Diabetes, Obesity & Metabolism最新文献

{"title":"Diabetes, glycaemic traits and cardiovascular disease in females and males: Observational and Mendelian randomisation analyses in the UK Biobank.","authors":"Sophie C de Ruiter, Lena Tschiderer, Diederick E Grobbee, Ynte M Ruigrok, Peter Willeit, Hester M den Ruijter, A Floriaan Schmidt, Sanne A E Peters","doi":"10.1111/dom.16406","DOIUrl":"https://doi.org/10.1111/dom.16406","url":null,"abstract":"<p><strong>Introduction: </strong>Observational studies have shown that the association between type 2 diabetes and cardiovascular disease (CVD) is stronger in females than in males. It remains unclear whether the causal effects of diabetes and glycaemic traits on CVD are also different between females and males.</p><p><strong>Methods: </strong>We performed sex-stratified observational and Mendelian randomisation (MR) analyses in the UK Biobank to investigate the sex-specific associations of type 2 diabetes and HbA1c with CVD outcomes (combined CVD, coronary heart disease [CHD], myocardial infarction, stroke, ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage). As secondary analyses, we performed sex-stratified MR for the association of genetically proxied fasting glucose and insulin with CVD outcomes.</p><p><strong>Results: </strong>In observational analysis, diabetes was associated with a greater excess risk for CHD in females than in males (female-to-male ratio of hazard ratios 1.11 [95% CI 1.03, 1.21]). The association of HbA1c with CVD outcomes was similar in both sexes. In MR, the relationship between genetic liability to diabetes and CHD was similar in females and males (female-to-male ratio of odds ratios 0.98 [95% CI 0.91, 1.05]). No sex differences were found for the association between diabetes and stroke in both observational and MR analyses. Moreover, MR results on HbA1c, fasting glucose and fasting insulin were similar for females and males.</p><p><strong>Conclusion: </strong>This study suggests that causal effects of diabetes and glycaemic traits on CVD are similar in females and males.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956555","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":"Ultra-processed food consumption among adults with prediabetes and diabetes, 2001-2018.","authors":"Zijing Guo, Amelia S Wallace, Mary R Rooney, Dan Wang, Casey M Rebholz, Eurídice Martínez Steele, Vanessa Garcia-Larsen, Julia A Wolfson, Mika Matsuzaki, Elizabeth Selvin, Michael Fang","doi":"10.1111/dom.16411","DOIUrl":"https://doi.org/10.1111/dom.16411","url":null,"abstract":"<p><strong>Aims: </strong>The American Diabetes Association recently recommended minimizing ultra-processed food consumption in persons with prediabetes or diabetes to reduce the risk of glycemic progression and clinical complications. We characterized trends in ultra-processed food consumption among these populations using nationally representative data.</p><p><strong>Materials and methods: </strong>We conducted serial cross-sectional analyses in adults ≥20 years with prediabetes or diabetes in the 2001-2018 National Health and Nutrition Examination Survey (NHANES). We defined prediabetes as HbA1c 5.7%-<6.5% and no self-reported diabetes diagnosis and diabetes as HbA1c ≥6.5% or self-reported diabetes diagnosis. We estimated the percent of total energy from ultra-processed food consumption (% kilocalories), as defined by Nova food classification system. We characterized the mean percent of total energy intake from ultra-processed food by diabetes status from 2001 to 2018 and assessed time trends with linear regression.</p><p><strong>Results: </strong>We included 16 024 adults (63.7% with prediabetes and 36.3% with diabetes). From 2001-2002 to 2017-2018, ultra-processed food consumption increased in adults with prediabetes (53.8 to 57.3% of kilocalories, p = 0.006) and diabetes (51.9 to 56.6% of kilocalories, p = 0.001). The proportion that consumed at least 75% of total kilocalories through ultra-processed food increased in persons with prediabetes (12.4 to 21.4%) and diabetes (8.9 to 20.5%). Younger adults (<45 years) and those without a college degree had the highest ultra-processed food consumption.</p><p><strong>Conclusion: </strong>Patient education, nutritional interventions and nationwide policies are needed to reduce the growing consumption of ultra-processed food in persons with prediabetes and diabetes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957195","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":"Recurrent hypoglycaemia leads to impairment in glucagon-mediated hepatic glycogenolysis in type 1 diabetic mice.","authors":"Min-Ne Li, Fang-Xin Jin, Jing-Jing Zhao, Yan Wang, Bao-Xiang Zhuang, Ru-Jiang Li","doi":"10.1111/dom.16409","DOIUrl":"https://doi.org/10.1111/dom.16409","url":null,"abstract":"<p><strong>Aims: </strong>To explore the alterations in pancreatic α cells and hepatic glycogen metabolism in mice with type 1 diabetes mellitus (T1DM) following recurrent hypoglycaemia, aiming to elucidate the underlying mechanisms that contribute to impaired counterregulatory responses to hypoglycaemia.