Diabetes, Obesity & Metabolism最新文献

{"title":"Real-world evaluation of automated insulin delivery therapy in type 1 diabetes: A multicentre study across regional and metropolitan Queensland, Australia.","authors":"Akash Konantambigi, Wenyong Wang, Dylan Boggild, Arushi Rana, Larisa Syphers, Catherine Presley, Candice Cummins, Usman Malabu, Kate Hawke, Vasant Shenoy, Gaurav Puri, Harshal Deshmukh","doi":"10.1111/dom.16485","DOIUrl":"https://doi.org/10.1111/dom.16485","url":null,"abstract":"<p><strong>Background: </strong>Automated insulin delivery (AID) systems, which integrate continuous glucose monitoring (CGM) with automated insulin dosing, have emerged as a transformative therapy. However, real-world data on AID effectiveness, particularly in regional Australia, remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective audit across three Australian hospital sites-Logan (metropolitan), Mackay and Townsville (regional)-to evaluate the impact of AID therapy in adults with Type 1 Diabetes Mellitus (T1DM). Data on demographics, comorbidities, CGM metrics and clinical outcomes were extracted from medical records and device platforms. The primary outcome was change in HbA1c and CGM time-in-range (TIR; 3.9-10 mmol/L) at follow-up. Follow-up data were recorded up to 12 months following AID commencement. Secondary outcomes included changes in body weight, glycaemic variability and predictors of HbA1c reduction.</p><p><strong>Results: </strong>The study consisted of 158 people living with T1DM who were initiated on AID. Following AID initiation, mean TIR improved from 53.4% (SD 21.1%) to 70.0% (SD 14.6%) (p < 0.0001), and time in hyperglycaemia (>13.9 mmol/L) declined from 18.7% (SD 19.4%) to 8.4% (SD 9.31%) (p < 0.0001). The mean HbA1c significantly decreased from 8.62% (SD 1.70) at baseline to 7.34% (SD 1.31) at follow-up across the entire study cohort (p < 0.0001), with 42.7% achieving <7% and 64.1% achieving <7.5% at follow-up. Multivariable regression identified higher baseline HbA1c (p < 0.0001) as a significant predictor of HbA1c reduction. Improvements were consistent across AID system types and geographical settings.</p><p><strong>Conclusions: </strong>AID therapy significantly improves glycaemic control in adults with T1DM in both regional and metropolitan Australia. Our findings support the real-world effectiveness of AID systems and highlight their potential to bridge care gaps across diverse settings.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155424","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":"The association between the visceral obesity indices and the future diabetes mellitus risk: A prospective cohort study.","authors":"Yue Zhang, Wenxing Gao, Binqi Li, Yang Liu, Xulei Tang, Li Yan, Zuojie Luo, Guijun Qin, Lulu Chen, Qin Wan, Zhengnan Gao, Weiqing Wang, Guang Ning, Yiming Mu","doi":"10.1111/dom.16492","DOIUrl":"https://doi.org/10.1111/dom.16492","url":null,"abstract":"<p><strong>Aim: </strong>As abnormal visceral fat accumulation is the core pathophysiology of diabetes mellitus (DM), this study evaluated five novel visceral obesity indices to provide optimized clinical metabolic risk assessment tools.</p><p><strong>Materials and methods: </strong>This study included 6575 participants aged ≥40 years without baseline diabetes. Waist-to-height ratio (WHtR), body roundness index (BRI), visceral adipose index (VAI), lipid accumulation product (LAP) and abdominal body shape index (ABSI) were exposure variables. Multivariable-adjusted Cox proportional hazards models analysed associations with diabetes onset; restricted cubic splines (RCS) explored dose-response relationships, stratified analyses and receiver operating characteristic (ROC) curve assessed model stability and predictive efficacy.</p><p><strong>Results: </strong>During an average follow-up period of 3.19 years, 752 (11.4%) of participants developed diabetes. Multivariable Cox regression showed that each visceral obesity index independently predicted the risk of diabetes (all P for trend <0.05), with LAP showing the strongest association (HR = 2.93, 95% CI = 2.27-4.01). The RCS model revealed the characteristics of a nonlinear dose-response relationship. Stratified analysis and sensitivity analysis confirmed the high stability of the association between LAP and the risk of diabetes. ROC curve analysis indicated that LAP had the optimal predictive efficacy (AUC = 0.752).</p><p><strong>Conclusions: </strong>Visceral obesity indices are closely linked to the risk of diabetes onset, highlighting the potential benefits of reducing visceral fat accumulation. Among these indices, LAP emerges as the most robust clinical indicator for predicting DM risk.