Diabetes, Obesity & Metabolism最新文献

{"title":"Cardiorenal Mortality and Safety Outcomes of GLP-1 Receptor Agonists in Type 2 Diabetes With BMI Below 27 kg/m²: A Target Trial Emulation.","authors":"Shao-Chia Chen, Yu-Nan Huang, Pei-Yun Li, Jo-Ching Chen, Gideon Meyerowitz-Katz, Shun-Fa Yang, Pen-Hua Su","doi":"10.1111/dom.71266","DOIUrl":"10.1111/dom.71266","url":null,"abstract":"<p><strong>Aims: </strong>Cardiorenal evidence for glucagon-like peptide-1 receptor agonists (GLP-1 RAs) derives mainly from trials in overweight or obesity; data in adults with Type 2 diabetes (T2D) and body mass index (BMI) below 27 kg/m² are limited.</p><p><strong>Materials and methods: </strong>We emulated a target trial in the TriNetX US Collaborative Network (index dates 2020 to 2026; maximum follow-up 24 months). Adults with T2D and BMI < 27 kg/m² newly initiating non-tirzepatide GLP-1 RAs were compared with new users of dipeptidyl peptidase-4 inhibitors (DPP-4i), sodium-glucose cotransporter-2 inhibitors (SGLT2i) or usual care. Comparisons used separate 1:1 propensity score matching. The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>After matching, 7389, 8969 and 8610 GLP-1 RA users were matched to DPP-4i, SGLT2i and usual care. Versus DPP-4i, GLP-1 RA was associated with lower all-cause mortality (hazard ratio [HR] 0.61; 95% confidence interval [CI] 0.52-0.71), major adverse cardiovascular events (MACE; HR 0.83; 95% CI 0.71-0.98) and coded heart failure (HR 0.71; 95% CI 0.60-0.85). Versus SGLT2i, MACE (HR 0.81; 95% CI 0.69-0.95) and coded heart failure (HR 0.56; 95% CI 0.47-0.65) were lower, but all-cause mortality was not (HR 0.89; 95% CI 0.76-1.05). Gastroparesis was more frequent versus DPP-4i.</p><p><strong>Conclusion: </strong>In people with T2D and BMI < 27 kg/m², GLP-1 RA use was associated with lower coded heart failure risk across all three comparisons, the most consistent finding. The lower all-cause mortality association versus DPP-4i and usual care, absent versus SGLT2i, should be interpreted cautiously as likely reflecting residual confounding rather than a benefit of this magnitude.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10498-10512"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816720","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":"Artificial Intelligence Analysis of Standard 12-Lead Electrocardiograms for Screening of Symptomatic Diabetic Peripheral Neuropathy.","authors":"Paweł Ignacy, Hanadi Aldosari, Krzysztof Irlik, Martyna Gut-Misiaga, Aleksandra Gil, Hanna Kwiendacz, Janusz Gumprecht, Gregory Y H Lip, Uazman Alam, Katarzyna Nabrdalik","doi":"10.1111/dom.71240","DOIUrl":"10.1111/dom.71240","url":null,"abstract":"<p><strong>Aim: </strong>To investigate whether artificial intelligence (AI) models trained on standard 12-lead electrocardiograms (ECG) can identify symptom-defined diabetic peripheral neuropathy (DPN) as assessed by the Michigan Neuropathy Screening Instrument Questionnaire (MNSI-Q).</p><p><strong>Materials: </strong>This was an observational study of people with diabetes enrolled in the Silesia-Diabetes Heart Project. DPN was assessed using the MNSI-Q. We used an original questionnaire cut-off score of ≥ 7 and revised cut-off score of ≥ 4 to diagnose DPN and classified DPN as highly symptomatic and moderately symptomatic accordingly. Feature extraction from 10-s raw ECG recordings utilised algorithms to identify recurring signal segments (motifs) and anomalies (discords). These features were used to train XGBoost, Support Vector Machine (SVM) and Ridge classifiers to differentiate between DPN-positive and DPN-negative people.</p><p><strong>Results: </strong>A total of 640 participants (mean age 54 ± 17; 52% female) were included. Of these, 95 (15%) had highly symptomatic DPN (MNSI-Q ≥ 7) and 281 (44%) had moderately symptomatic DPN (MNSI-Q ≥ 4). For the highly symptomatic DPN, the XGBoost classifier utilizing a combination of motifs and discords demonstrated the highest performance, achieving an area under the receiver-operating characteristic curve (AUC) of 0.89 (95% CI 0.88-0.91), an accuracy of 88.5% and a sensitivity of 93.4%. The model showed substantially lower predictive capability when tested against the broader screening threshold of MNSI ≥ 4 (AUC 0.64).