Diabetes, Obesity & Metabolism最新文献

{"title":"Variability in HbA1c and the risk of major clinical outcomes in type 2 diabetes with chronic kidney disease: Post hoc analysis from the CREDENCE trial.","authors":"Ying Zhu, Min Jun, Robert A Fletcher, Clare Arnott, Brendon L Neuen, Sradha S Kotwal","doi":"10.1111/dom.16363","DOIUrl":"https://doi.org/10.1111/dom.16363","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low levels of soluble neuropilin-1 were associated with depression in adults with newly diagnosed type 2 diabetes.","authors":"E O Melin, M Thunander, P Wanby, S Holmberg, H O Thulesius, M Landin-Olsson, M Hillman","doi":"10.1111/dom.16347","DOIUrl":"https://doi.org/10.1111/dom.16347","url":null,"abstract":"<p><strong>Aims: </strong>To explore the association between soluble neuropilin-1 (sNRP-1) and depression in patients with newly diagnosed type 2 diabetes (T2D).</p><p><strong>Materials and methods: </strong>Multicentre, cross-sectional study including adults with serologically confirmed newly diagnosed T2D. Included variables: sex, sNPR-1 (low sNRP-1 was defined as <226 ng/mL), psychometrically assessed depression and anxiety, antidepressants, BMI, haemoglobin A1c, C-peptide and pre-existing cardiovascular disease. Multiple regression analyses were performed with depression and low sNRP-1 as dependent variables.</p><p><strong>Results: </strong>The study comprised 837 participants (18-94 years, younger patients <60 years 38%). Depressed patients (n = 119) compared to non-depressed (n = 718) had a higher prevalence of anxiety (64% vs. 14%), antidepressants (36% vs. 14%), low sNRP-1 (45% vs. 22%) (all p < 0.001); physical inactivity (42% vs. 29%, p = 0.006); smoking (20% vs. 12%, p = 0.018); and higher BMI (p = 0.002). Independently associated with depression (n = 736) were anxiety (adjusted odds ratio (AOR) 11.7, p < 0.001), low sNRP-1 (AOR 3.3, p < 0.001), BMI (per kg/m²) (AOR 1.1, p = 0.016) and physical inactivity (AOR 1.8, p = 0.018). In younger patients (n = 288), independently associated with low sNRP-1 were depression (AOR 3.3, p < 0.001), myocardial infarction (AOR 3.8, p = 0.039) and younger age (per year) (AOR 0.97, p = 0.043). In older patients (n = 521), independently associated with low sNRP-1 were depression (AOR 3.1, p < 0.001), and younger age (0.97, p = 0.030).</p><p><strong>Conclusions: </strong>Low sNRP-1 (<226 ng/mL) was associated with depression in all patients with newly diagnosed T2D. In younger patients (<60 years), depression, pre-existing myocardial infarction and younger age were associated with low sNRP-1. In older patients, only depression and younger age were associated with low sNRP-1.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-pronged approach: Therapeutic effect of biological scaffold combined with immune intervention and β-cell replacement on type 1 diabetic mice.","authors":"Le Dai, Qing Wang","doi":"10.1111/dom.16373","DOIUrl":"https://doi.org/10.1111/dom.16373","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by β-cell damage and absolute insulin deficiency. We consider combining immune intervention and β-cell replacement by biological scaffold to treat T1DM. Zinc transporter 8 (ZnT8) is known to be a pancreatic islet-specific autoantigen. Studies have shown that ZnT8(107-115)/HLA-A2 dimers can be used as antigen-specific immunosuppressants for T1DM. Mesenchymal stem cells (MSCs) can be induced to differentiate into insulin-producing cells (IPCs) under certain conditions in vitro. In recent years, the development of biomaterials has provided a more suitable three-dimensional microenvironment for cell transplantation. Our research group previously prepared gelatin/polylactic acid (PLLA/G) nanofiber scaffold by electrospinning technology, fixed GLP-1 analogues on the scaffold by surface modification with polydopamine (pDA) and confirmed the scaffold can promote bone mesenchymal stem cells (BMSCs) proliferation and improve cell survival rate. In addition, the scaffold can promote the differentiation of BMSCs into IPCs. Subsequently, ZnT8(107-115)/HLA-A2 dimer was constructed and loaded on the scaffold and confirmed the scaffold loaded with immunosuppressants can inhibit the proliferation and cytotoxicity of specific CD8&lt;sup&gt;+&lt;/sup&gt; T cells in vitro. This study used the above scaffold to co-load ZnT8(107-115)/HLA-A2 dimer and