Diabetes/Metabolism Research and Reviews最新文献

{"title":"Less Is More? Physical Inactivity and Increased Risk of Diabetes-Related Foot Ulceration—A Systematic Review","authors":"Petra J. Jones,&nbsp;David G. Armstrong,&nbsp;Alex V. Rowlands,&nbsp;Harald Sourij,&nbsp;Afsaneh Noormandi,&nbsp;George Theodorakopoulos","doi":"10.1002/dmrr.70198","DOIUrl":"10.1002/dmrr.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Those at risk of diabetes-related foot ulceration (DFU) must balance sufficient physical activity to maintain glycaemic control and cardiovascular health whilst avoiding excessive trauma to their feet. Our systematic review aimed to assess whether physical inactivity and/or sedentary behaviour affect DFU outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Embase, Medline, and Scopus were searched for peer-reviewed studies using the criteria: (‘diabetes’ OR ‘diabetic’) AND (‘physical*’ OR ‘activ*’ OR ‘inactiv*’ OR ‘sedentary’) AND ‘foot’ AND ‘ulcer’, returning 4650 results excluding duplicates. 16 studies were included and assessed for risk of bias using the Newcastle-Ottawa Scale (NOS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen studies assessed physical inactivity and 1 assessed both inactivity and sedentary behaviour and DFU outcomes. Eleven of 16 (69%) studies reported significantly greater likelihood of DFU in inactive participants. Exploratory meta-analysis suggested physical inactivity to be associated with doubled DFU risk (OR 2.09, 95% CI 1.32–3.32, <i>p</i> = 0.002). Evidence that sedentary behaviour was associated with tripled DFU risk was based on a single prospective cohort and had a high risk of bias (OR 2.95, 95% CI: 1.5–6.4, <i>p</i> = 0.008; <i>n</i> = 175, NOS: poor). Study methodologies were heterogenous (e.g., inconsistent definitions of inactive), with habitual physical activity measured through interviews, patient records, or questionnaires in 14 of 16 studies (NOS rating: poor to fair).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Available evidence suggested that physical inactivity and sedentary behaviour were associated with an increased risk of DFU. Further research is needed to develop thresholds for physical inactivity and sedentary behaviour to reduce DFU risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399758","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":"Analysis of Circulating Long Non-Coding RNA in Prediabetes or Newly Diagnosed Type 2 Diabetes Subjects With or Without Heart Stress","authors":"Francesco Di Giacomo Barbagallo,&nbsp;Giosiana Bosco,&nbsp;Lorena Lanzafame,&nbsp;Maurizio Di Marco,&nbsp;Sabrina Scilletta,&nbsp;Luisa Spadaro,&nbsp;Giulia Crisci,&nbsp;Mariarosaria De Luca,&nbsp;Ernestina Marianna De Francesco,&nbsp;Roberta Malaguarnera,&nbsp;Agostino Milluzzo,&nbsp;Andrea Salzano,&nbsp;Alberto Maria Marra,&nbsp;Antonio Cittadini,&nbsp;Lucia Frittitta,&nbsp;Antonino Di Pino,&nbsp;Salvatore Piro,&nbsp;Roberto Scicali","doi":"10.1002/dmrr.70199","DOIUrl":"10.1002/dmrr.70199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Early myocardial stress may develop in subjects with prediabetes or newly diagnosed type 2 diabetes (T2D) even in the absence of overt heart failure. We aimed to evaluate circulating lncRNAs in prediabetes or newly diagnosed T2D subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study on 133 subjects with prediabetes or newly diagnosed T2D without a history of cardiovascular disease. All participants underwent clinical, biochemical and echocardiographic evaluations. Circulating lncRNAs MALAT1, NOS2P3, CCDC68, RNF145 and ARL4C were assessed. The study population was stratified into two groups according to the NT-proBNP value (Group 1, NT-proBNP &lt; 75 pg/mL; Group 2, NT-proBNP ≥ 75 pg/mL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Group 2 exhibited increased hs-CRP and epicardial adipose tissue (EAT) thickness, and lower E/A ratio (<i>p</i> for all &lt; 0.05). The investigated lncRNAs were upregulated in the Group 2 and were associated with NT-proBNP levels (<i>p</i> for all &lt; 0.05). LncRNAs ARL4C and NOS2P3 were associated with EAT thickness (<i>p</i> for all &lt; 0.05). Multiple regression analysis showed that