Journal of Diabetes最新文献

{"title":"Prescription Medication Expenditures for Patients With Diabetes in the United States: 2012–2021","authors":"Shanshan Li,&nbsp;Shaoxi Pan,&nbsp;Nan Xiao,&nbsp;Shaoxiang Jiang,&nbsp;Gorden G. Liu,&nbsp;Beini Lyu","doi":"10.1111/1753-0407.70106","DOIUrl":"https://doi.org/10.1111/1753-0407.70106","url":null,"abstract":"<p>Glucose-lowering medication expenditures per user by different payers among patients with diabetes.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673200","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":"The Role of Endothelin-1, Kidney Function and Diabetes in Patients With Coronary Artery Disease Underwent Percutaneous Coronary Intervention","authors":"Zixiang Ye,&nbsp;Enmin Xie,&nbsp;Yuan Du,&nbsp;Wenjia Zhang,&nbsp;Kefei Dou","doi":"10.1111/1753-0407.70127","DOIUrl":"https://doi.org/10.1111/1753-0407.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore the association between plasma big endothelin-1 (ET-1) and major adverse cardiovascular events (MACE) in CAD patients who underwent PCI with a focus on the influence of kidney function and diabetes status in secondary prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort of CAD patients underwent PCI and patients with impaired kidney function and diabetes were initially screened and categorized separately, subdivided based on ET-1 levels. The primary outcome was MACE, including all-cause mortality, nonfatal myocardial infarction, unplanned revascularization, and stroke. Statistical analyses included Cox regression, competing risks analysis (competing for non-cardiovascular death), and restricted cubic spline to assess the relationships between ET-1 and MACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 1344 CAD patients with impaired kidney function and 10,577 CAD patients with DM. During a median follow-up of 3 years, 20% of renal dysfunction patients and 12.9% of DM patients experienced MACE. In CAD patients with renal dysfunction, elevated ET-1 levels were associated with increased MACE risk (adjusted HR 1.333, 95% CI 1.169–1.519, <i>p</i> &lt; 0.001), with those in the highest group and DM showing a 2.134-fold (95% CI, 1.334–3.413, <i>p</i> &lt; 0.001) increased MACE risk. In CAD patients with DM, patients with eGFR ≤ 60 mL/min/1.73 m² and elevated ET-1 levels had a 2.297-fold (95% CI 1.822–2.895) increased risk of MACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ET-1 offered important prognostic value for CAD patients who underwent PCI, with especially bad prognoses observed in those with elevated ET-1 levels, renal dysfunction, and DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672937","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":"Commentary on “Association of Serum Total Bilirubin to Cholesterol Ratio With Progression of Chronic Kidney Disease in Patients With Type 2 Diabetes: A Retrospective Cohort Study”","authors":"Tinghua Zhang","doi":"10.1111/1753-0407.70129","DOIUrl":"https://doi.org/10.1111/1753-0407.70129","url":null,"abstract":"<p>Several key factors influencing bilirubin levels and lipid metabolism were not measured or adjusted for in the study. Notably, hemoglobin, which affects bilirubin metabolism [<span>5</span>], was not included in the analysis. Furthermore, longitudinal changes in body mass index (BMI), blood pressure, or albuminuria during follow-up were also not accounted for. These unmeasured confounders may influence the observed association between the TBIL/TC ratio and CKD progression.</p><p>Chen et al. have highlighted the potential of the TBIL/TC ratio as a biomarker for CKD progression in type 2 diabetes. However, the issues of outcome misclassification, medication confounding, and oversimplified threshold analyses necessitate cautious interpretation of their findings. Future studies should aim to: (1) Validate these findings in ambulatory cohorts using KDIGO-endorsed sustained eGFR decline criteria; (2) Integrate time-varying adjustments for nephroprotective medications and account for genetic and environmental confounders; (3) Report absolute risks and conduct decision-curve analyses to better evaluate the clinical utility of the TBIL/TC ratio. Addressing these limitations will help clarify whether the TBIL/TC ratio offers incremental value beyond established renal risk markers.