IPCs and implanted the scaffold into T1DM mice to study the blood glucose control and immunomodulatory effects on T1DM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;First, the PLLA/G scaffold was modified with pDA and fixed with Liraglutide (LIR) to obtain the PLLA/G-pDA-LIR scaffold. Rat BMSCs were loaded on the scaffold and the 'three-step induction method' was used to induce differentiation in vitro. The insulin expression of IPCs was detected by Dithizone (DTZ) staining, glucose stimulate insulin secretion (GSIS) in vitro and intraperitoneal glucose tolerance test (IPGTT) in vivo. Then, non obese diabetes mice were modelled with T1DM and randomly divided into 5 groups. Blank control group was not treated; negative control group underwent sham surgery; positive control group was injected with IPCs through tail vein; single load scaffold group was subcutaneously transplanted with PLLA/G-pDA-LIR scaffold loaded with IPCs; double load scaffold group was subcutaneously transplanted with PLLA/G-pDA-LIR scaffold loaded with IPCs and ZnT8(107-115)/HLA-A2 dimer. Blood glucose and body weight were measured weekly before and after transplantation. At 2, 4 and 6 W after transplantation, some mice were taken from each group to detect serum insulin and C-peptide, spleen lymphocyte subsets and Tregs and pancreatic Th1/Th2 cell inflammatory factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results of insulin expression in induced differentiated IPCs show that cells with insulin expression can be obtained through the \"three-step induction method\", and tra","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of body roundness index with cardiovascular disease and mortality among patients with metabolic syndrome.","authors":"Ziqi Chen, Iokfai Cheang, Xu Zhu, Qiang Qu, Sitong Chen, Yutong Xing, Yanli Zhou, Haifeng Zhang, Xinli Li","doi":"10.1111/dom.16346","DOIUrl":"https://doi.org/10.1111/dom.16346","url":null,"abstract":"<p><strong>Aims: </strong>The prevalence of metabolic syndrome (MetS) is increasing due to ageing populations and lifestyle changes, making it crucial to understand the relationship between body fat distribution and cardiovascular outcomes. Traditional measures such as body mass index (BMI) have limitations in assessing abdominal obesity. The body roundness index (BRI), a novel anthropometric measure combining waist circumference and height, has shown promise in evaluating this risk. This study aims to explore the association between BRI and cardiovascular disease (CVD) prevalence and mortality in a nationally representative sample of US adults with MetS.</p><p><strong>Materials and methods: </strong>This retrospective study used data from the National Health and Nutrition Examination Surveys (NHANES) 2001-2016, including 10 527 MetS-diagnosed participants. BRI was calculated and the cohort was divided into quartiles. Logistic regression and Cox proportional hazards models assessed the relationship between BRI and CVD prevalence, all-cause mortality and cardiovascular-specific mortality. Kaplan-Meier curves and restricted cubic spline analyses visualized survival patterns and non-linear relationships, with sensitivity analysis for validation.</p><p><strong>Results: </strong>Higher BRI quartiles were significantly associated with increased CVD prevalence (odds ratio [OR]: 1.56 [1.32-1.84], p < 0.001). In the fully adjusted model, BRI demonstrated a U-shaped relationship with all-cause and cardiovascular mortality, with a threshold value of 6.89 (p for non-linear ≤0.001). Above this threshold, each additional unit in BRI was linked to a 9% increase in cardiovascular mortality risk (hazard ratio [HR]: 1.09 [1.02-1.15], p = 0.006) and an 8% rise in overall mortality (HR: 1.08 [1.04-1.12], p < 0.001). Conversely, BMI showed a paradoxical relationship with reduced mortality risk in unadjusted models, which became insignificant after adjusting for confounders (p = 0.195; 0.144).</p><p><strong>Conclusions: </strong>BRI might be a more reliable predictor of cardiovascular outcomes and mortality in MetS patients than BMI. The identified threshold value of BRI can assist clinicians in making accurate prognostic evaluations. However, findings may vary by age and gender, underscoring the need for further research in diverse populations.