Diabetes最新文献

{"title":"914-P: Sodium–Glucose Cotransporter 2 (SGLT2) Inhibitors and Nephrolithiasis—An Updated Meta-analysis","authors":"ZOHA SHAHZAD, OSAMA IJAZ, BADR ILMAGUOOK, RAHILA ALI, SADIA S. USMANI, ARSLAN A. KHAN, SAEEDA YASMIN, ABDUL MOIZ, FNU SAMRAH","doi":"10.2337/db25-914-p","DOIUrl":"https://doi.org/10.2337/db25-914-p","url":null,"abstract":"Introduction and Objective: SGLT-2i are effective in treating type 2 diabetes (T2DM), promoting weight loss, reducing blood pressure, and lowering cardiovascular risk. Diabetes increases nephrolithiasis risk due to urine acidification and elevated oxalate concentrations. This meta-analysis evaluates the impact of SGLT-2i on nephrolithiasis incidence. Methods: A comprehensive search of Medline, Embase, Google Scholar, Cochrane CENTRAL, Scopus, and clinicaltrials.gov was conducted through November 2024. We included observational studies and RCTs comparing SGLT-2i to other diabetes medications or placebo. The primary outcome was nephrolithiasis incidence after treatment. A random-effects meta-analysis was performed to calculate the pooled odds ratio (OR). Results: Twenty-eight studies (75,371 participants) met the inclusion criteria. The pooled analysis showed that SGLT-2i significantly reduced the risk of nephrolithiasis compared to other medications or placebo (OR: 0.90; 95% CI: 0.83-0.98; p=0.02; I²=0%). This contrasts with a previous meta-analysis that found no association between SGLT-2i and nephrolithiasis. Conclusion: This updated meta-analysis shows that SGLT-2i reduce nephrolithiasis risk in T2DM, suggesting potential benefit for those with recurrent nephrolithiasis. These findings highlight the broader therapeutic benefits of SGLT-2i beyond glucose control. Disclosure Z. Shahzad: None. O. Ijaz: None. B. Ilmaguook: None. R. Ali: None. S.S. Usmani: None. A.A. Khan: None. S. Yasmin: None. A. Moiz: None. F. Samrah: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"13 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"248-OR: Thyroid-Stimulating Hormone Aggravates Ferroptosis in Schwann Cells via Suppression of the Nrf2/GPX4 Pathway—Implications for Diabetic Peripheral Neuropathy","authors":"SIJIA FEI, LIXIN GUO, QI PAN","doi":"10.2337/db25-248-or","DOIUrl":"https://doi.org/10.2337/db25-248-or","url":null,"abstract":"Introduction and Objective: Diabetic peripheral neuropathy (DPN) is a common and debilitating chronic complication of diabetes, characterized by Schwann cell injury, axonal degeneration, and neurovascular dysfunction. Recent studies suggest that elevated thyroid-stimulating hormone (TSH) levels are strongly associated with the progression of DPN, though the underlying mechanisms remain unclear. Ferroptosis, a regulated cell death driven by iron-dependent lipid peroxidation, may contribute to this process. This study explored the role of TSH in inducing ferroptosis in Schwann cells via the NRF2/GPX4 pathway. Methods: RSC96 Schwann cells were divided into four groups: control (CON), high glucose/palmitic acid (HG/PA), TSH treatment (TSH), and high glucose/palmitic acid with TSH (HG/PA+TSH). Transcriptomic sequencing was performed, and cell viability, proliferation, apoptosis, ROS levels, MDA, GSH, mitochondrial membrane potential (JC-1), and intracellular Fe2+ levels were assessed. Western blot analysis was conducted to evaluate changes in the NRF2/GPX4 pathway. Results: TSH with HG/PA reduced cell viability and proliferation, increased apoptosis, ROS levels, lipid peroxidation, and intracellular Fe2+, depleted GSH, and disrupted mitochondrial function. Transcriptomic analysis showed enrichment in lipid metabolism and oxidative stress pathways. Western blot revealed NRF2/GPX4 suppression. Conclusion: This study demonstrates that TSH induces ferroptosis in Schwann cells by suppressing the NRF2/GPX4 signaling pathway, thereby exacerbating oxidative stress, iron overload, and mitochondrial dysfunction. These findings provide novel insights into the mechanistic link between thyroid dysfunction and the pathogenesis of DPN and highlight potential therapeutic targets for protecting Schwann cells and mitigating disease progression in