</p><p>Tinghua Zhang: wrote, reviewed, and edited the manuscript. Additionally, he conceptualized the study concept and design.</p><p>The author declares no conflicts of interest.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672935","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":"Insulin Resistance in Type 1 Diabetes: Concepts and Implications for Therapy","authors":"Zachary Bloomgarden,&nbsp;Domenico Accili","doi":"10.1111/1753-0407.70126","DOIUrl":"https://doi.org/10.1111/1753-0407.70126","url":null,"abstract":"&lt;p&gt;Many people with type 1 diabetes (T1D) appear to develop insulin resistance. In a 6-year post-Diabetes Control and Complications Trial (DCCT) follow-up of intensive treatment participants, comparison of the 61 having a family history of T2D with the 521 not reporting such a history showed BMI increasing by 3.8 versus 2.9 kg/m&lt;sup&gt;2&lt;/sup&gt;, insulin requirement 0.73 versus 0.66 units/kg, and triglyceride 92 versus 76 [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Weight gain appears to be an important mediator of this insulin resistance. In the Pittsburgh Epidemiology of Diabetes Complications Study, adults with T1D had ~25% and 5% likelihood of having BMI 25–30 and ≥ 30, respectively, in 1986, with these figures increasing to ~35% and 25% by 2004 [&lt;span&gt;2&lt;/span&gt;]; in the T1D Exchange Clinic Registry, by 2016–2018 more than two thirds of T1D adults age ≥ 26 were overweight or obese [&lt;span&gt;3&lt;/span&gt;]. Comparing DCCT intensive treatment group participants in the top quartile of weight gain with those in the lower quartiles, insulin dose requirements, HbA1c, triglyceride, and BP were higher at DCCT close and 1- and 6-years post-trial, with those gaining the most weight being twice as likely to satisfy metabolic syndrome criteria at DCCT close, and 6 years later they were four times as likely to have metabolic syndrome [&lt;span&gt;4&lt;/span&gt;]; in addition to the metabolic syndrome, metabolic-associated fatty liver disease affects approximately one in five people with T1D [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Another potential cause of insulin resistance in T1D may be hyperglucagonemia. Along with insulin deficiency, T1D is associated with hyperglucagonemia, with loss of insulin-induced glucagon suppression, and with increased α-cell mass [&lt;span&gt;6&lt;/span&gt;]. Patients with T1D appear insensitive to the glucagon-suppressive effects of glucose and GLP-1, the latter potentially an indirect effect of decreased endogenous insulin secretion or, perhaps, a secondary state of insulin resistance. In addition to its action in increasing hepatic gluconeogenesis and glycogenolysis, glucagon accelerates hepatic amino acid metabolism and ureagenesis, with a potential physiologic feedback circuit in which amino acids such as alanine increase glucagon secretion, with glucagon then reducing amino acid levels; disruption of the liver–α-cell axis may cause hyperaminoacidemia and hyperglucagonemia, which may in turn contribute to hyperglycemia [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Insulin resistance becomes present early in the course of T1D [&lt;span&gt;8&lt;/span&gt;]. The insulin resistance in T1D is not explained by body mass index, body fat percentage, visceral fat, plasma lipids, or physical activity, and is also not fully explained by the degree of hyperglycemia [&lt;span&gt;9&lt;/span&gt;]. An additional cause of insulin resistance may be the hyperinsulinemia associated with peripheral insulin administration [&lt;span&gt;10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Insulin resistance in people with T1D appears, like that in type 2 diabetes, to be associated with the development o","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647497","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":"The Effect of Liver Transplantation on Anti-Glycaemic Agents in Patients With Pre-Existing Diabetes Mellitus: A Population-Based Cohort Study","authors":"Amy Coulden,&nbsp;Christina Antza,&nbsp;Orighomisan Awala,&nbsp;Nihit Shah,&nbsp;Leelavathy Kandaswamy,&nbsp;Ananda Nahar,&nbsp;Angela Phillips,&nbsp;Sneha Upadhyaya,&nbsp;Ayesha Asif,&nbsp;Zara Khan,&nbsp;Feaz Babwah,&nbsp;Matthew Armstrong,&nbsp;Samiul Mostaf,&nbsp;Wasim Hanif","doi":"10.1111/1753-0407.70088","DOIUrl":"https://doi.org/10.1111/1753-0407.