Diabetes, Obesity & Metabolism最新文献

{"title":"Diagnostic Yield of Structured Cushing Syndrome Evaluation in Treatment-Resistant Non-Diabetic Obesity: A Retrospective Pilot Study.","authors":"Naseem Eisa, Mira Khoury, Omar Barood","doi":"10.1111/dom.71161","DOIUrl":"10.1111/dom.71161","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10849-10852"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589758","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 Lipid Ratios With Cardiovascular Outcomes in Type 2 Diabetes: A Population Cohort Study.","authors":"Enrique Carretero-Anibarro, Jose Antonio Quesada, Manuel A Ruiz-Quintero, Didac Mauricio, Kamlesh Khunti, Domingo Orozco-Beltrán","doi":"10.1111/dom.71236","DOIUrl":"10.1111/dom.71236","url":null,"abstract":"<p><strong>Aims: </strong>To identify low- and high-risk intervals for major adverse cardiovascular events (MACE) and all-cause mortality according to lipid ratios in adults with Type 2 diabetes mellitus (T2DM), stratified by sex.</p><p><strong>Materials and methods: </strong>We used primary care electronic health records from the Spanish National Health Service including 303 199 adults with T2DM followed for a mean of 5.7 years (1.7 million person-years). Lipid indices were triglycerides/HDL cholesterol (TG/HDL-C), total cholesterol/HDL cholesterol (TC/HDL-C), non-HDL cholesterol/HDL cholesterol, LDL cholesterol/HDL cholesterol and the triglyceride-glucose (TyG) index. The outcome was a composite of all-cause mortality or hospitalisation for cerebrovascular or ischemic heart disease. Sex-specific Weibull models adjusted for clinical covariates were applied.</p><p><strong>Results: </strong>U-shaped associations were observed between lipid ratios and outcomes. Increased risk was associated with higher ratios in both sexes, with slightly lower risk thresholds in women, while very low values were also linked to excess risk.</p><p><strong>Conclusions: </strong>Extremes of lipid ratios were associated with higher cardiovascular risk, suggesting that moderate ranges may be protective. These easily obtainable markers may improve risk stratification and personalised prevention in T2DM care.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10236-10247"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786142","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":"Predictive Modelling of 3-Month Glycemic Target Achievement in Type 2 Diabetes Mellitus Using Artificial Intelligence and Continuous Glucose Monitoring: A Retrospective Cohort Study.","authors":"Qinyan Huang, Jing Kang, Rui Wang, Ming Zhang, Yan Chen","doi":"10.1111/dom.71224","DOIUrl":"10.1111/dom.71224","url":null,"abstract":"<p><strong>Aims: </strong>To develop and validate a machine learning model incorporating continuous glucose monitoring (CGM) metrics to predict 3-month glycemic target achievement in type 2 diabetes mellitus (T2DM) after short-term intensive insulin pump therapy followed by physician-selected maintenance treatment, and to build a web-based prediction tool.</p><p><strong>Materials and methods: </strong>We retrospectively included 1079 patients with T2DM and divided them into training, validation, and test sets (6:2:2). Eleven models were evaluated for discrimination, calibration, net benefit, and classification performance. Candidate models were compared for sensitivity to compression of correlated CGM predictors, interpretability, and suitability for web implementation. Nested logistic regression assessed the incremental value of CGM, and SHapley Additive exPlanations (SHAP) assessed feature contributions.</p><p><strong>Results: </strong>SVM_RBF achieved the highest test-set area under the curve (AUC; 0.926), compared with 0.917 for XGBoost (paired DeLong p = 0.521). The models had similar test-set discrimination and probabilistic accuracy, with no consistent difference in calibration. XGBoost was selected for implementation because it was less sensitive to compression of correlated CGM predictors and supported TreeSHAP. Leading predictors included diabetes duration, age, fasting C-peptide (FCP), mean amplitude of glucose excursions (MAGE), body mass index (BMI), and time in range (TIR). Adding CGM improved continuous net reclassification improvement (0.308, p = 0.013) and integrated discrimination improvement (0.0062, p = 0.029), but not AUC or categorical net reclassification improvement.