Diabetes/Metabolism Research and Reviews最新文献

{"title":"Real-World Databases in Diabetes: A Systematic Review","authors":"Jonah J. C. Thomas,&nbsp;Anna Meffen,&nbsp;Alessandro Rizzi,&nbsp;Andrew P. Kingsnorth,&nbsp;Beatrice Pieri,&nbsp;Ying He,&nbsp;Shirley Konnor,&nbsp;Clare Gillies,&nbsp;Kamlesh Khunti,&nbsp;Jonathan Valabhji,&nbsp;Shivani Misra,&nbsp;Amanda Adler,&nbsp;Christian Torp-Pedersen,&nbsp;Martina Vettoretti,&nbsp;Julia K. Mader,&nbsp;Pratik Choudhary","doi":"10.1002/dmrr.70241","DOIUrl":"10.1002/dmrr.70241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify publications that describe RWD databases in the field of diabetes and map their key characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Databases were searched (MEDLINE, SCOPUS, CINAHL from January 2018 to October 2025) to identify relevant publications describing RWD databases. Eligible studies were identified as RWD databases that contained more than 1000 adults and were followed up for one year or longer. Metadata including population, sample size, and outcomes were then extracted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 610 eligible RWD databases were identified from 1779 included articles. Databases were identified in 74 countries, with the majority collected in Europe (<i>n</i> = 193). Only 22 databases were identified in lower- and- middle income countries (as defined by the World Bank). Demographics, prescription, diagnosis, and biochemical information were collected frequently; however, mortality and technology related variables (CGM usage) were found in fewer datasets. Very few databases were open access however 205 mentioned having the possibility for data sharing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We have produced an online dashboard to summarise the RWD databases available in the field of diabetes. We found many RWD databases globally that contain a range of variables related to individuals' health; however, lower- and middle-income nations are underrepresented within these data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 7","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197235","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":"Obituary Jesse Roth","authors":"Paolo Pozzilli","doi":"10.1002/dmrr.70236","DOIUrl":"https://doi.org/10.1002/dmrr.70236","url":null,"abstract":"&lt;p&gt;&lt;b&gt;Professor Jesse Roth (5 August 1934–11 March 2026)&lt;/b&gt;&lt;/p&gt;&lt;p&gt;&lt;/p&gt;&lt;p&gt;The passing of Professor Jesse Roth marks the end of an extraordinary era in endocrinology and diabetes research. For those of us who had the privilege of working closely with him, his loss is not only that of one of the greatest physician-scientists of our time, but also of a mentor, an intellectual guide, and a dear friend.&lt;/p&gt;&lt;p&gt;Jesse Roth was born on 5 August 1934 in New York City and passed away on 11 March 2026, leaving behind an exceptional scientific legacy that transformed our understanding of diabetes and hormone action. His pioneering work on the insulin receptor fundamentally changed the way we view the pathophysiology of diabetes mellitus. Before his discoveries, diabetes was largely regarded simply as a disease of insulin deficiency. Through elegant and innovative research, Jesse demonstrated that target tissues could become resistant to insulin because of abnormalities in its receptor, introducing the concept of insulin resistance at the cellular level and opening entirely new directions for diabetes research.&lt;/p&gt;&lt;p&gt;Working initially at the National Institutes of Health, where he led the Diabetes Branch, and later at Johns Hopkins University, the Albert Einstein College of Medicine, and the Feinstein Institutes for Medical Research, Jesse built an international reputation as one of the founders of modern receptor biology. His work extended beyond insulin to numerous hormone receptors, establishing principles that became fundamental across endocrinology and cell biology.&lt;/p&gt;&lt;p&gt;Throughout his remarkable career, Professor Roth authored and co-authored more than 1000 scientific publications, a body of work that continues to influence generations of investigators. His publications were characterised not only by scientific rigour but also by remarkable clarity of thought, intellectual curiosity, and an unwavering commitment to asking the most important biological questions.