Journal of diabetes and its complications最新文献

{"title":"Gastrointestinal symptom burden in diabetic autonomic and peripheral neuropathy – A Danes cohort study","authors":"Huda Kufaishi ,&nbsp;Hatice Isik Mizrak ,&nbsp;Birgitte Brock ,&nbsp;Tine Willum Hansen ,&nbsp;Peter Rossing ,&nbsp;Christian Stevns Hansen","doi":"10.1016/j.jdiacomp.2024.108745","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108745","url":null,"abstract":"<div><h3>Objective</h3><p>We investigated associations between gastrointestinal symptoms - evaluated as a combined weighted symptom score (CWSS) – Diabetic autonomic neuropathy (DAN), and distal symmetrical polyneuropathy (DSPN) in type 1 and type 2 diabetes.</p></div><div><h3>Research design and methods</h3><p>Cross-sectional study in a tertiary outpatient clinic. CWSS was calculated based on questionnaires: gastroparesis composite symptom index (GCSI) and gastrointestinal symptom rating score (GSRS). DAN and DSPN were addressed using the composite autonomic symptom score 31 (COMPASS-31) questionnaire, cardiac autonomic reflex tests (CARTs), electrochemical skin conductance (ESC), vibration perception threshold (VPT), Michigan Neuropathy Screening Instrument (MNSI), pain- and thermal sensation.</p><p>Analyses were adjusted for age, sex, diabetes duration, smoking, LDL-cholesterol, HbA_1C and systolic blood pressure. Type 1 and type 2 diabetes were evaluated separately.</p></div><div><h3>Results</h3><p>We included 566 with type 1 diabetes and 377 with type 2 diabetes. Mean ± SD age was 58 ± 15 years and 565 (59.9 %) were women. A high CWSS was present in 143 (25 %) with type 1 and 142 (38 %) with type 2 diabetes. The odds of DAN by COMPASS-31 (<em>p</em> <em>&lt;</em> <em>0.001</em>) were higher in the high score group. For type 1 diabetes, odds of cardiac autonomic neuropathy were higher in the high CWSS group. The odds of DSPN by VPT and MNSI in type 1 diabetes, and by ESC, VPT and pain sensation in type 2 diabetes were higher in the high CWSS group.</p></div><div><h3>Conclusions</h3><p>A high symptom score was associated with neuropathy by COMPASS-31 and vibration perception. Gastrointestinal symptom burden associated inconsistently with other neuropathy tests between diabetes types.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140550955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of trimetazidine on myocardial injury in mice with diabetic cardiomyopathy","authors":"Dongming Zhao ,&nbsp;Jingming Ma ,&nbsp;Yuman Sun ,&nbsp;Wei Huang ,&nbsp;Jinyang Fan ,&nbsp;Mingzhe Ye ,&nbsp;Bo Hu ,&nbsp;Xinyi Sun","doi":"10.1016/j.jdiacomp.2024.108744","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108744","url":null,"abstract":"<div><h3>Introduction</h3><p>The prevalence of diabetes mellitus is increasing year by year globally, and diabetic cardiomyopathy (DCM), as the most common complication of type 2 diabetes mellitus, seriously affects the prognosis of patients. Trimetazidine (TMZ), as a drug affecting myocardial energy metabolism, mainly reduces the oxidation rate of β-oxidation by inhibiting 3-ketoacyl-CoA thiolase (3-KAT), a key enzyme in β-oxidation of free fatty acid (FFA), so that the energy metabolism substrate of cardiomyocytes preferentially selects glucose rather than fatty acids, increases the content of intracellular adenosine triphosphate (ATP), enhances the contractile function of cardiomyocytes, and improves the state of cellular ischemia and hypoxia. Previous studies have shown that TMZ is closely related to the activation and induction of apoptosis of the MAPK pathway and AMPK pathway, and plays a role in the treatment of diabetic cardiomyopathy, but the specific mechanism is still unclear.</p></div><div><h3>Objective</h3><p>This study aims to investigate the impact of TMZ on myocardial damage in mice exhibiting diabetic cardiomyopathy (DCM), and to furnish a laboratory foundation for the clinical treatment of diabetic cardiomyopathy.