Diabetes, Obesity & Metabolism最新文献

{"title":"Continuous glucose monitoring-derived time in range is associated with changes in cognitive function test scores in Japanese patients with type 2 diabetes mellitus.","authors":"Maki Inoue, Yoshiki Kusunoki, Mana Ohigashi, Keiko Osugi, Chikako Inoue, Akihito Otsuka, Daisuke Azuma, Hiroki Ikeda, Daisuke Tamada, Tadahiro Inagaki, Nobuaki Watanabe, Akio Miyoshi, Akinori Kanzaki, Manabu Kadoya, Kosuke Konishi, Hidenori Koyama","doi":"10.1111/dom.16511","DOIUrl":"https://doi.org/10.1111/dom.16511","url":null,"abstract":"<p><strong>Aims: </strong>Type 2 diabetes mellitus (T2DM) is known to be a risk factor for cognitive dysfunction and dementia. Time in range (TIR), which is derived from continuous glucose monitoring (CGM), has been widely used as an indicator of the quality of glycemic control. While cross-sectional studies have reported an association between CGM-derived TIR and cognitive function scores, few studies have longitudinally investigated the relationship between the two. This study aimed to prospectively investigate the association between CGM-derived TIR and changes in multiple cognitive function scores.</p><p><strong>Materials and methods: </strong>The present study used baseline and 2-year data from an ongoing multicenter cohort study. This study included 197 T2DM patients aged ≥60 years with undiagnosed dementia. Participants were examined with the mini-mental state examination (MMSE), the Japanese version of the Montreal cognitive assessment (MoCA-J) and the digit symbol substitution test (DSST) at both baseline and 2 years. Multiple regression analyses were performed to investigate the association between TIR and changes in cognitive function test scores over 2 years.</p><p><strong>Results: </strong>Multivariate regression analysis showed that there was a significant association between TIR and changes in MMSE (ΔMMSE) over 2 years (standard partial regression coefficient [β] = 0.187, p = 0.005). Similarly, multivariate regression models showed a significant association between TIR and ΔMoCA-J (β = 0.218, p = 0.001) and ΔDSST (β = 0.164, p = 0.036).</p><p><strong>Conclusions: </strong>In patients with T2DM with undiagnosed dementia, CGM-derived TIR might be associated with overall cognitive decline and reduced processing speed.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300812","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 do patients with obesity discontinue glucagon-like peptide 1 analogues?","authors":"Faisal I Almohaileb, Carel W le Roux, Michael Crotty","doi":"10.1111/dom.16531","DOIUrl":"https://doi.org/10.1111/dom.16531","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300817","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":"Hormonal adaptations to weight loss: Responses to an oral glucose load 4 weeks after obesity surgery and low-energy diet.","authors":"Giovanni Fanni, Fleur Hukema, Susanne Hetty, Argyri Mathioudaki, Magnus Sundbom, Ulf Risérus, Joel Kullberg, Maria J Pereira, Håkan Ahlström, Jan W Eriksson","doi":"10.1111/dom.16526","DOIUrl":"https://doi.org/10.1111/dom.16526","url":null,"abstract":"<p><strong>Aims: </strong>In addition to weight loss, obesity surgery (OS) leads to metabolic improvements that seem at least partly independent of weight loss and are also mediated by various endocrine pathways and the brain. For the first time, we compared the short-term effects of weight loss achieved by either OS or a low-energy diet (LED) on several hormonal systems, at fasting and upon an oral glucose challenge.</p><p><strong>Materials and methods: </strong>This study presents sub-analyses from a randomized controlled trial including 24 participants with obesity but without diabetes (BMI 35-45 kg/m²), randomized 2:1 to either OS or 4-week LED leading to comparable weight loss. Circulating levels of gut, pituitary, adrenal, thyroid hormones, glucagon, insulin-like growth factor-1 and sex hormone-binding globulin were measured at baseline and 4 weeks after either intervention, both at fasting and during an oral glucose tolerance test (OGTT).