Diabetes, Obesity & Metabolism最新文献

{"title":"Partial remission of type 1 diabetes: Do immunometabolic events define the honeymoon period?","authors":"J Jason Collier, Clive H Wasserfall, Michael A Brehm, Michael D Karlstad","doi":"10.1111/dom.16480","DOIUrl":"https://doi.org/10.1111/dom.16480","url":null,"abstract":"<p><p>Partial clinical remission in Type 1 diabetes (T1D) refers to a transient phase of improved glucose control following diagnosis. During this period, endogenous islet β-cells continue to produce and secrete insulin, resulting in lower exogenous insulin requirements and improved glycaemic status. Partial remission is often described colloquially as the 'honeymoon phase', a period lasting from months to years which is heterogeneous across patient groups. In this review, we discuss the immunometabolic events that may control the duration of the partial remission period by highlighting how glucose metabolism supports immune cell-driven inflammatory and autoimmune events. We thus propose that precise control of blood glucose within a healthy range delays the deleterious consequences that arise from autoimmune mechanisms within pancreatic islets, ultimately leading to the extension of the honeymoon phase. We further discuss data supporting the notion that managing blood glucose effectively also improves islet β-cell mass, function and maturity markers. Collectively, these paradigms help explain the success of recent clinical trial outcomes and offer novel opportunities to intervene in future study designs.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155423","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":"GLP-1 receptor agonists and addiction-related behaviours: A translational perspective.","authors":"Natalia Kulicka","doi":"10.1111/dom.16481","DOIUrl":"https://doi.org/10.1111/dom.16481","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148745","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":"Plasma LEAP2 concentration is associated with energy intake and postprandial insulin increase depending on meal size but not weight status in men.","authors":"María F Andreoli, Pablo N De Francesco, Olga E Titova, Mario Perello, Helgi B Schiöth","doi":"10.1111/dom.16483","DOIUrl":"https://doi.org/10.1111/dom.16483","url":null,"abstract":"<p><strong>Aims: </strong>While LEAP2 is increasingly recognized as an appetite-regulating hormone, its role in meal regulation and the dynamics of postprandial LEAP2 concentrations remain poorly understood in humans. The aim of the study was to (1) assess postprandial LEAP2 concentrations following a recommended-energy breakfast, exploring potential association with voluntary energy intake and modulation by weight status and (2) to examine the interplay between postprandial LEAP2 and insulin concentrations.</p><p><strong>Materials and methods: </strong>Eighty-four men with normal weight (NW) and 48 with overweight or obesity (OW/OB) received a test meal; pre- and postprandial LEAP2 and insulin concentrations were assessed. Energy intake was calculated by multiplying the weight of the food items consumed by their energy content according to their label.</p><p><strong>Results: </strong>Fasting LEAP2 was positively associated with glycaemia in participants with NW [Beta (95% CI): 0.289 (0.058, 0.520), p = 0.015] but not with OW/OB. Sixty-seven participants consumed the entire test meal (CMC, complete meal consumption); the rest consumed only part (PMC, partial meal consumption). Postprandial LEAP2 concentration was higher in the PMC (p = 0.017) than in the CMC group and in participants with OW/OB (p = 0.046). Pre (p = 0.027) and postprandial (p = 0.031) LEAP2 was inversely related to ingested calories, but only in PMC and independent of weight status. Postprandial insulin increase (p < 0.001) depended on LEAP2 only in CMC (p = 0.017) and was independent of weight status.</p><p><strong>Conclusions: </strong>The relationship of LEAP2 with energy intake and postprandial insulin increase is influenced by meal size but not weight status.