Yaffa Ein-Gal , Genya Aharon-Hananel , Tal Sigawi , Omer Hamtzany , Itamar Raz , Avivit Cahn
{"title":"A national quality survey of in-patient diabetic foot care calls for centralizing care and improving patient communication","authors":"Yaffa Ein-Gal , Genya Aharon-Hananel , Tal Sigawi , Omer Hamtzany , Itamar Raz , Avivit Cahn","doi":"10.1016/j.jdiacomp.2025.109088","DOIUrl":"10.1016/j.jdiacomp.2025.109088","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the quality of inpatient care for patients with diabetic foot ulcers (DFU) and examine the relationship between managerial awareness of quality indicators and the actual care provided, as documented in the electronic medical records (EMRs).</div></div><div><h3>Methods</h3><div>A peer-reviewed audit of inpatient DFU care based on interviews with hospital and department management, yielding a comprehensive management score for each hospital; review of electronic medical records (EMR); and patient interviews. Data regarding facilities and personnel were collected as well.</div></div><div><h3>Results</h3><div>Data was collected from 26 hospitals, 199 EMR and 86 patient interviews. Larger hospital size was correlated with higher comprehensive management scores (<em>p</em> = 0.008). Moreover, large hospitals were more likely to have dedicated DFU cohorts thus simplifying provision of multidisciplinary state-of-the-art care (<em>p</em> = 0.034). Committed managers were more likely to dedicate surgical sessions to DFU patients, mean (±SD) comprehensive management score of 95.9 ± 3.4 in hospitals with dedicated session vs. 79.7 ± 9.6 in those without (<em>p</em> < 0.001). Hospitals with committed management had better documentation and more prevalent use of correct diagnostic codes (<em>r</em> = 0.542), while higher dedication of head nurses of the DFU departments was significantly correlated with higher scores in inpatient care and patient education (<em>r</em> = 0.509, 0.826 respectively). Overall, patient communication and shared decision-making scored relatively low with only 78.8 % of the patients interviewed noting satisfaction.</div></div><div><h3>Conclusions</h3><div>Large hospitals were more likely to deliver high-quality multidisciplinary care, pivotal to the care of DFU patients. Dedicated management teams strongly impact better delivery of care. Better communication and shared decision-making should be reinforced.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109088"},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213121","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}
Dhruva Patel , Amy S. Shah , Bliss Magella , Mozhdeh Bahrainian , Elizabeth A. Brown , T.Y. Alvin Liu , Veeral Shah , Roomasa Channa , Risa M. Wolf
{"title":"High rate of complications in a real-world cohort of youth with T2D: a multicenter analysis","authors":"Dhruva Patel , Amy S. Shah , Bliss Magella , Mozhdeh Bahrainian , Elizabeth A. Brown , T.Y. Alvin Liu , Veeral Shah , Roomasa Channa , Risa M. Wolf","doi":"10.1016/j.jdiacomp.2025.109091","DOIUrl":"10.1016/j.jdiacomp.2025.109091","url":null,"abstract":"<div><h3>Introduction</h3><div>The TODAY2 study reported that 80 % of young adults with youth-onset T2D (YoT2D) had at least one diabetes comorbidity or complication at a mean duration of 13 years. Prevalence rates of comorbidities and microvascular complications in YoT2D with shorter duration and younger age is unclear, particularly in the age of new pharmacotherapies.</div></div><div><h3>Methods</h3><div>In a multicenter retrospective analysis, presence of comorbidities (hypertension (systolic BP > 130 or diastolic BP > 80), dyslipidemia (LDL > 130 mg/dL or triglycerides>150 mg/dL), elevated liver enzymes (AST > 25 U/L, or ALT U/L > 22 for females or >26 U/L for males)) and microvascular complications (microalbuminuria (microalbumin/creatinine ratio > 30), diabetic retinopathy) in patients with YoT2D at three academic pediatric diabetes centers were assessed. Ordinal logistic regression models assessed the associations between demographic and clinical variables and increased odds of either comorbidities or complications.