lncRNA ARL4C, NT-proBNP, age, male sex, and BMI were associated with EAT thickness (<i>p</i> for all &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Prediabetes or newly diagnosed T2D subjects with higher NT-proBNP levels exhibited an increased expression of circulating lncRNAs; moreover, lncRNAs ARL4C and NOS2P3 were associated with EAT thickness. Our findings suggest that the evaluation of circulating lncRNAs in addition to NT-proBNP may be useful to identify dysmetabolic subjects with an early myocardial stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers for Diabetic Peripheral Artery Disease: An Integrated Review and Clinical Perspective","authors":"Lihua Fang,&nbsp;Qing Ning,&nbsp;Yuqian Wu,&nbsp;Xiaokang Fang,&nbsp;Yueru Yao,&nbsp;Jie Ning","doi":"10.1002/dmrr.70200","DOIUrl":"10.1002/dmrr.70200","url":null,"abstract":"<div>\u0000 \u0000 <p>Type 2 diabetes mellitus and peripheral artery disease are pathophysiologically interlinked through shared mechanisms such as chronic inflammation and endothelial dysfunction, highlighting the imperative to identify common biomarkers for enhancing early detection and risk stratification. A review of PubMed through December 2025 was performed, culminating in the inclusion of 55 original studies. The synthesis revealed significant dysregulation of inflammatory markers including IL-6 and ICAM-1, endothelial and oxidative stress mediators such as TET3 and the PRDX family, along with coagulation markers such as von Willebrand factor and fibrinogen, all correlating with disease severity in comorbid patients. Multi-marker panels, exemplified by the HART PAD score and combined neutrophil-to-HDL ratio with systemic inflammation response index, demonstrated superior predictive accuracy compared to individual biomarkers. Subsequent investigations should prioritise prospective validation and clinical standardisation of these candidate markers. This scoping review offers a novel structured integration of biomarkers across fluid, cellular and functional domains, advocating for an integrated multi-marker strategy to facilitate personalised management in this high-risk population.</p>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinol, Carotenoid, and Tocopherol Intake and Status, and the Risk of Islet Autoimmunity and Type 1 Diabetes: The Environmental Determinants of Diabetes in the Young Study","authors":"Leena Hakola,&nbsp;Joanna L. Clasen,&nbsp;Ulla Uusitalo,&nbsp;Carin Andrén Aronsson,&nbsp;Sandra Hummel,&nbsp;Markus Mattila,&nbsp;Sari Niinistö,&nbsp;Jorma Toppari,&nbsp;Anette-G. Ziegler,&nbsp;William A. Hagopian,&nbsp;Beena Akolkar,&nbsp;Marian J. Rewers,&nbsp;Richard A. McIndoe,&nbsp;Åke Lernmark,&nbsp;Jeffrey P. Krischer,&nbsp;Jill M. Norris,&nbsp;Iris Erlund,&nbsp;Suvi M. Virtanen,&nbsp;the TEDDY Study Group","doi":"10.1002/dmrr.70196","DOIUrl":"https://doi.org/10.1002/dmrr.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To study the associations of dietary intake of A and E vitamins, as well as plasma retinols, carotenoids, and tocopherols in relation to development of islet autoimmunity and progression to T1D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The Environmental Determinants of Diabetes in the Young (TEDDY) Study followed 7659 newborns with genetic susceptibility to T1D for 6 years in the USA, Finland, Germany, and Sweden. Dietary vitamin intake was assessed repeatedly with 3-day food-records in full cohort at ages 6 months to 6 years. Plasma retinols, carotenoids, and tocopherols were analysed in a nested case-control setting with 359 children with islet autoimmunity and 1033 matched controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the full cohort analyses, dietary intake of retinol, <i>β</i>-carotene, and vitamin E was not associated with the risk of islet autoimmunity or progression to T1D. Further, none of the plasma retinol, carotenoid, and tocopherol biomarkers were associated with islet autoimmunity or T1D in the full nested case-control analyses. We observed effect modification by country, breastfeeding, sex, and follow-up time for both intake and biomarkers of vitamins on the risk of islet autoimmunity or T1D, and some subgroup associations. Finally, a plasma carotenoid metabolite (likely zeinoxanthin) (OR 0.61, 95% CI 0.39, 0.95, <i>p</i> = 0.03) and <i>γ</i>-carotene at 6 months (OR 0.65, 95% CI 0.45, 0.94, <i>p</i> = 0.02) were inversely associated with the odds of developing GADA-first.