Diabetes, Obesity & Metabolism最新文献

{"title":"Clinical and biochemical profile of individuals with renal glucosuria: A matched cohort study.","authors":"Afif Nakhleh, Limor Adler, Gida Ayada, Shirley Shapiro Ben David, Daniella Rahamim-Cohen, Ori Liran, Sagit Zolotov, Naim Shehadeh","doi":"10.1111/dom.16339","DOIUrl":"https://doi.org/10.1111/dom.16339","url":null,"abstract":"<p><strong>Aims: </strong>To compare the clinical and biochemical characteristics of individuals with renal glucosuria to matched controls.</p><p><strong>Materials and methods: </strong>We analysed data from 60,000 consecutive adults in Maccabi Healthcare Services, an Israeli health maintenance organization, who had at least two urine dipstick tests performed at least 3 months apart within 10 years before 11 March 2024. For each patient, we analysed the most recent urine test and the previous test taken at least 3 months earlier. We excluded individuals with prediabetes or diabetes, sodium-glucose cotransporter 2 inhibitor use and pregnancy. Individuals with renal glucosuria (two positive glucose urine tests plus an ICD-9-CM diagnosis) were matched 1:3 to controls (two negative glucose urine tests) by age, sex, weight and BMI. Clinical and laboratory data were assessed using univariate and multivariate logistic regression.</p><p><strong>Results: </strong>Of 227 individuals with renal glucosuria, 220 were matched with 660 controls selected from a total of 33,655 individuals. The mean age of the study population (n = 880) was 36.9 ± 12 years; 70% were female, and the mean BMI was 24.1 ± 4.1 kg/m². Individuals with renal glucosuria had higher haematocrit (adjusted odds ratio [aOR] 1.10, 95% confidence interval [CI] 1.04 to 1.16) and lower blood uric acid levels (aOR 0.70, 95% CI 0.58 to 0.85) compared with controls. No significant differences were observed in fasting glucose, estimated glomerular filtration rate, lipid profiles or the rates of hypertension, atherosclerotic cardiovascular disease or genitourinary infections.</p><p><strong>Conclusion: </strong>In young adults, renal glucosuria was associated with higher haematocrit and lower uric acid, with no other cardiometabolic differences from controls.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646445","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 level 2 hypoglycaemia on neuroaxonal damage biomarker in individuals with type 2 diabetes: A stepwise hypoglycaemic clamp study.","authors":"Harald Sourij, Kehkishan Azhar, Felix Aberer, Caren Sourij, Norbert J Tripolt, Harald Kojzar, Peter N Pferschy, Arabella Buchmann, Faisal Aziz, Michael Khalil","doi":"10.1111/dom.16340","DOIUrl":"https://doi.org/10.1111/dom.16340","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646534","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 safety of switching to iGlarLixi from premixed insulins in people with type 2 diabetes: The Soli-SWITCH study","authors":"Martin Haluzík MD,&nbsp;Katarzyna Cypryk MD,&nbsp;Agustina Alvarez MD,&nbsp;Felipe Lauand MD,&nbsp;Valérie Corp dit Genti MS,&nbsp;Okan Sefa Bakiner MD,&nbsp;Soo Lim MD","doi":"10.1111/dom.16276","DOIUrl":"10.1111/dom.16276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess the efficacy and safety of switching from premixed insulin to a once-daily, fixed-ratio combination of insulin glargine 100 U/mL + lixisenatide (iGlarLixi) in people with type 2 diabetes (T2D).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this phase 4, 24-week, single-arm study, participants switched from once-daily or twice-daily premixed insulin to iGlarLixi (EudraCT number 2021–003711-25). Key inclusion criteria: ≥18 years; premixed insulin therapy for ≥3 months and &lt; 10 years; ± 1–2 oral antidiabetic drugs (OADs); HbA1c ≥7.5% to ≤10.0%. The primary endpoint was the change in HbA1c from baseline to Week 24. Secondary endpoints included: participants achieving HbA1c &lt;7% and change in body weight at Week 24, and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 162 participants switched to iGlarLixi (89.5% from twice-daily premixed insulin); mean duration of diabetes was 15.7 (standard deviation [SD]: 8.3) years. Mean baseline HbA1c (8.5%) reduced by least squares (LS) mean of 1.2% (95% confidence interval [CI]: −1.4, −1.1) at Week 24, and 37.6% of participants had achieved an HbA1c target of &lt;7% (95% CI: 30.0, 45.7). LS mean body weight change from baseline to Week 24 was −1.0 kg (95% CI: −1.6, −0.5). Fasting and post-prandial plasma glucose decreased from baseline to Week 24 by 45.6 mg/dL (SD ± 52.4) and 67.6 mg/dL (SD ± 65.1), respectively. Confirmed symptomatic hypoglycaemia occurred in 38.3% of participants (ADA level 1: 35.8%; level 2: 15.4%; level 3: 0.0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>iGlarLixi initiation was associated with improved glycaemic control, without body weight gain or increased hypoglycaemia over 24 weeks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2730-2739"},"PeriodicalIF":5.