Journal of diabetes and its complications最新文献

{"title":"Degludec insulin versus efsitora insulin in diabetes mellitus management: A systematic review and meta-analysis","authors":"Helen Michaela de Oliveira ,&nbsp;Mariano Gallo Ruelas ,&nbsp;Victor Hugo Palhares Flávio-Reis ,&nbsp;Ivo Queiroz ,&nbsp;Deivyd Vieira Silva Cavalcante ,&nbsp;Lucas Mendes Barbosa ,&nbsp;Fernanda Valeriano Zamora","doi":"10.1016/j.jdiacomp.2025.109115","DOIUrl":"10.1016/j.jdiacomp.2025.109115","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the efficacy and safety of next-generation basal insulin efsitora versus insulin degludec in managing type 1 and type 2 diabetes.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, and CENTRAL databases until October 2024. This study followed PRISMA guidelines. Statistical analyses were performed using R version 4.4.1. The risk of bias was assessed using the RoB2 tool, and the quality of evidence was evaluated using the GRADE approach. This study was registered in PROSPERO under protocol CRD42024597806.</div></div><div><h3>Results</h3><div>Six randomized controlled trials involving 2590 patients were included in the analysis. Of these, 1376 (53.13 %) received efsitora insulin. No significant differences were observed between efsitora and degludec in glycemic efficacy outcomes, including HbA1c reduction, fasting blood glucose, weight change, and proportion of patients achieving HbA1c &lt;7 %. Regarding safety outcomes, most endpoints, such as adverse events, injection site reactions, hypersensitivity, severe hypoglycemia, and mortality, were comparable between groups, with no significant subgroup effects. However, subgroup analysis revealed a lower incidence of nocturnal hypoglycemia with efsitora in patients with type 2 diabetes, and a higher rate of serious adverse events in patients with type 1 diabetes, suggesting potential population-specific differences in safety profiles.</div></div><div><h3>Conclusion</h3><div>Efsitora and degludec insulins show similar overall efficacy and safety in the management of diabetes. However, subgroup analyses indicate that patient-specific factors, such as diabetes type, may influence the risk of certain adverse events. These findings support the importance of individualized insulin selection based on patient characteristics and risk profiles.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109115"},"PeriodicalIF":2.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571010","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":"Evaluation of IDx-DR software for diabetic retinopathy screening in outpatient clinics: Efficacy, safety, and feasibility in a real-world setting","authors":"Simone Leonora Huber ,&nbsp;Verena Parzer ,&nbsp;Bernhard Ludvik ,&nbsp;Andreas Pollreisz ,&nbsp;Nikolaus Mahnert ,&nbsp;Johanna Maria Brix","doi":"10.1016/j.jdiacomp.2025.109120","DOIUrl":"10.1016/j.jdiacomp.2025.109120","url":null,"abstract":"<div><h3>Aims</h3><div>This study assessed the IDx-DR software's effectiveness as a diabetic retinopathy (DR) screening tool in a routine outpatient setting. It also evaluated the software's safety and feasibility.</div></div><div><h3>Methods</h3><div>RA prospectively planned analysis of patients with diabetes was conducted at the diabetes outpatient clinic of a specialized tertiary care center from March 2021 to October 2022. These patients underwent retinal imaging with IDx-DR during routine visits.</div></div><div><h3>Results</h3><div>The majority of the 996 included patients were female (53.1 %), and the median age was 61.1 years. Notably, 40.2 % had a BMI ≥ 30 kg/m², and 35.8 % were active smokers. DR was detected by IDx-DR in n = 178 (26 %) of patients. 73.1 % of those patients were newly diagnosed with retinopathy without any history of retinopathy in the medical history (p &lt; 0.001). DR patients were older (median 60.4 vs 57.5 years; p = 0.050), had higher HbA1c levels (7.0 % vs. 7.6 %; p &lt; 0.001) and a higher frequency of ophthalmologic check-ups (p = 0.015). In multiple binary logistic regression, use of insulin (OR = 1.735 [1.096; 2.748], p = 0.19) and diabetes duration (medium vs. short: OR = 2.356 [1.36; 4.07], p = 0.002, long vs. short: OR = 1.776 [1.03; 3.06], p = 0.39) independently predicted DR, while age and sex were not significant predictors.</div></div><div><h3>Conclusions</h3><div>This study supports integrating AI tools like IDx-DR in DR screening. It highlights IDx-DR's utility and efficacy in improving DR detection and patient care, suggesting its potential for broader, cost-effective screening in Austria and possibly elsewhere.