</p><p><strong>Results: </strong>At 4 weeks, similar weight loss was achieved for the two interventions (7.7 for OS vs. 7.4% for LED). glucagon-like peptide-1 and peptide YY secretion during the OGTT increased after OS (p < 0.001 for OGTT_AUC for both hormones), but not LED, while glucagon secretion remained unaffected. Adrenocorticotropin, cortisol and prolactin levels during OGTT were increased after OS (p = 0.04, p < 0.001, p = 0.002, respectively), while parathyroid hormone levels were decreased (p = 0.007). Fasting triiodothyronine levels were reduced after OS (p = 0.01). Fasting sex hormone-binding globulin levels decreased after both interventions (p < 0.01).</p><p><strong>Conclusion: </strong>Rapid and extensive hormonal changes occur after OS, but not LED, despite similar weight loss. Of note, few differences were seen in the fasting state, whereas multiple endocrine pathways were affected during the oral glucose challenge. The findings suggest altered responses to oral glucose after OS in several hypothalamus-pituitary endocrine axes and peripheral endocrine glands.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300814","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":"Sustained metabolic improvements in a remotely delivered ketogenic nutrition programme for veterans with type 2 diabetes: A 3-year observational study.","authors":"Rebecca N Adams, Shaminie J Athinarayanan, Alison R Zoller, Amy L McKenzie, Robert E Ratner","doi":"10.1111/dom.16525","DOIUrl":"https://doi.org/10.1111/dom.16525","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the long-term effectiveness and safety of a remote, medically supervised ketogenic nutrition therapy intervention for Veterans with type 2 diabetes (T2D).</p><p><strong>Materials and methods: </strong>This retrospective observational analysis examined de-identified medical records of Veterans with T2D who engaged in a remote continuous care intervention. Outcomes were HbA1c, weight, diabetes medication use and cardiometabolic markers (lipids, liver enzymes, kidney function) among those who remained enrolled for 2 or 3 years. Separately, we assessed weight, glucose and medication changes at programme departure among Veterans who discontinued before 2 years. Outcomes were analysed across subgroups. Linear mixed-effects models and paired t-tests evaluated changes over time.</p><p><strong>Results: </strong>Among 640 enrolled Veterans (mean age: 59 years, BMI: 35 kg/m², HbA1c: 8.4%), 310 (49%) remained engaged at 2 years and 197 (33%) at 3 years. At both time points, HbA1c was reduced by approximately 0.8%, alongside decreases in diabetes medication use. Weight decreased by approximately 9% at both 2 and 3 years. Overall, reductions in HbA1c and weight were seen across subgroups. Veterans who discontinued before 2 years experienced metabolic improvements, with greater benefits among those enrolled at least 6 months.</p><p><strong>Conclusions: </strong>For US Veterans, long-term participation in a remote ketogenic nutrition therapy intervention was associated with sustained improvements in glycaemic control, weight, medication use and select cardiometabolic markers. A 0.8% HbA1c reduction is associated with meaningful reductions in diabetes-related complications, highlighting the potential clinical relevance of these findings.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300816","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":"Magnesium and thiamine supplementation increases renal mitochondrial respiration in lean C57BL/6J but not in obese ob/ob mice.","authors":"Sebastian Sill, Fariba Zivehe, Carina Heitmann, Delia Bahn, Julia Busch, Lyn Eigenfeldt, Thomas Fleming, Julia Szendrödi, Cesare Granata, Dan Ziegler, Gidon Bönhof, Michael Roden, Hadi Al-Hasani, Alexander Strom, Alexandra Chadt","doi":"10.1111/dom.16507","DOIUrl":"https://doi.org/10.1111/dom.16507","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300815","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":"Effect of saroglitazar on glycaemic parameters: A systematic review and meta-analysis of randomized controlled trials.","authors":"Luis E Simental-Mendía, Mario Simental-Mendía, Laura Jazel Barragán-Zuñiga, Mariana Arce-Quiñones","doi":"10.1111/dom.16506","DOIUrl":"https://doi.org/10.1111/dom.16506","url":null,"abstract":"<p><strong>Aims: </strong>Saroglitazar is a dual peroxisome proliferator-activated receptor (PPAR), predominantly a PPAR-α agonist and a moderate PPAR-γ agonist activity, which has shown positive effects in diabetic dyslipidaemia. However, its potential anti-diabetic effect has not been thoroughly investigated, and the data have been inconsistent. Thus, we conducted a meta-analysis to examine the impact of saroglitazar on glycaemic markers in patients with dyslipidaemia, type 2 diabetes and non-alcoholic fatty liver disease.