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646526","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":"Use of semaglutide and risk of non-arteritic anterior ischemic optic neuropathy: A Danish-Norwegian cohort study.","authors":"Emma Simonsen, Lars Christian Lund, Martin Thomsen Ernst, Vidar Hjellvik, Laszlo Hegedüs, Steffen Hamann, Øystein Kalsnes Jørstad, Hanne Løvdal Gulseth, Øystein Karlstad, Anton Pottegård","doi":"10.1111/dom.16316","DOIUrl":"https://doi.org/10.1111/dom.16316","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the putative association between semaglutide and non-arteritic anterior ischaemic optic neuropathy (NAION).</p><p><strong>Materials and methods: </strong>Data from national health registries in Denmark (2018-2024) and Norway (2018-2022) were used to compare NAION risk in individuals with type 2 diabetes initiating semaglutide versus sodium-glucose co-transporter 2 inhibitors (SGLT-2is). A supplementary self-controlled analysis examined NAION risk among all semaglutide users. National estimates were pooled using a fixed-effects model.</p><p><strong>Results: </strong>We identified 44 517 users of semaglutide for the management of type 2 diabetes in Denmark and 16 860 in Norway, with a total of 32 NAION events observed. The unadjusted incidence rate of NAION was 2.19/10 000 person-years among Danish semaglutide initiators, compared to 1.18 among SGLT-2i initiators. In Norway, the corresponding rates were 2.90 and 0.92, respectively. After adjustment, the pooled hazard ratio (HR) was 2.81 (95% confidence interval [CI] 1.67-4.75), and the incidence rate difference (IRD) was +1.41 (95% CI +0.53 to +2.29) per 10 000 person-years. Estimates were consistent across both countries but higher and less precise in Norway (HR 7.25; 95% CI 2.34-22.4) compared to Denmark (HR 2.17; 95% CI 1.20-3.92). Results remained consistent across sensitivity and supplementary analyses, with a stronger association observed in a post hoc per-protocol analysis (HR 6.35; 95% CI 2.88-14.0). In the supplementary self-controlled study, symmetry ratios (SRs) for NAION were 1.14 (95% CI 0.55-2.36) in Denmark and 2.67 (95% CI 0.91-8.99) in Norway.</p><p><strong>Conclusions: </strong>The use of semaglutide for managing type 2 diabetes is associated with an increased risk of NAION compared with the use of SGLT-2is. However, the absolute risk remains low.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646559","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 of phentermine/topiramate extended release in weight management and metabolic profiles: A multicentre study in South Korea.","authors":"Kyoung Min Kim, Jong Han Choi, Byoungduck Han, Yang-Im Hur, Jang Won Son, Ga Eun Nam, Jee-Hyun Kang, Yoon Jeong Cho, Won Jun Kim, Soo Lim","doi":"10.1111/dom.16342","DOIUrl":"https://doi.org/10.1111/dom.16342","url":null,"abstract":"<p><strong>Aims: </strong>Clinical trials have demonstrated the effectiveness of the phentermine and topiramate combination in weight management. This research evaluated the efficacy and safety of phentermine/topiramate extended release (ER) for weight management, focusing on alterations in body weight and metabolic parameters in routine clinical practice.</p><p><strong>Materials and methods: </strong>We retrospectively included people with obesity who initiated phentermine/topiramate ER between January 2020 and April 2023 at 10 tertiary hospitals in South Korea. The study assessed body weight changes at 5-6 months and for those who continued, at 12 months, along with metabolic parameters. Total body weight was measured using calibrated electronic scales with participants in light indoor clothing.</p><p><strong>Results: </strong>The cohort included 1839 patients (540 men and 1299 women), with a 5-6-month continuation rate of 48%. At 5-6 months, the mean weight reduction was 7.9%, with sex-specific losses of 7.1% in men and 8.2% in women. Over 56% of participants achieved more than 5% weight loss, with 23% exceeding a 10% reduction. Younger participants, women and those with moderate to severe obesity exhibited more pronounced weight loss compared to older men and individuals with mild obesity, respectively. Concurrently, phentermine/topiramate ER treatment improved glucose regulation, lipid profiles and decreased blood pressure: the HbA1c decreased by 0.4 ± 0.9%, low-density lipoprotein (LDL) cholesterol by 10 ± 32 mg/dL and systolic blood pressure by 6 ± 15 mmHg (all p < 0.001). Treatment was well-tolerated, with a 15% incidence of mild adverse events like paresthesia, dry mouth and insomnia. At 12 months, patients who persisted in treatment (21%) experienced an average weight loss of 9.6%, with 65% surpassing a 5% weight loss.