&lt;/p&gt;&lt;p&gt;His groundbreaking discoveries naturally attracted attention as Nobel-worthy science. Indeed, the identification and characterisation of the insulin receptor represented one of the major biomedical achievements of the twentieth century. Jesse's work evolved alongside that of other pioneers in the field, particularly Professor C. Ronald Kahn, with whom he shared both scientific competition and mutual respect in advancing our understanding of insulin receptor biology. Many in the scientific community considered these discoveries among those deserving recognition at the highest level.&lt;/p&gt;&lt;p&gt;However, Jesse's greatest legacy cannot be measured solely by publications or scientific achievements. He was an extraordinary mentor. Scientists from every continent came to train in his laboratories, carrying his scientific philosophy back to their own institutions. His trainees became leaders of academic departments, research institutes, and clinical programs throughout the world. His influence therefor","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 7","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149205788","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 Is Associated With Higher Symptom Burden in Patients With Disorders of Gut-Brain Interaction: A Multinational Population-Based Study","authors":"Keren Hod,&nbsp;Giovanni Marasco,&nbsp;Luigi Colecchia,&nbsp;Ami D. Sperber,&nbsp;Olafur S. Palsson,&nbsp;Shrikant I. Bangdiwala,&nbsp;Giovanni Barbara","doi":"10.1002/dmrr.70243","DOIUrl":"10.1002/dmrr.70243","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To compare multidomain symptom burden, psychological distress and healthcare utilisation across individuals with disorders of gut–brain interaction (DGBI) and diabetes and their overlap, and to assess obesity as an effect modifier.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis based on data from the Rome Foundation Global Epidemiology Study. Participants were classified according to self-reported physician-diagnosed diabetes and Rome IV criteria for DGBI. Outcomes included gastrointestinal symptoms, psychological distress (PHQ-4), somatic symptoms (PHQ-12), healthcare utilisation, medication use and dietary intake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 23,939 participants, 20,055 (83.8%) had DGBI only, 2205 (9.2%) had diabetes only and 1679 (7.0%) both. A consistent gradient was observed across most outcomes (overall <i>p</i> &lt; 0.001), with the highest burden in the DGBI–diabetes overlap group, intermediate in DGBI alone and the lowest in diabetes alone. The overlap group exhibited greater gastrointestinal symptom severity (e.g., abdominal pain severity 51.4 ± 21.6 vs. 47.6 ± 22.2 vs. 45.8 ± 26.0), higher somatic symptom burden (7.2 ± 4.1 vs. 6.5 ± 3.7 vs. 4.5 ± 3.4) and increased healthcare utilisation, including more frequent physician visits (34.3% vs. 14.0% vs. 24.5%) compared with the DGBI-only and diabetes-only groups, respectively. Psychological distress was elevated in both DGBI groups compared with diabetes alone (overall <i>p</i> &lt; 0.001). Obesity-modified several associations between DGBI–diabetes overlap and clinical outcomes, with many associations being stronger among participants without obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Coexisting DGBI and diabetes were associated with greater gastrointestinal and somatic symptom burden and healthcare utilisation, including within the upper gastrointestinal and bowel DGBI domains. Obesity modified several of these associations, with stronger associations generally observed among participants without obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 7","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197276","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":"Longitudinal Sleep Patterns and Risk of Type 2 Diabetes Mellitus","authors":"Ying Zhang,&nbsp;Zhen'ge Chang,&nbsp;Shuang Zhang,&nbsp;Yingying Guo,&nbsp;Qian Guo,&nbsp;Feiyu Zhang,&nbsp;Yating Chen,&nbsp;Fang Luo,&nbsp;Kefei Dou,&nbsp;Caixia Guo","doi":"10.1002/dmrr.70237","DOIUrl":"10.1002/dmrr.70237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Evidence relating sleep characteristics to type 2 diabetes mellitus (T2DM) has largely been based on single assessments. We examined whether transitions in a multidimensional healthy sleep score between two assessments were associated with incident T2DM and explored the relationship of the triglyceride-glucose (TyG) index to this