</p><p><strong>Conclusion: </strong>AI analysis of the standard ECG demonstrated a strong association with the presence of symptom-defined peripheral neuropathy but lacked sensitivity for milder presentation. With further validation, this method could serve as an accessible, supplementary screening aid to help identify high-risk patients during routine cardiovascular assessment.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10330-10342"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786056","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":"Fatty Liver Index and Differential Glycemic Responses to Ipragliflozin Versus Sitagliptin Over 52 Weeks: An Exploratory Post Hoc Analysis of the Niigata Ipragliflozin and Sitagliptin With Metformin (N-ISM) Study.","authors":"Masaru Kitazawa, Takashi Katagiri, Hiromi Suzuki, Mayuko Yamada, Mariko Hatta, Hiroki Takizawa, Koshiro Murai, Takaaki Sato, Yasuhiro Matsubayashi, Takaho Yamada, Shiro Tanaka, Hirohito Sone","doi":"10.1111/dom.71211","DOIUrl":"10.1111/dom.71211","url":null,"abstract":"<p><strong>Aims: </strong>To explore whether fatty liver index (FLI) stratification is associated with differential glycemic responses to sodium-glucose co-transporter-2 (SGLT2) versus dipeptidyl peptidase-4 (DPP-4) inhibitors as second-line therapy in type 2 diabetes without established atherosclerotic cardiovascular disease (ASCVD).</p><p><strong>Materials and methods: </strong>In this exploratory post hoc analysis of a previous 52-week randomised trial of ipragliflozin versus sitagliptin added to metformin in Japanese patients with type 2 diabetes, 91 patients were stratified by median FLI into low (< 51; n = 44) and high (≥ 51; n = 47) groups. The outcome was the 52-week change in glycated haemoglobin A1c (HbA1c). The treatment-by-FLI interaction was tested by baseline-HbA1c-adjusted analysis of covariance; FLI was also modelled continuously and parallel analyses used body mass index (BMI) and alanine aminotransferase (ALT).</p><p><strong>Results: </strong>The baseline-HbA1c-adjusted treatment-by-FLI interaction was significant at 52 weeks (p = 0.013): ipragliflozin was associated with a greater HbA1c reduction than sitagliptin in the high FLI group (-0.41%, 95% confidence interval -0.77, -0.06; p = 0.023), with no significant difference in the low FLI group (+0.24%; p = 0.194). The interaction was also significant with FLI modelled continuously (p = 0.013) and in mixed-model and multiple-imputation sensitivity analyses (p = 0.010 and 0.003). BMI and ALT showed similar significant interactions (p = 0.028 and 0.032), favouring ipragliflozin in the high-value subgroup. FLI provided the clearest signal but was not the only effect modifier.</p><p><strong>Conclusions: </strong>FLI-based stratification was associated with differential glycemic responses to ipragliflozin versus sitagliptin. These findings are hypothesis-generating, given the small, complete-case sample and the sample-derived cut-off. Prospective studies are warranted before FLI can inform antidiabetic drug selection.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10110-10121"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148756937","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":"Initiation of SGLT2 Inhibitors Versus DPP-4 Inhibitors in Metformin Users and Risk of Incident Depression: A Nationwide, Claims-Based Active-Comparator New-User Study.","authors":"Sangwoo Park, Seogsong Jeong, Hye Jun Kim, Dae Ho Lee, Soo Jung Choi, Sang Min Park","doi":"10.1111/dom.71261","DOIUrl":"10.1111/dom.71261","url":null,"abstract":"<p><strong>Aims: </strong>To examine the association between initiation of sodium-glucose cotransporter-2 (SGLT2) inhibitors and risk of incident depression compared with dipeptidyl peptidase-4 (DPP-4) inhibitors among adults with newly diagnosed Type 2 diabetes receiving metformin.