Journal of diabetes and its complications最新文献

{"title":"A real-world experience with ranibizumab 0.5 mg initial intensive treatment for diabetic macular edema: 24-week outcomes of the RISING-K study","authors":"Kunho Bae ,&nbsp;Na-Kyung Ryoo ,&nbsp;Yong-Sok Ji ,&nbsp;Jeong Hun Bae ,&nbsp;In Young Chung ,&nbsp;Han Joo Cho ,&nbsp;Junyeop Lee ,&nbsp;Jae Yon Won ,&nbsp;Hyewon Chung ,&nbsp;Younghoon Lee ,&nbsp;Jihyun Park ,&nbsp;Seung-Young Yu","doi":"10.1016/j.jdiacomp.2025.109251","DOIUrl":"10.1016/j.jdiacomp.2025.109251","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of initial intensive ranibizumab 0.5 mg treatment in Korean patients with diabetic macular edema (DME).</div></div><div><h3>Methods</h3><div>This was a multicenter, observational, retrospective study including patients with DME who received an initial intensive treatment, operationally defined as ≥3 ranibizumab 0.5 mg injections within 4 months (including the first dose). Primary outcome was mean change in best-corrected visual acuity (BCVA) at Week 24. Secondary outcomes were mean change in central subfield thickness (CST), intraretinal (IRF) and subretinal fluid (SRF), and diabetic retinopathy severity score (DRSS). Subgroup analyses evaluated these endpoints according to patients with/without prior anti-vascular endothelial growth factor (VEGF) treatment and by fluid compartment.</div></div><div><h3>Results</h3><div>Of total 83 patients (mean age: 63.4 years), 15 (18.1 %) received prior anti-VEGFs. At Week 24, mean BCVA gain from baseline was 5.1 ± 9.3 letters (<em>p</em> &lt; 0.001), 52.5 % and 13.8 % patients had ≥5 and ≥15 letters gain, respectively. Mean CST reduction from baseline was significant (−99.8 ± 122.1 μm; <em>p</em> &lt; 0.001). DRSS improved in 19.2 % patients. BCVA gain showed higher tendency in eyes with prior anti-VEGF exposure (7.1 vs 4.7 letters; <em>p</em> = 0.0873), whereas CST reduction tended to be greater in treatment-naïve eyes (−106.7 vs −68.3 μm; <em>p</em> = 0.3377. All patients had IRF at baseline which disappeared in 29 % patients after 24 weeks resulting in BCVA improvement. At baseline, 23 % patients had SRF, of which 13 % resolved by Week 24. Patients without SRF at baseline had greater BCVA improvement, while patients with SRF at baseline had greater mean CST reduction.</div></div><div><h3>Conclusion</h3><div>Initial intensive treatment with ranibizumab 0.5 mg was effective in both treatment-naïve and prior-treated patients with DME. Functional outcomes varied by prior anti-VEGF treatment and fluid compartment.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 2","pages":"Article 109251"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862443","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":"Ezetimibe attenuates diabetic retinopathy via NRF2-mediated suppression of inflammation and oxidative stress","authors":"Lei Cheng ,&nbsp;Shan Cheng ,&nbsp;Ran Zhu ,&nbsp;Guoxu Xu","doi":"10.1016/j.jdiacomp.2025.109250","DOIUrl":"10.1016/j.jdiacomp.2025.109250","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic retinopathy (DR) is a leading cause of blindness in working-age adults, driven by chronic inflammation and oxidative stress. Ezetimibe (EZE), a lipid-lowering agent, has been shown to activate the NRF2 pathway, but its role in DR remains unexplored. Our study utilized in vitro and in vivo models to investigate the protective effects of EZE on diabetic retinopathy (DR).</div></div><div><h3>Methods</h3><div>ARPE-19 cells were exposed to high glucose (HG, 25 mM) with or without EZE (5–20 μM) and/or ML385 (NRF2 inhibitor). NRF2 nuclear translocation, mitochondrial ROS (mtROS), and inflammatory mediators were assessed by Western blot, Immunofluorescence analysis, qPCR, and flow cytometry. In vivo, streptozotocin-induced diabetic wild-type (WT) and NRF2 knockout (Nrf2 KO) mice were treated with EZE (2 or 10 mg/kg/day) for 4 weeks. Retinal inflammation and structural integrity were evaluated by Western blot, H&amp;E staining, and immunohistochemistry.