Journal of Diabetes and Metabolic Disorders最新文献

{"title":"The effect of timing of physical exercise on glycemia: a systematic review and meta-analysis of human intervention studies.","authors":"Samantha B J Schipper, Romy Slebe, Linda J Schoonmade, Denis P Blondin, David J T Campbell, André C Carpentier, Jean-Pierre P Després, Joris Hoeks, Andries Kalsbeek, Parminder Raina, Patrick Schrauwen, Mireille J Serlie, Dirk Jan Stenvers, Chun-Xia Yi, Renée de Mutsert, Joline W J Beulens, Femke Rutters","doi":"10.1007/s40200-026-01954-z","DOIUrl":"10.1007/s40200-026-01954-z","url":null,"abstract":"<p><strong>Aim: </strong>Physical exercise (PE) may be important for glucose metabolism. Therefore, this systematic review and meta-analysis aims to investigate the effect of PE performed in the morning versus afternoon or evening on glycemia parameters in human intervention studies.</p><p><strong>Methods: </strong>MEDLINE and Embase.com were searched until February 2023 for intervention studies in the general adult population, examining the effect the timing of PE on glycemia parameters after one or multiple bouts of exercise. Results were meta-analysed using a random-effects models where appropriate or were described using qualitative synthesis.</p><p><strong>Results: </strong>55,569 publications were screened for a series of reviews, of which 20 studies (680 participants) were included in this review. In studies including one bout of PE (<i>n</i> = 12), glucose levels measured directly after PE were 0.26 mmol/L (95%CI -0.18;0.70, I² = 81%, <i>n</i> = 3) higher after morning PE, compared to afternoon PE. Studies including repeated PE for 1-12 weeks (<i>n</i> = 8), showed that fasting glucose was 0.25mmol/L (95%CI 0.02;0.47, I² = 32%, <i>n</i> = 7) higher in morning PE, compared to afternoon/evening PE. Other outcomes (e.g. 24 h mean glucose, HOMA-IR) could not be meta-analyzed and were assessed qualitatively, showing no associations or results in line with the results above. Only time in range (TIR) and hypoglycemic events tended to favor morning PE.</p><p><strong>Conclusion: </strong>This review suggests that fasting glucose may be higher following morning PE, compared with afternoon or evening PE in long-term studies. Evidence on glucose directly after PE in acute studies and other glycemic outcomes remains limited and inconclusive. The included studies were generally small, heterogeneous in design and interventions, and often did not account for important factors such as nutritional intake and chronotype. Therefore, well-designed, adequately powered trials that account for lifestyle factors and assess clinically relevant outcomes are needed to clarify these associations.</p><p><strong>Trial registration: </strong>This review is part of a larger search 'The effect of altering timing of physical activity, sleep and energy intake on glycemia and Type 2 Diabetes risk in humans', of which the protocol was registered in the PROSPERO database on November 27^th, 2021 under number: CRD42021287828.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-026-01954-z.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"150"},"PeriodicalIF":2.1,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138229","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":"Comparative study of multimorbidity of diabetic patients living in Ardabil and Tehran.","authors":"Mirsaeed Abdollahi, Farhad Pourfarzi, Hossein Poustchi, Pardis Sadeghipour, Nahid Hashemi-Madani, Somaieh Matin, Reza Malekzadeh","doi":"10.1007/s40200-026-01953-0","DOIUrl":"https://doi.org/10.1007/s40200-026-01953-0","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is highly prevalent among individuals with diabetes mellitus and substantially worsens clinical outcomes. This study compared the prevalence and patterns of multimorbidity among diabetic patients living in Ardabil and Tehran.</p><p><strong>Method: </strong>In this retrospective comparative study, data were obtained from diabetic patients enrolled in the PERSIAN cohort in Ardabil and the Institute of Diabetes and Metabolism in Tehran. Multimorbidity was defined as the coexistence of two or more chronic conditions, including hypertension, coronary artery disease, cerebrovascular disease, chronic kidney disease, dyslipidemia, obesity, asthma/COPD, and malignancy. Comparisons between two cities were conducted using the Chi-square (χ²) test and were also visually assessed using bar plots with 95%CI. Poisson regression models with robust standard errors (SE) were used to estimate prevalence ratios (PRs) for comorbidity according to city of residence.