</p><p><strong>Materials/methods: </strong>The alterations in pancreatic α cells and hepatic glycogenolysis were assessed in T1DM mice experiencing recurrent hypoglycaemia induced by insulin. Furthermore, glucagon intervention experiments were conducted on T1DM mice subjected to recurrent hypoglycaemia and on their primary hepatocytes to clarify further the mechanisms responsible for the observed changes in hepatic glycogenolysis.</p><p><strong>Results: </strong>In T1DM mice, recurrent hypoglycaemia led to a reduction of pancreatic α cell mass and a decrease in glucagon synthesis and secretion by these cells, indicating a compromised counterregulatory response to hypoglycaemia. Furthermore, repeated hypoglycaemic episodes disrupted hepatic glycogenolysis, thereby diminishing the liver's ability to respond to hypoglycaemia. The observed decrease in the expression of hepatic glucagon receptors was closely associated with the impairment of hepatic glycogenolysis, ultimately leading to a reduced hyperglycaemic effect of exogenous glucagon.</p><p><strong>Conclusions: </strong>Pancreatic α cells play a significant role in developing hypoglycaemic counterregulatory impairment induced by recurrent hypoglycaemia; however, the liver's role is even more critical. Recurrent hypoglycaemia can lead to a reduction in the expression of glucagon receptors in the liver, resulting in impaired hypoglycaemic counterregulation.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952852","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":"Attitudes towards therapeutic options for weight management, including weight loss medications and surgery, among people living with obesity and healthcare professionals in China: A secondary analysis from the ACTION-China study.","authors":"Yingying Luo, Yiming Mu, Wei Chen, Huali Wang, Di Zhao, Dongmei Liu, Jichun Zhang, Linong Ji","doi":"10.1111/dom.16369","DOIUrl":"https://doi.org/10.1111/dom.16369","url":null,"abstract":"<p><strong>Aims: </strong>To identify attitudes towards prescription of weight loss (WL) medications and WL surgery among people living with obesity (PLwO) and healthcare professionals (HCPs) in China.</p><p><strong>Materials and methods: </strong>This was a secondary analysis of the ACTION-China study (ClinicalTrials.gov: NCT05428501), a cross-sectional, descriptive, survey-based study conducted in mainland China from August to November 2022.</p><p><strong>Results: </strong>In total, 7000 PLwO and 1000 HCPs completed the survey. Most were concerned about the safety of long-term use of WL medications (73.6% of PLwO and 69.2% of HCPs) and WL surgery (76.7% of PLwO and 76.9% of HCPs). A smaller proportion of PLwO than HCPs (37.4% vs. 60.9%, respectively) thought that WL medications were more effective than other treatments. Similar proportions of PLwO and HCPs (33.4% and 32.4%, respectively) considered surgery to be more effective than other options, but more PLwO than HCPs were concerned about weight regain after WL surgery (64.1% vs. 35.2%, respectively). In total, 39.5% of PLwO thought that society and the healthcare system were slightly (31.8%) or completely (7.7%) meeting their needs, compared with 23.5% (21.1% and 2.4%, respectively) of HCPs. PLwO and HCPs agreed that the most important factor for improving WL outcomes was increasing awareness that obesity is a chronic disease that requires long-term management.</p><p><strong>Conclusion: </strong>PLwO and HCPs living in mainland China have different attitudes towards WL treatments, particularly regarding treatment effectiveness and weight regain after WL surgery.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958511","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":"Gut microbiome research: Revealing the pathological mechanisms and treatment strategies of type 2 diabetes.","authors":"Xinyi Fang, Yanjiao Zhang, Xinyue Huang, Runyu Miao, Yuxin Zhang, Jiaxing Tian","doi":"10.1111/dom.16387","DOIUrl":"https://doi.org/10.1111/dom.16387","url":null,"abstract":"<p><p>The high prevalence and disability rate of type 2 diabetes (T2D) caused a huge social burden to the world. Currently, new mechanisms and therapeutic approaches that may affect this disease are being sought. With in-depth research on the pathogenesis of T2D and growing advances in microbiome sequencing technology, the association between T2D and gut microbiota has been confirmed. The gut microbiota participates in the regulation of inflammation, intestinal permeability, short-chain fatty acid metabolism, branched-chain amino acid metabolism and bile acid metabolism, thereby affecting host glucose and lipid metabolism. Interventions focusing on the gut microbiota are gaining traction as a promising approach to T2D management. For example, dietary intervention, prebiotics and probiotics, faecal microbiota transplant and phage therapy. Meticulous experimental design and choice of analytical methods are crucial for obtaining accurate and meaningful results from microbiome studies. How to design gut microbiome research in T2D and choose different machine learning methods for data analysis are extremely critical to achieve personalized precision medicine.