Diabetology International最新文献

{"title":"Discontinuation of oral semaglutide due to adverse effects: a database study on Japanese individuals with type 2 diabetes.","authors":"Mizuki Ishiguro, Rimei Nishimura","doi":"10.1007/s13340-025-00868-0","DOIUrl":"https://doi.org/10.1007/s13340-025-00868-0","url":null,"abstract":"<p><p>The global prevalence of diabetes continues to rise, necessitating advancements in treatment, such as glucagon-like peptide-1 receptor agonists. While oral semaglutide has demonstrated comparable efficacy to injectable formulations, gastrointestinal symptoms remain a barrier to continued use. This study analyzed factors associated with discontinuation of oral semaglutide due to gastrointestinal symptoms in individuals newly prescribed the drug at Jikei University Hospital between 2022 and 2023. A total of 358 individuals were categorized into discontinuation (n =  65) and continuation (n  = 293) groups based on continuation of treatment for at least 180 days. Logistic regression analyses identified higher HbA1c levels and metformin use as significant predictive factors for discontinuation at 3 mg. Furthermore, individuals taking metformin  ≥  1000 mg/day (high-dose metformin) exhibited a significantly higher risk of discontinuation due to gastrointestinal symptoms. In the supplementary analyses that included individuals who escalated from 3 mg to higher doses, metformin use-regardless of dose-was associated with early gastrointestinal-related discontinuation at 3 mg. No significant predictive factors were identified at 7 mg or 14 mg. These findings suggest that careful consideration should be given when initiating oral semaglutide, particularly in individuals with high HbA1c levels or those receiving metformin therapy.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-025-00868-0.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"14"},"PeriodicalIF":1.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12775246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of finerenone with and without angiotensin-converting enzyme inhibitors/angiotensin receptor blockers on albuminuria in patients with diabetes and chronic kidney disease.","authors":"Saori Inoue, Takashi Kamiya, Reiichiro Fujita, Kaoru Yoshida, Aya Morita, Hiroko Yasuda","doi":"10.1007/s13340-025-00866-2","DOIUrl":"https://doi.org/10.1007/s13340-025-00866-2","url":null,"abstract":"<p><strong>Aims: </strong>Angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) are the foundation of renoprotective therapy in chronic kidney disease (CKD). However, some patients cannot tolerate these agents. This study aimed to evaluate the efficacy and safety of finerenone in patients with or without ACEi/ARB therapy.</p><p><strong>Methods: </strong>We retrospectively analyzed 83 patients with CKD and diabetes who received finerenone for ≥ 3 months at our hospital (June 2022 to March 2025). The patients were divided into ACEi/ARB users (n = 52) and non-users (n = 31). Changes in the estimated glomerular filtration rate, urinary albumin-to-creatinine ratio, and serum potassium concentrations were compared.</p><p><strong>Results: </strong>The urinary albumin-to-creatinine ratio significantly decreased after finerenone treatment in both groups (ACEi/ARB: 478 to 143 mg/gCr, p < 0.001; non-ACEi/ARB: 548 to 433 mg/gCr, p = 0.049). The degree of this reduction was greater in the ACEi/ARB group than in the non-ACEi/ARB group (0.376 vs. 0.846, p = 0.006). The estimated glomerular filtration rate significantly declined after finerenone treatment in the ACEi/ARB group (40 to 36.5 mL/min/1.73 m², p = 0.004) but not in the non-ACEi/ARB group. Serum potassium concentrations slightly increased after finerenone treatment in the ACEi/ARB group (p = 0.014) but not in the non-ACEi/ARB group. Adverse events included hyperkalemia (n = 7), renal failure (n = 1), and discontinuation in 11 patients.</p><p><strong>Conclusions: </strong>Finerenone reduces albuminuria even without ACEis/ARBs, but the effect is more pronounced with co-administration, albeit with higher risks of a decline in the estimated glomerular filtration rate and hyperkalemia. Finerenone monotherapy may be beneficial when ACEis/ARBs cannot be used, whereas combined therapy remains more effective but requires careful monitoring.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-025-00866-2.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"15"},"PeriodicalIF":1.