</p><p><strong>Materials and methods: </strong>We conducted a nationwide active-comparator new-user cohort study with a 90-day adherent-survivor landmark design, using the Korean National Health Insurance Service database linked with national health check-up and mortality data (2014-2022). Adults with newly diagnosed Type 2 diabetes receiving metformin who newly initiated SGLT2 inhibitors or DPP-4 inhibitors as add-on therapy were identified. This study was designed as a 90-day adherent-survivor landmark analysis. Propensity score matching was performed in a 1:1 ratio, yielding 10 013 matched pairs. The primary outcome was incident depression, defined as ≥ 2 outpatient or inpatient claims with ICD-10 codes F32-F33. The secondary outcome was suicide mortality. Cox proportional hazards models were used to estimate hazard ratios (HRs) under intention-to-treat and as-treated approaches.</p><p><strong>Results: </strong>Among 38 297 eligible participants, 300 depression events occurred among SGLT2 inhibitor users and 391 among DPP-4 inhibitor users in the matched cohort. Initiation of SGLT2 inhibitors was associated with a lower risk of depression compared with DPP-4 inhibitors (HR 0.85, 95% CI 0.73-0.99). Similar findings were observed in as-treated analyses (HR 0.80, 95% CI 0.65-0.98). Associations were generally consistent across clinically relevant subgroups and appeared more pronounced among older adults, females and individuals with greater comorbidity burden. Suicide mortality was infrequent in both groups.</p><p><strong>Conclusions: </strong>Among 90-day adherent survivors with Type 2 diabetes receiving metformin, initiation of SGLT2 inhibitors as add-on therapy was associated with a lower risk of incident depression compared with DPP-4 inhibitors.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10765-10779"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872374","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":"Finerenone for IgA Nephropathy After Renin-Angiotensin System Inhibitors Discontinuation: A Multicentre Retrospective Cohort Study.","authors":"Fang Zeng, Xiang Li, Yang Yang, Ran Zhang, Yebei Li, Daijin Ren, Xiaoli Wen, Wenjun Yan, Yu Wang, Xiaojie Xie, Dehui Liu, Gaosi Xu","doi":"10.1111/dom.71225","DOIUrl":"10.1111/dom.71225","url":null,"abstract":"<p><strong>Background: </strong>Finerenone has emerged as a promising therapeutic agent for IgA nephropathy (IgAN). The role of finerenone in IgAN patients who have discontinued renin-angiotensin system inhibitor (RASi) therapy remains poorly defined.</p><p><strong>Methods: </strong>This retrospective, multicentre cohort study enrolled patients with primary IgAN who received finerenone and/or RASi treatment. Participants were categorised into three groups: the finerenone plus RASi, finerenone (after RASi discontinuation) and RASi groups. All participants had a baseline estimated glomerular filtration rate (eGFR) ≥ 25 mL/min/1.73 m² and urinary total protein (UTP) ≥ 0.5 g/day. The primary outcomes included the percentage change in UTP from baseline and the rate of significant response (defined as ≥ 50% reduction in UTP and < 20% increase in serum creatinine).</p><p><strong>Results: </strong>Following 1:1:1 propensity score matching, a total of 258 patients were analysed, with 86 in each group. At 12 months, UTP decreased by 32.24% in the finerenone group and 34.35% in the RASi group (p = 0.220). The finerenone plus RASi group achieved a significantly greater reduction of 54.43% compared with either monotherapy group (both p < 0.01). Kaplan-Meier analysis confirmed that the finerenone plus RASi group achieved superior significant response rates compared with either monotherapy group (both log-rank p = 0.001). No significant difference was observed between the RASi and finerenone groups (log-rank p = 0.856). Although the finerenone plus RASi group exhibited a numerically steeper total eGFR decline (-1.48 vs. -0.44 vs. -0.52 mL/min/1.73 m²/year) and a greater increase in the chronic eGFR slope (0.66 vs. 0.37 vs. 0.49 mL/min/1.73 m²/year), neither difference reached statistical significance compared with the finerenone or RASi groups. The incidence of adverse events was comparable across all three groups.