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Retinol, carotenoids and tocopherols were not consistently associated with islet autoimmunity. This study adds to the understanding of factors and their interactions related to T1D development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324884","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":"Glucokinase Regulatory Protein Gene Polymorphism as a Predictive Biomarker for Early Renal Injury in Newly Diagnosed Early-Onset Type 2 Diabetes Mellitus","authors":"Rui Zhang,&nbsp;Ping Zhang,&nbsp;Tianhao Ba,&nbsp;Yilin Zhao,&nbsp;Wei Liu,&nbsp;Simin Zhang,&nbsp;Xiantong Zou,&nbsp;Yingying Luo,&nbsp;Wei Deng,&nbsp;Qiuping Wang,&nbsp;Lin Qi,&nbsp;Yufeng Li,&nbsp;Wenbo Wang,&nbsp;Liyong Zhong,&nbsp;Lili Huo,&nbsp;Chunxia Li,&nbsp;Dejun Hao,&nbsp;Yajing Zhang,&nbsp;Yan Xu,&nbsp;Fang Wang,&nbsp;Xueyao Han,&nbsp;Qian Ren,&nbsp;Linong Ji","doi":"10.1002/dmrr.70197","DOIUrl":"10.1002/dmrr.70197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Glucokinase regulatory protein gene (<i>GCKR</i>) polymorphisms have been linked to progressive renal dysfunction in diabetic populations. However, their role in early renal injury of diabetic kidney disease (DKD) remains unclear. This study aimed to investigate the association between <i>GCKR</i> genetic variants and early renal impairment in newly diagnosed early-onset type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 337 newly diagnosed early-onset T2DM patients from a prospective cohort were enroled. Baseline characteristics, estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (UACR) were collected. Seven single nucleotide polymorphisms (SNPs) in <i>GCKR</i> were genotyped using ASAMD microarrays. Participants were divided into normal (UACR &lt; 30 mg/g) and elevated albuminuria (UACR ≥ 30 mg/g) groups. Logistic regression and multivariate linear regression were performed to evaluate the relationship between <i>GCKR</i> genotypes and UACR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients had a mean age of 33.25 ± 5.38 years. Median eGFR was 119.33 mL/min/1.73 m², and median UACR was 14.97 mg/g; 107 patients (31.8%) presented with elevated UACR. Carriers of the <i>GCKR</i> rs1260326 T/T genotype exhibited significantly higher median UACR compared with C/T + C/C carriers (22.85 vs. 13.53 mg/g, <i>p</i> = 0.021). The rs1260326 T allele was independently associated with increased UACR under the additive genetic model (<i>p</i> = 0.003) adjusted for sex, age, body mass index (BMI), glycated haemoglobin (HbA1c), and systolic blood pressure (SBP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The <i>GCKR</i> rs1260326 T allele is independently associated with early renal injury in newly diagnosed early-onset T2DM. This genetic variant may serve as a predictive marker for early DKD risk stratification in this high-risk population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310290","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":"Hearing Loss in Adults With Diabetes and Prediabetes: A Systematic Review and Meta-Analysis","authors":"Mehwish Nisar,&nbsp;Shamshad Karatela,&nbsp;Anjana Rajagopal,&nbsp;Beenish Nisar Ahmed,&nbsp;Piers Dawes","doi":"10.1002/dmrr.70195","DOIUrl":"10.1002/dmrr.70195","url":null,"abstract":"<p>Diabetes impairs hearing through microvascular damage and neuropathy, yet the prevalence of moderate-to-severe hearing loss (≥ 40 dB HL) remains inadequately explored. Variations by age, diabetes duration, and socioeconomic factors are inadequately characterised. This systematic review quantified the prevalence and comparative risk of moderate-to-severe hearing loss in diabetes and prediabetes, exploring variations across age, national income level, and disease duration. We searched PubMed, Scopus, Web of Science, SPORTDiscus, and CINAHL (2000–2025) for observational studies reporting audiometric thresholds in diabetic or prediabetic subjects (PROSPERO: CRD42018100742). Quality was assessed using the Newcastle–Ottawa Scale. Random-effects meta-analyses generated pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias was evaluated via funnel plots and Egger’s regression. Of 3490 records, 29 studies qualified. Most examined type 2 diabetes; one included prediabetes. Twenty-three studies (<i>n</i> = 5221) yielded a pooled prevalence of 24% (95% CI: 19%–30%; <i>I</i>² = 94%). Eleven studies showed diabetes doubled hearing loss odds versus controls (OR = 2.41, 95% CI: 1.62–3.60; <i>I</i>² = 86.6%). Risk was significantly elevated in younger adults (&lt; 60 years: OR = 3.03, 95% CI: 2.17–4.22) but not in older adults (≥ 60 years: OR = 1.52, 95% CI: 0.72–3.22). Low- and middle-income countries showed the highest risk (OR = 4.51, 95% CI: 2.43–8.40) versus high-income countries (OR = 1.78, 95% CI: 1.05–3.02). Diabetes duration &lt; 10 years conferred elevated risk (OR = 2.68). Small-study effects were detected (Egger’s <i>p</i> = 0.019) but sensitivity analyses confirmed robustness. One in four diabetic adults has clinically significant hearing loss, particularly in younger individuals and resource-limited populations. These findings support the integration of routine audiometric screening into diabetes care.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303715","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 Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Co-Transporter-2 Inhibitors on Lean Body Mass in Humans: A Systematic Review and Meta-Analysis of Randomised Controlled Trials","authors":"Rishi Jobanputra,&nbsp;Jack A. Sargeant,&nbsp;Tatiana Plekhanova,&nbsp;Emily James,&nbsp;Abdullah Almaqhawi,&nbsp;David R. Webb,&nbsp;Melanie J. Davies,&nbsp;Thomas Yates","doi":"10.1002/dmrr.70194","DOIUrl":"https://doi.org/10.1002/dmrr.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The use of pharmacotherapies with weight loss properties for the management of obesity and chronic disease are now routinely prescribed. We investigated the evidence from randomised-controlled trials for the effects on lean body mass of glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose co-transporter-2 inhibitors (SGLT2i) in humans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>PubMed, MEDLINE, the Cochrane Library and CINAHL were searched from inception to October 2022. The primary outcome was change in body composition focused on measures of lean body mass (LBM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-six studies in population groups with obesity (<i>n</i> = 8), type 2 diabetes mellitus (<i>n</i> = 20), type 1 diabetes mellitus (<i>n</i> = 5) and polycystic ovary syndrome (<i>n</i> = 3) receiving a GLP-1RA or SGLT2i therapy versus placebo or active comparator satisfied our inclusion criteria, including 21 for GLP-1RA and 15 for SGLT2i. Meta-analysis showed an overall loss of LBM in the direction of the intervention groups prescribed GLP-1RA (MD: −1.51 kg [95% CI: −2.00 to −1.01]) and SGLT2i (MD: −1.04 kg [95% CI: −1.45 to −0.64]) with sub-group analysis showing largely consistent results when stratified by type of body composition outcome, type of body composition measurement technique and disease status. Results were not modified by sex. Further meta-analysis found that lean mass accounted for 28% (95% CI: 22%–34%) of overall weight loss induced by GLP-1RA and SGLT2i.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GLP-1RA and SGLT2i are associated with a loss of LBM that appears congruent with overall weight loss. Monitoring of body composition and provision of combined therapy to preserve lean mass during weight loss should be considered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282245","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 Ulceration in Dialysis-Dependent End-Stage Kidney Disease: A Systematic Review of Epidemiology, Clinical Outcomes and Mortality Risk","authors":"J. Z. M. Lim,&nbsp;D. Selvarajah,&nbsp;S. Mitra,&nbsp;N. S. L. Ng,&nbsp;G. Rayman,&nbsp;L. Vileikyte,&nbsp;F. L. Game,&nbsp;A. J. M. Boulton","doi":"10.1002/dmrr.70189","DOIUrl":"10.1002/dmrr.70189","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Diabetic foot ulceration (DFU) and lower limb complications are highly prevalent in people with end-stage kidney disease (ESKD), particularly those receiving dialysis; however, the overall burden and outcomes remain incompletely characterised. This systematic review with narrative synthesis aimed to summarise study characteristics and evidence on the epidemiology of DFU in ESKD, including incidence, prevalence, wound healing outcomes, and associations with lower-extremity amputation (LEA) and mortality.