diabetes. Disclosure S. Fei: None. L. Guo: Research Support; Abbott, AstraZeneca, Bayer Pharmaceuticals, Inc, Eli Lilly and Company, Innovent Biologics, Merck & Co., Inc, MSD Life Science Foundation, Novo Nordisk A/S, Sanofi, Jiangsu Hengrui Pharmaceuticals Co., Ltd, Tonghua Dongbao. Q. Pan: None. Funding The National Natural Science Foundation of China ( 82270881).","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"10 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"232-OR: Accuracy of Real-Time Continuous Glucose Monitoring in Hospitalized Patients with Diabetes and Impaired Kidney Function","authors":"YOSHINORI KAKUTANI, TOMOAKI MORIOKA, SHOKO MIYAMOTO, YUKO YAMAZAKI, AKINOBU OCHI, KATSUHITO MORI, TETSUO SHOJI, MASANORI EMOTO","doi":"10.2337/db25-232-or","DOIUrl":"https://doi.org/10.2337/db25-232-or","url":null,"abstract":"Introduction and Objective: Continuous glucose monitoring (CGM) systems improve glycemic control in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D) by reducing hypoglycemia and increasing time within target glucose range compared to capillary blood glucose testing. Recent factory-calibrated real-time CGM systems have enhanced usability and accuracy. However, their performance in patients with impaired kidney function, especially those in the hospital where high accuracy is crucial, has not been investigated. This study aimed to evaluate the accuracy of real-time CGM in hospitalized patients with diabetes and impaired kidney function. Methods: A total of 24 patients with diabetes, including T1D (n = 2), T2D (n = 20), and pancreatic diabetes (n = 2), hospitalized in a general ward were enrolled. Participants were categorized into three groups based on estimated glomerular filtration rate (eGFR, mL/min/1.73m²): G1-2 (eGFR ≥60), G3 (eGFR 30-59), and G4-5 (eGFR <30). Capillary glucose values measured using a point of care device (Accu-Chek Guide One, Roche) were compared with the glucose readings from a real-time CGM (G6, Dexcom) recorded at the closest corresponding time. Accuracy was assessed using mean absolute relative difference (MARD), the percentage of readings within ±15% or ±15 mg/dL of reference values (%15/15), and %20/20. Results: The study analyzed 289, 325, and 155 glucose pairs from the G1-2 (n=9), G3 (n=9), and G4-5 (n=6) groups, respectively. Mean HbA1c levels were 9.4% in G1-2, 11.2% in G3, and 7.2% in G4-5, with significant intergroup differences (p = 0.004). The overall MARD was 13.5%, with group-specific values of 15.9% in G1-2, 12.7% in G3, and 10.1% in G4-5, with significant differences among groups (p < 0.001). The intergroup difference was consistent with %15/15 (p < 0.001) and %20/20 (p < 0.001). Conclusion: This study demonstrated the accuracy of real-time CGM in hospitalized patients with diabetes and impaired kidney function. Disclosure Y. Kakutani: None. T. Morioka: Research Support; Boehringer-Ingelheim. S. Miyamoto: None. Y. Yamazaki: None. A. Ochi: None. K. Mori: Research Support; Mitsubishi Tanabe Pharma Corporation, Kyowa Kirin Co., Ltd, Sumitomo Dainippon Pharma Co., Ltd. Speaker's Bureau; Mitsubishi Tanabe Pharma Corporation, AstraZeneca, Novo Nordisk, Boehringer-Ingelheim, Kyowa Kirin Co., Ltd, Eli Lilly and Company. T. Shoji: None. M. Emoto: Speaker's Bureau; Novo Nordisk, Kyowa Kirin Co., Ltd. Research Support; Boehringer-Ingelheim.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"12 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"981-P: Success of Online CME at Improving Clinical Knowledge, Competence, and Confidence regarding CGM","authors":"AMY LARKIN, MICHAEL LACOUTURE, ANNE LE","doi":"10.2337/db25-981-p","DOIUrl":"https://doi.org/10.2337/db25-981-p","url":null,"abstract":"Introduction and Objective: We sought to determine if online continuing medical education (CME) could improve the clinical knowledge, competence and confidence of primary care physicians (PCPs) and diabetologists/endocrinologists (D/Es) related to CGM. Methods: Intervention was a 45-min online video expert interview series with downloadable slides. Education effect assessed with matched pre-/post-assessment design. A paired samples t-test was conducted for significance testing and a McNemar test was conducted at the question level (5% significance level, P <.05). Confidence was assessed in a Likert scale question. Data collection was May 15, 2024 to July 18, 2024. Results: 191 PCPs and 34 D/Es were included in the study, of which 41% of PCPs and 53% of D/Es improved their knowledge/competence. On a question-level: 15% of both PCPs and D/Es demonstrated improvements at patient selection for use of CGM (P<.05 for PCPs and P=NS for D/Es). 