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155425","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":"Why, how and in whom should we measure levels of lipoprotein(a): A review of the latest evidence and clinical implications.","authors":"Alexander C Razavi, Harpreet S Bhatia, Roger S Blumenthal, Michael D Shapiro, Anurag Mehta","doi":"10.1111/dom.16469","DOIUrl":"https://doi.org/10.1111/dom.16469","url":null,"abstract":"<p><p>Lipoprotein(a) [Lp(a)] is a genetically determined, causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease (CAVD). Despite robust evidence from epidemiological and genetic studies, Lp(a) remains underrecognised in clinical practice due to challenges in measurement, lack of guideline familiarity and limited therapeutic options. In this narrative review, we summarise the pathophysiological mechanisms linking Lp(a) to atherogenesis, thrombosis and inflammation, emphasising its unique structural features and causal role in cardiovascular disease. We discuss assay methodologies and make the case for a single lifetime measurement given the genetic stability of Lp(a). We review guideline-based indications for testing, highlighting high-risk populations such as those with premature ASCVD, a family history of cardiovascular disease and individuals of African or South Asian ancestry. We additionally outline clinical strategies to reduce ASCVD risk in individuals with elevated Lp(a), including lifestyle optimisation, statin therapy, PCSK9 inhibitors, and aspirin in select populations. Emerging targeted therapies, including antisense oligonucleotides and siRNA-based agents, demonstrate up to 90% Lp(a) reduction and are currently being evaluated in large-scale cardiovascular outcomes trials. As precision medicine advances, Lp(a) represents both a critical risk factor and a promising therapeutic target. Broader implementation of Lp(a) testing, particularly in high-risk individuals, will help improve ASCVD prevention efforts.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172363","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":"Efficacy and tolerance of liraglutide for weight loss in obese, type 2 diabetes and haemodialysis patients.","authors":"Maxime Touzot, Adela Voican, Louis Potier, Hélène Beaussier, Marine Cachanado, Emmanuelle Sacco, Gilles Chatellier, Christophe Ridel, Pablo Ureña-Torres, Isabela Banu, Olivier Dupuy","doi":"10.1111/dom.16484","DOIUrl":"https://doi.org/10.1111/dom.16484","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155421","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":"Disparities in diabetes burden in China and globally, with projections to 2050: A systematic analysis for the Global Burden of Disease Study 2021.","authors":"Min Yin, Wenqi Fan, Yi Yu, Zizhu Liu, Danyi Zhang, Chao Deng, Xia Li","doi":"10.1111/dom.16482","DOIUrl":"https://doi.org/10.1111/dom.16482","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155420","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":"Risk of new-onset type 1 diabetes in individuals with celiac disease and thyroid disease-An observational study.","authors":"Steve V Edelman, Daniel Agardh, Nancy Cui, Lichen Hao, Mattias Wieloch, Luigi Meneghini","doi":"10.1111/dom.16454","DOIUrl":"https://doi.org/10.1111/dom.16454","url":null,"abstract":"<p><strong>Aims: </strong>The objective of this study was to compare the risk of developing type 1 diabetes in individuals with celiac disease, hyperthyroidism and hypothyroidism to that of individuals without those conditions.</p><p><strong>Materials and methods: </strong>In this retrospective, observational, matched-cohort study based on real-world claims data, individuals with at least one diagnosis of celiac disease, hyperthyroidism (e.g. Graves' disease) or hypothyroidism (e.g. Hashimoto's disease) and a control cohort of individuals without any of these three conditions were included. Individuals from the disease and control cohorts were propensity score matched 1:1 based on baseline demographics and clinical characteristics. A Cox proportional hazards model was used to compare the risk of type 1 diabetes between cohorts.</p><p><strong>Results: </strong>Type 1 diabetes developed in 0.14% (68/47 099) of individuals with celiac disease compared to 0.06% (27/47 099) of controls. Of those with hyperthyroidism, type 1 diabetes developed in 0.17% (281/164 830) compared to 0.06% (99/164 830) of controls. Of those with hypothyroidism, type 1 diabetes developed in 0.18% (1756/980 477) compared to 0.08% (764/980 477) of controls. The risk of developing type 1 diabetes was increased for each of the disease cohorts compared to their respective controls (celiac disease: HR = 2.54 [p < 0.0001]; hyperthyroidism: adjusted HR = 2.98 [p < 0.0001]; hypothyroidism: HR = 2.41 [p < 0.0001]); risk was highest among individuals aged <18 years.</p><p><strong>Conclusions: </strong>The risk of developing type 1 diabetes was significantly higher for individuals with celiac disease or thyroid disease compared to those without any of these conditions. These findings support the screening of individuals with these conditions for stage 2 type 1 diabetes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172362","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":"Partial remission of type 1 diabetes: Do immunometabolic events define the honeymoon period?","authors":"J Jason Collier, Clive H Wasserfall, Michael A Brehm, Michael D Karlstad","doi":"10.1111/dom.16480","DOIUrl":"https://doi.org/10.1111/dom.16480","url":null,"abstract":"<p><p>Partial clinical remission in Type 1 diabetes (T1D) refers to a transient phase of improved glucose control following diagnosis. During this period, endogenous islet β-cells continue to produce and secrete insulin, resulting in lower exogenous insulin requirements and improved glycaemic status. Partial remission is often described colloquially as the 'honeymoon phase', a period lasting from months to years which is heterogeneous across patient groups. In this review, we discuss the immunometabolic events that may control the duration of the partial remission period by highlighting how glucose metabolism supports immune cell-driven inflammatory and autoimmune events. We thus propose that precise control of blood glucose within a healthy range delays the deleterious consequences that arise from autoimmune mechanisms within pancreatic islets, ultimately leading to the extension of the honeymoon phase. We further discuss data supporting the notion that managing blood glucose effectively also improves islet β-cell mass, function and maturity markers. Collectively, these paradigms help explain the success of recent clinical trial outcomes and offer novel opportunities to intervene in future study designs.