</p><p><strong>Materials and methods: </strong>The search strategy was conducted in PubMed, Web of Science, Scopus, ClinicalTrials.gov and Google Scholar databases. Randomized controlled trials reporting changes in glycaemic parameters after saroglitazar therapy were selected. The Cochrane risk-of-bias tool for randomized trials version 2 was used to assess the quality of the included studies. For meta-analysis, a random-effects model and the generic inverse variance method were conducted. Also, the leave-one-out method was applied for the sensitivity analysis.</p><p><strong>Results: </strong>A total of 10 clinical trials (N = 2077; mean age: 49.7 years; 40% female) were included. Regarding the quality of the included studies, two trials had a low risk of bias, seven trials showed some concerns and one study exhibited a high risk of bias. The meta-analysis of 10 randomized controlled trials showed that saroglitazar significantly reduces fasting glucose (weighted mean difference [WMD]: -12.11 mg/dL, 95% CI: -14.79, -9.43, p < 0.0001, I² = 40%), postprandial glucose (WMD: -16.17 mg/dL, 95% CI: -22.29, -10.04, p < 0.0001, I² = 0%) and HbA1c (WMD: -0.39%, 95% CI: -0.57, -0.22, p < 0.0001, I² = 72%) compared to active control or placebo. However, there was no significant effect on insulin levels (WMD: -1.03 μU/mL, 95% CI: -4.12, 2.06, p = 0.51, I² = 37%), HOMA-IR (WMD: -0.41, 95% CI: -0.86, 0.04, p = 0.07, I² = 41%) and C-peptide (WMD: -0.30 ng/mL, 95% CI: -0.76, 0.15, p = 0.19, I² = 0%) after saroglitazar therapy.</p><p><strong>Conclusions: </strong>Our results revealed that saroglitazar therapy improves glycaemic parameters through the reduction of fasting glucose, postprandial glucose and HbA1c.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300813","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":"Cardiac troponin at the point of care in acute and chronic coronary syndromes.","authors":"Michael McDermott, Yong Yong Tew, Jamie G Cooper, Deepak Harry, Nicholas L Mills","doi":"10.1111/dom.16503","DOIUrl":"https://doi.org/10.1111/dom.16503","url":null,"abstract":"<p><p>High-sensitivity cardiac troponin (hs-cTn) assays are integral to the assessment of patients with acute chest pain where prompt and accurate diagnosis of myocardial infarction enables timely delivery of potentially life-saving treatment. In the Emergency Department, implementation of central laboratory hs-cTn assays has reduced length of stay and unnecessary hospital admission. Recently hs-cTn assays have become available on point-of-care (POC) platforms that have equivalent analytical and diagnostic performance to central laboratory platforms but can deliver results more rapidly to guide decisions in real-time. These assays have the potential to further accelerate care in the Emergency Department and to facilitate the assessment of patients with suspected acute coronary syndromes in pre-hospital settings, primary care and the out-patient clinic. Greater accessibility to testing could broaden the role of hs-cTn to improve the risk stratification of patients with new onset exertional angina and chronic coronary syndromes. Whilst hs-cTn assays are already available for use at the point-of-care, prospective studies are required to determine the clinical and cost-effectiveness of testing in patients with acute and chronic coronary syndromes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309351","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":"Post-authorisation safety study to assess the risk of urinary tract cancer in people with type 2 diabetes initiating empagliflozin: A multi-country European study.","authors":"Niklas Schmedt, Ayman Alhamdow, Giorgi Tskhvarashvili, Laura Saarelainen, Xu Qiao, Muriel Lobier, Fabian Hoti","doi":"10.1111/dom.16477","DOIUrl":"https://doi.org/10.1111/dom.16477","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to assess the risk of urinary tract cancers (UTCs), including bladder and renal cancers, in people with type 2 diabetes (T2D) initiating empagliflozin compared with people initiating any dipeptidyl peptidase-4 inhibitor (DPP-4i) in the United Kingdom (UK), Sweden, and Finland.