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126410","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 bariatric surgery on glycaemic and metabolic outcomes in people with obesity and type 2 diabetes mellitus: A meta-analysis.","authors":"Xu Han, Liyun Pang, Xinxin Zhang, Haowen Gao, Haobing Guo, Wei Wang, Haoyu Feng, Jingfeng Gu, Guiqi Wang","doi":"10.1111/dom.16475","DOIUrl":"https://doi.org/10.1111/dom.16475","url":null,"abstract":"<p><strong>Aims: </strong>Bariatric surgery is a widely adopted intervention for managing obesity and improving glycaemic control in patients with type 2 diabetes mellitus (T2DM). This meta-analysis evaluates the impact of bariatric surgery on glycaemic and metabolic outcomes, including fasting blood glucose (FBG), postprandial glucose (PPG), HbA1c, C-peptide, HOMA-IR and fasting insulin levels.</p><p><strong>Materials and methods: </strong>Comprehensive search of PubMed, Scopus, EMBASE and Web of Science was conducted from inception to March 2025. Eligible studies were pooled using a random-effects model to calculate weighted mean differences (WMD) or standardized mean differences (SMD) with 95% confidence intervals (CIs). Heterogeneity was assessed using I² statistics, and publication bias was evaluated using funnel plots and Egger's tests.</p><p><strong>Results: </strong>Thirty-nine studies with 3855 participants were included. Bariatric surgery resulted in significant reductions in FBG (WMD = 3.461; 95% CI: 2.740-4.182, p < 0.001), PPG (WMD = 6.153; 95% CI: 4.298-8.007, p < 0.001) and HbA1c levels (WMD = 2.085; 95% CI: 1.561-2.608, p < 0.001). Modest but non-significant improvements were observed in C-peptide (SMD = 0.358; 95% CI: -0.043 to 0.759, p = 0.075) and fasting insulin (SMD = 1.593; 95% CI: -0.392 to 3.577, p = 0.104). Significant reductions in HOMA-IR levels (WMD = 2.480; 95% CI: 1.010-3.950, p = 0.009) were noted. High heterogeneity was observed across most outcomes. Publication bias was detected for FBG and HbA1C, while it was undetected for the rest of the outcomes.</p><p><strong>Conclusions: </strong>Bariatric surgery significantly improves glycaemic and metabolic outcomes in obese patients with T2DM. These findings support its integration into diabetes management pathways, offering a promising approach for long-term disease control and complication reduction. Further research is needed to evaluate long-term outcomes and mechanisms.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126409","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":"Comparative efficacy and safety of oral hypoglycaemic drugs as adjunctive therapy in the management of type 1 diabetes mellitus: A systematic review and meta-analysis.","authors":"Dong Wu, Xiaowu Wang, Qiao Liu, Xia Luo","doi":"10.1111/dom.16474","DOIUrl":"https://doi.org/10.1111/dom.16474","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the efficacy and safety of oral hypoglycaemic drugs (OHDs) as an adjunct to insulin therapy in patients with type 1 diabetes mellitus (T1DM), addressing the need for optimized glycaemic control and reduced insulin dependency.</p><p><strong>Materials and methods: </strong>A systematic literature search was conducted across PubMed, Embase and the Cochrane Library to identify randomized clinical trials (RCTs) published up to October 31, 2024. Primary outcomes included changes in glycated haemoglobin (HbA1c) and hypoglycaemia risk. Secondary endpoints assessed six efficacy and seven safety measures using meta-analysis. Treatment effects were quantified using weighted mean difference (WMD) and risk ratios (RRs) with 95% confidence intervals (CIs). Subgroup and indirect comparisons were performed to explore variations across patient demographics and drug classes.</p><p><strong>Results: </strong>The meta-analysis included 51 RCTs with 8664 participants. Overall, compared with placebo, OHDs demonstrated significant reductions in HbA1c (WMD -0.32%, p < 0.001), fasting plasma glucose (WMD -0.91 mmol/L, p < 0.001), postprandial plasma glucose (WMD -2.08 mmol/L, p < 0.001), daily insulin dosage(WMD -4.88 IU/day, p < 0.001) and body weight (WMD -1.89 kg, p < 0.001), while improving the percentage time in the target glucose range of 3.9-10.0 mmol/L (WMD 6.04%, p = 0.04). However, no significant change was observed in BMI (WMD -0.18 kg/m², p = 0.08). Compared with placebo, OHDs did not increase the risk of hypoglycaemia (RR 1.01, p = 0.08), severe hypoglycaemia (RR 0.95, p = 0.73) or nocturnal hypoglycaemia (RR 0.97, p = 0.24), but were associated with elevated risks of serious adverse events (RR 1.30, p = 0.005), discontinuation due to adverse events (RR 1.88, p < 0.001), genital tract infection (RR 3.30, p < 0.001), gastrointestinal side effects (RR 1.98, p < 0.001) and ketoacidosis (RR 3.14, p < 0.001). Indirect comparisons favoured alpha glucosidase inhibitor (AGI) over thiazolidinediones for HbA1c reduction (mean difference -0.46%, p < 0.001). Subgroup analysis revealed greater fasting glucose reduction in adults compared to children/adolescents (WMD -1.15 mmol/L vs. -0.26 mmol/L, p of group difference = 0.02).