</div></div><div><h3>Results</h3><div>The study included 298 youth (median age 16.6 years, 60 % female, 57 % Black, 14 % Hispanic). The median duration of T2D was 1.8 years, median HbA1c was 6.9 % (42 % had an HbA1c < 6.5 %). Over 80 % of patients had at least 1 comorbidity, 29 % with hypertension, 49 % with dyslipidemia, and 56 % with elevated liver enzymes. In the cohort, 21 % had at least 1 microvascular complication, 17 % with microalbuminuria, and 4.6 % with diabetic retinopathy. Proportion using GLP-1 receptor agonists and SGLT-2 inhibitors were 36 % and 7 %, respectively. Higher HbA1c and BMI increased the odds of having an additional comorbidity or complication, and longer diabetes duration increased the odds of having microvascular complications.</div></div><div><h3>Conclusions</h3><div>This study found comorbidities and microvascular complications in YoT2D at younger ages and short duration of diabetes despite use of new medications. Efforts are needed to improve glycemic control and other risk factors to reduce diabetes-related complications in YoT2D.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109091"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470751","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}
Jimena Soto-Hernaez , Rory J. McCrimmon , Ewan R. Pearson , Enrique Soto-Pedre
{"title":"Real-world initiation of continuous glucose monitoring (CGM) in adults with type 1 diabetes leads to increased body mass index - A brief report from IMI-SOPHIA study","authors":"Jimena Soto-Hernaez , Rory J. McCrimmon , Ewan R. Pearson , Enrique Soto-Pedre","doi":"10.1016/j.jdiacomp.2025.109089","DOIUrl":"10.1016/j.jdiacomp.2025.109089","url":null,"abstract":"<div><div>Continuous glucose monitoring (CGM) has beneficial effects on glycaemic control in adults with type 1 diabetes (T1D), but the potential effects on body mass index (BMI) remain unclear. This study underscores a trend of increasing BMI within two years after CGM initiation.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109089"},"PeriodicalIF":2.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147610","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}
Fernando Sebastian-Valles , Alberto Santiago-Redondo , Elena García-Artacho , Miguel Antonio Sampedro-Nuñez , Victor Navas-Moreno , Jose Alfonso Arranz Martín , Mónica Marazuela
{"title":"Impact of remnant cholesterol and triglycerides on diabetes foot and disease in type 1 diabetes: A propensity score-matched case-control study","authors":"Fernando Sebastian-Valles , Alberto Santiago-Redondo , Elena García-Artacho , Miguel Antonio Sampedro-Nuñez , Victor Navas-Moreno , Jose Alfonso Arranz Martín , Mónica Marazuela","doi":"10.1016/j.jdiacomp.2025.109082","DOIUrl":"10.1016/j.jdiacomp.2025.109082","url":null,"abstract":"<div><h3>Objective</h3><div>Remnant cholesterol is an emerging cardiovascular risk factor; however, its impact on diabetes foot disease (DFD) remains poorly studied. This study evaluates the association between dyslipidaemia and DFD in a cohort of individuals with type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>A nested case–control study was conducted within a cohort of 419 individuals with T1D. DFD was defined as a history of peripheral arterial disease—such as prior lower limb revascularization or vascular-origin amputations—or as the presence of diabetic foot according to the Wagner classification. Clinical and sociodemographic data were collected, and a 1:2 propensity score matching was performed based on age, sex, diabetes duration, smoking status, HbA1c, diabetic retinopathy, and nephropathy. Conditional logistic regression models were used to evaluate the association between dyslipidemia and DFD, adjusting for confounding variables.</div></div><div><h3>Results</h3><div>Of the 419 subjects, 56 (13.4 %) had DFD. After matching, 17 subjects were excluded, leaving 39 cases and 78 controls (<em>n</em> = 117). The mean age was 61.6 ± 14.3 years, 40.2 % were women, and the mean diabetes duration was 30.0 ± 14.4 years. Remnant cholesterol was significantly higher in cases (22 ± 10 mg/dL vs. 17 ± 11 mg/dL, <em>p</em> = 0.038), as were triglycerides (111 ± 49 mg/dL vs. 90 ± 65 mg/dL, <em>p</em> = 0.005). In multivariable analysis, remnant cholesterol (OR = 1.15, 95 % CI [1.03–1.27]) and triglycerides (OR = 1.03, 95 % CI [1.01–1.05]) were independently associated with DFD.</div></div><div><h3>Conclusion</h3><div>Remnant cholesterol and triglycerides are associated with DFD in individuals with long-standing T1D and high cardiovascular risk. Prospective studies are needed to confirm these findings.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109082"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124026","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}