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12775181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin edema in slowly progressive type 1 diabetes: improvement following adjustment of insulin therapy.","authors":"Emi Okamura, Norio Harada, Kana Okuno, Kana Yamamoto, Takaaki Murakami, Yohei Ueda, Daisuke Yabe","doi":"10.1007/s13340-025-00864-4","DOIUrl":"10.1007/s13340-025-00864-4","url":null,"abstract":"<p><p>Insulin edema is an uncommon complication that typically arises soon after initiating insulin therapy, most often in individuals with newly diagnosed diabetes or poorly controlled hyperglycemia. An old report from a single hospital in Africa showed an incidence of 3.5% among 491 insulin-treated individuals. Although the precise pathophysiology remains uncertain, proposed mechanisms include insulin-induced sodium retention, increased vascular permeability, and dysregulation of the renin-angiotensin-aldosterone system. Insulin edema has been described in both type 1 and type 2 diabetes; however, occurrence in slowly progressive type 1 diabetes mellitus (SPIDDM) is exceptionally rare. We report a woman with SPIDDM who developed bilateral lower-leg edema shortly after starting basal-bolus insulin therapy with insulin aspart and insulin degludec. She exhibited no signs of heart failure, liver disease, renal impairment, or allergic reaction to insulin. Cardiac function was normal on echocardiography, and B-type natriuretic peptide levels were within the reference range. She experienced marked edema and an approximately 7-kg weight gain after insulin initiation. Following modification of the insulin regimen and dietary sodium restriction (8 g/day of salt), the edema resolved rapidly within nine days without the use of diuretics. This case illustrates that insulin edema can occur even in individuals with SPIDDM. The observed improvement after insulin regimen adjustment likely reflects the combined influence of glycemic stabilization, fluid-electrolyte balance, and potential formulation-related factors, rather than a direct causal difference between insulin types. Clinicians should recognize this rare yet clinically important complication and adopt an individualized management approach that includes careful glycemic correction and, when appropriate, adjustment of the insulin regimen.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-025-00864-4.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"13"},"PeriodicalIF":1.2,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent diabetes and heart failure: revisiting epidemiological and clinicopathological interplay.","authors":"Jayagopal Pathiyil Balagopalan, Sandeep Bansal, Arpandev Bhattacharyya, Abdul Hamid Zargar, Sameer Dani, Abhijit Taraphder, Alan Almeida, Nilakshi Deka, Sanjay Jain, Onkar C Swami","doi":"10.1007/s13340-025-00855-5","DOIUrl":"https://doi.org/10.1007/s13340-025-00855-5","url":null,"abstract":"<p><p>The global prevalence of diabetes mellitus (DM) and heart failure (HF) is rapidly increasing. Hyperglycemia, insulin resistance and hyperglycemia-induced oxidative stress in people with DM are the key etiological factors of HF. The factors disrupt systemic, myocardial and cellular mechanisms, leading to lipotoxicity, mitochondrial dysfunction, altered calcium signaling and inflammation, ultimately resulting in HF. Heart failure on the other hand induces new-onset diabetes by modulating insulin signaling. Despite the availability of novel treatment approaches, these comorbid conditions continue to increase hospitalization, treatment expenditure and mortality. Therefore, a thorough understanding of the complex bidirectional relationship between DM and HF might be helpful in managing the associated complications of both conditions. This review aims to provide an overview of cellular and pathophysiological interplay of the glucovascular continuum from DM to HF, and vice versa. Additionally, updated estimates on prevalence and outcomes of incident HF in people with DM and new-onset DM after HF are discussed. Guidelines from the United States, Europe and Korea recommended sodium glucose cotransporter-2 inhibitors (SGLT-2is) for primary prevention of DM and HF, and for reduction of HF hospitalization. Evidences from large-scale clinical trials and meta-analyses have shown that SGLT2i (empagliflozin, canagliflozin and dapagliflozin), semaglutide (glucagon-like peptide-1 receptor agonist) and finerenone (mineralcorticoid receptor antagonist) act as effective anti-diabetic agents and provide cardiovascular protection. Future research should prioritize diabetic control to manage and prevent lipotoxicity, oxidative stress, inflammation and advanced glycation end-product formation in order to diminish the disease burden.