</div></div><div><h3>Results</h3><div>EZE dose-dependently promoted NRF2 nuclear translocation and reduced HG-induced mtROS, NF-κB activation, and expression of TNF-α, IL-6, MCP-1, COX-2, iNOS, and VEGFA in ARPE-19 cells. These effects were abolished by ML385. In WT diabetic mice, EZE improved fasting glucose, preserved retinal layer thickness, and reduced retinal inflammation. In contrast, EZE failed to exert protective effects in Nrf2 KO mice.</div></div><div><h3>Conclusions</h3><div>EZE exerts retinal protection in DR via NRF2-mediated suppression of oxidative stress and inflammation. These findings support the potential repurposing of EZE as a safe intervention for DR.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 2","pages":"Article 109250"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781233","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":"Diabetic ketoacidosis and hyperosmolar hyperglycemic state in type 2 diabetes patients with severe kidney disease: a 7-year retrospective analysis","authors":"Weiwei Liang ,&nbsp;Haocheng Yu ,&nbsp;Honghua Deng ,&nbsp;Junxin Chen ,&nbsp;Yanglei Cheng ,&nbsp;Zijun Xu ,&nbsp;Yanbing Li ,&nbsp;Hongyu Guan","doi":"10.1016/j.jdiacomp.2025.109253","DOIUrl":"10.1016/j.jdiacomp.2025.109253","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) represent two critical, acute hyperglycemic emergencies that can occur in individuals with diabetes. This study specifically aims to evaluate the in-hospital outcomes of DKA and HHS among patients with type 2 diabetes (T2D) who have severe kidney disease.</div></div><div><h3>Methods</h3><div>We analyzed data from the National Inpatient Sample (2016–2022) to classify adults with T2D and severe kidney disease into three groups: DKA, HHS, and neither. We looked at in-hospital mortality as the primary outcome and assessed complications, length of stay (LOS), and hospitalization costs as secondary outcomes.</div></div><div><h3>Results</h3><div>A total of 4773 admissions had DKA, 2179 had HHS, and 683,079 had neither. DKA was associated with significantly worse outcomes, including higher in-hospital mortality, increased rates of complications, as well as longer hospital stays and higher costs compared to those without DKA or HHS. HHS showed smaller and less consistent differences compared to non-DKA/HHS. It was associated with increased risks of neurologic events, septic shock, and the need for mechanical ventilation. Direct comparison confirmed that DKA imposed a substantially greater clinical and economic burden than HHS.</div></div><div><h3>Conclusions</h3><div>DKA poses a significantly greater risk of in-hospital mortality and complications in T2D with severe kidney disease. This highlights the critical need for targeted prevention and management strategies for DKA in this vulnerable population.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 2","pages":"Article 109253"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788351","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":"Prognostic value of non-alcoholic fatty liver disease, pericoronary fat attenuation index and computed tomography-derived fractional flow reserve in diabetic patients with suspected coronary artery disease","authors":"Ruili Qin ,&nbsp;Changqin Jiang ,&nbsp;Mengnan Zhang ,&nbsp;Xueyan Hou ,&nbsp;Xiaoling Tao ,&nbsp;Shuang Pan ,&nbsp;Zhaoqian Wang","doi":"10.1016/j.jdiacomp.2025.109216","DOIUrl":"10.1016/j.jdiacomp.2025.109216","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the predictive value of non-alcoholic fatty liver disease (NAFLD), pericoronary fat attenuation index (FAI), and computed tomography-derived fractional flow reserve (CT-FFR) for major adverse cardiovascular events (MACE) in diabetic patients with suspected coronary artery disease.</div></div><div><h3>Methods</h3><div>This study retrospectively included 466 diabetic patients who underwent coronary computed tomography angiography (CCTA) and non-contrast chest CT from January 2017 to December 2018. The clinical data and imaging parameters of patients were collected. MACE was defined as rehospitalization for unstable angina, non-fatal myocardial infarction, late coronary revascularization, cardiac death, and all-cause mortality.