Diabetes/Metabolism Research and Reviews最新文献

{"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}

{"title":"Impact of Glucagon-Like Peptide-1 Receptor Agonists on the Dementia Incidence in Patients With Type 2 Diabetes Mellitus: A Population-Based Longitudinal Cohort Study","authors":"Hung-Wen Cheng,&nbsp;Shun-Fa Yang,&nbsp;Pei-Lun Liao,&nbsp;Chiu-Hsian Lee,&nbsp;Gwo-Ping Jong","doi":"10.1002/dmrr.70058","DOIUrl":"https://doi.org/10.1002/dmrr.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Type 2 diabetes mellitus (T2DM) is recognized for increasing the risk of dementia; however, conclusive evidence supporting interventions to mitigate this risk remains elusive. This study endeavours to ascertain whether the glucagon-like peptide-1 receptor agonists (GLP-1RAs) correlate with reduced incidence of dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The cohort comprised individuals initiating treatment with either GLP-1RAs or non-GLP-1RAs medications between 201<span>3</span> and 2021. This study examined the association between GLP-1RAs and the risk of all-cause dementia. Propensity score-matched and Cox proportional hazard models were employed to calculate the adjusted hazard ratio (aHR) and confidence interval (CI) for the incidence of dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among a cohort comprising 109,778 individuals, the use of GLP-1RA demonstrated a reduced risk of dementia compared with its non-use (aHR, 0.90; 95% CI, 0.83–0.97). Subgroup analyses stratified by different diabetic complications revealed significantly lower dementia incidence rates among GLP-1RAs users than among non-GLP-1RAs users. Individuals aged ≤ 75 years demonstrated a significant protective effect within GLP-1RAs users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The utilization of GLP-1 receptor agonists instead of non-GLP-1RAs medications demonstrated an association with a decreased incidence of dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232307","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":"Associations of Prediabetes, Diabetes and Glucose-Related Markers With Cognition and Neuroimaging in a 2-Year Multidomain Lifestyle Randomised Controlled Trial","authors":"Thais Lorenzo,&nbsp;Tiia Ngandu,&nbsp;Jenni Lehtisalo,&nbsp;Riitta Antikainen,&nbsp;Juan Domingo Gispert,&nbsp;Nina Kemppainen,&nbsp;Tiina Laatikainen,&nbsp;Jaana Lindström,&nbsp;Juha Rinne,&nbsp;Hilkka Soininen,&nbsp;Timo Strandberg,&nbsp;Rafael de la Torre,&nbsp;Jaakko Tuomilehto,&nbsp;Alina Solomon,&nbsp;Miia Kivipelto","doi":"10.1002/dmrr.70053","DOIUrl":"https://doi.org/10.1002/dmrr.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Few longitudinal studies have explored Oral Glucose Tolerance Test markers (OGTT) and both cognitive and brain changes. We investigated OGTT and other glycaemia and insulin resistance markers, and cognitive and neuroimaging changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>At-risk individuals aged 60–77 years without dementia (<i>N</i> = 1259) were randomly enrolled in a 2-year multidomain lifestyle intervention or regular health advice program. 1025 participants without previously diagnosed diabetes underwent OGTT. Brain MRI scans were available for 132 participants and amyloid (PiB)-PET and FDG-PET scans for 47. Cognition was assessed using the modified Neuropsychological Test Battery (mNTB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher baseline dysglycaemia measures, particularly those from the OGTT, were connected to less favourable changes in multiple cognitive measures and hippocampal volume. Higher baseline triglyceride-glucose (TyG) index was associated with higher amyloid accumulation and decline in brain glucose metabolism. Higher baseline glycated haemoglobin (HbA1c) was related to favourable changes in processing speed and cortical thickness. There were no significant intervention-control differences in the change in glycaemia markers. Baseline dysglycaemia and glycaemia-related markers did not modify the previously reported intervention benefits on cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher baseline dysglycaemia measures are linked to more deleterious changes in cognition. Specifically, OGTT measures may be the most sensitive for detecting subtle glycaemic abnormalities associated with both unfavourable cognitive and neuroimaging changes. However, HbA1c shows mixed associations with cognition and neuroimaging in people at risk of dementia without previously diagnosed diabetes. This study emphasises the importance of more accurate glucose-related markers when investigating early stages of glucose metabolism abnormalities and their relationship to subtle cognitive impairment and its structural brain correlates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ID NCT01041989 https://clinicaltrials.gov</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232279","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":"Comparison of Sodium-Glucose Cotransporter 2 Inhibitors Versus Glucagon-Like Peptide-1 Receptor Agonists and Risks of Osteoarthritis and Arthroplasty in Patients With Type 2 Diabetes Mellitus: A Propensity Score-Matched Cohorts Retrospective Study","authors":"Yu-Chi Su,&nbsp;Pei-Chun Hsieh,&nbsp;Edward Chia-Cheng Lai,&nbsp;Yu-Ching Lin","doi":"10.1002/dmrr.70051","DOIUrl":"https://doi.org/10.1002/dmrr.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Sodium-glucose cotransporter 2 inhibitors (SGLT2is) may have the potential to lower the risk of osteoarthritis through an anti-inflammatory mechanism. This study compared the risks of new-onset osteoarthritis and joint replacement surgery between new users of SGLT2is and new users of glucagon-like peptide-1 receptor agonists (GLP-1 RAs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a propensity score-matched cohort retrospective study by using data obtained from the TriNetX platform. The Global Collaborative Network of TriNetX includes approximately 131 million patients from 109 health care organisations. First, new users of SGLT2is and GLP-1 RAs among patients with type 2 diabetes mellitus were identified. Two homogeneous groups were established through propensity score matching. The study outcomes were the risks of new-onset osteoarthritis and joint replacement surgery of the hip or knee. Hazard ratios (HRs) along with 95% CIs were calculated using the TriNetX platform.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Initially, the SGLT2is and GLP-1 RA groups comprised 51,177 and 52,977 patients, respectively. After matching, each group comprised 37,676 patients. The mean age of the patients was 59.5 years. Approximately 45% of the patients in both groups were women. The SGLT2is group had significantly lower risks of new-onset osteoarthritis (HR: 0.951; 95% CI: 0.916–0.988) and joint replacement surgery (HR: 0.703; 95% CI: 0.550–0.898) than the GLP-1 RA group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SGLT2is use was associated with reduced risks of new-onset osteoarthritis and joint replacement surgery compared with GLP-1 RA use in patients with type 2 diabetes mellitus. Future prospective studies are warranted to confirm our findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220226","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":"Role of Physical Activity in Reducing Diabetic Kidney Disease Risk in Adults: Data From the National Health and Nutrition Examination Survey, 2017–2018","authors":"Wirampa Tanglai,&nbsp;Apichai Wattanapisit,&nbsp;Osamu Watanabe,&nbsp;Thanakrit Jeamjitvibool,&nbsp;Mark Lockwood,&nbsp;Mia Cajita","doi":"10.1002/dmrr.70055","DOIUrl":"https://doi.org/10.1002/dmrr.