</p><p><strong>Conclusion: </strong>Finerenone achieved short-term proteinuria reductions in RASi discontinued IgAN patients similar to those achieved with RASi monotherapy. Finerenone combined with RASi enhanced antiproteinuric efficacy while maintaining safety.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10131-10141"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758432","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":"Hospitalisation Is a Strong Risk Factor for Discontinuation of Sodium-Glucose Cotransporter 2 Inhibitors for Type 2 Diabetes.","authors":"Tamara Y Milder, Leah Shepherd, Hans Kristian Raket, Jerry R Greenfield, Richard O Day, Jialing Lin, Juliana de Oliveira Costa, Sophie Stocker, Carol A Pollock, Brendon Neuen, Min Jun, Jane Ludington, Sallie-Anne Pearson, Michael O Falster","doi":"10.1111/dom.71219","DOIUrl":"10.1111/dom.71219","url":null,"abstract":"<p><strong>Aims: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are commonly withheld during hospitalisation because of concerns about diabetic ketoacidosis. We examined whether hospitalisation was associated with discontinuation of SGLT2i and compared patterns with another anti-hyperglycaemic medicine without similar inpatient safety concerns: dipeptidyl peptidase-4 inhibitors (DPP-4i).</p><p><strong>Materials and methods: </strong>We conducted a retrospective new-user cohort study using linked, population-level data for adult residents of New South Wales, Australia. Adults aged ≥ 40 years initiating SGLT2i or DPP-4i (separate cohorts) between 2016 and 2020 were followed until death, mid-2021, or treatment discontinuation (gap of ≥ 90 days without a dispensing of the index medicine). We used Cox proportional hazards models to estimate the association between hospitalisation and discontinuation, adjusting for demographic and clinical characteristics. We treated the 'hospitalisation period' (the inpatient stay plus the 90 days following discharge) as a time-dependent exposure.</p><p><strong>Results: </strong>Among people initiating SGLT2i (n = 106 098), the median age was 63 years and 61% were male. Overall, 35.1% were hospitalised during follow-up, and discontinuation was substantially more frequent during the hospitalisation period (56.4 per 100 person-years) compared with other follow-up times (37.6 per 100 person-years). This association remained significant after adjustment (HR: 1.83; 95% CI: 1.79-1.87). Similar patterns were observed among DPP-4i treated people (HR: 1.55; 95% CI: 1.51-1.58).</p><p><strong>Conclusions: </strong>Hospitalisation is a strong risk factor for discontinuation of SGLT2i and DPP-4i therapy. Strategies to support re-initiation of SGLT2i during transitions from hospital to community care are needed to prevent harm and maximise cardiorenal protective effects of these medicines.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10210-10217"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786202","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":"Impact of Metformin Plus Lifestyle Intervention Compared With Lifestyle Intervention Alone on Prediabetes Remission in Participants With Impaired Glucose Regulation: The China DPP Study.","authors":"Siyao He, Yongmei Hao, Ping Tu, Su Wang, Xuan Wang, Xinhua Yin, Qing He, Zhongyan Shan, Xueqin Wang, Jinrong Liang, Chang Liu, Yun Xie, Binhong Duan, Wenbo Wang, Zhengnan Gao, Li Li, Qiuhong Gong, Guangwei Li","doi":"10.1111/dom.71271","DOIUrl":"10.1111/dom.71271","url":null,"abstract":"<p><strong>Aims: </strong>Prediabetes affects 35% of Chinese adults and is associated with increased risks of cardiovascular disease and mortality. However, findings are inconsistent on the effects of lifestyle and pharmacological interventions in the prediabetes population achieving remission. This analysis aimed to compare the effects of metformin plus lifestyle intervention versus lifestyle intervention alone for prediabetes remission.