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"12"},"PeriodicalIF":1.2,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional models for type 2 diabetes study.","authors":"Qian-Qian Lu, Zhao Zheng, Peng Wang, Mohamad S Hakim, Y-B Yin","doi":"10.1007/s13340-025-00862-6","DOIUrl":"https://doi.org/10.1007/s13340-025-00862-6","url":null,"abstract":"<p><p>Type 2 diabetes (T2D) is a chronic metabolic disorder characterized by hyperglycemia, insulin resistance, and β-cell dysfunction. It is a complex disease involving the interaction of genetic, environmental, and lifestyle factors. Three-dimensional (3D) in vitro models provide substantial advantages over conventional 2D models for the study of biology, disease, and medicine. Current 3D models include spheroids, organoids, and organ-on-chip systems. The use of 3D models has become increasingly popular in T2D research. These models allow for the visualization and manipulation of complex biological systems, providing insight into the underlying mechanisms of the disease. They have been employed to study various aspects of T2D, including β-cell function, insulin secretion, and glucose metabolism. This review aims to summarize the current state of 3D models for T2D research, highlighting their advantages, limitations, and future directions.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"11"},"PeriodicalIF":1.2,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between changes in uric acid levels and renal function during 12 months of treatment with luseogliflozin.","authors":"Takuma Izutsu, Hiroyuki Ito, Suzuko Matsumoto, Hideyuki Inoue, Shinichi Antoku, Toshiko Mori, Sugitatsu Yoshito, Hashimoto Yo, Hashimoto Tomoko, Sugawara Takashi","doi":"10.1007/s13340-025-00853-7","DOIUrl":"10.1007/s13340-025-00853-7","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 (SGLT2) inhibitors can effectively improve blood glucose levels in patients with type 2 diabetes, reduce the risk of cardiovascular disease and heart failure, and prevent chronic kidney disease. Although they reduce uric acid (UA) levels, few studies have investigated the relationship between UA reduction and renal function. We evaluated the degree of reduction in UA levels, various metabolic parameters, and renal function in patients with type 2 diabetes mellitus treated with luseogliflozin in order to develop a better renal protection strategy.</p><p><strong>Methods: </strong>This retrospective study analyzed 353 patients with type 2 diabetes who were newly treated with luseogliflozin. Patients were divided into two groups based on baseline UA levels, namely, the low group (< 6.0 mg/dL) and high group (≥ 6.0 mg/dL), with 74 patients in each group. Changes in metabolic parameters including glycated hemoglobin (HbA1c), UA levels, and estimated glomerular filtration rate (eGFR) were monitored over 12 months.</p><p><strong>Results: </strong>Both groups showed significant reductions in UA and HbA1c at 12 months. eGFR decreased significantly in the low group (- 3.1 ± 0.9 mL/min/1.73 m², <i>p</i> = 0.002), whereas no significant change was observed in the high group (- 0.8 ± 1.3 mL/min/1.73 m², <i>p</i> = 0.667). UA reduction was greater in the high group (- 1.0 ± 0.2 mg/dL vs. - 0.3 ± 0.1 mg/dL, <i>p</i> < 0.001). UA changes were significantly correlated with eGFR changes (<i>p</i> = 0.008) but not with HbA1c changes.</p><p><strong>Conclusion: </strong>Changes in eGFR after luseogliflozin administration were significantly correlated with baseline eGFR, uACR, and changes in uric acid levels (Δ uric acid). The change in uric acid levels following SGLT2 inhibitor treatment was associated with metabolic parameters such as blood pressure and albuminuria, suggesting that it may function as a surrogate marker reflecting renal metabolic processes.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"7"},"PeriodicalIF":1.2,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12675881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between diabetes knowledge, treatment satisfaction and medication adherence among Malaysian geriatric patients.","authors":"Nur Syaqirah Natasha Mohamad Yusaini, Muhammad Eid Akkawi","doi":"10.1007/s13340-025-00860-8","DOIUrl":"10.1007/s13340-025-00860-8","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence among geriatric diabetic patients is influenced by various factors, including diabetes knowledge and treatment satisfaction. Understanding these relationships is crucial for improving adherence and health outcomes.