</p></div><div><h3>Method</h3><p>Male db/db mice (6 weeks old, <em>n</em> = 21) and male wild-type (wt) (6 weeks old, <em>n</em> = 20) mice were selected for the study. The wt mice were randomly assigned to the wt group (<em>n</em> = 10) and wt + TMZ group (<em>n</em> = 10), while the remaining db/db mice were randomly allocated to the db/db group (<em>n</em> = 11) and db/db + TMZ group (n = 10). Following 8 weeks of feeding, the wt + TMZ group and db/db + TMZ group received TMZ via gavage, whereas the remaining groups were administered physiological saline. Periodic measurements of blood glucose, blood lipids, and myocardial enzymes were conducted in mice, with samples obtained after the 12th week for subsequent biochemical analysis, myocardial pathology assessment, immunohistochemistry, western blot analysis, and TUNEL staining (TdT-mediated dUTP Nick-End Labeling).</p></div><div><h3>Result</h3><p>GLU, TC, TG, LDL-C, and CK-MB levels were significantly higher in db/db mice compared to wt mice (GLU: M ± SD wt 5.94 ± 0.37, db/db 17.63 ± 0.89, <em>p</em> &lt; 0.05, ES = 0.991; TC: M ± SD wt 3.01 ± 0.32, db/db 6.97 ± 0.36, <em>p</em> &lt; 0.05, ES = 0.972; TG: M ± SD wt 0.58 ± 0.2, db/db 1.75 ± 0.14, <em>p</em> &lt; 0.05, ES = 0.920; LDL-C: M ± SD wt 1.59 ± 0.12, db/db 3.87 ± 0.14, <em>p</em> &lt; 0.05, ES = 0.989; CK-MB: M ± SD wt 0.12 ± 0.01, db/db 0.31 ± 0.04, <em>p</em> &lt; 0.05, ES = 0.928). HDL-C levels were significantly lower in db/db mice (M ± SD wt 1.89 ± 0.08, db/db 0.64 ± 0.09, p &lt; 0.05, ES = 0.963). Histopathological analysis confirmed myocardial damage in db/db mice. Treatment with TMZ reduced GLU, TC, TG, LDL-C, and CK-MB levels (<em>p</em> &lt; 0.05, ES &gt; 0.9) and increased HDL-C levels compared to ","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140549557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of glucagon-like peptide-1 receptor agonists on fat accumulation in patients with diabetes mellitus and non-alcoholic fatty liver disease or obesity: A systematic review and meta-analysis of randomized control trials","authors":"Wanrun Xie,&nbsp;Zhenzhen Hong,&nbsp;Bo Li,&nbsp;Baoliang Huang,&nbsp;Shaobin Dong,&nbsp;Yuqi Cai,&nbsp;Lingyan Ruan,&nbsp;Qianhui Xu,&nbsp;Lunpan Mou,&nbsp;Yi Zhang","doi":"10.1016/j.jdiacomp.2024.108743","DOIUrl":"10.1016/j.jdiacomp.2024.108743","url":null,"abstract":"<div><h3>Aim</h3><p>This systematic review and meta-analysis aimed to comprehensively evaluate the impact of glucagon-like peptide 1 receptor agonists (GLP-1RAs) on visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in individuals with diabetes mellitus and non-alcoholic fatty liver disease (NAFLD) or obesity.</p></div><div><h3>Methods</h3><p>A search of PubMed, Embase, and Web of Science until October 2023 identified 13 Randomized Controlled Trials (RCTs) meeting the inclusion criteria. Bias risk was assessed using the Cochrane risk-of-bias instrument. Statistical analysis utilized standard mean differences (SMD) in Review Manager 5.4. Heterogeneity and publication bias were assessed. This study used the protocol registered with the Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY2023110020).</p></div><div><h3>Results</h3><p>GLP-1RA treatment significantly reduced VAT (SMD −0.55, 95 % CI [−0.90, −0.19]), SAT (SMD −0.59, 95 % CI [−0.99, −0.19]), body weight (SMD −1.07, 95 % CI [−1.67, −0.47]), and body mass index (BMI) (SMD −1.10, 95 % CI [−1.74, −0.47]) compared to controls. Heterogeneity was observed for VAT (I² = 79 %, <em>P</em> &lt; 0.01), SAT (I² = 73 %, <em>P</em> &lt; 0.01), body weight (I² = 82 %, <em>P</em> &lt; 0.01), and BMI (I² = 82 %, <em>P</em> &lt; 0.01). No publication bias was detected for VAT (<em>P</em> = 0.57) and SAT (<em>P</em> = 0.18). GLP-1RA treatment improved fasting blood glucose (FBG), postprandial glucose (PPG), hemoglobin A1c (HbA1c), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and fibrosis-4 (FIB-4).