Jiaxing Du, Shiyan Wu, Yanyan Wang, Mei Liu, Jiayu Huang, Yanhan Zhao, Yan Lin
{"title":"Maternal Gestational Diabetes and Trajectories of Offspring Fat-Lean Balance in the Millennium Cohort Study.","authors":"Jiaxing Du, Shiyan Wu, Yanyan Wang, Mei Liu, Jiayu Huang, Yanhan Zhao, Yan Lin","doi":"10.1111/dom.71260","DOIUrl":"10.1111/dom.71260","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to examine whether offspring exposed to maternal gestational diabetes mellitus (GDM) had different fat-lean balance trajectories from unexposed offspring and whether the estimated associations were attenuated after adjustment for maternal pre-pregnancy adiposity.</p><p><strong>Methods: </strong>Using UK Millennium Cohort Study data, we analysed body composition outcomes, including fat mass (FM), body fat percentage (BF%), fat mass index (FMI), fat-free mass index (FFMI), and the FMI/FFMI ratio. Linear mixed-effects models characterised body composition trajectories from ages 7-17 years, with additional adjustment to assess the attenuation of the estimates after accounting for maternal pre-pregnancy adiposity.</p><p><strong>Results: </strong>The analysis included 14 329 offspring, of whom 170 were exposed to maternal GDM. In the primary adjusted model, GDM-exposed offspring had higher model-predicted values for all body composition indices than unexposed offspring across the observed ages. GDM-by-age interaction terms indicated age-varying between-group differences for FM, FMI, and the FMI/FFMI ratio (all p < 0.05), with borderline evidence for BF% (p = 0.050) and no clear evidence for FFMI. After additional adjustment for maternal pre-pregnancy adiposity, the estimated between-group differences were attenuated, and some age-specific contrasts, particularly at age 7 years, were no longer statistically significant. Nevertheless, age-varying between-group patterns remained evident for several body composition indices.</p><p><strong>Conclusion: </strong>Maternal GDM exposure was associated with age-varying differences in offspring fat mass and fat-lean balance during childhood and adolescence, and these associations were attenuated after adjustment for maternal pre-pregnancy adiposity.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10475-10485"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816723","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":"Real-World Incretin-Based Therapy for Obesity After Solid Organ Transplantation: A Single-Centre Retrospective Study From Poland.","authors":"Karolina Kędzierska-Kapuza, Edward Franek","doi":"10.1111/dom.71222","DOIUrl":"10.1111/dom.71222","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10914-10916"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148807830","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}
Yael Barer, Tal Schiller, Maya Nitecki, Gilad Twig, Gabriel Chodick
{"title":"Glucose Challenge Test Values Within the Normal Range and Long-Term Risk of Type 2 Diabetes by Pre-Pregnancy BMI: A Retrospective Cohort Study.","authors":"Yael Barer, Tal Schiller, Maya Nitecki, Gilad Twig, Gabriel Chodick","doi":"10.1111/dom.71259","DOIUrl":"10.1111/dom.71259","url":null,"abstract":"<p><strong>Aims: </strong>Gestational diabetes (GDM) is the strongest known risk factor for maternal type 2 diabetes. However, little is known about type 2 diabetes risk in women with normal glucose challenge test (GCT) results during pregnancy. We investigated the association between GCT results in the normal range and type 2 diabetes risk, both overall and across pre-pregnancy BMI categories.</p><p><strong>Materials and methods: </strong>This retrospective cohort study identified pregnant women aged 20-50 who had normal (< 140 mg/dL) GCT results between 2004 and 2022. Follow-up for type 2 diabetes extended from the date of the last documented GCT until 31 September 2024. Survival analyses examine GCT and combine BMI-GCT exposures.</p><p><strong>Results: </strong>Among 249 190 eligible women (mean age 32.7 years), 1354 developed type 2 diabetes during a median follow-up of 7 years. GCT results within the normal range were associated with the risk of type 2 diabetes, in a graded manner, without a clear threshold. Compared to women with normal pre-pregnancy BMI and GCT of 70-89 mg/dL, women with a GCT of 130-140 mg/dL had adjusted hazard ratios for type 2 diabetes ranging from 14.7 (95% CI: 6.2-33.3) among women with normal BMI to 145 (95% CI: 67.7-309) among women with obesity.</p><p><strong>Conclusions: </strong>Pre-pregnancy BMI and GCT values within the normal range can be used for further type 2 diabetes risk stratification, ranging from minimal risk among women with a GCT < 90 mg/dL and normal weight to substantially increased risk among women with pre-pregnancy overweight or obesity.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10390-10398"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148807884","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}