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anecdotally, patients with diabetes mellitus after undertaking a liver transplant have reported improved glycaemic control and reduced insulin requirements, compared to other organ transplants where glycaemic control often worsens. This study aimed to evaluate possible changes in anti-glycaemic agent requirements pre- and post-liver transplantation and correlate them with the immunosuppression used and the reason for transplant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this observational, retrospective study, we investigated 258 adults with pre-existing diabetes mellitus who underwent liver transplant from October 2009 to January 2020 at a tertiary UK center. We compared pre- and post-transplant insulin treatment requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age was 56 years, and the median duration of diabetes was 96 months. From a subgroup of 100 patients (38.8%) using insulin therapy, there was a reduction in insulin requirements from 60.5 ± 44.6 units/day before transplant to 51.1 ± 31.2 units/day at 1 month post-transplantation (15.5%, <i>p</i> = 0.02), 43.4 ± 29.5 units/day at 3 months post-transplantation (28.2%, <i>p</i> &lt; 0.0001) and 33.6 ± 29.7 units/day at 6 months post-transplantation (44.4%, <i>p</i> &lt; 0.0001). There was a significant correlation between the difference in insulin requirement before and 6 months post-transplant and the tacrolimus dose used as immunosuppressive therapy post-liver transplant. There was no correlation with the use of other immunosuppressive therapies and change in insulin requirement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Insulin requirements significantly reduced post-liver transplant by almost 50%, despite initiation of immunosuppressive therapy. This is one of the first studies showing this effect, highlighting the role of the liver in regulating glucose metabolism, insulin utilization, and insulin resistance. Pooled data from other specialist centers need to be examined.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635496","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":"Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross-Sectional Study","authors":"Ruixue Feng,&nbsp;Donge Yan,&nbsp;Mingxin Bai,&nbsp;Xingwu Ran,&nbsp;Dawei Chen,&nbsp;Chun Wang,&nbsp;Lihong Chen,&nbsp;Shuang Lin,&nbsp;Sen He,&nbsp;Yan Liu,&nbsp;Murong Wu,&nbsp;Zhiyi Lei,&nbsp;Yun Gao","doi":"10.1111/1753-0407.70124","DOIUrl":"https://doi.org/10.1111/1753-0407.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To investigate the association between different categories of diabetic autonomic neuropathy (DAN) and left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study of 3440 participants with T2DM recruited in Diabetic Foot Care Center of West China Hospital, Sichuan University from January 2016 to February 2024. LVDD was assessed via echocardiography, defined as an average E/e′ ratio &gt; 14. Twenty-four hour Holter ECG, postvoid residual volume (PVR) examinations, and gastric emptying scintigraphy were employed to evaluate cardiac autonomic dysfunction, diabetic neurogenic bladder (DNB), and diabetic gastrointestinal autonomic neuropathy (DGAN), respectively. Logistic regression and propensity score matching (PSM) analyses were employed to examine the associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Severe cardiac autonomic dysfunction (SDNN &lt; 50 ms) was independently associated with LVDD, with odds ratios (OR) 1.731 (95% CI: 1.103–2.719, <i>p</i> = 0,018) after adjustment for potential confounding factors. LVDD tended to be independently associated with DNB (OR 1.356; 95% CI [0.992, 1.856]; <i>p</i> = 0.056). PSM analysis further validated the independent associations of SDNN &lt; 50 ms (OR 1.587, 95% CI 1.028, 2.450, <i>p</i> = 0.037) and DNB (OR 1.454, 95% CI 1.011, 2.090, <i>p</i> = 0.043). However, DGAN was not independently associated with LVDD. Additionally, women had a higher risk of LVDD compared to men (OR 1.995, 95% CI 1.379, 2.885, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Severe (SDNN &lt; 50 ms), rather than mild–moderate, cardiac autonomic dysfunction, and DNB are independently associated with LVDD in individuals with T2DM. Additionally, women have a higher risk of LVDD than men.