</p><p><strong>Conclusion: </strong>The study suggests phentermine/topiramate ER is an effective option for obesity management in a South Korean population, though long-term adherence remains a challenge.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646530","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":"Biosimilar insulins: Narrative review of the regulatory framework and registration studies.","authors":"Tim Heise, J Hans DeVries","doi":"10.1111/dom.16320","DOIUrl":"https://doi.org/10.1111/dom.16320","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Biosimilar insulins have been commercially available in the EU since 2014. Currently, six biosimilar insulins are approved in the EU and four in the US. However, commercial success has been limited, which may be in part due to concerns among physicians and people with diabetes that biosimilar insulins are substandard in efficacy, safety, and quality compared to reference products. Indeed, unlike generic drugs, which are identical chemical copies of their reference counterparts, in a biological manufacturing process, subtle differences can arise between products, even if the tertiary molecular structures are the same. Therefore, there is a clear regulatory pathway for the approval of biosimilars. For biosimilar insulins, preclinical (hormone receptor and cell) studies are needed to investigate potential differences in the response to biosimilar insulins and their reference medicinal products. In addition, there is a requirement for pivotal clinical pharmacology studies involving the euglycaemic glucose clamp technique to investigate comparative time-action profiles, whereas later-phase clinical safety, efficacy, and immunogenicity studies usually are no longer needed for the approval of biosimilar insulins. This narrative review provides an overview of pivotal phase 1 clamp and supportive larger phase 3 studies that supported the registration of biosimilar insulins in the EU and US, and discusses the need for interchangeability and immunogenicity studies. Overall, the current regulatory approach in the EU and in the USA ensures that there are no relevant differences between biosimilar insulins and their reference products. Therefore, people with diabetes and prescribers can use EU or US approved biosimilars without any concerns. PLAIN LANGUAGE SUMMARY: Six biosimilar insulins are approved by the EU regulator, the European Medicines Agency, and are currently available on the EU market. Three biosimilar insulins are approved by the US regulator, the Food and Drugs Agency, and are currently available on the US market. However, commercial success has been limited, which may be in part due to concerns among physicians and people with diabetes that biosimilar insulins are perhaps not quite the same as the original products with respect to efficacy, safety, and quality. Such concerns could be valid, because unlike generic drugs, which are identical chemical copies of their reference counterparts, biosimilar protein biosimilar and originator drugs cannot be chemically identical. In a biological manufacturing process, subtle difference can and will arise between products, even if the tertiary molecular structures, that is the amino acid sequence, the interactions between different parts of the protein and the three-dimensional folding, are the same. To assure that these unavoidable subtle differences do not result in differences in efficacy, safety and quality, there is a clear regulatory pathway for the approval of biosimilars. In addition to chemic","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646441","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":"Discordance between serum cholesterol concentration and atherogenic lipoprotein particle number in people with metabolic disease: A systematic review.","authors":"Craig Witt, Lee G Renfroe, T Scott Lyons","doi":"10.1111/dom.16335","DOIUrl":"https://doi.org/10.1111/dom.16335","url":null,"abstract":"<p><p>This systematic review examines the discordance between low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B-100 (apoB) in individuals with metabolic diseases, such as metabolic syndrome and type 2 diabetes, and