</div></div><div><h3>Results</h3><div>During a median follow-up of 70 months, 76 patients experienced MACE. NAFLD (hazard ratio [HR] = 2.248; 95 % confidence interval [CI]: 1.362–3.710; <em>P</em> = 0.002), pericoronary FAI &gt; −71.42 HU (HR = 4.063; 95 % CI: 2.316–7.131; <em>P</em> &lt; 0.001), and CT-FFR ≤ 0.80 (HR = 6.023; 95 % CI: 2.567–14.132; <em>P</em> &lt; 0.001) associated with MACE independently. We developed six MACE prediction models: model 1: traditional clinical risk factors; model 2: model 1 + NAFLD; model 3: model 2 + CCTA characteristics; model 4: model 3 + CT-FFR ≤ 0.80; model 5: model 3 + pericoronary FAI &gt; −71.42 HU; model 6: model 5 + CT-FFR ≤ 0.80. The areas under curve of above six models were 0.698, 0.741, 0.861, 0.890, 0.917 and 0.936 respectively.</div></div><div><h3>Conclusions</h3><div>NAFLD, pericoronary FAI, and CT-FFR were independent predictors of MACE in diabetic patients. The multiparametric model 6 demonstrated the optimal predictive performance for MACE.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109216"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512978","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":"Dipeptidyl peptidase-4 inhibitors and diabetic retinopathy in type 2 diabetes: A network meta-analysis of randomized clinical trials","authors":"Amparo Ortiz-Seller ,&nbsp;José Tomás Real ,&nbsp;Esteban Morcillo ,&nbsp;José Luis Ortiz","doi":"10.1016/j.jdiacomp.2025.109234","DOIUrl":"10.1016/j.jdiacomp.2025.109234","url":null,"abstract":"<div><h3>Aims</h3><div>To update evidence on the relationship between dipeptidyl peptidase-4 (DPP-4) inhibitors and incident diabetic retinopathy (DR) in type 2 diabetes.</div></div><div><h3>Methods</h3><div>We searched Embase, PubMed, Web of Science, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (to July 2025) for randomized controlled trials (RCTs) and pooled odds ratios (ORs) with 95 % credible intervals (CrIs) using a Bayesian network meta-analysis. Network meta-regression assessed estimated effect modification; a model-based network meta-analysis (MBNMAdose) evaluated dose–response. Evidence certainty was appraised with Confidence in Network Meta-Analysis (CINeMA).</div></div><div><h3>Results</h3><div>Forty-three trials (74,546 participants; 779 DR events) were analyzed. No DPP-4 inhibitor significantly changed the DR risk versus placebo (ORs ranged from 0.31 [omarigliptin] to 2.31 [saxagliptin]; all CrIs crossed 1.0). Rankings suggested omarigliptin as most favorable, alogliptin/linagliptin/sitagliptin intermediate, and saxagliptin/teneligliptin least favorable. Baseline DR incidence moderated treatment effects; other prespecified covariates were not significant. MBNMAdose showed no dose-response relationship for DR.</div></div><div><h3>Conclusions</h3><div>Current randomized evidence indicates class-level neutrality of DPP-4 inhibitors on DR incidence, with no dose–response signal. Choice among gliptins may therefore be guided primarily by glycemic efficacy, safety, and participant characteristics rather than retinal risk.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109234"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615023","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":"Empagliflozin versus metformin for glucose variability and metabolic outcomes in drug-naïve type 2 diabetes: The EMPA-FIT study","authors":"Soo Lim ,&nbsp;Cheol Young Park ,&nbsp;In Kyung Jeong ,&nbsp;Ji Sung Yoon ,&nbsp;Sang Yong Kim ,&nbsp;Eun Seok Kang ,&nbsp;Junghyun Noh ,&nbsp;Kyu Yeon Hur ,&nbsp;Sungrae Kim","doi":"10.1016/j.jdiacomp.2025.109214","DOIUrl":"10.1016/j.jdiacomp.2025.109214","url":null,"abstract":"<div><h3>Aims</h3><div>Sodium-glucose cotransporter-2 (SGLT2) inhibitors offer cardiovascular and renal benefits beyond glycemic control. However, their effect on glucose variability (GV) in drug-naïve individuals with type 2 diabetes (T2D) is not well established. This study compared the effects of empagliflozin versus metformin on GV and metabolic outcomes.