</p><p><strong>Results: </strong>A total of 921 diabetic patients were included. Multimorbidity was significantly more prevalent in Tehran than in Ardabil (97.8% vs. 92.4%, <i>P</i> < 0.001), with a higher proportion of patients having three or more comorbidities (44.7% vs. 30.2%). Hypertension, coronary artery disease, chronic kidney disease, dyslipidemia, and cancer were more common in Tehran, whereas obesity was more prevalent in Ardabil. In the fully adjusted model, residence in Tehran was associated with a 5.2% higher comorbidity prevalence (PR = 1.052, 95% CI: 1.017-1.087).</p><p><strong>Conclusion: </strong>Diabetic patients in Tehran exhibit a significantly greater multimorbidity burden than those in Ardabil, possibly driven by longer diabetes duration. These findings highlight the need for region-specific strategies for multimorbidity management in Iran.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"148"},"PeriodicalIF":1.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138218","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":"National trends and disparities in cardiomyopathy-related mortality among individuals with diabetes mellitus in the United States: A retrospective observational study from 1999 to 2019.","authors":"Mahnoor Fatima, Faiza Fatima, Ahmed Raza, Iqra Shahid, Mohsin Rashid, Muneeba Shaukat, Tahleel Abbas, Laiba Sarfraz, Syed Mohamin Abbas Shah, Jones Onesime, Aymar Akilimali","doi":"10.1007/s40200-026-01959-8","DOIUrl":"https://doi.org/10.1007/s40200-026-01959-8","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of DM and Cardiomyopathy is increasing. This study offers a longitudinal analysis of mortality patterns due to these two diseases, along with regional and demographic insights that highlight disparities in mortality rates in the US from 1999 to 2019.</p><p><strong>Methods: </strong>The CDC WONDER mortality database was used to determine crude death rates (CR) and age-adjusted mortality rates (AAMRs) per 1000,000 individuals, 25 years and above. Joinpoint Regression was used to examine annual percent change (APC), average APC (AAPC), and parallelism. Stata analysis was done to assess the significance of the association between mortality trends and different variables.</p><p><strong>Results: </strong>From 1999 to 2019, there were 141,167 deaths with an AAPC of -3.26. Males (43.11) had higher AAMR than females (22.31). The Blacks had the highest AAMR (56.37) while non-Hispanic Asians experienced the lowest (22.62). AAMRs varied by region (Midwest: 33.56, South: 32.00, West: 31.61, Northeast: 27.14). States with the highest AAMR were Hawaii and Ohio; Colorado had the lowest AAMR. Non-metropolitan areas showed a higher AAMR (32.37) than metropolitan areas (31.11). Crude mortality rate was highest for the 85 + age group.</p><p><strong>Conclusions: </strong>Mortality due to cardiomyopathy in people with DM decreased in the US. Males, Blacks, the Midwestern region, and non-urban areas had higher mortality, highlighting the need for targeted interventions to mitigate the mortality burden.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-026-01959-8.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"149"},"PeriodicalIF":1.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138250","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":"<i>Relationship</i> of <i>vitamin D deficiency</i> with prediabetes and diabetes in older adults.","authors":"Mitra Moodi, Amir Tiyuri, Sudabeh Eshaghi, Farshad Sharifi, Zoya Tahergorabi","doi":"10.1007/s40200-026-01962-z","DOIUrl":"https://doi.org/10.1007/s40200-026-01962-z","url":null,"abstract":"<p><strong>Introduction: </strong>Since, as the global population ages and also, non-communicable diseases including type 2 diabetes is one of the most common challenges for public healthcare system worldwide present study aimed to the <i>relationship</i> of <i>vitamin D deficiency</i> with prediabetes and diabetes in older adults.