21% of PCPs and 29% of D/Es demonstrated improvements at overcoming barriers to CGM use in a practical scenario (P<.01 for both PCPs and D/Es). 14% of PCPs and 18% of D/Es demonstrated improvements at identifying benefits of CGM (P<.01 for PCPs and P=NS D/Es). 34% of PCPs and 21% of D/Es had a measurable improvement in confidence in initiating CGM (P<.01 for PCPs and P=NS for D/Es). Continued educational gaps include: 61% of PCPs and 56% of D/Es need education on patient selection for CGM use, 50% of PCPs and 56% of D/Es need additional education on overcoming barriers to CGM, and 35% of PCPs need additional education on benefits of CGM. Conclusion: This study demonstrates the success of online CME consisting of an expert interview series on improving clinical knowledge, competence and confidence of both PCPs and D/Es related to CGM use. Significant continued knowledge and competence gaps were identified in both groups, with the largest gaps in knowledge seen in PCPs and competence in D/Es. Disclosure A. Larkin: None. M. LaCouture: None. A. Le: None. Funding Independent educational grant from Abbott Diabetes Care","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"180 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"481-P: Chronic Kidney Disease Amplifies Dementia Risk in Patients with Diabetic Retinopathy—A Korean National Health Information Data-Based Study","authors":"NA HYUN SONG, YEONSOO PARK, MIN KYONG MOON","doi":"10.2337/db25-481-p","DOIUrl":"https://doi.org/10.2337/db25-481-p","url":null,"abstract":"Introduction and Objective: Diabetes mellitus (DM) and its complications are global health problem. Dementia, which also causes substantial morbidity and mortality among the elderly, has been shown to be associated with diabetic retinopathy (DR) and chronic kidney disease (CKD). However, the combined impact of these conditions on dementia risk remains unclear. This study aims to investigate the individual and combined effects of DR and CKD on dementia risk. Methods: Using the nationwide database of National Health Insurance Service in South Korea, 2,356,298 patients aged 40 years or older with diabetes who underwent routine health examination from 2015 to 2016 were included. The mean follow-up duration was 5.63 years. Dementia incidence was defined using International Classification of Diseases 10th revision codes (ICD-10). Cox proportional hazards analysis was used to calculate hazard ratios (HR) of dementia in patients with CKD or DR, adjusting for covariates such as age, sex, BMI, income, smoking, alcohol consumption, and comorbidities. Results: The incidence rate (IR) of dementia was increased in patients with CKD (HR 1.16, 95% CI: 1.15-1.18). Similarly, DR patients showed higher dementia risk compared to non-DR patients, with proliferative diabetic retinopathy (PDR) associated with higher HR of 1.26 (95% CI: 1.21-1.31) compared to 1.09 (95% CI 1.08-1.10) in non-PDR patients. Furthermore, CKD amplified dementia risk in DR patients. Compared to patients without CKD or DR, patients with CKD and PDR had an HR of 1.57 (95% CI 1.49-1.64), higher than the HR in PDR patients without CKD (HR 1.26, 95% CI 1.21-1.31). Subgroup analysis showed that younger patients (age 40-64 years) had higher HRs than older patients (≥65 years) within the same disease groups. Conclusion: This study suggests the synergistic effect of CKD in DR patients on dementia risk, emphasizing the need of early screening and integrated care for diabetes-related complications. Disclosure N. Song: None. Y. Park: None. M. Moon: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"42 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"778-P: Pemvidutide, a