association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a landmark analysis among 60,249 UK Biobank participants with sleep assessed at visits 1 and 2. Visit 2 was defined as time zero for follow-up. Sleep pattern transitions were classified according to poor, intermediate, or healthy sleep status at each assessment. Cox proportional hazards models were used to estimate associations with incident T2DM. TyG analysis was treated as exploratory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 4.2 years, 1284 incident T2DM cases occurred. Compared with stable healthy sleep, stable poor sleep was associated with higher risk (hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.32–3.27). Baseline-stratified analyses did not show higher risk for improvement from poor or intermediate sleep relative to remaining in the same baseline category. The full-cohort spline showed evidence of nonlinearity (<i>p</i> for nonlinearity &lt; 0.001), and TyG analyses were exploratory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sleep pattern transitions between the two assessments were associated with incident type 2 diabetes, and the association differed by baseline sleep status. Repeated sleep assessment may complement single-time-point evaluation in understanding the role of sleep in diabetes risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 7","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168613","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":"Abdominal MRI-Derived Liver, Visceral Fat, and Pancreatic Phenotypes Improve Prediction of Incident Type 2 Diabetes","authors":"Ruotong Peng,&nbsp;Xuyang Diao,&nbsp;Yiwen Dai,&nbsp;Jingxin Chen,&nbsp;Linqing Zhu,&nbsp;Menghan Zhu,&nbsp;Xinqing Yang,&nbsp;Yang Pan,&nbsp;Yuling Liu,&nbsp;Darui Gao,&nbsp;Yanyu Zhang,&nbsp;Mengmeng Ji,&nbsp;Wuxiang Xie,&nbsp;Fanfan Zheng","doi":"10.1002/dmrr.70235","DOIUrl":"https://doi.org/10.1002/dmrr.70235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate whether abdominal magnetic resonance imaging (MRI)-derived metabolic phenotypes improve the opportunistic prediction of incident type 2 diabetes (T2D) beyond clinical risk models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This study included 36,833 UK Biobank participants who underwent abdominal MRI and were free of T2D at imaging baseline. The original Cambridge Diabetes Risk Score (CDRS) was evaluated, and glycated haemoglobin (HbA1c) was added to form the clinical CDRS model. MRI phenotypes were selected using a LASSO-based selection-frequency analysis and added to construct the clinical CDRS-MRI model. Model performance was assessed in an internal validation set using Harrell's C-index, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 7.38 years, 570 participants developed incident T2D. The selection-frequency analysis retained four MRI phenotypes: liver proton density fat fraction, liver volume, visceral fat volume, and pancreas volume. In the internal validation set, C-indices were 0.765 (95% CI, 0.731–0.800) for the original CDRS model, 0.820 (95% CI, 0.786–0.849) for the clinical CDRS model, and 0.849 (95% CI, 0.818–0.877) for the clinical CDRS-MRI model. The clinical CDRS-MRI model improved the C-index by 0.084 versus the original CDRS model and by 0.029 versus the clinical CDRS model, with a continuous NRI of 56.2% (95% CI, 40.6%–70.0%) and an IDI of 0.022 (95% CI, 0.010–0.037).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Abdominal MRI-derived phenotypes improved the prediction of incident T2D beyond established clinical risk models. These findings support secondary use of available abdominal MRI data for metabolic risk stratification, pending external validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 7","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099404","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":"Metabolomic Profiling Delineates Stage-Associated Metabolic Remodelling in Cardiovascular-Kidney-Metabolic Syndrome","authors":"Xuemei Gong,&nbsp;Chunyang Li,&nbsp;Jing Chen,&nbsp;Yujiao Wang,&nbsp;Wenge Tang,&nbsp;Xuehui Zhang,&nbsp;Jianzhong Yin,&nbsp;Xing Zhao,&nbsp;Haopeng Yu,&nbsp;Ping Fu,&nbsp;Xiaoxi Zeng","doi":"10.1002/dmrr.70230","DOIUrl":"10.1002/dmrr.70230","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Cardiovascular–kidney–metabolic (CKM) syndrome represents an integrated continuum of metabolic, kidney, and cardiovascular abnormalities. However, the stage-specific metabolic