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;MEDLINE (via PubMed), EMBASE and the Cochrane Database of Systematic Reviews were searched from inception to 31 January 2026 for longitudinal and cross-sectional studies, including registry data, in adults with ESKD or on dialysis. Outcomes included DFU epidemiology, wound healing, revascularisation, LEA and mortality.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The review included 64 observational studies. In dialysis-dependent populations, DFU incidence is high and increases with advancing renal impairment, often preceding dialysis initiation. Evidence on whether dialysis initiation itself increases DFU risk is limited and heterogeneous, although observational cohorts suggest a temporal association with haemodialysis initiation, particularly within the first 2 years. Data comparing haemodialysis and peritoneal dialysis are scarce. Wound healing outcomes were variable, with earlier recurrence observed, although multidisciplinary care improved healing, largely driven by perfusion and ulcer severity rather than renal function alone. Although based on observational and heterogeneous data, dialysis-dependent ESKD was frequently identified as an independent predictor of LEA after adjustment for confounders, with coexisting peripheral arterial disease, a key determinant of adverse limb outcomes. Mortality risk appeared to compound following amputation, with observational data suggesting high post-amputation mortality (approaching 50% at 2 years and 70% at 5 years), consistent with a shift towards limb loss rather than increased DFU occurrence. Interpretation is limited by study heterogeneity, observational design, limited long-term data on healing and recurrence, and inadequate stratification by dialysis modality.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Current evidence underscores substantial gaps in understanding the natural history and optimal management of diabetic foot disease in dialysis-dependent ESKD. Future research should prioritise well-designed p","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260189","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 GA and GMI/GA Ratio With All-Cause Mortality in Well-Controlled Type 2 Diabetes Defined by Continuous Glucose Monitoring","authors":"Jiaying Ni,&nbsp;Cheng Zhang,&nbsp;Jinghao Cai,&nbsp;Chunfang Wang,&nbsp;Wei Zhu,&nbsp;Yufei Wang,&nbsp;Xiaojing Ma,&nbsp;Jingyi Lu,&nbsp;Tian Xia,&nbsp;Jian Zhou","doi":"10.1002/dmrr.70192","DOIUrl":"10.1002/dmrr.70192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>There is uncertainty whether traditional glycemic metrics remain associated with long-term outcomes among patients with type 2 diabetes who achieve recommended continuous glucose monitoring (CGM) targets. This study was aimed to investigate the association of glycated albumin (GA) and ratio of glucose management indicator to GA (GMI/GA) with risks of all-cause mortality in type 2 diabetes achieving CGM targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 3482 patients with type 2 diabetes who met CGM targets, defined as time in range (TIR) &gt;70%, time below range (TBR_&lt;3.9) &lt;4%, and time above range (TAR_&gt;10.0) &lt;25%, were included in the cohort study. Cox proportional hazards models and restricted cubic spline were used to evaluate associations of GA and GMI/GA with mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 11.0 years, 514 patients (14.8%) died. GA exhibited significant linear positive association with risks of all-cause mortality, and the highest GA quartile had 34% increased risk (HR = 1.34, 95% CI 1.01–1.78). Conversely, GMI/GA ratio showed significant non-linear association (<i>p</i> for nonlinearity = 0.042). Compared with the reference third quartile (0.36–0.40), participants in the lowest quartile (&lt;0.30) had 40% higher risk of all-cause mortality (HR = 1.40, 95% CI 1.10–1.80).