</p></div><div><h3>Conclusions</h3><p>This meta-analysis highlights GLP-1RAs' potential to reduce fat accumulation, body weight, and BMI and improve glycemic control in individuals with diabetes mellitus and NAFLD or obesity. These findings supported using GLP-1RAs as promising therapeutic agents to address abnormal adipose tissue distribution and metabolic dysfunction.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of sitagliptin with basal-plus insulin regimen versus insulin alone in non-critically ill hospitalized patients with type 2 diabetes: SITA-PLUS hospital trial","authors":"Abraham Edgar Gracia-Ramos ,&nbsp;María del Pilar Cruz-Dominguez ,&nbsp;Eduardo Osiris Madrigal-Santillán ,&nbsp;Raúl Rojas-Martínez ,&nbsp;José Antonio Morales-González ,&nbsp;Ángel Morales-González ,&nbsp;Mónica Hernández-Espinoza ,&nbsp;Joaquín Vargas-Peñafiel ,&nbsp;María de los Ángeles Tapia-González","doi":"10.1016/j.jdiacomp.2024.108742","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108742","url":null,"abstract":"<div><h3>Aims</h3><p>To compare the efficacy and safety of basal-plus (BP) insulin regimen with or without sitagliptin in non-critically ill patients with type 2 diabetes (T2D).</p></div><div><h3>Methods</h3><p>This open-label, randomized clinical trial included inpatients with a previous diagnosis of T2D and blood glucose (BG) between 180 and 400 mg/dL. Participants received basal and correctional insulin doses (BP regimen) either with or without sitagliptin. The primary outcome was the difference in the mean daily BG among the groups.</p></div><div><h3>Results</h3><p>Seventy-six patients (mean age 60 years, 64 % men) were randomized. Compared with BP insulin therapy alone, the sitagliptin-BP combination led to a lower mean daily BG (158.8 <em>vs</em> 175.0 mg/dL, <em>P</em> = 0.014), a higher percentage of readings within a BG range of 70–180 mg/dL (75.9 % <em>vs</em> 64.7 %, <em>P</em> &lt; 0.001), and a lower number of BG readings &gt;180 mg/dL (<em>P</em> &lt; 0.001). Sitagliptin-BP resulted in fewer basal and supplementary insulin doses (<em>P</em> = 0.024 and <em>P</em> = 0.017, respectively) and lower daily insulin injections (<em>P</em> = 0.023) than those with insulin alone. The proportion of patients with hypoglycemia was similar in the two groups.</p></div><div><h3>Conclusions</h3><p>For inpatients with T2D and hyperglycemia, the sitagliptin and BP regimen combination is safe and more effective than insulin therapy alone.</p><p><span>Clinicaltrials.gov</span><svg><path></path></svg> identifier: <span>NCT05579119</span><svg><path></path></svg></p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing cardio-renal-metabolic risk in patients with type 2 diabetes: the role of finerenone","authors":"Tiziana Filardi ,&nbsp;Alessandra Feraco ,&nbsp;Antoine Ouvrard-Pascaud ,&nbsp;Manfredi Rizzo ,&nbsp;Massimiliano Caprio","doi":"10.1016/j.jdiacomp.2024.108741","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108741","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140341613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin improves diabetic neuropathy by reducing inflammation through up-regulating the expression of miR-146a and suppressing oxidative stress","authors":"Fengmin Liu ,&nbsp;Fangqin You ,&nbsp;Lihang Yang ,&nbsp;Siyun Wang ,&nbsp;Diya Xie","doi":"10.1016/j.jdiacomp.2024.108737","DOIUrl":"10.1016/j.jdiacomp.2024.108737","url":null,"abstract":"<div><h3>Purpose</h3><p>Diabetic neuropathy (DN) is a notable complication of diabetes mellitus. The potential involvement of miR-146a in DN regulation is presently under investigation. Metformin, a commonly prescribed medication for diabetes, is the primary therapeutic intervention. This study aimed to unveil the potential protective effects of metformin on diabetic neuropathy and explore the mechanisms underlying its action.</p></div><div><h3>Method</h3><p>Six-weeks male Sprague Dawley rats (<em>n</em> = 40) were randomly divided into 5 groups. The rat model of diabetic neuropathy (DN) was established by administering streptozotocin (STZ). To investigate the effects on the sciatic nerve and resident Schwann cells (RSCs), metformin and miR-146a mimics were administered, and our research explored the potential underlying mechanism.