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624665","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":"Global, Regional, and National Epidemiology of Vision Impairment due to Diabetic Retinopathy Among Working-Age Population, 1990–2021","authors":"Yang Meng,&nbsp;Yuan Liu,&nbsp;Runping Duan,&nbsp;Baoyi Liu,&nbsp;Zhuangling Lin,&nbsp;Yuan Ma,&nbsp;Lan Jiang,&nbsp;Zijian Qin,&nbsp;Tao Li","doi":"10.1111/1753-0407.70121","DOIUrl":"https://doi.org/10.1111/1753-0407.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To evaluate the global, regional, and national trends of vision impairment associated with diabetic retinopathy (DR) in the working-age population (20–65 years) from 1990 to 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a population-based analysis using data from the Global Burden of Disease Study 2021. Vision impairment was defined as low vision (Snellen visual acuity of &lt; 6/18 to ≥ 3/60) and blindness (Snellen visual acuity of &lt; 3/60 or central visual field &lt; 10°). The burden of DR-related vision impairment, that is, prevalence and years lived with disability (YLD), was analyzed by sex, age, location, and sociodemographic index (SDI). A Bayesian age-period-cohort analysis was employed to forecast the future burden up to 2035.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1990 to 2021, the global prevalence rate and YLD rate of DR-related vision impairment increased significantly. In 2021, 2.85 million prevalent cases and 250 117 YLDs were reported, representing 2.8-fold and 3.0-fold increases compared to 1990, respectively. South Asia and China were identified as the most severely burdened region and country in 2021, respectively. Throughout 1990–2021, females consistently bore a greater burden than males. In terms of SDI, the burden was predominantly concentrated in middle-SDI countries. Predictive analysis suggests a continued increase in the number of patients and YLDs by 2035.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Globally, there has been a substantial increase in the burden of DR-related vision impairment among working-age individuals, with disparities observed in terms of sex, location, and SDI. Given the projected worsening of this burden, targeted interventions are needed to address this global health challenge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624664","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":"Characterization of Novel WFS1 Variants in Three Diabetes Pedigrees","authors":"ChangQing Liu,&nbsp;HangYu Fang,&nbsp;Dong Wang,&nbsp;YiPing Cheng,&nbsp;Ping Shi,&nbsp;ChunXiao Yu,&nbsp;XiaoHong Li,&nbsp;Hui Zhao,&nbsp;Wei Hou,&nbsp;ZhenKui Guo,&nbsp;Chao Xu,&nbsp;QingBo Guan","doi":"10.1111/1753-0407.70114","DOIUrl":"https://doi.org/10.1111/1753-0407.70114","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Mutations in the &lt;i&gt;WFS1&lt;/i&gt; gene are implicated in Wolfram syndrome (WS), Wolfram-like syndrome (WFLS), and maturity-onset diabetes of the young (MODY). Wolfram syndrome 1 (&lt;i&gt;WFS1&lt;/i&gt;) is a diabetes-related gene encoding wolframin, a glycoprotein with nine transmembrane domains localized in the endoplasmic reticulum. However, the relationship between &lt;i&gt;WFS1&lt;/i&gt; mutations and their associated phenotypes remains incompletely understood, requiring additional patient data collection for further investigation. Here we collected and analyzed clinical data from three diabetes pedigrees, and to assess the genotype-phenotype correlation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;High-throughput sequencing was employed to detect &lt;i&gt;WFS1&lt;/i&gt; gene mutations, followed by pathogenicity and conservation analysis using bioinformatics software. A three-dimensional wolframin protein structure was constructed to investigate the potential effects of the mutations. Moreover, the distribution of &lt;i&gt;WFS1&lt;/i&gt; mutations and their associated clinical phenotypes were analyzed by summarizing genetic variations of the &lt;i&gt;WFS1&lt;/i&gt; gene recorded in the Human Gene Mutation Database.