Michael A. Überall , Zoltan Kender , Tamara Quandel , Sylvia Engelen , Lucia Garcia Guerra , Tawfik Fajri , Samuel M. Allen , Rita L. Freitas , Mariëlle H. Eerdekens
{"title":"Progressive improvements in patient-reported outcomes with the high-concentration capsaicin patch: A retrospective cohort study in patients with painful diabetic peripheral neuropathy (CASPAR study)","authors":"Michael A. Überall , Zoltan Kender , Tamara Quandel , Sylvia Engelen , Lucia Garcia Guerra , Tawfik Fajri , Samuel M. Allen , Rita L. Freitas , Mariëlle H. Eerdekens","doi":"10.1016/j.jdiacomp.2025.109085","DOIUrl":"10.1016/j.jdiacomp.2025.109085","url":null,"abstract":"<div><h3>Objective</h3><div>To assess long-term outcomes and tolerability associated with repeated topical high-concentration capsaicin patch (HCCP) treatments in painful diabetic peripheral neuropathy (pDPN).</div></div><div><h3>Methods</h3><div>CASPAR, a retrospective, non-interventional cohort study of HCCP for neuropathic pain, utilizes real-world data from the German Pain e-Registry. This analysis included 826 patients with pDPN of the hands, feet, or legs receiving ≥1 HCCP with ≥12 months of follow-up.</div></div><div><h3>Results</h3><div>Significant reductions in 24-ho average pain intensity (API) were seen at baseline to Month 3 (mean 57.5 vs 42.4). Successive treatments generated further improvements; these were lost upon HCCP discontinuation. Patients receiving four HCCPs had a mean API decrease from 59.0 (baseline) to 16.0 (Month 12). A ≥30 % API decrease was achieved at Month 12 in 98.9 %, 90.8 %, 67.7 %, and 22.0 % of patients receiving four, three, two, or one HCCP, respectively. Improvements were observed across sleep, QoL, mood, daily activities, and concomitant pain medication use, with the greatest benefits for patients receiving four HCCPs. Results were consistent across treatment locations. Safety and tolerability aligned with the well-established profile for HCCP, consisting of local application-site reactions.</div></div><div><h3>Conclusion</h3><div>HCCP is a non-systemic treatment for pDPN associated with increasing improvements in neuropathic pain, sleep, mood, and QoL with successive treatments.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109085"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239431","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}
Charlotte B. Schmidt , Eva Keijsper , Judith E. Bosmans , Bert Jan Potter van Loon , Frank J. Snoek , Adriaan Honig
{"title":"Medical costs and health care utilization in Dutch diabetes patients with high levels of diabetes-distress","authors":"Charlotte B. Schmidt , Eva Keijsper , Judith E. Bosmans , Bert Jan Potter van Loon , Frank J. Snoek , Adriaan Honig","doi":"10.1016/j.jdiacomp.2025.109086","DOIUrl":"10.1016/j.jdiacomp.2025.109086","url":null,"abstract":"<div><h3>Aims</h3><div>Diabetes-distress is prevalent in persons with diabetes. However, studies on the association between diabetes-distress, costs and healthcare utilization are scarce. We aim to explore whether diabetes-distress is related to healthcare utilization and medical costs.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, diabetes patients completed the Problem Areas in Diabetes Short Form (PAID5) and the Patient Health Questionnaire (PHQ9). Healthcare utilization (in number of yearly visits) was measured using the Trimbos and iMTA questionnaire on Costs associated with Psychiatric illness (TiC-P), and extraction from the hospital's medical records. Healthcare costs were calculated using Dutch standard costs. Generalized linear models (Gamma log link) were used to estimate the associations while adjusting for confounders.