</p></div><div><h3>Result</h3><p>The sciatic nerve samples obtained from diabetic rats exhibited noticeable morphological damage, accompanied by decreased miR-146a expression (2.61 ± 0.11 vs 5.0 ± 0.3, <em>p</em> &lt; 0.01) and increased inflammation levels (p65: 1.89 ± 0.04 vs 0.82 ± 0.05, <em>p</em> &lt; 0.01; TNF-α: 0.93 ± 0.03 vs 0.33 ± 0.03, p &lt; 0.01). Notably, the administration of metformin effectively ameliorated the structural alterations in the sciatic nerve by suppressing the inflammatory pathway (p65: 1.15 ± 0.05 vs 1.89 ± 0.04, <em>p</em> &lt; 0.01; TNF-α: 0.67 ± 0.04 vs 0.93 ± 0.03, <em>p</em> &lt; 0.01) and reducing oxidative stress (NO: 0.062 ± 0.004 vs 0.154 ± 0.004umol/mg, <em>p</em> &lt; 0.01; SOD: 3.08 ± 0.09 vs 2.46 ± 0.09 U/mg, p &lt; 0.01). The miR-146a mimics intervention group exhibited comparable findings.</p></div><div><h3>Conclusion</h3><p>This study's findings implied that metformin can potentially mitigate diabetic neuropathy in rats through the modulation of miR-146a expression.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724000631/pdfft?md5=2585500751e9c93b148c0660e5c27001&pid=1-s2.0-S1056872724000631-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for chronic kidney disease in middle eastern patients with type 2 diabetes mellitus: A cross-sectional study using the KDIGO classification","authors":"Randa Farah ,&nbsp;Abdulrahman Alhajahjeh ,&nbsp;Oraib Al-farahid ,&nbsp;Hana Abuzaid ,&nbsp;Dana Hyassat ,&nbsp;Gaith Al-Khuraisat ,&nbsp;Rana Al-Shimi ,&nbsp;Faisal Athamnah ,&nbsp;Ahmad Aldurgham ,&nbsp;Husam Aljabiry ,&nbsp;Kamel Ajlouni","doi":"10.1016/j.jdiacomp.2024.108740","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108740","url":null,"abstract":"<div><h3>Aims</h3><p>Chronic kidney disease (CKD) is prevalent in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate risk factors for CKD progression across the kidney disease-Improving Global Outcomes (KDIGO)categories in a Middle Eastern population beyond hyperglycemia as emphasized by KDIGO guidelines which classifying CKD by cause and severity<strong>.</strong></p></div><div><h3>Methods</h3><p>This cross-sectional study targeted 1603 patients with T2DM. Risk factors for CKD progression were determined using odds ratios (ORs) and 95 % confidence intervals (CIs).</p></div><div><h3>Results</h3><p>Overall, 35.5 %, 31.7 %, and 32.8 % of patients were classified as low-risk, moderate-risk, and high-/very high-/highest-risk, respectively. Several factors were associated with high/very high/highest risk categorization, including being aged &gt;45 years (OR: 1.85, 95 % CI: 1.36–2.49; <em>P</em> &lt; 0.001), male gender (OR: 1.87, 95 % CI: 1.38–2.54; <em>P</em> &lt; 0.001), hypertension (OR: 3.66, 95 % CI: 2.32–5.78; <em>P</em> &lt; 0.001), and T2DM duration of ≥15 years (OR: 3.2, 95 % CI: 2.27–4.5; <em>P</em> &lt; 0.001). Patients with more concurrent risk factors were notably represented in the high/very high/highest risk category.</p></div><div><h3>Conclusions</h3><p>Male patients, older patients, and those with comorbid hypertension, longstanding T2DM, and additional concurrent risk factors have a significantly higher risk of advanced CKD. Such findings should be considered when planning management approaches for patients with CKD.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased glycemic variability results in abnormal differentiation of T cell subpopulation in type 2 diabetes patients","authors":"Qi Sun,&nbsp;Ping Yang,&nbsp;Qing-Wei Gu,&nbsp;Wen-Sa Gu,&nbsp;Wei Wang,&nbsp;Jie Wang,&nbsp;Xiao-Ming Mao","doi":"10.1016/j.jdiacomp.2024.108738","DOIUrl":"10.1016/j.jdiacomp.2024.108738","url":null,"abstract":"<div><h3>Aims</h3><p>We aimed to investigate the association between glycemic variability (GV) and the abnormal differentiation of T-cell subpopulations in patients with type 2 diabetes mellitus (T2DM).