Léna Robert, Ines Belalem, Corinne Vigouroux, Hippolyte Dupuis, Marie Christine Vantyghem, Mathilde Simonson, Estelle Nobecourt, Héléna Mosbah, Sophie Beliard, Stéphanie Jellimann, Sonja Janmaat, Camille Vatier, Sophie Lamothe
{"title":"Efficacy and Safety of SGLT2 Inhibitors in Patients With Genetic Lipodystrophy: A Real-Life Experience From a National Reference Network.","authors":"Léna Robert, Ines Belalem, Corinne Vigouroux, Hippolyte Dupuis, Marie Christine Vantyghem, Mathilde Simonson, Estelle Nobecourt, Héléna Mosbah, Sophie Beliard, Stéphanie Jellimann, Sonja Janmaat, Camille Vatier, Sophie Lamothe","doi":"10.1111/dom.71126","DOIUrl":"10.1111/dom.71126","url":null,"abstract":"<p><strong>Aim: </strong>Lipodystrophy syndromes are rare diseases with metabolic and cardiovascular consequences. This study explores the metabolic and renal effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients with genetic lipodystrophy.</p><p><strong>Patients and methods: </strong>Patients with familial partial lipodystrophy (n = 57) or congenital generalised lipodystrophy (n = 2) (86% women) were initiated with SGLT2i in the French reference network PRISIS. We retrospectively collected clinical and biological data before initiation, after 6-18 months (short-term, mean ± SD 12.5 ± 6.4 months) and at the latest follow-up on SGLT2i (long-term, 29.0 ± 10.7 months).</p><p><strong>Results: </strong>Body mass index decreased from 25 [22.9-28] (median [IQR]) to 24.4 [22.1-26.5] then 23.9 [22.1-26.4] kg/m<sup>2</sup> (p < 0.001) and HbA1c from 7.8 [7.1-8.8] to 7.3 [6.7-7.7] and 7.3% [6.9-8] (p < 0.01 and p = 0.05, respectively). Systolic blood pressure (130 [120-143.25] to 126 [120-137] mmHg), ALT (33 [23.5-44] to 30 [26-40] IU/L), GGT (44 [28.5-62.5] to 37 [27.85-45.5] IU/L) and liver stiffness (6.8 [5.9-11.8] to 5.8 [5-6.9] kPa) declined significantly at short-term (p < 0.05, 0.02, 0.02 and < 0.01, respectively). The dual-energy X-ray absorptiometry-based fat mass percentage (23.6 [18-29.3] to 20.8 [17.8-25.3], p = 0.07) and truncal-to-lower limb fat ratio (1.36 [1.18-1.50] to 1.17 [0.98-1.41], p = 0.08) tended to decrease at short-term. Urinary albumin-to-creatinine ratio, when elevated at baseline (> 3 mg/mmol, n = 18 patients), decreased from 10.8 [6.3-24.9] to 8.0 mg/mmol [2.8-14.4] (p = 0.02). Treatment discontinuation (7%) was mainly due to vaginal mycoses. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>In a real-life setting, SGLT2i therapy is associated with improvement in HbA1c, body weight, blood pressure, hepatic parameters and albuminuria in patients with genetic lipodystrophy.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10318-10329"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liliane Viana Pires, Matheus Menezes-Santos, Andréa Costa Goes, Heitor Siqueira Ribeiro, Luana Ferreira Alves, Beatriz Cruz Dos Santos, Jéssyca Teles Barreto, Roberta Cristina Vieira Meneses, Ana Mara de Oliveira E Silva, Ana Hermínia Andrade E Silva, Sadraque Eneas de Figueiredo Lucena
{"title":"Exploratory Analysis of Type 2 Diabetes Mellitus Metabolic Phenotypes and Their Association With Vitamin D Status in Primary Care Patients.","authors":"Liliane Viana Pires, Matheus Menezes-Santos, Andréa Costa Goes, Heitor Siqueira Ribeiro, Luana Ferreira Alves, Beatriz Cruz Dos Santos, Jéssyca Teles Barreto, Roberta Cristina Vieira Meneses, Ana Mara de Oliveira E Silva, Ana Hermínia Andrade E Silva, Sadraque Eneas de Figueiredo Lucena","doi":"10.1111/dom.71275","DOIUrl":"10.1111/dom.71275","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to perform an exploratory characterisation of metabolic phenotypes in primary care patients with type 2 diabetes mellitus (T2DM), using a predefined approach and examine their association with vitamin D status.