</div></div><div><h3>Results</h3><div>Diabetes-distress was related to healthcare utilization, mean difference 10, 95 % CI 9 to 14, but not to healthcare costs, mean difference €467, 95 % CI -71 to 1006. When controlling for depressive symptoms, comorbidity, age, ethnicity, socioeconomic status and diabetes duration, diabetes-distress remained associated with healthcare utilization, mean difference 9, 95 % CI 2 to 16.</div></div><div><h3>Conclusions</h3><div>This is the first study to evaluate associations between diabetes-distress and healthcare utilization and costs in diabetes patients. Diabetes-distress was significantly related to an increased amount of healthcare utilization, but not costs.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109086"},"PeriodicalIF":2.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116912","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":"Prevalence of cardiovascular and renal comorbidities among patients with type 2 diabetes routinely treated in the primary care setting in Greece: An epidemiological study (the RECARDIA study)","authors":"Nikolaos Papanas , Vasileios Tsimihodimos , Niki Katsiki , John Doupis , Emmanouil Pagkalos , Nikos Nikas , Nikos Papakonstantopoulos , George Karpouzos , Nikolaos Tentolouris","doi":"10.1016/j.jdiacomp.2025.109087","DOIUrl":"10.1016/j.jdiacomp.2025.109087","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to generate real-world data on the prevalence of cardiovascular disease (CVD), including atherosclerotic CVD (ASCVD) and heart failure (HF), as well as chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM) routinely treated in Greece.</div></div><div><h3>Methods</h3><div>This was a non-interventional, epidemiological, multicentre, cross-sectional and retrospective chart review study of T2DM patients attending a routine clinical visit at 198 outpatient primary care settings across Greece from November 2020 to February 2022.</div></div><div><h3>Results</h3><div>Among 2000 enrolled T2DM outpatients, the prevalence of ASCVD was 20.40 % (95 % confidence interval [CI]: 18.67 %–22.25 %), of HF 8.03 % (95 % CI: 6.67 %–9.63 %), and of CKD 49.55 % (95 % CI: 47.36 %–51.74 %). Hypertension was correlated with increased risk of ASCVD, HF or CKD, dyslipidaemia with ASCVD and CKD, obesity solely with HF, and smoking with ASCVD. Patients over 65 years were at higher risk of ASCVD, HF or CKD, whereas those with T2DM for ≥10 years had a higher risk of ASCVD or HF. Finally, males were more likely to have ASCVD</div></div><div><h3>Conclusions</h3><div>The present study confirms the high prevalence of CVD and CKD among Greek T2DM patients managed in primary care, that potentially qualify for new antidiabetic treatments with cardiovascular or renal benefits.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109087"},"PeriodicalIF":2.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124027","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}
Hilma Tillqvist , Miska Vuorlaakso , Mika Helminen , Juha Kiiski , Ilkka Kaartinen
{"title":"Clinical frailty scale as a tool to predict outcomes after lower extremity amputation among patients with diabetes: A retrospective cohort study","authors":"Hilma Tillqvist , Miska Vuorlaakso , Mika Helminen , Juha Kiiski , Ilkka Kaartinen","doi":"10.1016/j.jdiacomp.2025.109084","DOIUrl":"10.1016/j.jdiacomp.2025.109084","url":null,"abstract":"<div><h3>Aims</h3><div>The primary aim of this study was to investigate how the Clinical Frailty Scale (CFS) associates with survival of patients with diabetes after lower extremity amputation (LEA).</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients with diabetes undergoing nontraumatic LEA at Tampere University Hospital during 2007–2020. Kaplan-Meier and Cox regression analyses were performed to evaluate the effect of CFS on overall survival (OS), amputation-free survival (AFS) and leg salvage (LS).