</div></div><div><h3>Methods</h3><div>In this multicenter, open-label, randomized study, 46 drug-naïve adults with T2D (HbA1c 6.5 %–10.0 %) received empagliflozin (10 mg/day; <em>n</em> = 23) or metformin (1000 mg/day; <em>n</em> = 23) for 12 weeks. The primary outcome was change in mean amplitude of glucose excursions (MAGE), assessed by continuous glucose monitoring. Secondary outcomes included standard deviation of glucose, time-in-range (TIR), metabolic parameters, and safety.</div></div><div><h3>Results</h3><div>At Week 12, empagliflozin significantly reduced MAGE (−19.58 mg/dL; 95 % CI: −30.62, −8.53) compared with metformin (−4.33 mg/dL; 95 % CI: −7.98, −0.68) (<em>n</em> = 19 vs. <em>n</em> = 18, respectively). TIR improved in both groups, with no significant between-group differences. Empagliflozin treatment led to greater reductions in body weight and waist circumference, along with increases in HDL-cholesterol and decreases in triglyceride and uric acid levels. The decrease in HbA1c from baseline was greater in the empagliflozin group (−1.15 % [95 % CI: −1.44, −0.85]) than in the metformin group (−0.78 % [95 % CI: −1.02, −0.54]), resulting in a statistically significant between-group difference (<em>p</em> = 0.049). Adverse events were mild and comparable between groups.</div></div><div><h3>Conclusions</h3><div>Empagliflozin significantly reduced GV and provided additional metabolic benefits in drug-naïve individuals with T2D. These findings support its potential utility in early diabetes management, particularly in targeting glycemic variability.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109214"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505024","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":"Baseline NT-proBNP and incident heart failure in type 1 diabetes: The epidemiology of diabetes complications study","authors":"William B. Horton ,&nbsp;Mitra Mosslemi ,&nbsp;Maria Sanchez Valenzuela ,&nbsp;Rachel G. Miller ,&nbsp;Trevor J. Orchard ,&nbsp;Tina Costacou","doi":"10.1016/j.jdiacomp.2025.109235","DOIUrl":"10.1016/j.jdiacomp.2025.109235","url":null,"abstract":"<div><div>This study investigated whether NT-proBNP values were associated with long-term heart failure (HF) incidence in people with type 1 diabetes. Our results showed continuous lnNT-proBNP was significantly associated with 10-year HF risk, while the guideline-recommended threshold NT-proBNP ≥125 ng/L was not, in the Epidemiology of Diabetes Complications Study.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109235"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648662","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":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(25)00296-X","DOIUrl":"10.1016/S1056-8727(25)00296-X","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109243"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733441","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":"Effect of the PPARG rs1801282 polymorphism on weight reduction and metabolic syndrome outcomes in obese individuals undergoing a partial meal replacement hypocaloric diet","authors":"Daniel de Luis,&nbsp;Olatz Izaola,&nbsp;David Primo,&nbsp;Daniel Rico,&nbsp;Juan Jose López","doi":"10.1016/j.jdiacomp.2025.109209","DOIUrl":"10.1016/j.jdiacomp.2025.109209","url":null,"abstract":"<div><h3>Background and aims</h3><div>No studies to date have specifically evaluated the effect of the <em>rs1801282</em> polymorphism on body weight loss. This study evaluates the role of the PPARG <em>rs1801282</em> polymorphism in modulating body weight loss and cardiovascular risk factor improvements in response to a partial meal replacement (pMR) hypocaloric diet among Caucasian patients with obesity.</div></div><div><h3>Methods</h3><div>A total of 512 subjects with severe obesity, defined by a body mass index (BMI) exceeding 35 kg/m², were recruited for the study. Each participant was instructed to follow a pMR hypocaloric diet a 12-week intervention period. Throughout the trial, comprehensive assessments were performed, including anthropometric parameters (body weight, BMI, fat mass, and waist circumference), blood pressure, biochemical profiling (lipid concentrations, fasting insulin levels, and calculation of the homeostatic model assessment of insulin resistance (HOMA-IR)) and Metabolic syndrome (MS).