heterogeneity underlying this clinical framework remains incompletely characterised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We performed plasma metabolomic profiling in 1374 participants from the China Multi-Ethnic Cohort across CKM stages 0–4. Participants from Chengdu and Chongqing provinces comprised the discovery cohort (<i>n</i> = 969), whereas those from Yunnan province comprised the validation cohort (<i>n</i> = 405). Stage-associated metabolites were identified using prespecified pairwise comparisons with OPLS-DA and covariate-adjusted limma analyses. Weighted correlation network analysis identified coordinated metabolic modules. Machine-learning models were developed to evaluate discrimination of advanced CKM (stages 3–4) using metabolite signatures independent of conventional CKM-defining variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 858 endogenous metabolites, 261 unique metabolites were associated with CKM stages, revealing distinct metabolic patterns from early to advanced CKM. Stage 1 was characterised by altered lipid- and bile acid-related metabolites, stage 2 by broader lipid and amino-acid remodelling, and stage 3 by additional carbohydrate, aromatic amino-acid, secondary bile acid, host–microbial, and renal-handling signals. Metabolic separation between stages 3 and 4 was comparatively weak. WGCNA identified a CKM-associated turquoise module, with γ-glutamylvaline as a hub metabolite. A model incorporating age, sex, and eight metabolites derived from the discovery cohort showed favourable performance for distinguishing advanced CKM from earlier stages and achieved an AUROC of 0.874 (95% CI, 0.802–0.931) in the validation cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CKM stages exhibit distinct and non-linear metabolic signatures. A compact metabolomic panel independent of conventional CKM-defining variables may provide complementary molecular information for advanced CKM phenotyping and future risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 6","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70230","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041487","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":"Metabolite Signatures in Postpartum Prediabetes and Diabetes Among Indian Women With Prior Gestational Diabetes Mellitus: Insights From CHIP-F Study","authors":"Sahil Kapoor,&nbsp;Ambika Singh,&nbsp;Neelam Mahlawat,&nbsp;J. Manivannan,&nbsp;Arpita Singh,&nbsp;Shinjini Bhatnagar,&nbsp;Nikhil Tandon,&nbsp;Yashdeep Gupta,&nbsp;Pallavi Kshetrapal","doi":"10.1002/dmrr.70232","DOIUrl":"10.1002/dmrr.70232","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) increases the risk of postpartum dysglycaemia. This study investigates candidate metabolites and perturbed metabolic pathways associated with postpartum prediabetes/diabetes among high-risk Indian/South-Asian women with prior GDM, a largely unexplored population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this nested case-control study within the Cohort of Indian Women with Hyperglycaemia in Pregnancy and their Families (CHIP-F), untargeted metabolomics (UPLC-MS/MS) was performed on plasma samples from 216 women with prior GDM, which included 22 participants with postpartum diabetes, 88 with prediabetes and 106 with normoglycaemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Untargeted metabolomics combined with machine learning approach revealed distinct metabolic alterations associated with postpartum dysglycaemia (prediabetes/diabetes) among women with prior GDM. After adjustment for age, body mass index, family history of diabetes, and postpartum duration, each 1-standard deviation increase in the log-transformed concentrations of Tyrosine (aOR = 1.71, 95% CI: 1.01–2.91) and L-Kynurenine (aOR = 1.69, 1.02–2.80) was associated with higher odds of diabetes. Similarly, higher concentrations of 2-Aminoisobutyric acid (aOR = 1.50, 1.09–2.06), Butyrylcarnitine (aOR = 1.99, 1.44–2.75), L-Norleucine (aOR = 1.96, 1.41–2.72), and Propionylcarnitine (aOR = 1.94, 1.41–2.67) were associated with higher odds of prediabetes. Pathway analysis revealed potential dysregulation of aromatic amino acids (AAAs) metabolism in prediabetes. In diabetes, in addition to dysregulation of AAAs, potential lipid metabolic disturbances were also present.