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 300 diabetic patients aged 60 and above at outpatient clinics of a Malaysian teaching hospital. Interviews were conducted for each participant using a set of questionnaires that included a sociodemographic form, 20 questions from the simplified Diabetes Knowledge Test (DKT), 11 questions from the Treatment Satisfaction Questionnaire for Medication (TSQM-II), and 12 questions from the Malaysia Medication Adherence Assessment Tool (MyMAAT).</p><p><strong>Results: </strong>Participants demonstrated moderate diabetes knowledge [median = 6.67(6.00-7.78)] and high medication adherence [73%]. Diabetes knowledge was significantly associated with age [70-79 years: p = 0.012, above 80: <i>p</i> = 0.007], educational status [high school: <i>p</i> = 0.007, college/university: <i>p</i> < 0.001], and medication type [the presence of insulin in the regimen: <i>p</i> = 0.009]. A significant relationship was found between diabetes knowledge and treatment satisfaction [<i>p</i> < .001] and medication adherence [<i>p</i> = 0.004]. Each one-unit increase in diabetes knowledge was associated with a 34.2% decrease in the odds of nonadherence (OR = 0.658, 95% CI: 0.494-0.876, <i>p</i> = 0.004). Factors like gender [female: <i>p</i> = 0.014], occupational status [retired/ unemployed: <i>p</i> = 0.022], and type of diabetes medications [<i>p</i> < .001] influenced treatment satisfaction, while education [high school: <i>p</i> = 0.004] and global satisfaction [<i>p</i> = 0.009] affected adherence.</p><p><strong>Conclusions: </strong>Geriatric diabetic patients demonstrated inadequate knowledge about diabetes, and this limited knowledge was significantly associated with lower treatment satisfaction and poorer medication adherence.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"5"},"PeriodicalIF":1.2,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing ROCK biology to revolutionize diabetic nephropathy: decoding mechanisms, designing therapies.","authors":"Keiichiro Matoba","doi":"10.1007/s13340-025-00861-7","DOIUrl":"10.1007/s13340-025-00861-7","url":null,"abstract":"<p><p>Diabetes remains a major cause of kidney failure globally, presenting substantial challenges to healthcare systems worldwide. Although significant progress has been made in understanding its pathogenesis, residual risks persist despite current therapies. Emerging evidence underscores the pivotal role of small GTPases-particularly Rho and Rho-associated coiled-coil-containing protein kinase (ROCK)-in the progression of diabetic nephropathy. This comprehensive review consolidates current knowledge on the distinct pathophysiological roles of the ROCK isoforms, ROCK1 and ROCK2, in diabetic nephropathy, drawing on recent insights from both genetic and pharmacological studies. We explore how ROCK signaling interfaces with key pathological mechanisms, including podocyte injury, glomerulosclerosis, tubular dysfunction, and metabolic disturbances. Particular emphasis is placed on isoform-specific functions: ROCK1 primarily regulates AMP-activated protein kinase-mediated fatty acid metabolism and mitochondrial dynamics, while ROCK2 modulates peroxisome proliferator-activated receptor α signaling and inflammatory responses. Furthermore, we discuss the translational implications of these findings, focusing on the therapeutic potential of ROCK inhibitors in chronic kidney disease (CKD) with diabetes and related disorders, such as focal segmental glomerulosclerosis, as well as their impact on electrolyte balance. By integrating molecular insights with clinical considerations, this review provides a framework for developing targeted strategies to halt the CKD progression in people with diabetes.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"3"},"PeriodicalIF":1.2,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a home-based low-to-moderate-intensity dance exercise program on glycemic control and quality of life in elderly patients with type 2 diabetes: a single-arm, intervention study.","authors":"Atsushi Ujiie, Kenji Hara, Mio Kubo, Mototaka Yamauchi, Takafumi Tsuchiya, Kohzo Takebayashi, Yasuyuki Maruyama, Koshi Hashimoto","doi":"10.1007/s13340-025-00854-6","DOIUrl":"10.1007/s13340-025-00854-6","url":null,"abstract":"<p><strong>Background: </strong>Exercise therapy improves glycemic control and reduces cardiovascular risk factors in patients with type 2 diabetes (T2D). However, access to professionally supervised programs is limited, particularly for older adults. Home-based, weather-independent, exercise options have yet to be investigated in detail.