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developments in albuminuria testing: A key biomarker for detection, prognosis and surveillance of kidney and cardiovascular disease-A practical update for clinicians.","authors":"Jelle M Beernink, Dominique van Mil, Gozewijn D Laverman, Hiddo J L Heerspink, Ron T Gansevoort","doi":"10.1111/dom.16359","DOIUrl":"https://doi.org/10.1111/dom.16359","url":null,"abstract":"<p><p>Albuminuria, the abnormal presence of albumin in urine, is a key marker of kidney damage and a strong predictor of kidney and cardiovascular outcomes. Its clinical significance has evolved from early historical observations to its current role in chronic kidney disease (CKD) detection, risk stratification and treatment monitoring. Advances in measurement techniques and evidence from large-scale studies have reinforced its prognostic value, particularly in guiding interventions such as renin-angiotensin-aldosterone system blockade, sodium-glucose cotransporter-2 inhibitors and non-steroidal mineralocorticoid receptor antagonists. Albuminuria assessment is now integrated into CKD staging, cardiovascular risk prediction models and therapy selection. Despite its established utility, challenges remain, including measurement variability, assay standardisation and under-utilisation in clinical practice. This review provides a practical update on albuminuria testing, summarising its historical development, technical aspects and clinical implications, and emphasising its role in CKD management and cardiovascular risk assessment.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 1 diabetes risk factors, risk prediction and presymptomatic detection: Evidence and guidance for screening.","authors":"Ezio Bonifacio, Anette-Gabriele Ziegler","doi":"10.1111/dom.16354","DOIUrl":"https://doi.org/10.1111/dom.16354","url":null,"abstract":"<p><p>Type 1 diabetes is recognized as a chronic disease with a presymptomatic phase that does not require insulin therapy and a clinical phase where insulin treatment becomes necessary. The presymptomatic phase is characterized by the presence of autoantibodies targeting pancreatic islet beta cell antigens (islet autoantibodies). This phase is further classified into three stages: Stage 1, defined by normoglycaemia; Stage 2, characterized by dysglycaemia; and Stage 3, marked by hyperglycaemia, which typically presents clinically and necessitates insulin therapy. The prospect of therapies to delay the onset of clinical disease and insulin treatment has been a driver of research into the presymptomatic phase since the discovery of islet autoantibodies. With the recent approval of teplizumab as a therapy to delay disease progression, attention has increasingly focused on diagnosing individuals with Stage 1 and Stage 2 type 1 diabetes. However, diagnosing an asymptomatic condition that affects fewer than 1 in 200 individuals poses significant challenges. As we enter this new era of diagnosis, it is crucial to refine diagnostic approaches to ensure accuracy and effectiveness. This review summarizes current evidence and guidance while emphasizing the need for continued research alongside broader application of screening. PLAIN LANGUAGE SUMMARY: Type 1 diabetes is an autoimmune disease that affects approximately 0.5% of individuals. In this publication, the authors provide a comprehensive overview of strategies for identifying individuals in the pre-symptomatic, early stages of the disease. Early-stage type 1 diabetes can be detected by the presence of autoantibodies against specific proteins in the blood, signaling an ongoing disease process before clinical symptoms appear. Genetic factors also contribute to the development of these autoantibodies and the disease itself. The paper explores how these markers are used for early identification, emphasizing optimal screening ages and the role of confirmation tests in preventing misdiagnosis. A key consideration in early diagnosis is that disease progression varies-some individuals develop clinical diabetes rapidly, while others may take many years. The authors discuss additional tests that can help predict how soon a diagnosed individual may require insulin treatment. Finally, the paper highlights ongoing challenges in optimizing screening for wider application and the complexities of integrating research-based screening into routine clinical practice.