evaluates the implications for atherosclerotic cardiovascular disease (ASCVD) risk assessment. A systematic literature search was conducted using Academic Search Complete, CINAHL Complete, and MEDLINE databases from 10 January 2024 to 28 May 2024. Studies were selected based on pre-defined inclusion and exclusion criteria, focusing on observational studies that compared LDL-C, non-HDL-C, and apoB levels in individuals with metabolic disease. Studies were included if they assessed fasted blood samples and reported lipid measurements, excluding those involving drug therapies or dietary interventions. Nine studies met the inclusion criteria, revealing significant discordance between LDL-C and apoB levels in individuals with metabolic syndrome or type 2 diabetes. These individuals often achieve optimal LDL-C levels while exhibiting elevated apoB and non-HDL-C concentrations, highlighting the limitations of LDL-C as the sole marker for ASCVD risk. The discordance is largely attributed to differences in LDL particle size and density, with metabolic disease contributing to a higher proportion of small, dense, atherogenic LDL particles. Elevated triglyceride-rich lipoproteins (TRLs), such as very low-density lipoproteins (VLDL), were also identified as contributing to ASCVD risk underestimation by traditional LDL-C measurements. While LDL-C remains a central marker for ASCVD, apoB quantification provides a more accurate assessment of ASCVD risk, particularly in individuals with metabolic diseases. Incorporating apoB levels into therapeutic strategies for lipid reduction is recommended to improve cardiovascular risk management in this population.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646448","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 use of tirzepatide among individuals without evidence of type 2 diabetes: Results from the Veradigm® database.","authors":"Theresa Hunter Gibble, Chanadda Chinthammit, Jennifer M Ward, Katherine Cappell, Robert Sedgley, Machaon Bonafede, Birong Liao, Emily R Hankosky","doi":"10.1111/dom.16330","DOIUrl":"https://doi.org/10.1111/dom.16330","url":null,"abstract":"<p><strong>Aims: </strong>To understand real-world tirzepatide use among individuals without type 2 diabetes (T2D) diagnoses in a US electronic health record (EHR) database.</p><p><strong>Materials and methods: </strong>This retrospective, descriptive, cohort study used Veradigm's® Network EHR database linked with administrative claims. Adults (≥18 years) included had ≥1 tirzepatide prescription (index period: 13 May 2022-31 August 2023); continuous medical and pharmacy enrolment for ≥12 months pre-index; and no T2D diagnosis or baseline T2D medications except metformin (overall cohort). 'Anti-obesity medication (AOM)-eligible cohort' included individuals with body mass index (BMI) ≥30 or ≥27 kg/m² and ≥1 obesity-related complication (ORC) and ≥6 months of continuous post-index enrollment.</p><p><strong>Results: </strong>The overall cohort included 10,193 individuals (mean age: 45.0 years; female: 77.1%). Among 6623 individuals with BMI data, 5931 were AOM-eligible. Of these, 3470 had 6-month follow-up data (AOM-eligible cohort; ≥1 ORC: 76.5%; ≥2 ORCs: 51.8%). Treatment patterns at 6 months were assessed among 755 individuals with complete claims data in the AOM-eligible cohort. Most individuals (95.6%) were initiated on a tirzepatide dose of ≤5 mg. At the fifth prescription refill (n = 448), 91.1% were receiving tirzepatide doses of ≤10 mg. At 6 months, tirzepatide adherence was 55.5% and persistence was 54.2%. Among discontinued individuals (n = 346), 10.1% switched to an alternate AOM.</p><p><strong>Conclusions: </strong>Majority of individuals in the AOM-eligible cohort had ≥1 ORC, and half had ≥2 ORCs, indicating that in this study cohort tirzepatide was being used in people with multimorbidity. Tirzepatide dose escalation in this real-world cohort was slower than in clinical trials, which may have implications for its real-world effectiveness.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622997","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":"Association of BMI with mortality and health-related quality of life among 4.4 million adults: Evidence from a nationwide, population-based, prospective cohort study.","authors":"Yi Wu, Chunying Lin, Chunqi Wang, Runsi Wang, Bolin Jin, Xiaoyan Zhang, Bowang Chen, Yang Yang, Jianlan Cui, Wei Xu, Lijuan Song, Hao Yang, Wenyan He, Yan Zhang, Xi Li","doi":"10.1111/dom.16325","DOIUrl":"https://doi.org/10.1111/dom.16325","url":null,"abstract":"<p><strong>Aims: </strong>The body mass index (BMI), as an easy-to-calculate measure of body fatness, is closely associated with all-cause mortality, but few studies with a large enough scale have examined the relationship between BMI and quality of life. A comprehensive and precise insight into a new range is needed.