</p><p><strong>Objective: </strong>The present study examined the effects of a self-directed, low-to-moderate intensity dance exercise program performed at home on glycemic control and health-related quality of life (HRQOL) in older adults with T2D.</p><p><strong>Methods: </strong>In this single-arm, intervention study, 20 elderly patients with T2D (median age, 70.5 years) participated in a standardized, unsupervised, home-based, aerobic dance program (\"DaredeMo Dance\") for at least 20 min per day for 12 weeks. The program was designed to be of low-to-moderate intensity, namely < 4 metabolic equivalents (METs). Primary outcomes were changes in HbA1c, glycoalbumin (GA), and HRQOL (assessed using SF-36v2). Secondary outcomes included body mass index (BMI), blood pressure (BP), and fasting plasma glucose (FPG).</p><p><strong>Results: </strong>After 12 weeks, significant improvements were observed in BMI (23.4 to 23.2 kg/m², <i>P</i> = 0.002), systolic BP (134.0 to 125.0 mmHg, <i>P</i> = 0.004), diastolic BP (72.0 to 67.5 mmHg, <i>P</i> = 0.040), HbA1c (7.3 to 7.0%, <i>P</i> = 0.0012), and FPG (150 to 140 mg/dL, <i>P</i> = 0.034). HRQOL improved in all eight domains of SF-36v2, with significant improvements in Bodily Pain, General Health, Vitality, and Mental Health.</p><p><strong>Conclusions: </strong>A standardized, indoor, low-to-moderate intensity, dance program improved glycemic control and HRQOL in older adults with T2D. This approach offers a safe, accessible, and sustainable exercise option for those with limited access to professional guidance.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-025-00854-6.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"6"},"PeriodicalIF":1.2,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential association of hyperglucagonemia with C-peptide levels in diabetic ketosis/ketoacidosis and hyperosmolar hyperglycemic state.","authors":"Tatsuya Iida, Sayuri Nii, Hiroto Nishikawa, Eriko Kodama, Hideyuki Imai, Mai Hashizume, Rie Tadokoro, Chiho Sugisawa, Toru Iizaka, Fumiko Otsuka, Shoichiro Nagasaka","doi":"10.1007/s13340-025-00852-8","DOIUrl":"10.1007/s13340-025-00852-8","url":null,"abstract":"<p><strong>Aims/introduction: </strong>Glucagon plays a pivotal role in the development of hyperglycemia in diabetes mellitus. The purpose of this study was to investigate the hypothesis that hyperglucagonemia based on measurements of pancreas-specific glucagon is present in diabetic ketosis/ketoacidosis (DK/DKA) and hyperosmolar hyperglycemic state (HHS), and if so, to explore factors contributing to that hyperglucagonemia.</p><p><strong>Materials and methods: </strong>A total of 109 patients (92 with DK/DKA, and 17 with HHS) were investigated. Pancreas-specific glucagon levels were measured with a sandwich enzyme-linked immunosorbent assay at treatment initiation. The relationships of plasma glucagon levels, serum ketone bodies levels, and endogenous insulin secretion were assessed. The change in plasma glucagon levels after treatment was also assessed.</p><p><strong>Results: </strong>The median plasma glucagon level was significantly higher in the HHS group (142.9 pg/mL) than in the DK/DKA group (63.6 pg/mL). In the DK/DKA group, the plasma glucagon level was positively correlated with the serum ketone bodies level (ρ = 0.55, <i>P</i> < 0.0001), but there was no correlation in the HHS group. In the DK/DKA group, a negative correlation was seen between the plasma glucagon level and the serum C-peptide immunoreactivity (CPR)/plasma glucose ratio in type 1 diabetes patients (n = 26) (ρ = - 0.67, <i>P</i> = 0.0002). In the HHS group, a positive correlation was seen between the plasma glucagon level and the serum CPR/plasma glucose ratio (ρ = 0.71, <i>P</i> = 0.0013). The plasma glucagon level was significantly lower after treatment in both the DK/DKA and HHS groups.</p><p><strong>Conclusions: </strong>Hyperglucagonemia was found in DK/DKA and HHS with pancreas-specific glucagon measurements. The results suggest that the causes of hyperglucagonemia differ in DK/DKA due to type 1 diabetes mellitus and HHS.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13340-025-00852-8.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"17 1","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145603219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}