</p><p><strong>Methods: </strong>In this cross-sectional study 1324 older aged 60 years and older participated. A questionnaire containing demographic information, physical activity and smoking habits was completed by trained interviewers for all participants. Then, weight, height and waist circumference, Body Mass Index (BMI) also, systolic and diastolic blood pressures (mmHg) of all subjects were measured and calculated. Fasting blood sugar (FBS) after overnight fasting and serum 25OHD levels were measured. Analyses were conducted using Stata 17 software.</p><p><strong>Results: </strong>The mean age of participants was 69.76 ± 7.56 years, and 52.0% were female. The mean serum 25(OH) D level was 31.14 ± 15.99 ng/mL, and 25.45% of participants were classified as vitamin D deficient. Diabetes and prediabetes were present in 29.08% and 22.96% of participants, respectively. In the fully adjusted ordinal logistic regression model, higher serum vitamin D levels were significantly associated with lower odds of having a worse diabetes status (adjusted OR = 0.90; 95% CI: 0.84-0.97; <i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>In conclusion, 25OHD deficiency was related with diabetes mellitus status in older adults after full control of multiple potential confounders. These findings support policy and awareness program related the importance of improving vitamin D for prevention of prediabetes and diabetes mellitus in older adult population.</p><p><strong>Clinical trial number: </strong>Not applicable.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"147"},"PeriodicalIF":1.6,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138267","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":"Prevalence of low physical activity among children and adolescents in the Middle East and North Africa Region: a systematic review and meta-analysis.","authors":"Amirhossein Habibzadeh, Shaghayegh Khanmohammadi, Parisa Fallahtafti, Melina Farshbafnadi, Ozra Tabatabaei-Malazy, Shirin Djalalinia, Moloud Payab, Hanieh-Sadat Ejtahed, Hanye Sohrabi, Afshin Ostovar, Nazila Rezaei","doi":"10.1007/s40200-026-01956-x","DOIUrl":"https://doi.org/10.1007/s40200-026-01956-x","url":null,"abstract":"<p><p>Low physical activity (LPA) is a growing public health concern among youth, contributing to chronic disease risk. In this review, LPA was operationally defined as failing to meet the World Health Organization (WHO) recommendation of at least 60 min of moderate-to-vigorous physical activity (MVPA) per day for children and adolescents aged 5-19 years, although studies using alternative cut-points were included and documented. This systematic review and meta-analysis estimated the pooled prevalence of LPA among children and adolescents in the Middle East and North Africa (MENA) region. PubMed, Embase, Web of Science, and Scopus were searched up to May 2025 for observational studies reporting LPA prevalence among individuals aged 5-19 years in MENA countries. Random-effects models were used to calculate pooled estimates, with subgroup analyses by sex, age, and measurement instrument. A total of 54 studies across 19 MENA countries were included, covering 71 population-specific observations and a total of 257,208 participants. The overall pooled prevalence of LPA across all studies was 64% (95% CI: 59-69%). Adolescents had the highest prevalence at 71% (95% CI: 66-75%). Girls had a significantly higher prevalence of LPA (72%, 95% CI: 63-80%) compared to boys (45%, 95% CI: 34-56%). Country-specific prevalence ranged widely, from 44% in Iran to 93% in Algeria. Substantial heterogeneity was observed across all analyses (I² > 99%), reflecting genuine contextual and methodological variation. The risk of bias assessment (Joanna Briggs Institute (JBI) tool) indicated that included studies were generally of low to moderate risk, with no studies rated as high risk. However, the overall certainty of evidence was graded as low due to substantial heterogeneity. Interpretation of pooled estimates should consider the substantial heterogeneity and variability in measurement tools. Across all measurement instrument subgroups, girls consistently exhibited higher inactivity levels. LPA is highly prevalent among youth in the MENA region, particularly among girls and adolescents, with large inter-country variations warranting targeted interventions.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-026-01956-x.