</p><p><strong>Materials and methods: </strong>Based on the ChinaHEART (Health Evaluation And risk Reduction through nationwide Teamwork), a nationwide, population-based cohort study, 4,485,773 participants living in 20,159 communities or villages were passively followed for death records, through a linkage of data with the National Mortality Surveillance System and Vital Registration. Firstly, we conducted Cox proportional-hazards regression models to assess the hazard ratios (HRs) of BMI on the risk of all-cause and cause-specific mortality. Secondly, we used logistic regression models to examine associations between BMI and health-related quality of life (HRQL). Fully adjusted models were adjusted for age, sex, annual household income, occupation, education level, marriage, medical insurance, urbanity, tobacco smoking, alcohol consumption and the history of hypertension, diabetes mellitus, dyslipidaemia and cardiovascular disease (CVD).</p><p><strong>Results: </strong>Among the 4 485 773 included participants with an average age of 56.4 ± 10.0 years, 59.0% were female. During the follow-up period, which had a median duration of 5.3 years, a total of 142 004 cases of all-cause mortality were confirmed. After adjusting for participant characteristics and lifestyles, we observed the U-shaped association between BMI and all-cause mortality with an inflection of 26-27 kg/m², and the estimated HR per 1 kg/m² increase in BMI was 0.92 (95% CI 0.92-0.93) and 1.03 (95% CI 1.03-1.04) below and above the turning point, respectively. An inverted J-shape pattern between BMI and HRQL with a peak of 22-23 kg/m² was found, in which the odd ratio per 1 kg/m² increase in BMI was 0.98 (95% CI 0.98, 0.99) below 22-23 kg/m² and 1.03 (95% CI 1.03-1.03) above this point.</p><p><strong>Conclusions: </strong>We found distinct ranges of BMI for minimized mortality risk and maximized HRQL. The BMI range corresponding to the HRQL is lower than the BMI range corresponding to the lowest risk of death generally. Therefore, it is worth considering how to define the new recommended range for a new BMI based on the goal of 'living a longer and healthier life'.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622933","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":"Kidney outcomes with SGLT2 inhibitors in patients with diabetes and an insulin-deficient phenotype: A real world analysis.","authors":"Anat Tsur, Avivit Cahn, Lior Hanoch, Rena Pollack","doi":"10.1111/dom.16329","DOIUrl":"https://doi.org/10.1111/dom.16329","url":null,"abstract":"<p><strong>Aim: </strong>Diabetic kidney disease (DKD) is a major complication of diabetes, including in insulin-deficient phenotypes, yet data on kidney outcomes with sodium-glucose cotransporter 2 inhibitors (SGLT2i) in this population are limited. This study investigates the impact of SGLT2i on kidney outcomes in patients with insulin-deficient diabetes using real world data.</p><p><strong>Materials and methods: </strong>This retrospective cohort study utilized data from a large Health Maintenance Organization in Israel and included 12,530 propensity score-matched adults with insulin-deficient diabetes. Patients were categorized into SGLT2i users and non-users and followed for a median of 1657 days. The primary outcome was a composite of ≥50% decline in eGFR to <60 mL/min/1.73 m² or progression to eGFR <15 mL/min/1.73 m². Secondary outcomes included doubling of serum creatinine and changes in albuminuria category.</p><p><strong>Results: </strong>SGLT2i use was associated with a reduced incidence of the primary outcome (6.1% vs. 7.5%; HR 0.79, p < 0.001). Secondary analyses revealed significant reductions in serum creatinine doubling (HR 0.76, p < 0.001) and improvements in albuminuria, with 51% of SGLT2i users transitioning to normoalbuminuria. Benefits were consistent across subgroups. Although diabetic ketoacidosis (DKA) incidence was higher among SGLT2i users (2.81% vs. 2.19%, p = 0.03), the overall frequency was low.</p><p><strong>Conclusions: </strong>SGLT2i demonstrated substantial kidney protection in insulin-deficient patients, extending benefits beyond type 2 diabetes. These findings highlight SGLT2i as a potential therapeutic option for mitigating DKD in high-risk populations.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622961","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}