Balanced GLP-1/Glucagon Dual Receptor Agonist, Enhances Reverse Cholesterol Transport in a Golden Syrian Hamster Model","authors":"MAYNARA LUCCA ANDRADE, JOHN J. SUSCHAK__III, BERTRAND GEORGES, FRANCOIS BRIAND, M S. ROBERTS","doi":"10.2337/db25-778-p","DOIUrl":"https://doi.org/10.2337/db25-778-p","url":null,"abstract":"Introduction and Objective: Pemvidutide is a long-acting, peptide-based GLP-1/glucagon dual receptor agonist that elicits significant reductions in body weight and serum lipids in preclinical and clinical studies. Reverse cholesterol transport (RCT) is an important process for removing excess cholesterol from peripheral tissues. Preclinical studies have suggested that glucagon may enhance the elimination of cholesterol, possibly due to enhanced RCT. Here, we investigated the effects of pemvidutide on RCT via cholesterol excretion in a preclinical model. Methods: Obese male Golden Syrian hamsters were treated daily with pemvidutide or vehicle for 35 days. On Day 35, macrophages labelled with 3H-cholesterol were injected intraperitoneally, and the appearance of the 3H-cholesterol in plasma, liver, and feces was quantitated over 72 hours. In an independent study, changes in the hepatic expression of genes involved in cholesterol transport were measured by reverse transcription-polymerase chain reaction (RT-PCR) following pemvidutide treatment. Results: Pemvidutide treatment significantly reduced total plasma triglycerides, total cholesterol, and LDL-cholesterol as compared to vehicle controls. Specifically, pemvidutide significantly reduced plasma 3H-cholesterol and increased the excretion of 3H-cholesterol and its metabolites in feces over 72 hours. RT-PCR analysis showed significantly increased hepatic gene expression of the cholesterol transporters ABCG5 and ABCG8 in the pemvidutide treated group compared to vehicle. Conclusion: Pemvidutide treatment increased excretion of cholesterol into feces and upregulated transporters of cellular cholesterol in the liver, consistent with increased RCT. These findings suggest that in addition to other mechanisms, pemvidutide improves serum cholesterol through enhanced cholesterol excretion. Disclosure M. Lucca Andrade: Employee; Altimmune Inc. J.J. Suschak: Employee; Altimmune Inc. B. Georges: Employee; Altimmune Inc. F. Briand: Employee; PHYSIOGENEX. Stock/Shareholder; PHYSIOGENEX. M.S. Roberts: Employee; Altimmune Inc.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"10 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"1745-P: Long-Term Safety and Efficacy of Once-Weekly Dosage of 2.4 mg Semaglutide for Weight Loss in Patients with and without Diabetes—An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials","authors":"MIAN MUHAMMAD SALMAN ASLAM, WANIA U. REHMAN, QURAT UL AIN M. MUHAMMAD, MUHAMMAD TALHA SHAUKAT, MUHAMMAD HASSNAIN NASRULLAH, MUHAMMAD HASSAN, FATIMA SAEED, MUHAMMAD A. TARIQ","doi":"10.2337/db25-1745-p","DOIUrl":"https://doi.org/10.2337/db25-1745-p","url":null,"abstract":"Introduction and Objective: Obesity is a multifaceted health crisis necessitating a nuanced understanding to direct evidence-based therapeutic strategies. Glucagon-like peptide-1 receptor agonists (GLP1RAs) such as semaglutide have shown encouraging yet contradictory outcomes. This study aims to evaluate the long-term efficacy and safety of once-weekly 2.4 mg semaglutide for weight loss in patients with and without diabetes. Methods: A systematic search was conducted in MEDLINE (via PubMed), Cochrane Library, Google Scholar, and ClinicalTrials.gov up to December 31, 2024, for relevant randomized controlled trials (RCTs) comparing semaglutide versus placebo. The protocol was registered on PROSPERO (ID: CRD42024532538). Meta-analysis was performed using R statistical software to calculate mean differences (MD), risk ratios (RR), and corresponding 95% confidence intervals (CI). Results: Twelve RCTs with 23,600 participants (semaglutide: 12,492; placebo: 11,108) were included. Semaglutide significantly reduced body weight compared to placebo, with a mean percentage reduction of -7.91% and an absolute reduction of -10.40 kg (p < 0.01). Higher proportions of patients