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952850","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":"G3BP1, a stress granule core protein, ameliorates metabolic dysfunction-associated fatty liver disease by attenuating hepatocyte lipid deposition","authors":"Xingjing Liu MD,&nbsp;Huimei Yu MMed,&nbsp;Tongtong Hu MD,&nbsp;Yu He MMed,&nbsp;Yiming Li MMed,&nbsp;Qi Yuan MMed,&nbsp;Meijuan Dong MMed,&nbsp;Dezhen Liu MMed,&nbsp;Yue Xu MMed,&nbsp;Li Mao MD","doi":"10.1111/dom.16302","DOIUrl":"https://doi.org/10.1111/dom.16302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Abnormal lipid accumulation is an important cause of metabolic dysfunction-associated fatty liver disease (MAFLD) progression and can induce several stress responses within cells. This study is the first to explore the role and molecular mechanism of stress granules (SGs) in MAFLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A gene knock-down model of G3BP1, a core SG molecule in mice and HepG2 cells, was constructed to explore the role of SGs in MAFLD induced in vivo by a high-fat diet or in vitro by palmitic acid (PA). Methods included metabolic phenotyping; western blotting; qPCR; and immunofluorescence, haematoxylin/eosin and masson staining. The downstream molecules of G3BP1 and its specific molecular mechanism were screened using RNA sequencing (RNA-seq).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>G3BP1 and TIA1 expression were upregulated in high-fat diet-fed mouse liver tissues and PA-induced HepG2 cells, and the two molecules showed significantly increased colocalisation. G3BP1 knock-down slightly increased TIA1 expression in the livers of obese mice but not in lean mice. G3BP1 deficiency aggravated liver lipid deposition and insulin resistance in obese mice, and this phenotype was confirmed in vitro in PA-induced hepatocytes. RNA-seq demonstrated that G3BP1 slowed down MAFLD progression by inhibiting APOC3, possibly through a mechanistic suppression of APOC3 entry into the nucleus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study reveals for the first time a protective role for SGs in MAFLD. Specifically, knocking down the core G3BP1 molecule in SGs aggravated the progression of fatty acid-induced MAFLD through a mechanism that may involve the nuclear entry of APOC3. These findings provide a new therapeutic direction for MAFLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 6","pages":"2985-2995"},"PeriodicalIF":5.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897250","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 abdominal fat distribution on sepsis: A comparison with traditional anthropometric indices in the UK Biobank study.","authors":"Yang Yang, Zhenyu Peng, Wenbin Nan, Hongliang Zhang, Zhenhua Xing","doi":"10.1111/dom.16407","DOIUrl":"https://doi.org/10.1111/dom.16407","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to examine the dose-response relationship between visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), and sepsis and sepsis-related mortality. Additionally, we seek to determine whether VAT or ASAT offers better prognostic value for above outcomes compared to traditional measures such as waist circumference (WC) and body mass index (BMI), using data from the UK Biobank.</p><p><strong>Materials and methods: </strong>In this secondary analysis of the UK Biobank, 25,083 participants with available abdominal MRI data were included. Cox proportional hazards regression was used to examine the association between VAT and ASAT, both as tertiles and continuous variables, and the incidence of sepsis as well as sepsis-related mortality.</p><p><strong>Results: </strong>Over a median follow-up of 14.1 years (interquartile range: 13.4-14.9 years), 305 cases of incident sepsis (0.86 per 1000 person-years) and 90 sepsis-related deaths (0.25 per 1000 person-years) were identified. Both VAT and ASAT showed a linear relationship with sepsis risk, with hazard ratios (HR) of 1.29 (95% CI: 1.12-1.47) for VAT and 1.22 (95% CI: 1.07-1.40) for ASAT per standard deviation increase. After further adjusting for BMI or WC, the association with ASAT was eliminated, while VAT remained significant. Only VAT was positively associated with sepsis-related mortality, although this association was nullified after adjusting for BMI or WC. VAT was a more important predictor of sepsis risk than BMI or WC, and its inclusion improved the predictive model already adjusted for BMI or WC. In contrast, ASAT did not provide any additional predictive value for either sepsis risk or sepsis-related mortality compared to BMI and WC.