</p><p><strong>Conclusion: </strong>The XGBoost model estimates 3-month glycemic target achievement within this treatment pathway and was implemented as a web-based clinical decision-support tool.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10045-10057"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Metabolic Inflammation Index for Cardiovascular Prognosis: Evidence From Three International Cohorts in Middle-Aged and Older Adults.","authors":"Menglu Liu, Na Xu, Gengyu Sha, Yunqing Ye, Kailun Yan, Kexin Zhang, Fanyong Xu, Yi Yao, Fangshun Tan, Jidong Guo, Nuerbahati Heisha, Yuejin Yang, Jinqing Yuan, Xueyan Zhao","doi":"10.1111/dom.71213","DOIUrl":"10.1111/dom.71213","url":null,"abstract":"<p><strong>Background: </strong>Chronic inflammation and insulin resistance (IR) are key drivers of cardiovascular disease (CVD); however, their joint impact on cardiovascular risk remains poorly understood.</p><p><strong>Methods: </strong>We developed the metabolic-inflammatory index (eMII) based on estimated glucose disposal rate (eGDR) in a derivation cohort (ELSA) and evaluated its transportability in two external validation cohorts (CHARLS, HRS). Multivariate Cox regression was utilised to assess the joint impact of IR and inflammation on long-term CVD risk.</p><p><strong>Results: </strong>A total of 14,168 middle-aged and older adults were included (mean age 61.68 ± 9.67 years). In fully adjusted Cox models, low eGDR, elevated hs-CRP and their combined status were all associated with increased CVD risk, with the highest risk observed in participants with both poor metabolic function and high inflammation. Exploratory mediation analysis indicated that eGDR accounted for 41.14%, 46.50% and 75.47% of the inflammation-CVD association in ELSA, CHARLS and HRS, respectively. In terms of the new index-eMII, higher eMII levels were consistently linked to elevated CVD risk across all cohorts; compared with the lowest quartile, the highest quartile showed hazard ratios of 1.66 (ELSA), 2.28 (CHARLS) and 1.83 (HRS) (all p < 0.001). Lastly, incorporating eMII into traditional risk models showed potential for improving cardiovascular risk prediction, with a more noticeable reclassification benefit observed within CHARLS.</p><p><strong>Conclusions: </strong>eMII is a cross-population predictor of CVD, highlighting metabolic impairment as a key factor through which inflammation drives cardiovascular risk. It provides a practical perspective for observing joint metabolic-inflammatory burdens in middle-aged and older adults.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10753-10764"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872263","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":"Insulin Resistance-Adiposity Burden and Incident Cardiovascular Disease Across Glycaemic Transitions in Prediabetes: Risk Stratification After Reversion to Normoglycaemia.","authors":"Huimin Cai, Yi Fu, Fangge Zhu, Jinming Qiu, Haoyuan Ye, Enmin Xie","doi":"10.1111/dom.71280","DOIUrl":"10.1111/dom.71280","url":null,"abstract":"<p><strong>Aims: </strong>To examine whether insulin resistance (IR), assessed by cumulative triglyceride-glucose (TyG)-derived indices and change patterns, stratifies incident cardiovascular disease (CVD) risk after glycaemic transition in adults with prediabetes.</p><p><strong>Materials and methods: </strong>Data were obtained from 1468 participants with prediabetes in the China Health and Retirement Longitudinal Study. Glycaemic transition and TyG-derived indices were assessed from Wave 1 to Wave 3. Indices included TyG, TyG-ABSI (a body shape index), TyG-BRI (body roundness index), TyG-CVAI (Chinese visceral adiposity index) and TyG-WWI (weight-adjusted waist index). Cumulative indices summarised measurements across Waves 1 and 3 and exploratory k-means clustering identified broad two-wave exposure patterns. Incident CVD was assessed from Waves 3 to 5. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>During a median 5.0-year follow-up, 294 CVD events occurred. Compared with persistent prediabetes, reversion to normoglycaemia was not associated with lower CVD risk (HR 0.97, 95% CI 0.72-1.31), whereas progression to diabetes was associated with higher risk (HR 1.53, 95% CI 1.14-2.07). In joint analyses, reversion with low cumulative indices was not associated with increased CVD risk, whereas reversion with high indices was significantly associated with elevated risk for most indices (HRs 1.55-2.05). Among participants who reverted to normoglycaemia, high cumulative TyG-derived indices were significantly associated with higher CVD risk (adjusted HRs 1.89-2.52; all p < 0.05). Change-pattern analyses were concordant.</p><p><strong>Conclusions: </strong>Glycaemic transition status did not fully stratify subsequent CVD risk. Cumulative TyG-related measures further stratified CVD risk across glycaemic transition groups, including among participants who reverted to normoglycaemia.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10526-10539"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816801","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":"Omnipod 5 Delivers Superior Economic Value Compared to Multiple Daily Injections: A Cost-Effectiveness Analysis in Adults With T1D From a Payer Perspective in Sweden.","authors":"Johan Jendle, Colin Hopley, Anuj Narang, Raffaele Scarica, Helena Hellerstedt, Melanie Littlewood","doi":"10.1111/dom.71231","DOIUrl":"10.1111/dom.71231","url":null,"abstract":"<p><strong>Aim: </strong>Analyse the cost-effectiveness of the Omnipod 5 automated insulin delivery system versus multiple daily injections (MDI) with continuous glucose monitoring for type 1 diabetes among adults in Sweden.</p><p><strong>Methods: </strong>Cost-effectiveness was analysed with the IQVIA Core Diabetes Model (version 10.0) taking the perspective of the payer in Sweden including healthcare system and combined healthcare system and societal costs. Treatment effects were derived from the RADIANT randomised controlled trial and acute complication rates from Biester et al. 2021. Treatment-specific health utilities were sourced from a Time Trade-Off (TTO) elicitation study. Incremental costs, life expectancy, quality-adjusted life-years (QALY) and incremental cost-utility ratios (ICURs) were calculated using a 50-year time horizon for the base case and sensitivity analysis tested changes in parameters including treatment effects, baseline HbA1c and time horizons.</p><p><strong>Results: </strong>Omnipod 5 was found to be cost-effective in the base case and sensitivity analyses, with ICURs below the willingness-to-pay threshold of 500 000 SEK per QALY. In the base case Omnipod 5 was found to have lower rates of diabetes-related complications and provide 3.82 in additional QALY. Higher therapy costs with Omnipod 5 were offset by savings in the cost of complications and savings in costs associated with absenteeism. Considering direct costs only the ICUR was 201 161 SEK per QALY. Considering combined costs it was 179 247 SEK per QALY.</p><p><strong>Conclusion: </strong>Omnipod 5 was found to offer superior value compared with MDI, showing cost-effectiveness for adults with type 1 diabetes in Sweden with better patient outcomes and fewer complications.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10142-10152"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148756927","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":"Age-Specific Associations of Moderate-to-Vigorous Physical Activity With Relative and Absolute Risk of Type 2 Diabetes in UK Biobank Participants.","authors":"Qiuyu Feng, Raymond Noordam, Denghui Hu, Gali Albalak, Ko Willems van Dijk, Diana van Heemst","doi":"10.1111/dom.71214","DOIUrl":"10.1111/dom.71214","url":null,"abstract":"<p><strong>Aims: </strong>We assessed the age-specific associations between moderate-to-vigorous physical activity (MVPA) and incident type 2 diabetes.</p><p><strong>Materials and methods: </strong>We included UK Biobank participants with valid accelerometry data without diabetes mellitus at baseline (N = 87 975; 62.7 years [IQR, 55.6-67.9]; 57% women). We examined whether age, sex and baseline metabolic disease status modified the associations of MVPA volume (lower versus higher) and, in exploratory analyses, MVPA timing (later-day versus earlier-day) with incident type 2 diabetes. Age-specific relative and absolute associations were assessed across 5-year age bins using hazard ratios (HRs) and incidence rate differences (IRDs), and additionally stratified by sex and baseline metabolic disease status.