in the semaglutide group achieved weight loss thresholds of ≥10%, ≥15%, and ≥20% (p < 0.01). Waist circumference, fasting plasma glucose, and lipid profiles improved (p < 0.01). Adverse events, primarily gastrointestinal, were more common with semaglutide (RR = 1.56; p < 0.01), contributing to higher discontinuation rates (RR = 4.67; p < 0.01). Conclusion: Semaglutide demonstrates robust efficacy in achieving significant weight loss and improving metabolic parameters in patients with and without diabetes. However, its tolerability remains a challenge, warranting further research to optimize safety. Disclosure M. Aslam: None. W.U. Rehman: None. Q.M. Muhammad: None. M. Shaukat: None. M. Nasrullah: None. M. Hassan: None. F. Saeed: None. M.A. Tariq: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"49 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"108-OR: A Systematic Review and Meta-analysis of RCTs to Prevent Diabetic Neuropathy in Adults with Type 2 Diabetes","authors":"ALANA L. SHEEHAN, JORDAN O'MALLEY, SOPHIA GUNAWAN, SUNDAR NATARAJAN, GREGORY LAYNOR, ANDREW NICHOLSON, NICHOLAS ILLENBERGER","doi":"10.2337/db25-108-or","DOIUrl":"https://doi.org/10.2337/db25-108-or","url":null,"abstract":"Introduction and Objective: Diabetic peripheral neuropathy (DPN) is a serious complication. Clinical guidelines recommend targeting modifiable risk factors to prevent DPN, but their effectiveness is unclear. We conducted a systematic review and meta-analysis to evaluate the effectiveness of treating modifiable risk factors to prevent DPN in adults with type 2 diabetes (T2D). Methods: Following PRISMA guidelines, Pubmed, Embase, and clinicaltrials.gov databases were searched for RCTs published since 1980 targeting glycemia, lipids, BP, obesity, smoking, lifestyle modification and multifactorial interventions. Two independent reviewers screened identified articles via Covidence. A third reviewer resolved disagreements. Meta-analysis for each intervention type was conducted using a random-effects model with R. Results are reported as ORs with 95% CI, p-values and I2 statistics. Results: We identified 832 articles from our search. After removal of duplicates and studies marked as ineligible through automated tools, 677 studies underwent title-abstract screening. Of these, 640 were deemed negative and 37 positives moved on to full-text screening. Another 9 studies were identified by non-systematic search. These 46 RCTs underwent full-text screening which yielded 12 studies with relevant extractable data. Meta-analysis was conducted for glycemic control: [n=6] (OR = 0.92, 95% CI 0.84: 1.01, p = 0.07, I2=0%); lifestyle: [n=2] (OR = 0.99, 95% CI 0.86: 1.13, p = 0.83, I2 = 0%) and multifactorial: [n=2] (OR =0.76, 95% CI 0.62: 0.93, p = 0.01, I2 = 0%). Insufficient high-quality RCTs were identified for lipid-lowering [n = 1], smoking cessation [n = 0], obesity [n = 0] and BP [n = 1] for meta-analysis. Conclusion: We found a reduced risk of DPN from multifactorial RCTs, borderline for glycemic control and no effect from lifestyle modification. These findings highlight the need for further research with incident DPN as outcome in adults with T2D to generate actionable results. Disclosure A.L. Sheehan: None. J. O'Malley: None. S. Gunawan: None. S. Natarajan: None. G. Laynor: None. A. Nicholson: None. N. Illenberger: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"30 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"1736-P: Metabolic Health, Obesity, and Renal Cell Carcinoma Risk in Korean Young Adults—A Population-Based Cohort Study","authors":"HYEWON MUN, JAE-SEUNG YUN, KYUNGDO HAN, JANG WON SON","doi":"10.2337/db25-1736-p","DOIUrl":"https://doi.org/10.2337/db25-1736-p","url":null,"abstract":"Introduction and Objective: The rising incidence of renal cell carcinoma (RCC) among young adults is a growing concern, with the relationship between metabolic health and obesity in its development remaining understudied, particularly in Asian populations. This study investigates the association between metabolically unhealthy obesity and RCC risk in Korean young adults aged 20-39 years, examining changes in metabolic health and