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among patients achieving CGM targets, elevated GA and lower GMI/GA were associated with higher risks of all-cause mortality. These findings suggest that traditional glycemic metrics may complement CGM metrics in the assessment of long-term risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266723","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":"Sustained Glycaemic Control and Preserved Beta-Cell Function in Newly Diagnosed Type 1 Diabetes Treated With Semaglutide","authors":"Massimo Carollo,&nbsp;Sabina Martinenghi,&nbsp;Alessandra Gallo,&nbsp;Francesco Piarulli","doi":"10.1002/dmrr.70191","DOIUrl":"10.1002/dmrr.70191","url":null,"abstract":"&lt;p&gt;The management of type 1 diabetes mellitus (T1DM) focuses on replicating physiological insulin secretion to keep blood glucose levels within a narrow target range, thereby reducing the risk of both acute and long-term complications [&lt;span&gt;1&lt;/span&gt;]. Despite significant advancements in insulin therapies and glucose monitoring technologies, managing T1DM remains challenging [&lt;span&gt;1&lt;/span&gt;]. Issues such as glycaemic variability, weight management, and the ongoing risk of hypoglycaemia persist as major concerns [&lt;span&gt;1&lt;/span&gt;]. These challenges can adversely affect patients' quality of life, which is often lower compared with that of the general population [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In recent years, an increasing number of adjunctive therapies to insulin have been explored to improve metabolic outcomes in individuals with T1DM. Several pharmacologic agents are under investigation for their potential to enhance glycaemic control and/or preserve or restore beta-cell function (e.g., GLP-1 receptor agonists [GLP-1 RAs], verapamil, and various immunomodulatory therapies) [&lt;span&gt;3&lt;/span&gt;]. Among GLP-1 RAs, liraglutide and, in particular, semaglutide have shown promising effects in both newly diagnosed patients and overweight or obese individuals with long-duration T1DM [&lt;span&gt;4-8&lt;/span&gt;]. A recent systematic review and meta-analysis of eight studies found that semaglutide was associated with reduced body weight and improved glycaemic control at 3, 6, and 12 months, and short-term decreases in total daily insulin dose at 3–6 months but not at 12 months in overweight or obese adults with long-standing T1DM [&lt;span&gt;8&lt;/span&gt;]. Additionally, a retrospective case series of 10 adults (21–39 years, mean body mass index 25.1 ± 1.6) with newly diagnosed T1DM initiated semaglutide within 3 months of diagnosis, in addition to standard insulin therapy and a low-carbohydrate diet [&lt;span&gt;6&lt;/span&gt;]. Over 12 months, prandial insulin was discontinued in all patients and basal insulin in 7 of 10 patients, with glycated haemoglobin (HbA1c) decreasing from 11.7 ± 2.1% at diagnosis to 5.7 ± 0.4% and a concomitant increase in fasting C-peptide levels. Glycaemic control was excellent (time-in-range 89 ± 3%), with only mild hypoglycaemia during semaglutide dose escalation and no episodes of diabetic ketoacidosis or serious adverse events. To date, semaglutide is approved by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) only for the treatment of type 2 diabetes mellitus (T2DM) and overweight/obesity; therefore, in Italy, its use in T1DM is off-label, with costs fully borne by the patient. The rationale for its use in T1DM is based on its ability to stimulate glucose-dependent insulin secretion in the presence of residual beta-cell function, suppress inappropriate postprandial glucagon secretion during hyperglycaemia, and slow gastric emptying [&lt;span&gt;3&lt;/span&gt;]. Preclinical studies have suggested a potential role of semaglutide in preserving beta-cel","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"42 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220401","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}