</p><p><strong>Conclusions: </strong>VAT is independently associated with sepsis risk and improves its prediction beyond traditional measures like BMI and WC. However, VAT does not enhance the prediction of sepsis-related mortality, with BMI and WC performing better in this context.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951991","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 evidence of insulin and biosimilar insulin therapy-Opportunities to improve adherence, outcomes and cost-effectiveness.","authors":"Aimin Yang, Jiazhou Yu, Johnny T K Cheung, Juliana C N Chan, Elaine Chow","doi":"10.1111/dom.16386","DOIUrl":"https://doi.org/10.1111/dom.16386","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Insulin has been discovered for more than a century; however, its benefits to people with diabetes are yet to be fully realized due to barriers related to access, quality of care and costs. Insulin therapy remains the cornerstone of diabetes management. The multicausality of diabetes and its subtypes calls for comprehensive phenotyping and use of biomarkers to ensure timely use of insulin to achieve early glycaemic control for long-term benefits. Biosimilar insulins are biologic products that closely resemble originator insulins without significant differences in safety or efficacy. The lower investment costs needed for research and development make biosimilar insulin more affordable to improve access. While the efficacy of insulin products is proven in controlled settings, real world evidence (RWE) from real world data (RWD) plays a crucial role in assessing the safety, efficacy, cost-effectiveness, adherence to and impacts of different insulin products, including biosimilars, on clinical outcomes. In this narrative review, we summarized the trends of insulin use and patterns of biosimilar insulin utilization in real world practice across different regions. We reviewed RWE on clinical safety, efficacy and cost-effectiveness of biosimilar insulin, as well as therapeutic inertia and non-adherence with insulin therapy. We also highlighted barriers to insulin adherence and enablers for persistence, along with potential solutions to promote the use of insulin and technologies for optimizing glycaemic control in different subtypes of diabetes. During our extensive literature review, we identified data gaps in the usage of biosimilar insulin in real world practice. We advocate for implementing a diabetes register designed fit-for-purpose, managed by a trained doctor-nurse team with system support, to generate RWE. By setting up registers with structured data collection, we can generate high quality data for integrative analysis with electronic health records (EHR) and health claims to evaluate the impacts of insulin products and other diabetes programmes on clinical outcomes, quality of life and healthcare costs to inform practice and policies. PLAIN LANGUAGE SUMMARY: Diabetes affects approximately 10.5% of the global population and insulin is a vital treatment for diabetes management. Insulin was discovered more than a century ago, although its benefits to people with diabetes are yet to be fully realized due to barriers related to access, quality of care, and costs. Real-world evidence from real-world data plays a crucial role in assessing the safety, efficacy, cost-effectiveness, adherence to, and impacts of different insulin products, including biosimilars, on clinical outcomes. In this publication, the authors provided a detailed review of the patterns of use and cost-effectiveness of biosimilar insulin, and identified major data gaps. The authors explained the methodology, utility, and limitations of generating real-world evidence based on ","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957962","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 GLP-1 receptor agonists on circulating inflammatory markers in type 2 diabetes patients: A systematic review and meta-analysis.","authors":"Yifan Ren, Yuzhang Chen, Wenbin Zheng, Wen Kong, Yunfei Liao, Jiaoyue Zhang, Meng Wang, Tianshu Zeng","doi":"10.1111/dom.16366","DOIUrl":"https://doi.org/10.1111/dom.16366","url":null,"abstract":"<p><strong>Aim: </strong>To investigate whether the antidiabetic agent glucagon-like peptide-1 receptor agonists (GLP-1 RAs) can exert anti-inflammatory effects while lowering blood glucose, we performed a meta-analysis and systematic review.