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"146"},"PeriodicalIF":1.6,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138248","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":"Comparative effects of psychological interventions (PRECEDE, PLISSIT, BETTER, and Counseling) on female sexual function index (FSFI) scores in women with diabetes: a systematic review and network meta-analysis.","authors":"Asghar Rostami, Solmaz Norouzi, Alirea Rafi, Iraj Jafaripour, Zahra Askari, Mahdi Bodagh","doi":"10.1007/s40200-026-01960-1","DOIUrl":"https://doi.org/10.1007/s40200-026-01960-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Female sexual dysfunction (FSD) is highly prevalent in women with diabetes and is influenced by biopsychosocial factors. Although psychological interventions such as PRECEDE, PLISSIT, BETTER, and structured counseling show promise, direct comparative evidence is lacking. This network meta-analysis aimed to evaluate and rank the efficacy of these models in improving sexual function among diabetic women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;The protocol was prospectively registered in PROSPERO (CRD420251185900). We systematically searched PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Scopus from January 2015 to the end of 2025. Eligible studies were randomized controlled trials (RCTs) and quasi-experimental studies (including controlled before-after and single-arm pre-post designs) that enrolled adult women (≥ 18 years) with diabetes mellitus (type 1, type 2, or unspecified; gestational diabetes-only studies excluded), compared PRECEDE, PLISSIT, BETTER, or structured counseling versus control (usual care, waitlist, or no intervention), and reported FSFI total scores (or comparable validated scales) at post-intervention. No language restrictions were applied. A frequentist random-effects network meta-analysis was conducted using standardized mean differences (SMDs). Interventions were ranked using P-scores. Heterogeneity was quantified with I&lt;sup&gt;2&lt;/sup&gt; and τ&lt;sup&gt;2&lt;/sup&gt;. Risk of bias was assessed using Cochrane RoB 2 (RCTs) and ROBINS-I (non-randomized studies). Publication bias was evaluated via funnel plots, Egger's, and Begg's tests. Meta-regression explored effects of study design and sample size.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;Of 2,347 records, 10 studies (3 RCTs and 7 quasi-experimental studies; N = 1,294 participants) were included. The network was star-shaped, with all active interventions connected only to the control group and no direct head-to-head comparisons between interventions; therefore, all comparative effects are based solely on indirect evidence. Accordingly, treatment rankings and P-score (SUCRA-equivalent) values should be interpreted with caution and considered exploratory rather than definitive indicators of comparative effectiveness. All interventions demonstrated positive effect sizes compared with the control. PRECEDE showed the largest point estimate (SMD = 2.14, 95% CI: - 0.02 to 4.30, P-score = 0.471), followed by BETTER (SMD = 1.38, 95% CI: - 0.38 to 3.15, P-score = 0.222), counseling (SMD = 0.92, 95% CI: - 0.05 to 1.89, P-score = 0.136), and PLISSIT (SMD = 0.73, 95% CI: - 0.59 to 2.05, P-score = 0.115). Also, substantially high heterogeneity was observed (I&lt;sup&gt;2&lt;/sup&gt; = 97.7%, τ&lt;sup&gt;2&lt;/sup&gt; = 1.19). However, all confidence intervals overlapped and included null, indicating no statistically significant difference between any active intervention and control. Subgroup analysis revealed significant differences by study design (p = 0.0344), with quasi-experim","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"145"},"PeriodicalIF":1.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13212860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054783","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":"Risk factors associated with prediabetes-to-diabetes conversion in a majority-minority county: a real-world analysis.","authors":"Joyce Y Lee, Ifigeneia Stathaki, Paul Gaura, Tiffany Huynh, Alexis Tran","doi":"10.1007/s40200-026-01949-w","DOIUrl":"10.1007/s40200-026-01949-w","url":null,"abstract":"<p><strong>Purpose: </strong>To identify key risk factors associated with the progression from prediabetes to type 2 diabetes in a majority-minority county in the United States and evaluate their relative contributions.