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155423","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":"GLP-1 receptor agonists and addiction-related behaviours: A translational perspective.","authors":"Natalia Kulicka","doi":"10.1111/dom.16481","DOIUrl":"https://doi.org/10.1111/dom.16481","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148745","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":"Plasma LEAP2 concentration is associated with energy intake and postprandial insulin increase depending on meal size but not weight status in men.","authors":"María F Andreoli, Pablo N De Francesco, Olga E Titova, Mario Perello, Helgi B Schiöth","doi":"10.1111/dom.16483","DOIUrl":"https://doi.org/10.1111/dom.16483","url":null,"abstract":"<p><strong>Aims: </strong>While LEAP2 is increasingly recognized as an appetite-regulating hormone, its role in meal regulation and the dynamics of postprandial LEAP2 concentrations remain poorly understood in humans. The aim of the study was to (1) assess postprandial LEAP2 concentrations following a recommended-energy breakfast, exploring potential association with voluntary energy intake and modulation by weight status and (2) to examine the interplay between postprandial LEAP2 and insulin concentrations.</p><p><strong>Materials and methods: </strong>Eighty-four men with normal weight (NW) and 48 with overweight or obesity (OW/OB) received a test meal; pre- and postprandial LEAP2 and insulin concentrations were assessed. Energy intake was calculated by multiplying the weight of the food items consumed by their energy content according to their label.</p><p><strong>Results: </strong>Fasting LEAP2 was positively associated with glycaemia in participants with NW [Beta (95% CI): 0.289 (0.058, 0.520), p = 0.015] but not with OW/OB. Sixty-seven participants consumed the entire test meal (CMC, complete meal consumption); the rest consumed only part (PMC, partial meal consumption). Postprandial LEAP2 concentration was higher in the PMC (p = 0.017) than in the CMC group and in participants with OW/OB (p = 0.046). Pre (p = 0.027) and postprandial (p = 0.031) LEAP2 was inversely related to ingested calories, but only in PMC and independent of weight status. Postprandial insulin increase (p < 0.001) depended on LEAP2 only in CMC (p = 0.017) and was independent of weight status.</p><p><strong>Conclusions: </strong>The relationship of LEAP2 with energy intake and postprandial insulin increase is influenced by meal size but not weight status.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126410","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":"Impact of bariatric surgery on glycaemic and metabolic outcomes in people with obesity and type 2 diabetes mellitus: A meta-analysis.","authors":"Xu Han, Liyun Pang, Xinxin Zhang, Haowen Gao, Haobing Guo, Wei Wang, Haoyu Feng, Jingfeng Gu, Guiqi Wang","doi":"10.1111/dom.16475","DOIUrl":"https://doi.org/10.1111/dom.16475","url":null,"abstract":"<p><strong>Aims: </strong>Bariatric surgery is a widely adopted intervention for managing obesity and improving glycaemic control in patients with type 2 diabetes mellitus (T2DM). This meta-analysis evaluates the impact of bariatric surgery on glycaemic and metabolic outcomes, including fasting blood glucose (FBG), postprandial glucose (PPG), HbA1c, C-peptide, HOMA-IR and fasting insulin levels.</p><p><strong>Materials and methods: </strong>Comprehensive search of PubMed, Scopus, EMBASE and Web of Science was conducted from inception to March 2025. Eligible studies were pooled using a random-effects model to calculate weighted mean differences (WMD) or standardized mean differences (SMD) with 95% confidence intervals (CIs). Heterogeneity was assessed using I² statistics, and publication bias was evaluated using funnel plots and Egger's tests.</p><p><strong>Results: </strong>Thirty-nine studies with 3855 participants were included. Bariatric surgery resulted in significant reductions in FBG (WMD = 3.461; 95% CI: 2.740-4.182, p < 0.001), PPG (WMD = 6.153; 95% CI: 4.298-8.007, p < 0.001) and HbA1c levels (WMD = 2.085; 95% CI: 1.561-2.608, p < 0.001). Modest but non-significant improvements were observed in C-peptide (SMD = 0.358; 95% CI: -0.043 to 0.759, p = 0.075) and fasting insulin (SMD = 1.593; 95% CI: -0.392 to 3.577, p = 0.104). Significant reductions in HOMA-IR levels (WMD = 2.480; 95% CI: 1.010-3.950, p = 0.009) were noted. High heterogeneity was observed across most outcomes. Publication bias was detected for FBG and HbA1C, while it was undetected for the rest of the outcomes.</p><p><strong>Conclusions: </strong>Bariatric surgery significantly improves glycaemic and metabolic outcomes in obese patients with T2DM. These findings support its integration into diabetes management pathways, offering a promising approach for long-term disease control and complication reduction. Further research is needed to evaluate long-term outcomes and mechanisms.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126409","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}