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identified distinct candidate metabolic signatures associated with postpartum prediabetes and diabetes in Indian/South-Asian women with a history of prior GDM, highlighting early disruptions in AAAs and lipid metabolism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 6","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041484","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":"Diabetic Foot Syndrome: A Paradigm of Complexity and a Call for Comprehensive Ownership by the Diabetologists","authors":"Vittorio Oteri,&nbsp;Luca Dalla Paola","doi":"10.1002/dmrr.70234","DOIUrl":"10.1002/dmrr.70234","url":null,"abstract":"&lt;p&gt;To the Editor,&lt;/p&gt;&lt;p&gt;We are writing to highlight a critical paradox within contemporary diabetology: the systematic underestimation of diabetic foot syndrome (DFS). Despite its extreme complexity, this syndrome is frequently overlooked, causing clinicians to forfeit an unparalleled professional opportunity, whereas patients are still lacking the high-level comprehensive care they deserve; this phenomenon is visibly mirrored in countries like Italy, where structural fragmentation often impacts care equity [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;This gap in diabetes care is clinically unjustified nowadays. People with DFS are at extreme cardiovascular, renal, metabolic, and infective risk; their short-term mortality risk is so staggering that the disease carries a burden akin to advanced oncology [&lt;span&gt;2&lt;/span&gt;]. This is a condition that gives the illusion of chronicity but effectively ‘metastasises’ and manifests in an acute manner through lower limb complications and systemic failure. Such a crisis cannot be managed with fragmented, reactive care that arrives too late; it demands a proactive approach orchestrated by a clear team leader, to mitigate lower limb amputations and mortality risk of people with DFS [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In this scenario, we should move away from the outdated perception that diabetic foot care is a mere technical hyper-specialisation; in reality, it demands the multifaceted, holistic management of complex patients, and diabetologists possess the comprehensive medical background required to address this syndrome.&lt;/p&gt;&lt;p&gt;In order to fine-tune these clinical competencies, specific interdisciplinary management workshops led by specialists representing multiple disciplines (diabetology and endocrinology, cardiology, nephrology, infectious disease, internal medicine, intensive care) must become a cornerstone of continuous medical education, to keep the pace with the most up-to-date diagnostic and therapeutic strategies [&lt;span&gt;4&lt;/span&gt;]. From a research perspective, diabetologists should be encouraged to increase the initiation of studies, especially clinical trials, investigating pharmacological strategies to reduce mortality and burden of complications, tailored specifically to people with DFS, a high-risk population notoriously underrepresented or excluded from major landmark cardiovascular and renal outcome studies.&lt;/p&gt;&lt;p&gt;Other than medical management, DFS clearly necessitates a surgical mindset to achieve limb-salvage goals [&lt;span&gt;5&lt;/span&gt;]. Unfortunately, traditional surgical specialties, including general, vascular, plastic, and orthopaedic surgery, frequently show limited interest in taking long-term ownership of this specific pathology. This surgical vacuum leaves the operative and reconstructive field wide open, positioning the diabetologist to naturally step into the surgical arena; the rounded figure of the clinician-surgeon who treats patients with an internist approach from a systemic point of view, and with an orthoplastic ","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 6","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026482","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":"Metabolic Dysfunction-Associated Steatotic Liver Disease in Adults With Acromegaly: A Meta-Analysis of Observational Studies","authors":"Alessandro Mantovani,&nbsp;Riccardo Morandin,&nbsp;Elisa Molinaroli,&nbsp;Dario Messetti,&nbsp;Nicoletta Rolli,&nbsp;Matteo Forti,&nbsp;Marta Zoco,&nbsp;Stergios A. Polyzos,&nbsp;Giovanni Targher","doi":"10.1002/dmrr.70231","DOIUrl":"10.1002/dmrr.70231","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Acromegaly is a chronic, progressive disease characterised by excess growth hormone secretion and elevated circulating insulin-like growth factor 1 