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the deidentified EHR from the University of California, Irvine Health (2013-2023). Adults with prediabetes (confirmed by ICD codes and HbA1c values) were included, and those with diabetes of any form at baseline or with missing data were excluded. Baseline demographics and clinical factors were compared among those who progressed to T2D (converters) to those who did not (non-converters). Ordinal logistic regression and Cox proportional hazards models were used to assess predictors of conversion timing and risk.</p><p><strong>Results: </strong>A total of 2648 adults had confirmed prediabetes, of which 510 (19.3%) developed T2D. Among converters, 81.6% progressed within 5 years of the initial prediabetes diagnosis. The two groups were similar at baseline, except converters had higher obesity rates and were more likely to have Hispanic/Latino ethnicity (<i>p</i> < 0.001). Elevated baseline HbA1c was a strong independent predictor of earlier conversion to T2D (OR 0.41 per 1% increase, <i>p</i> < 0.001). Baseline triglycerides provided a modest additional effect (<i>p</i> = 0.047). Hispanic/Latino ethnicity was associated with a significantly higher risk of progression to T2D (adjusted HR 1.25, 95% CI 1.03-1.49, <i>p</i> = 0.021).</p><p><strong>Conclusions: </strong>Elevated HbA1c and triglycerides at baseline were associated with early conversion to T2D. This study underscores the need for early, targeted intervention in individuals with high-risk ethnic and clinical profiles to stop T2D.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"135"},"PeriodicalIF":2.1,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963762","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":"Joint effect of hepatic steatosis index and triglyceride glucose index on cardio-renal outcomes: a real-world study.","authors":"Yun Shen, Lizheng Shi, Vivian Fonseca, Elizabeth Nauman, Eboni Price-Haywood, Gang Hu","doi":"10.1007/s40200-026-01937-0","DOIUrl":"10.1007/s40200-026-01937-0","url":null,"abstract":"<p><strong>Objective: </strong>Hepatic steatosis index (HSI) and triglyceride glucose (TyG) index are emerging markers associated with metabolic health and cardiovascular risk. Their combined effects on cardio-renal outcomes remain poorly understood. This study evaluated the joint effect of HSI and TyG index on cardio-renal outcomes in a real-world population.</p><p><strong>Methods: </strong>We analyzed 16,109 participants, stratified by tertiles of TyG index and HSI groups (≤ 36 vs. >36). Cardio-renal outcomes included composite major adverse cardiovascular events (MACE: cerebrovascular events, coronary artery disease, heart failure, myocardial infarction) and renal events (eGFR decline ≥ 50%, end-stage kidney disease [ESKD], proteinuria). Hazard ratios (HRs) were calculated using multivariable Cox proportional hazards models adjusted for demographics and clinical covariates.</p><p><strong>Results: </strong>Higher TyG tertiles were associated with a significantly increased risk of composite cardio-renal outcomes (HR for tertile 3 vs. tertile 1: 1.58; 95% CI: 1.37-1.83). Subgroup analysis showed that individuals with HSI > 36 and TyG tertile 3 had the highest risks for composite MACE (HR: 1.62; 95% CI: 1.34-1.96) and composite renal outcomes (HR: 3.13; 95% CI: 2.10-4.68) compared with other subgroups. Both higher TyG and HSI levels showed a particularly strong association with proteinuria (HR for HSI > 36 and TyG tertile 3: 3.69; 95% CI: 2.26-6.02).</p><p><strong>Conclusions: </strong>The combined assessment of HSI and TyG index provides a valuable tool for identifying individuals at high risk for cardio-renal outcomes. These findings highlighted the importance of metabolic markers in predicting complications and underscore the need for early interventions targeting these populations.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-026-01937-0.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"132"},"PeriodicalIF":2.