</p><p><strong>Methods: </strong>We searched 4 online databases (Medline, Embase, Cochrane Library and the Web of Science) for randomised controlled trials (RCTs) that examined changes after GLP-1RAs intervention in commonly accepted biomarkers of inflammation: C-reactive protein (CRP), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), leptin, adiponectin, plasminogen activator inhibitor-1 (PAI-1), monocyte chemotactic protein-1(MCP-1) and advanced glycation end products (AGEs).</p><p><strong>Results: </strong>This meta-analysis included 52 eligible RCTs (n = 4734) with a median follow-up of 24 weeks, a mean age of 54.13 years, 44.46% females, body mass index (BMI) 29.80 kg/m², glycated haemoglobin (HbA1c) 8.28% and diabetes duration 7.27 years. GLP-1 RAs treatment, compared to placebo or conventional diabetes therapies (including oral medicine and insulin), resulted in significant reductions in CRP, TNF-α, IL-6, IL-1β and leptin (standard mean difference [SMD] -0.63 [-1.03, -0.23]; SMD -0.92 [-1.57, -0.27]; SMD -0.76 [-1.32, -0.20], SMD -3.89 [-6.56, -1.22], SMD -0.67 [-1.09, -0.26], respectively), as well as significant increases in adiponectin (SMD 0.69 [0.19, 1.19]).</p><p><strong>Conclusions: </strong>Our meta-analysis demonstrates that GLP-1 RAs exert significant anti-inflammatory effects in patients with T2DM. Our findings provide important insights that may guide the therapeutic application of GLP-1 RAs and inform the development of related therapies.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956001","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":"Type 1 diabetes presenting in adults: Trends, diagnostic challenges and unique features.","authors":"Carmella Evans-Molina, Richard A Oram","doi":"10.1111/dom.16402","DOIUrl":"https://doi.org/10.1111/dom.16402","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Type 1 diabetes (T1D) has been historically regarded as a childhood-onset disease; however, recent epidemiological data indicate that adult-onset T1D accounts for a substantial proportion of cases worldwide. There is evidence that adult-onset T1D is associated with the classic T1D triad of elevated genetic risk, the presence of islet-specific autoantibodies and progression to severe insulin deficiency. In this article, we review our understanding of the commonalities and differences between childhood and adult-onset T1D, and we highlight significant knowledge gaps in our understanding of the diagnosis, incidence, trajectory and treatment of adult-onset T1D. Compared to children, adults presenting with T1D exhibit differences in genetic risk, immunologic profiles and metabolic outcomes, including differences in the type and number of autoantibodies present, genetic associations and total genetic burden, rates of C-peptide decline, the persistence of C-peptide in long-duration disease and glycaemic control. In addition, obesity and metabolic syndrome are increasingly common in adults, which not only blurs the clinical distinction of adult-onset T1D from type 2 diabetes (T2D) but also likely contributes to differences in metabolic outcomes and rates of progression. Because T2D is so prevalent in the adult population, adult-onset T1D is misclassified as T2D in at least one in three cases, leading to delays in appropriate treatment. Current diagnostic tools, including autoantibody testing and C-peptide measurement, are underutilised or lack specificity in distinguishing adult-onset T1D from atypical T2D. Additionally, the impact of different responses to disease-modifying therapy between adults and children is unclear. Addressing these knowledge gaps requires expanded epidemiological studies, diverse patient registries and refined classification criteria to improve early detection and treatment strategies. A deeper understanding of adult-onset T1D will be critical to reduce the burden of misdiagnosis, lead to earlier diagnosis and treatment and optimise population-based screening approaches in this under-recognised population. PLAIN LANGUAGE SUMMARY: Type 1 diabetes (T1D) is an autoimmune disease that causes metabolic and nutritional complications due to the destruction of insulin-producing pancreatic β cells. T1D was formerly known as \"juvenile diabetes\" because it was assumed that most cases occurred in childhood; however, recent epidemiological data show that nearly half of all T1D cases are diagnosed in adulthood. Despite the high prevalence of adult-onset T1D, there are challenges with correctly diagnosing T1D in adulthood, and significant knowledge gaps remain regarding the incidence, trajectory, and treatment of adult-onset T1D. In this article, we summarize the current understanding of commonalities and differences between childhood and adult-onset T1D. Particularly, we highlight age-related differences in genetic risk, immunologic profi","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954329","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}