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to explore the relationship between PA domains, PA intensity, sedentary time, cardiometabolic factors, inflammatory markers, and risk of diabetic kidney disease (DKD) in adults. It also examined potential moderators of the relationship between PA and DKD including age, race and ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This cross-sectional study used data from the 2017–2018 National Health and Nutrition Examination Survey and included participants aged ≥ 18 years. The survey subjectively measured PA using the Global Physical Activity Questionnaire. After conducting multiple imputations to address missing data, we performed hierarchical logistic regression to identify factors significantly associated with DKD diagnosis and to examine moderating effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DKD prevalence was 13.32%. Non-Hispanic Black participants showed higher odds of DKD than non-Hispanic White participants. Age, waist circumference, systolic blood pressure, fasting glucose levels, haemoglobin A1C, high-sensitivity C-reactive protein, sedentary time, and occupation-related PA were significant predictors of DKD. Although age, race and ethnicity were significant predictors of DKD, we observed no moderating effects of these variables on the PA-DKD risk relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cardiometabolic markers, inflammatory markers, and sedentary time significantly increase DKD risk, whereas occupation-related PA serves as a protective factor. This study highlights the need for interventions promoting a more active lifestyle in diabetic populations to mitigate their DKD risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191114","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":"Pep19: A Novel Approach for Reducing Visceral Fat and Improving Sleep Quality in Obese Adults—Results From an Early-Stage Clinical Trial","authors":"Andrea S. Heimann,&nbsp;Prachi Singh,&nbsp;Emer S. Ferro,&nbsp;Frank Greenway,&nbsp;Arnon Krongrad","doi":"10.1002/dmrr.70056","DOIUrl":"https://doi.org/10.1002/dmrr.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Conformational-sensitive antibodies were used to identify the orally active peptide DIIADDEPLT (Pep19) as an inverse agonist of cannabinoid type 1 receptor. Pep19 safely improved metabolic parameters in murine models of diet-induced obesity, and in healthy dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate Pep19's impact on quality of life and body composition in obese adults, hypothesising that the metabolic effects of Pep19 observed in animal models could translate to humans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Subjects, males (<i>n</i> = 12) and females (<i>n</i> = 12), from 46 to 59 years old, weighing 91–106 kg, body mass index between 30 and 35 kg/m², were evaluated over 60 days in a placebo-controlled, triple-blinded clinical trial; participants received either a placebo, 2 or 5 mg Pep19 capsules once daily at bedtime. The primary endpoint was a broad measure of quality of life assessed using validated questionnaires. The key secondary endpoints included weight loss, reduction in visceral fat (measured by dual-energy X-ray absorptiometry), and changes in waist, hip, and chest measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pep19 was well tolerated with no reported adverse effects. Remarkable reductions in visceral fat were observed in the 5 mg Pep19 group, with a 17 ± 4.7% loss (<i>p</i> &lt; 0.05), without any change in lean mass. Additionally, sleep quality improved significantly by 35 ± 10% in the 2 mg Pep19 group and 25 ± 16% in the 5 mg Pep19 group (<i>p</i> &lt; 0.05). In the 5 mg Pep19 group, significant reductions in body weight and waist circumferences were also observed (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the limitations related to the use of convenience sampling, a small sample size, and a short intervention duration, which may restrict generalisation and health claims, Pep19 demonstrates exceptional innovative potential as a novel approach to reduce visceral fat and improve sleep quality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185903","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 Contributions of Risk Factor Modifications to the Reduction of Cardiovascular Risk in Patients With Antidiabetic Treatment: A Meta-Regression Analysis and Model-Based Analysis","authors":"Xingyun Zhu,&nbsp;Chu Lin,&nbsp;Zonglin Li,&nbsp;Xiaoling Cai,&nbsp;Fang Lv,&nbsp;Wenjia Yang,&nbsp;Linong Ji","doi":"10.1002/dmrr.70052","DOIUrl":"https://doi.org/10.1002/dmrr.