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109120"},"PeriodicalIF":2.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579475","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":"Association of aortic pulse wave velocity with cardiovascular outcomes and all-cause mortality in diabetes: A systematic review and meta-analysis","authors":"Ziyue Zhang ,&nbsp;Rongpei Yang ,&nbsp;Wen Wu ,&nbsp;Zhen Wang","doi":"10.1016/j.jdiacomp.2025.109118","DOIUrl":"10.1016/j.jdiacomp.2025.109118","url":null,"abstract":"<div><h3>Aims</h3><div>Patients with diabetes have experienced excess cardiovascular (CV) diseases. Accurate prediction of CV risk has been one of the ultimate tasks of contemporary diabetology. Aortic stiffness (AS), a key indicator of vascular health, has been increasingly considered as a valuable biomarker for CV risk and mortality prediction. We sought to investigate and calculate the predictive value of AS measured by pulse wave velocity (PWV) for cardiovascular CV events and/or all-cause mortality for patients with diabetes.</div></div><div><h3>Methods</h3><div>A comprehensive search was carried out in the PubMed, Embase, and Cochrane Library up to 11 June 2024. We included observational studies where investigators reported the association of PWV with CV events or all-cause mortality in patients with diabetes. Newcastle-Ottawa Quality Assessment Scale was used for quality assessment. Information about study design, participant demographics, baseline characteristics, hazard ratio (HR) and so on were extracted from study documents. Heterogeneity among studies was assessed by using the I² statistic. Acceptable levels of heterogeneity were defined as I² &lt; 75 %. Fixed-effects model (Inverse Variance) was utilized for synthesis when I² &lt; 50 %, and a random-effects model (DerSimonian-Laird) was used when I² &gt; 50 %. Visual inspection of funnel plots, Egger's test and Begg's test were used to evaluate the existence of publication bias. Trim-and-fill method was further used to identify and adjust for publication bias.</div></div><div><h3>Results</h3><div>We included 12 studies. For each 1 m/s increase in cfPWV in diabetes population, the risk of a CV events increased by 7 % [HR 1.07, 95%CI 1.02–1.12, 3132 subjects, random-effects model], and the risk of all-cause mortality increased by 7 % [HR 1.07, 95%CI 1.03–1.12, 1700 subjects, fixed-effects model]. Diabetic patients with higher cfPWV had a 1.71-fold increased risk of CV events compared with those with lower cfPWV [HR 1.71, 95%CI 1.22–2.40, 2075 subjects, random-effects model]. Since different studies may have used different modeling methods, we performed a quantitative synthesis for each modeling method separately, which consequently led to variations in subjects sizes.</div></div><div><h3>Conclusions</h3><div>Despite certain limitations of this study, such as heterogeneity, our findings indicate that PWV could be a strong predictor of future CV events and all-cause mortality in patients with diabetes.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109118"},"PeriodicalIF":2.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548694","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":"Low imaging-detected muscle mass as a prognostic factor for overall and amputation-free survival in patients undergoing lower extremity amputation","authors":"Elli Kykkänen ,&nbsp;Ilkka Kaartinen ,&nbsp;Otso Arponen ,&nbsp;Miska Vuorlaakso","doi":"10.1016/j.jdiacomp.2025.109119","DOIUrl":"10.1016/j.jdiacomp.2025.109119","url":null,"abstract":"<div><h3>Background</h3><div>Amputations and sarcopenia are both increasing globally. This study investigates the association between imaging-detected muscle mass and outcomes after lower extremity amputation.</div></div><div><h3>Methods</h3><div>The sample population included patients undergoing amputation with abdominal computed tomography (CT) scans. The psoas muscle index (PMI) and skeletal muscle index (SMI) were evaluated at the level of the 3rd lumbar vertebra. Overall survival (OS) and amputation-free survival (AFS) were evaluated.</div></div><div><h3>Results</h3><div>A total of 72 patients (mean age: 66.4 ± 18.5 years) were evaluated in the study. Lower PMI and SMI were associated with decreased OS (PMI/SMI: HR 4.120, 95 % confidence interval [CI]: 1.692–10.032/HR 2.487, 95 % CI: 1.091–5.666) and AFS after the first amputation (PMI/SMI: HR 3.561, 95 % CI: 0.938–13.516/HR 3.982, 95 % CI: 1.080–14.677) in univariate models. Low PMI and SMI remained significant in multivariable models adjusted for age, sex, and amputation level.