levels. Data on hepatic fat content and liver stiffness in adults with active or controlled acromegaly remain inconsistent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched PubMed and Scopus from inception through 15 June 2026 to identify studies comparing hepatic steatosis and liver stiffness in adults with acromegaly and in controls. Hepatic fat content was quantified using magnetic resonance imaging (MRI)-based techniques, and liver stiffness was assessed using vibration-controlled transient elastography or other elastography methods. Pooled effect sizes were reported as weighted mean differences (WMDs) with 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 9 observational studies, including 190 patients with acromegaly and 235 age-, sex-, and BMI-matched controls. Compared with controls, patients with acromegaly had significantly lower hepatic fat content, as assessed by MRI-based techniques (six studies; random-effects WMD −3.04% [95% CI −4.81 to −1.26%]; <i>I</i>² = 43.7%). This difference remained significant in patients with active acromegaly (6 studies; WMD −2.96% [95% CI −4.30 to −1.62]; <i>I</i>² = 0%), but not in those with controlled acromegaly (four studies; WMD −2.57% [95% CI −6.72 to 1.59]; <i>I</i>² = 70.3%). Liver stiffness measurements did not differ between patients with acromegaly and control subjects (four studies; WMD 0.94 kPa [95% CI −0.45 to 2.33], <i>I</i>² = 87.9%). Sensitivity analyses yielded consistent findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our meta-analysis suggests that patients with acromegaly have significantly lower hepatic fat content than controls, particularly among those with active disease, whereas liver stiffness does not appear to differ significantly between the groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 6","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013231","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":"Low Preoperative Free Triiodothyronine, Particularly in Females, Is Associated With Reduced Weight Loss and Diabetes Remission After Bariatric Surgery in Euthyroid Adults","authors":"Shaobo Li,&nbsp;Yinfang Tu,&nbsp;Hongwei Zhang,&nbsp;Yunfeng Xiao,&nbsp;Yuqian Bao,&nbsp;Jun Yin,&nbsp;Yujin Ma,&nbsp;Haoyong Yu,&nbsp;Fengjing Liu","doi":"10.1002/dmrr.70228","DOIUrl":"10.1002/dmrr.70228","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>With the rising prominence of GLP-1 receptor agonists, identifying predictors of optimal bariatric surgery candidates has become increasingly important. We investigated cross-sectional relationships between thyroid hormones and obesity-related parameters, and evaluated the predictive value of baseline thyroid hormones for weight loss (WL) and diabetes remission (DR) after bariatric surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included a cross-sectional cohort of 1567 euthyroid patients with overweight or obesity, of whom 1034 with complete 1 year postoperative data were included in the longitudinal analysis. Body composition was assessed using validated predictive equations and abdominal MRI. The primary outcomes were successful WL (total WL ≥ 25%) and DR (fasting glucose &lt; 5.6 mmol/L and HbA1c &lt; 6.0% without antidiabetic medications) during the 3 year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Breakpoint analysis indicated that free triiodothyronine (FT3) plateaued beyond an age threshold while showing a linear correlation with fat-free mass index. Higher baseline FT3 tertiles were significantly linked to increased likelihood of achieving successful WL and DR at 1 year follow-up, with stronger associations in females. Optimal FT3 thresholds were identified as 4.75 (females) and 5.05 (males) for WL, and 4.57 (females) and 5.00 (males) for DR. Preoperative FT3 levels below these thresholds were significantly associated with reduced WL and DR over 3 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum FT3 exhibits an age-related breakpoint effect, and low preoperative FT3, particularly in females, is a critical predictor of suboptimal short- and long-term WL and DR success post-bariatric surgery. Sex-specific FT3 thresholds may aid in preoperative risk stratification and inform personalised treatment decisions in the era of expanding obesity therapeutics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 6","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963842","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}