/24 h in individuals with (1.404 [1.111–1.774], <i>p</i> = 0.005) and, to a lesser extent, without (1.167 [1.009–1.350], <i>p</i> = 0.038) CKD. A non-linear association was observed between AER as Log2 transformed continuous variable and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For the same level of kidney function, higher AER within the normoalbuminuric range was independently associated with all-cause mortality, thus supporting to the use of albuminuria-lowering drugs in people with type 2 diabetes and mildly elevated albuminuria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov, NCT00715481, retrospectively registered 15 July, 2008.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473236","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":"N-Lactoyl Amino Acids: Emerging Biomarkers in Metabolism and Disease","authors":"Khaled Naja,&nbsp;Laila Hedaya,&nbsp;Asma A. Elashi,&nbsp;Manfredi Rizzo,&nbsp;Mohamed A. Elrayess","doi":"10.1002/dmrr.70060","DOIUrl":"https://doi.org/10.1002/dmrr.70060","url":null,"abstract":"<p>N-lactoyl amino acids (Lac-AA) form an emerging class of metabolites that have gained significant attention in recent years due to their ubiquitous presence in different biological systems and potential roles in various biochemical processes. This narrative review aims to provide a comprehensive overview of the current understanding of Lac-AA, emphasising their biosynthesis, physiological roles, and potential implications in various diseases. We discuss the discovery of Lac-AA as signalling molecules, and their involvement in exercise-induced appetite suppression, energy metabolism, and other pathways. This review explores the complex relationship between Lac-AA and various pathological conditions, including mitochondrial disorders, type 2 diabetes, phenylketonuria, cancer, and rosacea. We also examine the interplay between Lac-AA and the gut microbiota, as well as their association with metformin treatment. Furthermore, we address the ongoing debate regarding whether Lac-AA are merely reflections of lactate and amino acid levels or independent signalling molecules. This review synthesises the latest research findings, highlights the significance of Lac-AA in metabolic research, and identifies promising avenues for future investigation in this rapidly evolving field.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314927","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":"Vision Loss as a Rising Global Health Challenge: Comprehensive Analysis of High Fasting Plasma Glucose Burden and Projections to 2035","authors":"Zhirui Zhang,&nbsp;Changxing Liu,&nbsp;Xufang Tan,&nbsp;Jiadi Wang,&nbsp;Jing Yao","doi":"10.1002/dmrr.70054","DOIUrl":"https://doi.org/10.1002/dmrr.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vision loss caused by high fasting plasma glucose (HFG) is a growing global health concern. This study evaluates the global and regional burden of HFG-attributable vision loss from 1990 to 2021 and projects future trends through 2035.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using Global Burden of Disease (GBD) 2021 data, we assessed disability-adjusted life years (DALYs) across 204 countries, stratified by gender, age, and Sociodemographic Index (SDI). Temporal trends were analysed using Joinpoint regression, and projections were made using ARIMA modelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Global DALYs due to HFG-related vision loss rose from 613,694 in 1990 to 1,674,401 in 2021. South Asia and Sub-Saharan Africa experienced the highest burdens, especially among females and older adults. Although age-standardized DALY rates slightly declined globally, they remained elevated in low-SDI regions. Projections suggest a continued increase through 2035.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The burden of vision loss due to HFG is rising, with stark regional and demographic disparities. Urgent, targeted interventions are needed to reduce this growing health burden, particularly in low-SDI areas and among high-risk populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273149","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":"Recommendations for the Management of Diabetes During Ramadan Applying the Principles of the ADA/ EASD Consensus: Update 2025","authors":"Mahmoud Ibrahim,&nbsp;Ebtesam M. Ba-Essa,&nbsp;Asma Ahmed,&nbsp;Ehtasham Ahmad,&nbsp;Firas A. Annabi,&nbsp;Hanene Chaabane,&nbsp;Dario Tuccinardi,&nbsp;Melanie J. Davies,&nbsp;Francesco De Domenico,&nbsp;Robert H. Eckel,&nbsp;Nancy Elbarbary,&nbsp;Pamela Houeiss,&nbsp;Silvia Manfrini,&nbsp;Shabeen Naz Masood,&nbsp;Omar Mobarak,&nbsp;Shehla Shaikh,&nbsp;Safia Mimouni-Zerguini,&nbsp;Guillermo E. Umpierrez","doi":"10.1002/dmrr.70057","DOIUrl":"https://doi.org/10.1002/dmrr.70057","url":null,"abstract":"<p>Ramadan fasting is a sacred ritual observed by approximately 1.8 billion Muslims each year, most of whom adhere to fasting due to its significance as a core pillar of Islam. Able-bodied Muslims who