</p></div><div><h3>Methods</h3><p>In total, 108 hospitalized patients with T2DM were enrolled and divided into two subgroups (normal glycemic excursion (NGE) and high glycemic excursion (HGE)) according to their mean amplitude of glycemic excursion (MAGE) level. The MAGE was evaluated via continuous glucose monitoring for 72 h consecutively. Flow cytometry was used to determine the proportions of T cell subpopulations.</p></div><div><h3>Results</h3><p>The T helper (Th) 1 cell/Th2 cell ratio was significantly higher, and the proportion of regulatory T cells (Tregs) was significantly lower in the NGE group than in the HGE group (all <em>P</em> &lt; 0.05). After fully adjusting for confounders, the MAGE was positively associated with the Th1 cell/Th2 cell ratio (β = 0.370; <em>P</em> = 0.009) and negatively associated with the proportion of Tregs (β = −0.554; <em>P</em> = 0.001).</p></div><div><h3>Conclusion</h3><p>The MAGE was an independent risk factor for abnormally high Th1 cell/Th2 cell ratio and proportion of Tregs. Abnormal differentiation of T cell subpopulations induced by GV may impair β-cell function, aggravate insulin resistance, and contribute to the development of diabetic complications.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with cognitive performance and cognitive impairment in older adults with type 1 diabetes: Data from the Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) study","authors":"Luciana Mascarenhas Fonseca ,&nbsp;Lauren Kanapka ,&nbsp;Kellee Miller ,&nbsp;Richard Pratley ,&nbsp;Michael R. Rickels ,&nbsp;Shafaq Rizvi ,&nbsp;Yogish C. Kudva ,&nbsp;Ruth S. Weinstock ,&nbsp;Naomi S. Chaytor","doi":"10.1016/j.jdiacomp.2024.108739","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108739","url":null,"abstract":"<div><h3>Background</h3><p>Adults with type 1 diabetes (T1D) are considered at increased risk for cognitive impairment and accelerated brain aging. However, longitudinal data on cognitive impairment and dementia in this population are scarce.</p></div><div><h3>Objective</h3><p>To identify risk factors associated with cognitive performance and cognitive impairment in a longitudinal sample of older adults with T1D.</p></div><div><h3>Methods</h3><p>We analyzed data collected as part of the Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) Study, in which 22 endocrinology practices participated. Randomized participants with T1D ≥60 years of age who completed at least one cognitive assessment were included in this study (<em>n</em> = 203). Cognitive impairment was classified using published recommendations.</p></div><div><h3>Results</h3><p>Older age, male sex, non-private health insurance, worse daily functioning, diagnosis of neuropathy, and longer duration of diabetes were associated with worse cognitive performance, but not cognitive impairment. 49 % and 39 % of the sample met criteria for cognitive impairment at baseline and 52 weeks respectively. Of the participants that had data at both time points, 10 % were normal at baseline and impaired at 52 weeks and 22 % of participants (44 % of those classified with cognitive impairment at baseline) reverted to normal over 52 weeks.</p></div><div><h3>Conclusion</h3><p>This study indicated that several demographic and clinical characteristics are associated with worse cognitive performance in older adults with T1D, but there were no associations between these characteristics and cognitive impairment defined by NIH Toolbox cognitive impairment criteria. Caution is warranted when assessing cognition in older adults with T1D, as a large percentage of those identified as having cognitive impairment at baseline reverted to normal after 52 weeks. There is need for future studies on the interrelationship of cognition and aging to better understand the effects of T1D on cognitive health, to improve clinical monitoring and help mitigate the risk of dementia in this population.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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