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This meta-regression analysis and model-based analysis aimed to assess the contributions of the risk factors and identify the predominant ones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed/MEDLINE, Embase, and Cochrane databases were searched for randomized controlled trials with reports of cardiovascular events in patients receiving antidiabetic treatments. Five treatment-response factors such as changes in haemoglobin A1c (HbA1c), systolic blood pressure (SBP), body weight, low-density lipoprotein cholesterol (LDL-C) and estimated glomerular filtration rate (eGFR), and six baseline factors such as HbA1c, SBP, body weight, LDL-C, eGFR and age were included in the analyses. Eligible data were first analysed by a meta-regression analysis and then by a mathematical model-based analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In all 41 studies were included. Among all treatment response factors, reduction in body weight and SBP were key factors in lowering cardiovascular risk. A 5-kg body weight reduction accounted for 5%, 33%, 11.6%, 13% and 31.2% risk reduction in MACE, CV death, MI, stroke, and HHF, respectively. A 5-mmHg SBP reduction contributed 42.3%, 34.9%, 38.5%, 11% and 21.4% to the risk reduction in MACE, CV death, MI, stroke and HHF, respectively. Among all baseline factors, an increase in the baseline body weight was the main contributor to cardiovascular risk reduction. A 5-kg increase in baseline body weight was associated with 12.5%, 3.5%, 6.5% and 8.4% risk reduction in MACE, CV death, MI, and stroke, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The reduction in body weight and SBP level were the dominant contributors to cardiovascular risk reduction among all 11 included potential factors. The treatment response factors might be more crucial to reduce cardiovascular risk when compared with baseline factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 5","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185874","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":"Pregnancy-Specific Glucose Management Index Predicts Preterm Birth and Pre-Eclampsia Superior to HbA1c in Women With Type 1 Diabetes Mellitus","authors":"Daizhi Yang,&nbsp;Ping Ling,&nbsp;Chaofan Wang,&nbsp;Xueying Zheng,&nbsp;Hongrong Deng,&nbsp;Xubin Yang,&nbsp;Jinhua Yan,&nbsp;Wen Xu,&nbsp;Sihui Luo,&nbsp;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}

{"title":"Could Ghrelin Expression Regulate Diastolic Cardiac Function in Type 2 Diabetic Obese Patients?","authors":"Celestino Sardu,&nbsp;Nunzia D'Onofrio,&nbsp;Maria Consiglia Trotta,&nbsp;Maria Luisa Balestrieri,&nbsp;Giovanni Francesco Nicoletti,&nbsp;Giovanbattista D'Amico,&nbsp;Carlo Fumagalli,&nbsp;Carla Contaldi,&nbsp;Giuseppe Pacileo,&nbsp;Lucia Scisciola,&nbsp;Maddalena Nicoletti,&nbsp;Ludovica Vittoria Marfella,&nbsp;Matilde Sbriscia,&nbsp;Ferdinando Carlo Sasso,&nbsp;Giuseppe Signoriello,&nbsp;Giuseppe Paolisso,&nbsp;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′ &lt; 9, <i>n</i> 76) and those with altered LV-DF: group 2 (9 &lt; E/E′ &lt; 14; <i>n</i> 96) and group 3 (E/E′ &gt; 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> &lt; 0.05). They did not differ for ghrelin expression (<i>p</i> &gt; 0.05). They evidenced different tissue/serum expression of miR-21, miR-92 and miR-126 (<i>p</i> &lt; 0.05). Group 2 versus group 1 over-expressed tissue inflammatory markers and SGLT2 (<i>p</i> &lt; 0.05), with higher extent in group 3 versus group 1 (<i>p</i> &lt; 0.01) and versus group 2 (<i>p</i> &lt; 0.025). SIRT1 was downregulated in group 2 versus group 1 (<i>p</i> &lt; 0.05), and versus group 3 (<i>p</i> &lt; 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> &lt; 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,&nbsp;Hadel Khalil,&nbsp;Eyal Cohen-Sela,&nbsp;Ori Eyal,&nbsp;Hagar Interator,&nbsp;Asaf Oren,&nbsp;Irina Laurian,&nbsp;Anna Dorfman,&nbsp;Efrat Chorna,&nbsp;Yael Lebenthal,&nbsp;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> &lt; 0.001, CI: 0.42–0.57), (61.16 mmol/mol vs. 55.72 mmol/mol, respectively <i>p</i> &lt; 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}