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 178 participants randomly selected in Sergipe, Brazil. Phenotypic clusters were derived using body mass index (BMI), glycated haemoglobin levels, age at diagnosis, insulin resistance (homeostatic model assessment (HOMA) for insulin resistance) and β-cell function (HOMA-B). To explore differences across phenotypes, we evaluated high-sensitivity C-reactive protein [hs-CRP] and serum ferritin levels, waist circumference and BMI, serum concentrations of 25-hydroxyvitamin D [25(OH)D] and therapeutic profile. Clustering was performed using the K-medoids algorithm. Group comparisons were performed using the Kruskal-Wallis and Fisher's exact tests and associations were assessed using multivariable logistic regression. A p-value of < 0.05 was considered significant.</p><p><strong>Results: </strong>Four metabolic phenotypes were identified: two more severe clusters (severe insulin-deficient diabetes (SIDD)-like and severe insulin-resistant diabetes-like) and two milder clusters (mild obesity-related diabetes (MOD)-like and mild age-related diabetes (MARD)-like). Significant differences were observed in age, insulin use, waist circumference and fasting glucose, triglycerides and hs-CRP levels. Median 25(OH)D levels were lower in severe phenotypes compared with milder phenotypes. The SIDD-like group, characterised by marked insulin deficiency, showed 3.68-fold higher odds of vitamin D insufficiency (< 30 ng/mL) compared with the MARD-like phenotype (p = 0.013).</p><p><strong>Conclusions: </strong>The metabolic phenotypes were explored in a primary care T2DM cohort, supporting their reproducibility across clinical settings. Vitamin D status varied by phenotype severity, with more severe phenotypes more likely to exhibit insufficiency.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10603-10614"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving Short- and Long-Term Type 2 Diabetes Risk Prediction for Middle-Aged British Adults.","authors":"Cunrong Huang, Andre Lopes, Annie Britton","doi":"10.1111/dom.71289","DOIUrl":"10.1111/dom.71289","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes prediction tools are valuable for prevention and resource planning. Few tools exist to predict long-term diabetes risk for British adults. We aim to develop and validate a diabetes prediction tool for short- and long-term risk.</p><p><strong>Materials and methods: </strong>Prediction model development (Training, n = 4502) and internal validation (Test, n = 1929) used Whitehall II data (WHII); external validation used English Longitudinal Study of Ageing (ELSA) data, with incident diabetes as outcome. Predictors were selected using LASSO-Cox, random survival forests (RSF) and best subset selection. Three candidate Cox models were built from these predictor sets and compared. Performance was assessed with C-indices, calibration and decision curve analysis (DCA). A continuous risk score and quartile-based risk groups were derived; a nomogram was created.</p><p><strong>Results: </strong>Across WHII Test (235 events) and ELSA (255 events), three models showed broadly similar discrimination, calibration and DCA patterns. LASSO- and RSF-selected models performed comparably and slightly better than best subset. LASSO and RSF both selected ethnicity, body mass index, waist-to-height ratio, height, triglyceride-glucose index, fasting glucose, family history of diabetes and socioeconomic status; LASSO additionally selected smoking, whereas RSF also included age, triglycerides, high-density lipoprotein cholesterol, systolic and diastolic blood pressure. In ELSA, risk-score C-indices (95% CIs) were 0.800 (0.773-0.827) for the LASSO-selected model and 0.801 (0.774-0.827) for the RSF-selected model; risk-group C-indices were 0.737 (0.715-0.759) and 0.727 (0.707-0.748), respectively.</p><p><strong>Conclusions: </strong>We developed and externally validated a tool to estimate 5-, 10- and 15-year diabetes risk in British middle-aged adults, which may support primary care decision-making.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10574-10585"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeff R Ma, Sean Tan, Gerald F Watts, Nick S R Lan, Robert Hungerford, Peter J Psaltis, Jessica A Marathe, Stephen J Nicholls, Adam J Nelson