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of adjunctive glycaemic agents with vascular protective properties in individuals with type 1 diabetes: Potential benefits and risks.","authors":"Ahmad M Rajab, Sam Pearson, Ramzi A Ajjan","doi":"10.1111/dom.16332","DOIUrl":"https://doi.org/10.1111/dom.16332","url":null,"abstract":"<p><p>Glycaemic therapy in type 1 diabetes (T1D) is focused on insulin, with the majority of studies investigating different insulin preparations, delivery devices and dosing accuracy methods. While insulin deficiency is the key mechanism for hyperglycaemia in T1D, individuals with this condition can also develop insulin resistance (IR), making optimisation of glycaemia more challenging. Importantly, IR in T1D increases the risk of both microvascular and macrovascular complications; yet, it is rarely targeted in routine clinical care. In this narrative review, we briefly discuss the mechanistic pathways for diabetes complications in individuals with T1D, emphasising the adverse role of IR. We subsequently cover the use of adjunctive glycaemic therapies for improving the metabolic profile in T1D, focusing on therapies that have possible or definite cardiovascular or renal protective properties in individuals with type 2 diabetes. These include metformin and agents in the thiazolidinedione, Sodium-Glucose Cotransporter-2 inhibitor (SGLT2i) and Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RA) groups. In addition to reviewing the role of these agents in improving metabolic parameters, we address their potential vascular and renal protective effects in individuals with T1D. We suggest a pragmatic approach for using these agents in T1D, based on current knowledge of their benefits and risks, while also highlighting gaps in knowledge and areas that require further research. It is hoped that the review raises awareness of the role of adjunctive therapies in T1D and offers healthcare professionals simple guidance on using such agents for the management of high-risk individuals with T1D.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cost-effectiveness analysis alongside trial of a digital health-supported and community pharmacy-based prediabetes management programme (PRIME Programme) in Malaysia.","authors":"Kah Woon Teoh, Yeji Baek, Zanfina Ademi, Shaun Wen Huey Lee","doi":"10.1111/dom.16350","DOIUrl":"https://doi.org/10.1111/dom.16350","url":null,"abstract":"<p><strong>Aims: </strong>This study assessed the cost-effectiveness of a digital health-supported and community pharmacy-based lifestyle intervention (PRIME) programme for individuals with prediabetes in Malaysia over a 6-month period.</p><p><strong>Materials and methods: </strong>A trial-based cost-effectiveness study with a 6-month time horizon was conducted. Ninety-one participants (intervention, n = 46; usual care, n = 45) across 13 community pharmacies were included. The intervention group received in-depth counselling from pharmacists, in-app prediabetes education modules and peer support, while the usual care group received counselling based on pharmacists' usual practice. The primary outcome was quality-adjusted life years (QALY). Incremental cost-effectiveness ratios (ICER) per QALY gained of the intervention were compared with usual care from healthcare and societal perspectives. Non-parametric bootstrapping was used to examine uncertainty.</p><p><strong>Results: </strong>At 6months, the QALY achieved was 0.467 (95% CI 0.456 to 0.479) in the intervention group and 0.466 (95% CI 0.451 to 0.482) in the usual care group, resulting in a net gain of 0.005 QALY (95% CI -0.017 to 0.026) in the intervention group. The incremental healthcare and societal costs were US$6.10 (95% CI $5.33 to $6.88) and $10.69 (95% CI $6.03 to $15.35), respectively. From a healthcare perspective, the ICER per QALY gained was $1354, with a probability of 69.2% being cost-effective, while the corresponding figures were $2371 and 67.7% from a societal perspective. Results were below the willingness-to-pay threshold at $11 845 and were robust to sensitivity analyses.</p><p><strong>Conclusion: </strong>A community pharmacy-based and digital health-supported lifestyle intervention to manage prediabetes may be cost-effective compared with usual care in Malaysia over a 6-month period.