are capable of fasting are religiously required to do so. Ramadan is profoundly spiritual and of great importance in the Muslim community that occurs for roughly 30 days, in alignment with the lunar calendar. During Ramadan, Muslims abstain from food and drink for 11–16 h a day on average; however, this could be significantly shorter or longer depending on the season and the geographic location, ultimately breaking their fast during the sunset meal ‘Iftaar’. Before the great strides were taken in the management of diabetes, these patients were initially considered not able to observe this holy month, creating significant frustration and disconnect with their families and loved ones. As patient outcomes improved through the emergence of better pharmacotherapy and increasing use of technology, these restrictions have been reconsidered. This prompted us to create the 2005 first global statement regarding best practices in the management of diabetes during Ramadan as an official American Diabetes Association (ADA) report. Since then, we have received numerous requests and comments asking for updated versions that include the latest data, medications, and technology. We decided to issue an update every 5 years, including 2010, 2015 and 2020. Our updated recommendations collate some of the more directly implicative findings on patient care for Ramadan fasting and align closely with the ADA's consensus for diabetes management. We recommend the prioritisation of pharmacologic therapies with a low risk profile for hypoglycaemia. Technological advancements, including integrated pump-sensor systems, hybrid closed-loop systems, and artificial intelligence (AI)-equipped continuous glucose monitoring (CGM) devices, show great promise in the monitoring of blood glucose levels and can provide tangible reductions in hypoglycaemia episodes, suggesting possible utility in the facilitation of fasting in patients with type 1 diabetes mellitus (T1D). Our recommendations align with the ADA consensus for the use of CGM devices, in concordance with appropriate time in range (TIR) targets to reduce hypoglycaemia and glycaemic variability. The implications of Ramadan fasting on atherosclerotic cardiovascular disease (ASCVD) risk remain uncertain due to the sparsity of evidence, but the literature suggests an increased risk. Until more conclusive evidence is reported, we advise patients with a high ASCVD risk to avoid Ramadan fasting. We emphasise the pivotal role primary care providers (PCPs) have in counselling, managing, and following patients who intend to fast and advise counselling to begin ideally 6–8 weeks prior to Ramadan start, with particular recommendations to be given to patients post-bariatric surgery.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273150","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":"Enhancing Type 2 Diabetes Care With CGM Integration: Insights From an Italian Expert Group","authors":"Concetta Irace,&nbsp;Angelo Avogaro,&nbsp;Federico Bertuzzi,&nbsp;Raffaella Buzzetti,&nbsp;Riccardo Candido,&nbsp;Stefano Del Prato,&nbsp;Paolo Di Bartolo,&nbsp;Paolo Fiorina,&nbsp;Carlo Bruno Giorda,&nbsp;Francesco Giorgino","doi":"10.1002/dmrr.70059","DOIUrl":"https://doi.org/10.1002/dmrr.70059","url":null,"abstract":"<p>Type 2 diabetes (T2D) is a pandemic and strongly impact patients' prognosis. Several barriers may hamper the achievement of good glycaemic control, which is the aim of diabetes care. These include but are not limited to poor treatment adherence, poor self-management, and heterogeneity of the disease context. Diabetes self-management is critical, particularly in insulin-treated patients and it is largely based on glucose monitoring, which allows recording glucose levels to make informed decisions with respect to meals, exercise, and other daily-life activities. For decades, glucose monitoring has been based on self-measurement of capillary blood glucose, which has some obvious important limitations. With the start of the new century, systems for continuous glucose monitoring (CGM) have become available. These systems measure subcutaneous interstitial glucose levels in a continuous or intermittent manner. They allow a better description of daily glucose pattern and glycaemic trend, a more accurate identification of glucose peaks and identification of otherwise unrecognised hypoglycaemic episodes, and a more reliable assessment of the stability of glycaemic control. CGM has been repeatedly shown to improve glycaemic control and reduce the risk of hypoglycaemia in type 1 diabetes (T1D). Over the years however, evidence has been gathered on the CGM use in T2D on different treatment regimens and wider applications are clearly desired. The aim of this expert opinion paper is to summarise the currently available evidence on CGM use across the whole spectrum of T2D and suggest practical indications beyond current guidelines.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256271","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}