{"title":"Interpreting Triglycerides: A National Cross-Sectional Review of Laboratory Reporting Practices.","authors":"Jeff R Ma, Sean Tan, Gerald F Watts, Nick S R Lan, Robert Hungerford, Peter J Psaltis, Jessica A Marathe, Stephen J Nicholls, Adam J Nelson","doi":"10.1111/dom.71254","DOIUrl":"10.1111/dom.71254","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10895-10898"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148807880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Phenotypic Heterogeneity of Diabetic Kidney Disease and Its Association With Cardiovascular and Renal Outcomes: Evidence From a Chinese Multicentre Cohort.","authors":"Yi Li, Zuhai Hu, Liping Chen, Huichang Jia, Weili Wang, Shiyu Zhou, Xin Xu, Huhai Zhang, Hongwen Zhao","doi":"10.1111/dom.71239","DOIUrl":"10.1111/dom.71239","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD), a major microvascular complication of diabetes, is the leading cause of chronic kidney disease (CKD) and progression to end-stage kidney disease (ESKD). DKD exhibits substantial clinical heterogeneity, ranging from the classic proteinuric phenotype to the increasingly recognised nonproteinuric phenotype. However, cardiovascular, kidney and all-cause mortality risks across these phenotypes remain incompletely characterised.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 14 367 adults with DKD in the China Renal Data System (CRDS). Major adverse cardiovascular events (MACEs), ESKD and all-cause mortality were ascertained from longitudinal electronic health records. Multi-state models were used to characterise transitions among clinical states and to estimate transition-specific risks across DKD phenotypes.</p><p><strong>Results: </strong>Over a median follow-up of 2.1 years, 17.1% of participants experienced MACE, while 7.0% and 10.0% progressed to ESKD and experienced all-cause mortality, respectively. High urinary albumin-to-creatinine ratio (UACR)-related phenotypes emerged as persistent risk factors across various disease trajectories. In particular, the phenotype combining low estimated glomerular filtration rate (eGFR) and high UACR had the highest risks of progression to ESKD and of death after MACE.</p><p><strong>Conclusions: </strong>Our findings show that DKD phenotypes defined by baseline eGFR and UACR were associated with distinct cardiovascular, kidney and mortality risks. Albuminuria remained an important prognostic marker even when eGFR was preserved, whereas the combination of low eGFR and high albuminuria identified the highest risk group. These findings support improved phenotypic risk stratification and may inform future clinical research and individualised risk assessment in DKD.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10248-10260"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786331","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":"Effects of Sarpogrelate Versus Aspirin on Whole Blood Viscosity in Patients With Type 2 Diabetes and Peripheral Artery Disease.","authors":"Fatima Nari, Jooyeop Lee, Joohee Kim, Soo Lim","doi":"10.1111/dom.71265","DOIUrl":"10.1111/dom.71265","url":null,"abstract":"<p><strong>Background: </strong>Whole blood viscosity (WBV) is associated with impaired microvascular circulation and cardiovascular risk in patients with Type 2 diabetes mellitus (T2DM) and peripheral artery disease (PAD). This study investigated the efficacy and safety of sarpogrelate compared with aspirin on WBV in patients with T2DM and PAD.</p><p><strong>Methods: </strong>This randomised, open-label clinical trial enrolled adults with T2DM and PAD. A total of 66 participants were randomised to aspirin (n = 33) or sarpogrelate (n = 33) for 24 weeks. The primary endpoint was change in diastolic WBV at a shear rate of 1 s<sup>-1</sup> from baseline to week 24. Secondary endpoints included tissue oxygen delivery index, pain visual analogue scale (VAS) and cold sensation scores.</p><p><strong>Results: </strong>After 24 weeks, diastolic WBV did not decrease significantly in both groups (sarpogrelate group: 31.91 ± 7.83 to 30.76 ± 7.08, mean change, -1.15 ± 9.25; p = 0.509; aspirin group: 33.32 ± 8.86 to 32.12 ± 9.60, mean change, -1.20 ± 8.36; p = 0.432). VAS scores improved significantly in both groups (mean change, -9.09 ± 18.09; p = 0.007 for sarpogrelate; -6.13 ± 16.47; p = 0.047 for aspirin), with no between-group difference. Cold sensation scores improved only in the sarpogrelate group (mean change, -0.21 ± 0.55; p = 0.033 vs. -0.23 ± 0.85; p = 0.147 for aspirin group), with no between-group difference.</p><p><strong>Conclusion: </strong>In patients with T2DM and PAD, sarpogrelate did not significantly improve WBV compared with aspirin. VAS scores and cold sensation improved significantly within the sarpogrelate group with no between-group difference.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10449-10458"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811383","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}