</div></div><div><h3>Conclusions</h3><div>Imaging-detected low muscle mass is associated with impaired OS and AFS in patients undergoing lower extremity amputation. Evaluation of muscle mass from available CT scans may provide useful information for clinical decision-making.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109119"},"PeriodicalIF":2.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536218","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":"Letter to the editor regarding “High rate of complications in a real-world cohort of youth with T2D: a multicenter analysis”","authors":"Rachana Mehta ,&nbsp;Ranjana Sah","doi":"10.1016/j.jdiacomp.2025.109117","DOIUrl":"10.1016/j.jdiacomp.2025.109117","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109117"},"PeriodicalIF":2.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536219","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":"Association of tirzepatide with erectile dysfunction in people with type 2 diabetes","authors":"Kevin Cowart ,&nbsp;Christopher Murphy ,&nbsp;Nicholas Carris","doi":"10.1016/j.jdiacomp.2025.109116","DOIUrl":"10.1016/j.jdiacomp.2025.109116","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the association between tirzepatide and the risk of developing erectile dysfunction (ED) in men with type 2 diabetes (T2D), compared with sitagliptin, injectable semaglutide, and dulaglutide.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used the TriNetX global health research network from May 13, 2022 to May 17, 2025. Male patients aged 18–70 with T2D and no prior ED were included. Three 1:1 propensity score-matched comparisons were conducted: tirzepatide vs. sitagliptin, injectable semaglutide, or dulaglutide. The outcome was a diagnosis of ED or prescription of a PDE-5 inhibitor.</div></div><div><h3>Results</h3><div>Tirzepatide was associated with a significantly reduced risk of ED across all comparisons. Risk ratios (RR) for the composite outcome of ED diagnosis or PDE-5 inhibitor use were: tirzepatide vs. sitagliptin: RR, 0.70 (95 % CI: 0.64,0.76); tirzepatide vs. injectable semaglutide: RR, 0.67 (95 % CI: 0.62,0.72); tirzepatide vs. dulaglutide: RR, 0.55 (95 % CI: 0.51,0.59). All comparisons were statistically significant (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Tirzepatide was associated with a lower risk of ED in men with T2D compared to sitagliptin, injectable semaglutide, and dulaglutide. Randomized trials are needed to confirm these findings and explore potential mechanisms.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109116"},"PeriodicalIF":2.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548692","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":"Beneficial effects of SGLT-2 inhibitors on cardiac autonomic function: surprises never end!","authors":"Dimitrios Patoulias ,&nbsp;Paschalis Karakasis ,&nbsp;Imran Rangraze ,&nbsp;Mohamed El-Tanani ,&nbsp;Manfredi Rizzo","doi":"10.1016/j.jdiacomp.2025.109113","DOIUrl":"10.1016/j.jdiacomp.2025.109113","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 10","pages":"Article 109113"},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564825","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":"Heterogeneity of treatment effects of glucose-lowering drug classes for type 2 diabetes: LEGEND-T2DM network real-world evidence","authors":"David M. Dávila-García ,&nbsp;Thomas Falconer ,&nbsp;Nicole Pratt ,&nbsp;Karthik Natarajan ,&nbsp;George Hripcsak","doi":"10.1016/j.jdiacomp.2025.109114","DOIUrl":"10.1016/j.jdiacomp.2025.109114","url":null,"abstract":"<div><h3>Aims</h3><div>To assess heterogeneity of treatment effects (HTE) of glucose-lowering drug classes by clinical (cardiovascular [CV] risk, renal impairment) and demographic (age, sex) subgroups in adults with type 2 diabetes mellitus (T2D).</div></div><div><h3>Methods</h3><div>The LEGEND-T2DM network identified 4,746,939 adults with T2D on metformin monotherapy who initiated one of four glucose-lowering drug classes: glucagon-like peptide-1 receptor agonists (GLP-1 RA), sodium-glucose cotransporter 2 inhibitors (SGLT2i), dipeptidyl peptidase-4 inhibitor (DPP-4i) or sulfonylureas. HTE was assessed between glucose-lowering drug classes by clinical (low CV risk vs. higher CV risk; without renal impairment vs. renal impairment) and demographic (lower vs. middle vs. older age; male vs. female) subgroups. Outcomes included MACE (primary), acute myocardial infarction, stroke, sudden cardiac death and safety endpoints.