</p><p><strong>Conclusions: </strong>OHDs as adjunctive therapy in T1DM significantly improve glycaemic control and reduce insulin requirements. However, their use is associated with notable safety concerns, particularly ketoacidosis and other adverse events. Clinicians must conduct thorough risk assessments and tailor treatment plans to individual patient profiles to balance efficacy and safety. Future research should focus on long-term outcomes and strategies to mitigate adverse effects.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126408","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":"Beyond diabetes: Testing long-term metformin adherence for dementia prevention.","authors":"Timothy Daly, Simon Okholm, Bruno P Imbimbo","doi":"10.1111/dom.16472","DOIUrl":"https://doi.org/10.1111/dom.16472","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126295","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":"Long-term outcomes following alternative second-line oral glucose-lowering treatments: Results from the real-world progression in type 2 diabetes mellitus United Kingdom (RAPIDS-UK) model.","authors":"Orlagh U Carroll, Patrick Bidulka, Anirban Basu, Amanda I Adler, Stephen O'Neill, Andrew H Briggs, David G Lugo-Palacios, Kamlesh Khunti, Richard Grieve","doi":"10.1111/dom.16447","DOIUrl":"https://doi.org/10.1111/dom.16447","url":null,"abstract":"<p><strong>Aims: </strong>To compare long-term complications for people with type 2 diabetes mellitus (T2DM) following second-line treatment in routine practice with sulphonylureas (SU), dipeptidyl peptidase-4 inhibitors (DPP4i), or sodium-glucose co-transporter-2 inhibitors (SGLT2i) added to metformin.</p><p><strong>Materials and methods: </strong>We used the RAPIDS microsimulation model to predict diabetes complications over 5 years after second-line treatment initiation. We combined information on 'real-world' treatment duration in England from the Clinical Practice Research Datalink with evidence on treatment effectiveness from Randomised Controlled Trials (RCTs). We estimated between-treatment differences in the probabilities of end-stage kidney disease (ESKD), heart failure hospitalisation (HF), diabetic eye disease, myocardial infarction (MI), and lower-extremity amputation (LEA).</p><p><strong>Results: </strong>The predicted probabilities of complications within 5 years were lower following second-line treatment with SGLT2i compared to SU and DPP4i. The mean (95% CI) difference (reduction) in the predicted probability of ESKD following SGLT2i versus SU was -0.81% (-0.89, -0.73), and for SGLT2i versus DPP4i the corresponding difference was -0.87% (-0.95, -0.79). The reduction in the probability of HF following SGLT2i versus SU was -0.90% (-1.01, -0.80), and for SGLT2i versus DPP4i it was -0.95% (-1.06, -0.84). The corresponding differences in the probabilities of diabetic eye disease following SGLT2i versus SU were -1.41% (-1.57, -1.26), and for SGLT2i versus DPP4i was -0.44% (-0.59, -0.29). The predicted probabilities of LEA were similar across treatments. Pre-existing CVD did not modify the predicted probabilities of complications.</p><p><strong>Conclusions: </strong>For a general T2DM population, second-line treatment with SGLT2i rather than SU or DPP4i can reduce the probability of complications within 5 years.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118463","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":"Effects of combined treatment with zibotentan and dapagliflozin compared to dapagliflozin alone in patients with diabetic and non-diabetic chronic kidney disease.","authors":"Victor Wasehuus, J David Smeijer, Phil Ambery, Peter J Greasley, Emma Wijkmark, David C Wheeler, Peter Rossing, Hiddo J L Heerspink","doi":"10.1111/dom.16468","DOIUrl":"https://doi.org/10.1111/dom.16468","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate whether type 2 diabetes status modifies the efficacy and safety of combining zibotentan (zibo), a selective endothelin receptor antagonist, and dapagliflozin (dapa) compared to placebo plus dapagliflozin in individuals with chronic kidney disease (CKD).