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874430","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":"Genetic predisposition to diabetes and risk of stroke in a Native Hawaiian population.","authors":"Stacy C Brown, Cameron P Both, Mālialani Kanaʻiaupuni, Leah Dowsett, Keolu Fox, Kazuma Nakagawa, Mariana Gerschenson, Guido J Falcone","doi":"10.1007/s40200-026-01940-5","DOIUrl":"10.1007/s40200-026-01940-5","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes is a highly heritable risk factor for stroke, with many known genetic variants. The role of these genetic variants in cerebrovascular disease has not been studied in Kānaka Maoli (Native Hawaiian) populations. We aimed to determine if genetic predisposition to diabetes is associated with a higher risk of stroke in a Kānaka Maoli population.</p><p><strong>Methods: </strong>We conducted a genetic association case/control study using data from Kānaka Maoli participants in the Population Architecture using Genomics and Epidemiology (PAGE) study. Stroke cases were identified through health questionnaires and matched by age and sex at a 1:10 ratio. We modeled genetic predisposition to diabetes with a polygenic risk score that included independent genetic variants known to be associated with diabetes at a genome-wide significance level (<i>p</i> < 5 × 10⁸). This polygenic risk score served as the independent variable in logistic regression models for both diabetes and stroke.</p><p><strong>Results: </strong>A total of 440 Kānaka Maoli individuals were included (15% under 50 years old, 85% aged 50-69, 65% female). There were 40 stroke patients and 400 age- and sex-matched control subjects. Genetic predisposition to diabetes was linked to a 23% increased risk of developing diabetes (OR 1.23, CI 1.01-1.51; <i>p</i> = 0.04) and a 45% increased risk of stroke (OR 1.45, CI 1.03-2.05; <i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>In a Kānaka Maoli population, genetic predisposition to diabetes is associated with an increased risk of stroke. Future research to identify effect modifiers of this relationship may uncover significant public health strategies.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"130"},"PeriodicalIF":2.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868482","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":"Aerobic exercise reduces oxidative damage and improves heart function in diabetic rats with heart failure: No extra effect from photobiomodulation.","authors":"Naira Helena Bohrer Scherer, Alan Christhian Bahr, Lucas Capalonga, Gilson Pires Dorneles, Pedro Dal Lago","doi":"10.1007/s40200-026-01924-5","DOIUrl":"10.1007/s40200-026-01924-5","url":null,"abstract":"<p><strong>Purpose: </strong>The coexistence of diabetes mellitus (DM) and heart failure (HF) worsens clinical outcomes and complicates therapeutic strategies. This study investigated the effects of aerobic exercise (AE), with or without photobiomodulation (PBM), on cardiac function, glycaemic control, inflammation, and oxidative stress in diabetic rats with HF.</p><p><strong>Methods: </strong>Fifty rats were initially enrolled. Ten animals died during myocardial infarction surgery (20% mortality), and among the 40 survivors, exclusions based on small infarct size resulted in a final sample of 30 rats for analysis (HFDM: <i>n</i> = 11; HFDM + AE: <i>n</i> = 12; HFDM + AE+PBM: <i>n</i> = 7). AE was performed on a treadmill for eight weeks. PBM (850 nm, 4.4 J) was applied bilaterally to the gastrocnemius muscle after each AE session.</p><p><strong>Results: </strong>AE was associated with increased exercise duration, running distance, and maximal speed compared with HFDM (<i>p</i> < 0.0001). AE also improved haemodynamic indices (+ dP/dtmax and -dP/dtmin; <i>p</i> < 0.001), reduced left ventricular posterior wall thickness (<i>p</i> = 0.0001), lowered fasting glycaemia (<i>p</i> = 0.032), and enhanced antioxidant defenses, including increased catalase and glutathione peroxidase activity and reduced plasma lipid peroxidation (TBARS; <i>p</i> < 0.0001). The addition of PBM did not confer further benefits beyond those induced by AE (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>AE improved functional capacity, cardiac structural and haemodynamic parameters, fasting glycaemia, and oxidative stress in rats with HF and DM. Under the conditions applied, PBM did not provide additional benefits, indicating that further studies are needed to optimize PBM protocols and clarify its potential role as an adjunct therapy in HFDM.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"25 1","pages":"124"},"PeriodicalIF":2.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690319","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}