</div></div><div><h3>Results</h3><div>Pairwise differences (<em>n</em> = 1115 tests) between adjusted hazard ratios (HRs) showed 49 nominally significant associations (<em>p</em> &lt; 0.05) and one statistically significant difference after Bonferroni correction (<em>p</em> &lt; 4.5 × 10⁻⁵). Among older subjects (vs. younger), those taking GLP-1 RA (vs. sulfonylureas) had statistically significant difference in risk of hypoglycemia (HRs: lower age, 0.53 ± 0.14 vs. older age, 0.20 ± 0.05, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>HTE among glucose-lowering drug classes by clinical and demographic subgroups may provide guidance to generate hypothesis-testing studies to inform T2D treatment decisions.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109114"},"PeriodicalIF":2.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502148","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":"DNA repair and inflammatory response genes play a central role in protecting patients with long-standing type 1 diabetes from vascular complications","authors":"Türküler Özgümüş ,&nbsp;Oksana Sulaieva ,&nbsp;Most Champa Begum ,&nbsp;Ola Ekström ,&nbsp;Ruchi Jain ,&nbsp;Peter Nilsson ,&nbsp;Kari Anne Sveen ,&nbsp;Tore Julsrud Berg ,&nbsp;Valeriya Lyssenko","doi":"10.1016/j.jdiacomp.2025.109112","DOIUrl":"10.1016/j.jdiacomp.2025.109112","url":null,"abstract":"<div><h3>Aims</h3><div>Individuals with type 1 diabetes (T1D) are typically diagnosed at a young age and exposed to lifelong hyperglycaemia. Despite improved metabolic control, the risk of vascular complications remains challenging. However, some individuals remain free from developing major diabetic complications even after long duration, so-called “escapers”. This study investigated transcriptomic biomarkers linked to protection from microvascular complications in the Dialong cohort of long-standing T1D.</div></div><div><h3>Methods</h3><div>Differential gene expression analysis was conducted to identify differences between patients with long-term T1D without complications (non-progressors), those with vascular complications (progressors), and healthy controls without T1D.</div></div><div><h3>Results</h3><div>Among the differentially expressed genes, <em>HERC2</em>, <em>S1PR3</em>, <em>RNASE3</em>, and <em>CD33</em> were significantly altered between non-progressors and progressors. Functional annotation analyses identified the strongest mechanisms across all groups to be linked to post-translational protein modification, such as Lys-Gly isopeptide bond involved in SUMOylation (p = 5e-17) - a biological process of covalent attachment and detachment of SUMO (Small Ubiquitin-like Modifier) small proteins to modify protein function. The second-ranked pathway was enrichment of DNA repair/damage (p = 6e-5), cell cycle and division (p = 4e-4), and immune response genes (p = 1e-7).</div></div><div><h3>Conclusions</h3><div>These findings underscore the role of post-translational protein modifications, DNA repair pathways and immune tolerance in protecting long-standing T1D patients from vascular complications.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109112"},"PeriodicalIF":2.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470793","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":"A mediation analysis assessing if interleukin-6 mediates the association between obesity and new-onset type-2-diabetes","authors":"Nicholas W. Carris ,&nbsp;Rahul Mhaskar ,&nbsp;Emily Coughlin ,&nbsp;Easton Bracey ,&nbsp;Hariom Yadav ,&nbsp;Ganesh V. Halade ,&nbsp;Matthew J. Valente","doi":"10.1016/j.jdiacomp.2025.109110","DOIUrl":"10.1016/j.jdiacomp.2025.109110","url":null,"abstract":"<div><div>Obesity and chronic low-level inflammation increase chronic disease development. The study objective was to better understand how obesity is linked to inflammation and inflammation to new-onset type-2-diabetes. This observational mediation analysis found that 8.1 % of the total effect of increasing BMI on new-onset type-2-diabetes risk was mediated by interleukin-6.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109110"},"PeriodicalIF":2.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502149","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}