</p><p><strong>Methods and materials: </strong>We conducted a post hoc analysis of the ZENITH-CKD trial, a multicentre 12-week, double-blind, randomized, active-controlled, phase 2b study involving 447 participants with CKD (261 with and 186 without type 2 diabetes). Participants were assigned to zibotentan (0.25 or 1.5 mg) plus dapagliflozin 10 mg or placebo plus dapagliflozin 10 mg. Changes in urinary albumin-to-creatinine ratio (UACR) and markers of fluid retention (bodyweight and B-type natriuretic peptide [BNP]) were compared in participants with and without type 2 diabetes.</p><p><strong>Results: </strong>Zibo/dapa 0.25/10 mg changed UACR by -37.7% (90% CI: -40.4, -23.4) compared to placebo/dapa in participants without diabetes and by -17.9% (90% CI: -31.3, -2.0) in participants with diabetes (p-interaction 0.096). Effects of zibo/dapa 1.5/10 mg on UACR were consistent regardless of diabetes status (-34.0% (90% CI: -45.0, -20.8) vs. -33.0% (90% CI: -42.2, -22.5), p-interaction 0.921). Changes in body weight and BNP did not differ by diabetes status. Fluid retention occurred in five participants with diabetes assigned to zibo/dapa 1.5/10 mg and one participant with diabetes in the zibo/dapa 0.25/10 mg group. Fluid retention did not occur in those without diabetes in both zibo/dapa groups. With placebo/dapa, fluid retention occurred in one participant without diabetes and in none with diabetes.</p><p><strong>Conclusions: </strong>Combination therapy with zibotentan and dapagliflozin demonstrated consistent efficacy and safety across CKD patients with and without type 2 diabetes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109309","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":"Cost-effectiveness of ON101 with general wound care for diabetic foot ulcers among patients with type 2 diabetes in Singapore: Analysis of a multi-ethnic country in Asia.","authors":"Hsuan-Yu Su, Khong-Yik Chew, Nicholas Graves, Huang-Tz Ou","doi":"10.1111/dom.16473","DOIUrl":"https://doi.org/10.1111/dom.16473","url":null,"abstract":"<p><strong>Aims: </strong>Diabetic foot ulcers (DFUs) impose a vast health and economic burden on individuals and healthcare systems globally. We assessed the cost-effectiveness of adding ON101, a novel treatment for accelerating wound healing, to general wound care (GWC) versus GWC alone for DFUs in Singapore, a multi-ethnic country with increasing DFU prevalence in a growing type 2 diabetes population.</p><p><strong>Materials and methods: </strong>A Markov model was utilized to estimate the healthcare costs and quality-adjusted life years (QALYs) over 5 years from a healthcare sector perspective. Model inputs were mainly derived from the Singapore Wound Registry and published literature. The primary outcome was the incremental cost-effectiveness ratio (ICER). Subgroup analyses stratified by clinically important DFU conditions and scenario analyses were conducted to confirm the study's robustness.</p><p><strong>Results: </strong>Compared to GWC alone, adding ON101 yielded greater QALY gained (i.e., 0.15) and lower healthcare costs (i.e., -US$16237) for patients with DFUs. Remarkable cost-savings from the use of ON101 with GWC were observed for patients with complex DFUs, namely ICERs of -US$161 963, -US$181 726 and -US$199 130 per QALY gained for cases with HbA1c ≥ 9%, ulcer duration >6 months and ulcer size >5 cm², respectively. Scenario analysis comparing ON101 with GWC to negative pressure wound therapy with GWC yielded an ICER of -US$677 243 per QALY gained.</p><p><strong>Conclusions: </strong>Combining ON101 with GWC versus GWC alone was highly cost-effective for DFUs in Singapore. Also, the economic results for complex DFU cases underscore the value of ON101 in addressing DFU treatment challenges for managing complex cases, offering cost-savings alongside clinical benefits.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109270","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":"Performance of the DEXCOM G7 CGM system during and after major surgery.","authors":"Gabija Krutkyte, Eva-Dorothea Rolfes, David Herzig, Dominik P Guensch, Thilo Schweizer, Patrick Y Wuethrich, Guido Beldi, Andreas P Vogt, Lia Bally","doi":"10.1111/dom.16462","DOIUrl":"https://doi.org/10.1111/dom.16462","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118464","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}