</p><p><strong>Results: </strong>Associations of MVPA volume with type 2 diabetes were most consistently modified by age, baseline prediabetes (all p-values for interaction < 0.05), with stronger associations observed among participants younger than the median population age (< 62.7 years, HR = 2.44 [95% CI: 2.05-2.90] versus HR = 1.65 [95% CI: 1.47-1.86]) and participants without prediabetes. Across 5-year age groups, HRs declined with age, whereas IRDs increased in the overall population. No clear effect modification was observed for the association between MVPA timing and type 2 diabetes risk.</p><p><strong>Conclusions: </strong>The relative association between higher MVPA volume and lower type 2 diabetes risk attenuated with age and was weaker among individuals with prediabetes, whereas absolute risk reductions were larger among older and metabolically higher-risk individuals. These findings support considering both relative and absolute measures when targeting MVPA interventions for type 2 diabetes prevention.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10099-10109"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757201","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":"Glycaemic Changes After Semaglutide Discontinuation in Adults With Type 1 Diabetes Using Automated Insulin Delivery: Analysis of the ADJUST-T1D Extension Study.","authors":"Eslam Montaser, Kanchan Bhasin, Davida Kruger, Halis Kaan Akturk, Andrew Ahmann, Janet K Snell-Bergeon, Viral N Shah","doi":"10.1111/dom.71287","DOIUrl":"10.1111/dom.71287","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate changes in glycaemic control following semaglutide discontinuation in adults with Type 1 diabetes and obesity who completed the ADJUST-T1D randomised controlled trial.</p><p><strong>Materials and methods: </strong>Continuous glucose monitoring (CGM) data were collected during a 12-week extension phase after the ADJUST-T1D trial. Analyses included participants previously randomised to semaglutide who discontinued treatment (n = 16) and participants previously randomised to placebo who did not receive a glucagon-like peptide-1 receptor agonist during follow-up (n = 22). Changes in CGM-derived metrics from Week 26 to the extension phase were compared using Wilcoxon rank-sum tests with Benjamini-Hochberg adjustment. Analysis of covariance (ANCOVA) adjusting for Week 26 values was performed as a sensitivity analysis.</p><p><strong>Results: </strong>Compared with placebo, participants who discontinued semaglutide experienced a greater decline in time in range (70-180 mg/dL) (median change -3.6% vs. 1.5%; adjusted p = 0.044). Semaglutide discontinuation was also associated with greater increases in glucose standard deviation (6.0 vs. 1.2 mg/dL; adjusted p = 0.044) and coefficient of variation (3.1% vs. 1.1%; adjusted p = 0.044), indicating worsening glycaemic variability. Time above range (> 180 mg/dL) increased numerically but did not remain significant after adjustment (adjusted p = 0.064). No significant between-group differences were observed in hypoglycaemia-related CGM metrics. ANCOVA analyses showed consistent findings.</p><p><strong>Conclusions: </strong>In adults with Type 1 diabetes and obesity, semaglutide discontinuation was associated with a greater decline in time in range and increased glycaemic variability compared with placebo over 12 weeks. These findings suggest that glycaemic benefits achieved during treatment may not be fully sustained following withdrawal.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10736-10742"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862792","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":"Person-Reported and Continuous Glucose Monitoring (CGM) Recorded Hypoglycaemia in People With Insulin-Treated Type 2 Diabetes and Mild to Moderate Chronic Kidney Disease; Post Hoc Analysis From the Hypo-METRICS Study.","authors":"Julie M B Brøsen, Daniel Malmsiø, Patrick Divilly, Gilberte Martine-Edith, Natalie Zaremba, Namam Ali, Rory J McCrimmon, Simon Heller, Mark Evans, Bastiaan de Galan, Julia K Mader, Eric Renard, Allan A Vaag, Pratik Choudhary, Ulrik Pedersen-Bjergaard","doi":"10.1111/dom.71247","DOIUrl":"10.1111/dom.71247","url":null,"abstract":"<p><strong>Background and aims: </strong>People with diabetes and chronic kidney disease (CKD) may be at increased risk of iatrogenic hypoglycaemia. We compared rates of sensor-detected (SDH) and person-reported hypoglycaemia (PRH) in people with insulin-treated Type 2 diabetes (T2D) with and without CKD in the Hypo-METRICS study.