obesity status over time. Methods: We analyzed data from 6,312,579 young adults from the Korea National Health Insurance Service database (2009-2021). Participants were initially categorized into four groups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). After a 2-year follow-up, participants were reclassified into 16 subgroups based on metabolic health status changes. Cox proportional hazards models calculated hazard ratios (HRs) for RCC risk, adjusting for demographic and lifestyle factors. Results: During follow-up, 4,218 new RCC cases were identified. Compared to the MHNO group, adjusted HRs (95% CIs) for RCC were significantly elevated in MUNO (1.225 [1.124-1.334]), MHO (1.52 [1.297-1.782]), and MUO (2.14 [1.969-2.325]) groups. Subgroup analyses showed a significant age interaction at 30 years (P=0.0271). BMI demonstrated a dose-dependent relationship with RCC risk, and risk increased with the number of metabolic syndrome components. Participants maintaining or developing MUO showed the highest risk, with stable MUO having the greatest HR (2.468 [2.153-2.828]). Conclusion: Both metabolic health and obesity significantly influence RCC risk in young adults, with metabolically unhealthy individuals facing elevated risks even at normal weight. These findings emphasize the importance of evaluating metabolic health beyond BMI in Asian populations for better risk assessment and prevention strategies. Disclosure H. Mun: None. J. Yun: None. K. Han: None. J. Son: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"22 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"863-P: A Multicenter, Randomized, Open-Label, Controlled Study on Evaluating the Efficacy and Safety of Switching from Daily DPP-4 Inhibitors to Cofrogliptin in Patients with Type 2 Diabetes Mellitus in China","authors":"CONGQING PAN, LIMING CHEN, HONGWEI JIANG, YI FENG, SUIJUN WANG, JIN ZHANG, ZHONGJING WANG, YUSEN ZHOU","doi":"10.2337/db25-863-p","DOIUrl":"https://doi.org/10.2337/db25-863-p","url":null,"abstract":"Introduction and Objective: Cofrogliptin is a novel ultra-long-acting DPP-4 inhibitor (DPP-4i) which could maintain good glycemic control in type 2 diabetes (T2D) patients with 10mg dose once biweekly. This study aims to assess the efficacy and safety of switching daily DPP-4i to cofrogliptin in Chinese T2D patients, focusing on blood glucose fluctuations. Methods: T2D patients previously treated by daily DPP-4i with or without metformin for at least 12 weeks were included. Eligible patients were randomly 1:1 assigned to the daily DPP-4i group (continued their medication) or the cofrogliptin group (switched the daily DPP-4i to biweekly cofrogliptin) for the treatment of 24 weeks. 14-day CGM was conducted from week -2 to 0 and from week 22 to 24. The primary endpoint was the change in time in range (TIR, 3.9-10.0 mmol/L) from baseline to 24 weeks. Results: A total of 64 participants with mean HbA1c of 7.04% and TIR of 83.79% were enrolled. After 24-week treatment, the mean TIR (%) relative to baseline changed by an increase of 0.545 in the cofrogliptin group and a decrease of 9.614 in the daily DPP-4i group. There was a significant difference between the two groups with least-squares (LS) mean difference of 10.159 (95%CI: 3.194, 17.124, P=0.0050). The change in mean glucose (MG, mmol/L) and coefficient of variation (CV, %) from baseline also showed significant difference with LS Mean difference of -1.016 (95%CI: -1.644, -0.388, P=0.0020) and -3.370 (95%CI: -5.998, -0.741, P=0.0129) in favor of the cofrogliptin group. There were no severe hypoglycemia events in both groups and the incidence of adverse events was similar between the two groups. Conclusion: The treatment of switching to cofrogliptin from daily DPP-4i resulted in better maintenance of TIR, MG, and CV in T2D patients, irrespective of metformin co-use, and showed good tolerability and safety. Clinical trial information: NCT06703268. Disclosure C. Pan: None. L. Chen: None. H. Jiang: None. Y. Feng: None. S. Wang: None. J. Zhang: None. Z. Wang: None. Y. Zhou: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"179 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}