</p><p><strong>Materials and methods: </strong>This was a secondary analysis of the China Diabetes Prevention Program (CDPP), a multicentre unblinded randomised controlled trial of 1678 participants aged 18-70 years with impaired glucose regulation from 43 hospitals across China (NCT03441750). Participants were randomly assigned (1:1) using block randomisation stratified by glucose status (impaired fasting glucose or impaired glucose tolerance), presence of hypertension and use of anti-hypertensive medication. They received either metformin plus lifestyle intervention or lifestyle intervention alone for 2 years. The primary outcome was prediabetes remission rate.</p><p><strong>Results: </strong>During a median follow-up of 2.03 years, remission was achieved in 262/831 (31.5%) (138/396 men; 124/435 women) participants in the metformin plus lifestyle group versus 213/847 (25.1%) (106/397 men; 107/450 women) in the lifestyle alone group, with similar effects across subgroups. After adjusting for baseline characteristics, addition of metformin increased the rate of remission (HR 1.39, 95% CI 1.16-1.67, p < 0.001). Higher baseline HbA1c was associated with lower remission rates (HR 0.23, 95% CI 0.18-0.29, p < 0.001).</p><p><strong>Conclusions: </strong>Adding metformin to a lifestyle intervention significantly improved prediabetes remission rates over lifestyle intervention alone in Chinese adults with impaired glucose regulation. This may be an effective approach for prediabetes management.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10555-10564"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823738","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 Efsitora Demonstrates Similar Efficacy and Safety Profiles to Insulin Icodec in Insulin-Experienced Individuals With Type 2 Diabetes Mellitus: Matching-Adjusted Indirect Comparisons of QWINT-3 Versus ONWARDS 2, and QWINT-4 Versus ONWARDS 4.","authors":"Harpreet S Bajaj, Marvin Fischer, Michael B Davidson, Abdul M Tarafder, Christopher J Michaels, Rachel H Tao, Alex Pashley, Jess Amis, Josefine Redig","doi":"10.1111/dom.71272","DOIUrl":"10.1111/dom.71272","url":null,"abstract":"<p><strong>Aims: </strong>To conduct indirect treatment comparisons (ITCs) of insulin efsitora alfa (efsitora) versus insulin icodec (icodec) in insulin-experienced individuals with Type 2 Diabetes Mellitus.</p><p><strong>Methods: </strong>Efficacy, safety and patient reported outcomes were compared via matching-adjusted ITCs using results from randomised controlled trials: QWINT-3 versus ONWARDS 2 (basal-insulin experienced individuals) and QWINT-4 versus ONWARDS 4 (basal-bolus insulin-experienced individuals).</p><p><strong>Results: </strong>In basal insulin-experienced participants, efsitora was comparable to icodec for change from baseline (CfB) in HbA1c (%) (efficacy estimand mean difference [MD] [95% CI]: 0.137 [-0.058, 0.333]), proportion of participants (PoP) discontinuing treatment due to adverse event (risk difference: -0.0002 [-0.0223, 0.0220]) and CfB in Diabetes Treatment Satisfaction Questionnaire-Change (DTSQc) (MD: 1.01 [-0.243, 2.27]). Efsitora exhibited significantly reduced weight gain (MD: -1.52 kg [-2.60, -0.447]) and had lower event rates of Level 2 or 3 hypoglycaemia (rate ratio: 0.436 [0.241, 0.786]) versus icodec, despite no significant difference in PoP with Level 2 or 3 hypoglycaemia (odds ratio [OR]: 0.581 [0.294, 1.14]). In basal-bolus insulin-experienced participants, efsitora was comparable to icodec: CfB in HbA1c (%) (MD: -0.0447 [-0.252, 0.163]); CfB in body weight (kg) (MD: -0.316 [-1.45, 0.817]); PoP with Level 2 or 3 hypoglycaemia (OR: 1.10 [0.698, 1.73]); event rate of Level 2 or 3 hypoglycaemia (rate ratio [95% CI]: 1.03 [0.759, 1.39]).