</p><p><strong>Materials and method: </strong>Insulin-treated T2D patients with > 1 hypoglycaemic episode within the last 3 months wore a blinded continuous glucose monitor (CGM) and recorded PRH on the bespoke Hypo-METRICS app for 10 weeks. SDH was defined as per consensus guidelines. The participants were grouped based on estimated glomerular filtration rate (eGFR), that is CKD 1 (eGFR ≥ 90 mL/min; n = 117), CKD 2 (eGFR 60-89 mL/min; n = 140), and CKD 3 (eGFR 30-59 mL/min; n = 56). We used descriptive statistics, Kruskal-Wallis rank sum tests, and a negative binomial models to control for confounders.</p><p><strong>Results: </strong>In total, 313 participants with T2DM were included. Median age increased with declining eGFR (p < 0.001). Median (IQR) events per week for SDH < 3.9 mmol/L were 1.72 (0.66-3.43) in CKD 1, 2.12 (0.85-4.55) in CKD 2, and 2.22 (1.09-4.57) in CKD 3 (p = 0.12). For SDH < 3.0 mmol/L, these rates were 0.20 (0.00-0.50), 0.21 (0.10-0.61), and 0.20 (0.00-0.71), respectively (p = 0.88). PRH events had medians of 1.05 (0.40-2.12), 1.31 (0.61-2.42), and 1.28 (0.68-2.25) for CKD 1, CKD 2, and CKD 3 (p = 0.24).</p><p><strong>Conclusion: </strong>In people with insulin-treated T2DM and CKD stages 2 or 3, the rates of SDH and PRH do not significantly differ from those in people without CKD.</p><p><strong>Trial registration: </strong>ClinicalTRials.gov: NCT04304963.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10664-10669"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862771","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":"Quality of Diabetes Care Among Older Adults in Germany-Results of the Study on Health of Older People 2022/2023 Compared With Previous National Health Surveys.","authors":"Yong Du, Giselle Sarganas, Beate Gaertner, Maike Buchmann, Judith Fuchs, Hannelore Neuhauser, Christin Heidemann","doi":"10.1111/dom.71184","DOIUrl":"10.1111/dom.71184","url":null,"abstract":"<p><strong>Aims: </strong>The study aims (1) to evaluate the quality of diabetes care considering guideline-recommended medical therapies, cardiometabolic factors, and self-management of health behaviours among older adults with diabetes in Germany, and (2) to examine time trends.</p><p><strong>Materials and methods: </strong>People aged 66 years and older with diabetes were identified from the examination part of the German national Study on Health of Older People (Gesundheit65+) in 2022/2023. Diabetes care indicators included physical exercise, non-smoking, non-obesity, blood pressure (BP) control, guideline-based medication use for statins, ACEI/ARB, GLP-1RA/SGLT2i, and aspirin. Temporal trends were examined in a subgroup aged 66-79 years using national health survey data from 1997 to 1999 and 2008 to 2010.</p><p><strong>Results: </strong>Of 292 older adults with diabetes in Gesundheit65+, 90.6% were non-smokers, 69.6% were non-obese, 74.2% achieved BP control, and 45.5% engaged in physical exercise. Overall, 73.6% reported use of antidiabetics, with 24.3% treated by mono-metformin therapy, 16.9% with insulin (alone or in combination), and 32.4% by other glucose-lowering medication. Guideline-recommended medication use was 65.7% for statins overall and 88.4% for ACEI/ARB among individuals with hypertension. Among individuals with cardiovascular disease, it was 36.8% for GLP-1 RA/SGLT2i and 55.4% for aspirin. Trend analysis in 66- to 79-year-olds showed a decrease in insulin use and improvements regarding physical exercise, non-obesity, BP control and guideline-based medications.</p><p><strong>Conclusions: </strong>In Germany, most older adults with diabetes meet targets of non-smoking, non-obesity and BP control. Use of novel glucose-lowering medications with cardiorenal benefits is low. Despite improvements over time, guideline-based medication use should be further improved.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10018-10027"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710573","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}