</div></div><div><h3>Results</h3><div>A total of 1043 patients with mean age 71.0 years were included. Compared to patients with low CFS (1, 2), scores 3–4 and 5–9 were associated with reduced OS (HR 1.821, <em>p</em> < 0.001; HR 4.585, <em>p</em> < 0.001), AFS (HR 1.575, <em>p</em> < 0.001; HR 4.031, <em>p</em> < 0.001) and LS (HR 1.435, <em>p</em> = 0.049; HR 2.478, <em>p</em> < 0.001). The multivariable Cox regression analysis showed that CFS remained a significant predictor of OS, AFS and LS.</div></div><div><h3>Conclusions</h3><div>This study demonstrates a high prevalence of frailty among patients with diabetes undergoing LEA, suggesting that frailty assessment should be integrated into clinical decision-making for this patient population. The CFS score appears to be a promising tool for evaluating patients facing amputation to enhance survival rates.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109084"},"PeriodicalIF":2.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099303","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":"Joint effect of nicotine use and diabetes distress on glycemic control in young adults with type 1 diabetes","authors":"Enzo G. Plaitano , Catherine Stanger","doi":"10.1016/j.jdiacomp.2025.109083","DOIUrl":"10.1016/j.jdiacomp.2025.109083","url":null,"abstract":"<div><div>Nicotine inhibits glucose metabolism. In this national cross-sectional analysis of 388 young adults with type 1 diabetes and above target glycemic control, vaping was the most common route of nicotine use, and heavy nicotine use plus higher type 1 diabetes distress was related to worse objective measures of glycemic control.</div><div><strong>Trial registration</strong>: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT04646473</span><svg><path></path></svg></span>; <span><span>https://clinicaltrials.gov/ct2/show/NCT04646473</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109083"},"PeriodicalIF":2.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090287","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":"Differential impact of short-term and long-term glycemic variability on peripheral nerve function in type 2 diabetes: A 5-year cohort study","authors":"Takamasa Iwamoto , Machiko Morita , Shuji Hidaka , Kentaro Sada , Miyuki Iwamoto , Hirotaka Shibata","doi":"10.1016/j.jdiacomp.2025.109081","DOIUrl":"10.1016/j.jdiacomp.2025.109081","url":null,"abstract":"<div><h3>Aims</h3><div>Several studies have demonstrated the association between glycemic variability (GV) and diabetic peripheral neuropathy (DPN). However, none has compared the effects of short-term and long-term GV on DPN in a cohort. This study evaluates the association between short-term and long-term GV and peripheral nerve function in a cohort of outpatients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>Overall, 230 patients who had continuously attended the outpatient hospital for 5 years were enrolled. Short-term GV was assessed using continuous glucose monitoring (FreeStyle Libre Pro®), focusing on metrics such as the glucose levels’' standard deviation and time in range. Long-term GV was evaluated by using visit-to-visit variability in glycated hemoglobin (HbA1c), including the HbA1c standard deviation and coefficient of variation. Nerve conduction was assessed using DPNCheck™ by measuring sural nerve action potential (SNAP) amplitude and sensory conduction velocity (SCV). Multiple regression models were built to determine independent associations of GV and HbA1c variability metrics with SCV and SNAP amplitude.</div></div><div><h3>Results</h3><div>Most short-term GV indices were not associated with SNAP amplitude but significantly correlated with SCV; these associations were not evident after adjusting for HbA1c. Long-term GV showed minimal correlation with SCV, while strong associations with SNAP amplitude persisted after adjusting for the 5-year mean HbA1c.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate that short-term and long-term GVs have differential impacts on peripheral nerve function in outpatients with type 2 diabetes; with short-term GV associated with SCV and long-term with SNAP amplitude.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109081"},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147529","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}