</p><p><strong>Conclusions: </strong>These indirect comparisons suggest that efsitora had lower event rates of hypoglycaemia and less weight gain compared to icodec in basal insulin-experienced participants. Efsitora was comparable to icodec for all other endpoints.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10725-10735"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872356","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":"Mortality in FOURIER Participants With Diabetes: A Regulatory-Data Reanalysis of Evolocumab Outcomes.","authors":"J Erviti, F H van Bruggen, L C Saiz, J M Wright, M Gutiérrez-Valencia","doi":"10.1111/dom.71108","DOIUrl":"10.1111/dom.71108","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10835-10839"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534614","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":"Linking Metabolic Subgroups and Adverse Pregnancy Outcomes in GDM: A Complementary Analytic Approach of Logistic Regressions and Machine Learning.","authors":"Yanjing Zeng, Jing Zhou, Zhengbin Ou, Yun Li, Junping Fan, Nan Wang, Chunxia Cheng, Hui Yang, Man Ping Wang, Jie Dong, Jia Guo","doi":"10.1111/dom.71246","DOIUrl":"10.1111/dom.71246","url":null,"abstract":"<p><strong>Aims: </strong>Associations between metabolic heterogeneity in women with gestational diabetes mellitus (GDM) and adverse pregnancy outcomes have often been explored without considering interrelated metabolic biomarkers, limiting accurate predictions of outcomes. This study aimed to identify metabolic heterogeneity across distinct classes of biomarkers in GDM women and link this metabolic heterogeneity with adverse pregnancy outcomes through a complementary analytic approach.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using medical records of GDM women from 2018 to 2023 in Central South China. We identified metabolic heterogeneity of GDM using unsupervised k-means clustering based on oral glucose tolerance test (OGTT) 0, 1 and 2 h, uric acid (UA), triglycerides (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL). We then linked this metabolic heterogeneity to adverse pregnancy outcomes through a complementary analytic approach, including logistic regression for group traits and machine learning for single features.</p><p><strong>Results: </strong>The first approach categorised 2246 GDM women into four distinct metabolic subgroups: reference (36%, relatively normal and average biomarker levels), fasting hyperglycemia (23.3%), hyperuricemia and hypertriglyceridemia (34.9%) and combined metabolic dysregulation (5.8%). The complementary analytic approach yielded consistent results. The hyperuricemia and hypertriglyceridemia subgroup showed higher odds of preterm delivery (OR = 1.86, 95% CI = 1.15-3.01). The combined metabolic dysregulation subgroup had the highest risks of preterm delivery (OR = 3.45, 95% CI = 1.79-6.65), insulin treatment (OR = 14.67, 95% CI = 8.72-24.66) and hypertensive disorders of pregnancy (OR = 2.72, 95% CI = 1.48-5.01). SHAP analysis showed that 57%-71% of the subgroup-defining biomarkers ranked among the top 15 predictive features.</p><p><strong>Conclusions: </strong>This study confirms the metabolic heterogeneity in GDM women, supporting synergistic effects among metabolic factors and the need for integrated metabolic management. The identified metabolic subgroups may facilitate risk stratification in real-world settings by integrating biomarkers from multiple metabolic pathways. Women in the hyperuricemia and hypertriglyceridemia subgroup, as well as those in the combined metabolic dysregulation subgroup, urgently require interventions to improve pregnancy outcomes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":"10292-10305"},"PeriodicalIF":6.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786295","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}