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faster-acting insulin aspart versus insulin aspart for adults with type 1 diabetes treated with non-automated insulin pump and continuous glucose monitoring-A double-blind randomized controlled crossover trial.","authors":"Ajenthen G Ranjan, Signe Schmidt, Kirsten Nørgaard","doi":"10.1111/dom.16326","DOIUrl":"https://doi.org/10.1111/dom.16326","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of faster-acting insulin aspart (faster aspart) compared with insulin aspart in adults with type 1 diabetes (T1D) using a non-automated insulin pump and continuous glucose monitoring (CGM).</p><p><strong>Methods: </strong>This double-blinded crossover study randomly assigned participants to start with either faster aspart or insulin aspart for 16 weeks, followed by a 3-week washout period, then switching to the alternate therapy for another 16 weeks. Insulin pump settings were adjusted every 3 weeks. The primary outcome was time in range (TIR: 3.9-10.0 mmol/L). Secondary outcomes included other CGM metrics and HbA1c.</p><p><strong>Results: </strong>Forty adults (20 males) with a median age of 54 years, T1D duration of 27 years, and HbA1c of 59 mmol/mol (7.5%) were included. At the study end, TIR was (mean ± SD) 60.6 ± 12.1% for insulin aspart and 62.5 ± 12.3% for faster aspart, p = 0.24 (primary endpoint). The baseline-adjusted estimated treatment difference (ETD) for TIR was 6.0% (95%CI: 2.2;9.9), p = 0.002; time above range (>10.0 mmol/L) was -5.7% (-9.8; -1.6), p = 0.007; and time below range (<3.9 mmol/L) was -0.4% (-1.1;0.4), p = 0.30-all in favour of faster aspart. Faster aspart significantly improved the coefficient of variation (34.0 ± 3.7% vs. 35.9 ± 4.9%, p = 0.02) and the HbA1c levels (ETD -1.9 (-3.7; -0.2) mmol/mol or - 0.18% (-0.34;-0.02), p = 0.03). No significant differences were observed in severe adverse events, including severe hypoglycaemia and diabetic ketoacidosis. Faster aspart had more injection site reactions than insulin aspart (p = 0.03).</p><p><strong>Conclusion: </strong>Faster aspart improved baseline-adjusted TIR, TAR, CV and HbA1c after 16 weeks with frequent insulin pump adjustments but had a higher incidence of injection site reactions.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FRONTIER: FReeStyle Libre system use in Ontario among people with diabetes in the IC/ES database-Evidence from real-world practice: Patients on basal insulin, glucagon-like peptide 1 receptor agonist or oral therapies.","authors":"Alexandria Ratzki-Leewing, Stewart B Harris, Rémi Rabasa-Lhoret, Yeesha Poon","doi":"10.1111/dom.16266","DOIUrl":"https://doi.org/10.1111/dom.16266","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to investigate glycated haemoglobin (HbA1c) levels and healthcare resource utilization (HCRU; emergency department [ED] visits or hospitalization) before and after adoption of FreeStyle Libre sensor-based glucose monitoring systems (FSL) by people with type 2 diabetes mellitus (T2DM) on basal insulin without glucagon-like peptide 1 receptor agonist (GLP-1 RA) therapy, basal insulin with GLP-1 RA therapy, GLP-1 RA therapy without insulin or oral therapy alone.</p><p><strong>Materials and methods: </strong>Routinely collected administrative health data (housed at IC/ES, formerly the Institute for Clinical Evaluative Sciences) in Ontario, Canada were used to identify 20 253 people with T2DM who had a first FSL claim between 16 September 2019 and 31 August 2020 (index date) and remained active on FSL for 24 months' follow-up. HCRU was measured for 12 months before the index date and the last 12 months of the 24-month follow-up period. HbA1c data were taken from the latest tests in each period.</p><p><strong>Results: </strong>Mean HbA1c was statistically significantly reduced after FSL acquisition among people aged ≤65 or >65 years in all four treatment groups (range, 0.3-0.8% reduction). After FSL acquisition, ED visits and hospitalization were statistically significantly reduced in the oral therapy only group and in some basal insulin subgroups (without GLP-1 RA, all except hospitalization aged ≤65 years; with GLP-1 RA, only ED visits aged ≤65 years).</p><p><strong>Conclusions: </strong>Among people with T2DM using basal insulin and/or non-insulin therapies, HbA1c levels were statistically significantly improved and HCRU was reduced after initiation of FSL.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}