</p><p><strong>Materials and methods: </strong>This was a non-interventional, multi-country cohort study based on secondary data in Sweden, Finland, and the UK. The study used an active comparator, new user design and included propensity score-matched adults with T2D initiating empagliflozin or a DPP-4i between 2014 and 2020 (2021 for the UK). Follow-up started at the index date (first prescription or dispensation for empagliflozin or a DPP-4i) and 180 days were considered as the latency period. Incidence rates (IRs) and hazard ratios (HRs) were estimated under an as-treated approach in each country. HRs were then entered into a random-effects meta-analysis.</p><p><strong>Results: </strong>The main analyses included 151 055 matched people. The mean age for empagliflozin initiators was 57.0-63.2 years across the countries, and most were female (59.6%-67.8%). A meta-analysis of country-level HR showed no evidence of an increased risk of UTC (adjusted HR = 0.88, 95% confidence intervals [CIs]: 0.66-1.17), bladder cancer (adjusted HR = 0.91, 95% CI: 0.63-1.33) or renal cancer (adjusted HR = 0.89, 95% CI: 0.57-1.38) for empagliflozin initiators compared with DPP-4i initiators. Various sensitivity analyses also validated the robustness of the main findings.</p><p><strong>Conclusions: </strong>No increased risk of UTC, bladder, and renal cancer was observed when empagliflozin initiators were compared with DPP-4i initiators in this non-interventional cohort study.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281819","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 effect of sodium-glucose cotransporter 2 inhibitors on HbA1c variability and cardiovascular and renal adverse outcome in patients with T2DM.","authors":"Ran Guo, Ambarish Pandey, Chanchal Chandramouli, Mei-Zhen Wu, An-Ping Cai, Ying-Xian Liu, Qing-Wen Ren, Jia-Yi Huang, Jing-Nan Zhang, Wen-Li Gu, Hao-Chen Xuan, Wouter Ouwerkerk, Jasper Tromp, Tiew-Hwa Katherine Teng, Christopher Tze-Wei Tsang, Ching-Yan Zhu, Yik-Ming Hung, Carolyn S P Lam, Kai-Hang Yiu","doi":"10.1111/dom.16509","DOIUrl":"https://doi.org/10.1111/dom.16509","url":null,"abstract":"<p><strong>Aims: </strong>To compare the effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP-4) inhibitors in reducing haemoglobin A1c (HbA1c) variability and improving cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM) and high HbA1c variability.</p><p><strong>Methods: </strong>This territory-wide cohort study involved patients with T2DM and an HbA1c variability score (HVS) >60% who initiated SGLT2 inhibitors or DPP-4 inhibitors in Hong Kong between 2015 and 2022. Propensity score (PS) matching was used to adjust for confounders. The primary outcome was post-treatment HVS within 3 years. Secondary outcomes included major adverse cardiovascular events (MACE) and serious renal events (SRE).</p><p><strong>Results: </strong>Among 20,205 T2DM patients with a baseline HVS >60%, 4,612 SGLT2 inhibitor users were 1:1 matched with DPP-4 inhibitor users. When referencing the 0%-20% quintile, patients initiating SGLT2 inhibitors versus DPP-4 inhibitors exhibited a reduced likelihood of being in higher HVS quintiles [21%-40%: odds ratio (OR) 0.76, 95% confidence interval (CI) 0.66-0.88; 41%-60%: OR 0.57, 95% CI 0.50-0.65; 61%-80%: OR 0.49, 95% CI 0.42-0.56; and 81%-100%: OR 0.40, 95% CI 0.34-0.47]. SGLT2 inhibitors were associated with a reduced risk of MACE [hazard ratio (HR) 0.69; 95% CI 0.60-0.79] and SRE (HR 0.71; 95% CI 0.63-0.80) compared to DPP-4 inhibitors.</p><p><strong>Conclusion: </strong>In patients with high HbA1c variability, SGLT2 inhibitor initiation was associated with superior effectiveness in reducing HbA1c variability compared to DPP-4 inhibitors. The initiation of SGLT2 inhibitors versus DPP-4 inhibitors was linked to significantly reduced cardiovascular and renal adverse events.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281821","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":"Pyridoxamine does not reduce arterial stiffness in an 8-week randomized double-blind placebo-controlled intervention trial with abdominally obese individuals.","authors":"Mathias D G Van den Eynde, Myrthe M van der Bruggen, Alfons J H M Houben, Koen D Reesink, Bart Spronck, Tammo Delhaas, Jean J L J M Scheijen, Toshio Miyata, Casper G Schalkwijk","doi":"10.1111/dom.16524","DOIUrl":"https://doi.org/10.1111/dom.16524","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281820","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}