</div></div><div><h3>Results</h3><div>The cohort included 107 individuals (20.9 %) homozygous for the CC allele, 203 individuals (39.6 %) heterozygous (CG), and 202 individuals (39.5 %) homozygous for the GG allele. BMI (−2.3 ± 0.3 kg/m² vs − 1.0 ± 0.1 kg/m² (p = 0.01)), body weight (−9.0 ± 1.1 kg vs − 3.8 ± 2.1 kg (p = 0.01)), fat mass (−8.1 ± 0.2 kg vs − 2.8 ± 0.2 kg (p = 0.01)), waist circumference (−6.8 ± 0.1 cm vs − 5.1 ± 0.1 cm (p = 0.01)), glucose levels (−15.1 ± 1.9 mg/dl vs − 4.1 ± 2.8 mg/dl, p = 0.01), insulin (−9.8 ± 1.3 UI/L vs − 3.7 ± 2.1 UI/L, p = 0.01), HOMA-IR (−2.2 ± 1.0 units vs − 0.60 ± 0.2 units, p = 0.01), CRP (−1.3 ± 0.1 mg/dl vs − 0.2 ± 0.2 mg/dl, p = 0.01), triglycerides (−24.1 ± 3.3 mg/dl vs − 4.1 ± 3.2 mg/dl, p = 0.01), total-cholesterol (−23.2 ± 1.1 mg/dl vs − 8.9 ± 1.2 mg/dl, p = 0.01), LDL-cholesterol (−17.2 ± 1.2 mg/dl vs − 5.7 ± 1.1 mg/dl, p = 0.01), and HDL-cholesterol (8.2 ± 0.3 mg/dl vs 2.3 ± 1.2 mg/dl, p = 0.01) modifications were better in non-G allele carriers. After intervention, the odds ratio (OR) of MS in non-carrier of G allele improved OR 0.39 (95 %CI: 0.24–0.63; p = 0.02).</div></div><div><h3>Conclusions</h3><div>This study shows that the PPARG rs1801282 polymorphism modulates the response to pMR in Caucasian patients with obesity, with G allele carriers displaying a less favourable improvement in body weight and metabolic parameters.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109209"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563924","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":"Associations of modifiable lifestyle and clinical factors with cognitive function in adults with type 2 diabetes","authors":"Anahita Golchin ,&nbsp;Karen C. Johnson ,&nbsp;Denise K. Houston ,&nbsp;Jose A. Luchsinger ,&nbsp;Kristen M. Beavers ,&nbsp;Alain G. Bertoni ,&nbsp;Haiying Chen ,&nbsp;Lynne Wagenknecht ,&nbsp;Mark A. Espeland ,&nbsp;for the Action for Health in Diabetes (Look AHEAD) Aging Study Group","doi":"10.1016/j.jdiacomp.2025.109227","DOIUrl":"10.1016/j.jdiacomp.2025.109227","url":null,"abstract":"<div><h3>Aims</h3><div>Type 2 diabetes and obesity accelerate cognitive decline. Maintaining salutary levels of multiple lifestyle and clinical risk factors might be expected to protect against this. We examined whether healthier levels of adiposity, cardiorespiratory fitness, physical activity, and diabetes control were associated with better cognitive functioning.</div></div><div><h3>Methods</h3><div>Data are from the Action for Health in Diabetes clinical trial of adults with type 2 diabetes and overweight or obesity. Standardized measures of body mass indices, percent body fat, objective and self-reported physical activity, cardiorespiratory fitness, and HbA1c were collected across 4 and 8 years. Associations between healthier versus less healthy levels (categorized based on ± one standard deviation from the cohort mean) of these measures with subsequent standardized (z-scores) assessments of cognitive function were assessed using linear regression.</div></div><div><h3>Results</h3><div>Among 3723 participants, high versus low cardiorespiratory fitness was associated with 0.08 to 0.13 standard deviation better global cognitive function, executive function, and attention (<em>p</em> &lt; 0.001). Lower versus high HbA1c was associated with 0.17 to 0.22 standard deviation better cognitive function for all domains (p &lt; 0.001). Associations that fitness and HbA1c had with cognitive function were independent and additive. No significant associations with cognitive function were found for physical activity or adiposity.</div></div><div><h3>Conclusions</h3><div>Maintaining greater cardiorespiratory fitness and better diabetes control may protect cognitive function in type 2 diabetes.</div></div><div><h3><span><span><strong>ClinicalTrials.gov</strong></span><svg><path></path></svg></span> <strong>Identifier</strong></h3><div><span><span>NCT00017953</span><svg><path></path></svg></span></div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109227"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518129","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}