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Four heterozygous &lt;i&gt;WFS1&lt;/i&gt; mutations were identified in three diabetes families. Among these, c.1523_1524del/p.Y508Cfs*34 was identified as a frameshift mutation, while the others were missense mutations. Bioinformatics predictions revealed that c.766A&gt;G/p.K256E is a benign and novel mutation, whereas the remaining mutations were classified as pathogenic. Furthermore, c.985T&gt;A/p.F329I was validated as a MODY-associated mutation within a specific family. A comprehensive summary of all reported &lt;i&gt;WFS1&lt;/i&gt; mutations indicated that mutations associated with WS phenotypes are approximately 18.7 times more frequent than those associated with MODY phenotypes. Missense mutations accounted for the highest proportion of &lt;i&gt;WFS1&lt;/i&gt; mutations associated with different clinical phenotypes, with the majority located in exon 8.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study identified a novel &lt;i&gt;WFS1&lt;/i&gt; mutation, c.766A&gt;G/p.K256E, expanding the known mutation spectrum of the &lt;i&gt;WFS1&lt;/i&gt; gene. The findings suggest that inactivating mutations and benign missense mutations are associated with more severe WS phenotypes compared to purely pathogenic missense mutations. Moreover, c.985T&gt;A/p.F329I was validated as a MODY associated mutation. Finally, by summarizing the genotype–phenotype relationship","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598385","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":"Healthy Sleep Behaviors Reduce the Risk of Microvascular and Cardiovascular Complications in Patients With Type 2 Diabetes and Are Associated With Potential Serum Biomarkers: A UK Biobank Observational Cohort Study","authors":"Rui Lan,&nbsp;Lina Mao,&nbsp;Tingting Luo,&nbsp;Wenjin Luo,&nbsp;Yao Qin,&nbsp;Hanwen Ye,&nbsp;Jingbo Hu,&nbsp;Shuming Yang,&nbsp;Qifu Li,&nbsp;Zhihong Wang,&nbsp;Xiangjun Chen","doi":"10.1111/1753-0407.70107","DOIUrl":"https://doi.org/10.1111/1753-0407.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association of sleep behaviors with microvascular complications and cardiovascular outcomes in diabetic patients is not clear. Furthermore, serum biomarkers that can be used to evaluate this association have not been characterized. Therefore, this study investigated the association of the overall sleep score with the diabetic complications and the potential underlying serum metabolic biomarkers in patients with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study included 30 915 T2DM patients without complications from the UK Biobank. The sleep score of the participants was evaluated based on sleep behaviors such as sleep duration, insomnia, snoring, chronotype, and daytime sleepiness. The potential biomarkers, including cystatin C (Cys C), apolipoprotein A (Apo A), C-reactive protein (CRP), albumin, and γ-glutamyl transpeptidase (GGT), were also determined to evaluate their role as potential indicators of the association between the sleep score and the diabetic complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants with a healthy sleep score of 4–5 had lower risks of microvascular complications (HR = 0.80 [95% CI: 0.72, 0.89]) and cardiovascular outcomes (HR = 0.70 [95% CI: 0.61, 0.81]) compared to those with a sleep score of 0–1. Furthermore, cys C showed the best effects by explaining the associations of overall healthy sleep behaviors with microvascular complications and cardiovascular outcomes by 30.36% and 14.36%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data showed that healthy sleep behaviors were associated with a reduced risk of diabetic complications. Moreover, serum biomarkers of renal function, lipids, systemic inflammation, and hepatic function partially mediated the relationship between sleep behaviors and diabetic complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514727","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":"Alpha-Linolenic Acid and Mortality Among Adults With Type 2 Diabetes: Findings From Two National Cohorts","authors":"Boyang Chen,&nbsp;Qi Wu,&nbsp;Sibo Liu,&nbsp;Hongkun Di,&nbsp;Wen Hu,&nbsp;Tianzhu Qin,&nbsp;Yushuang Wang,&nbsp;Rong Chen,&nbsp;Han Wang,&nbsp;Ying Chen,&nbsp;Xiang Cheng,&nbsp;Jiawei Yin,&nbsp;Liegang Liu,&nbsp;Zhilei Shan","doi":"10.1111/1753-0407.70110","DOIUrl":"https://doi.org/10.1111/1753-0407.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dietary alpha-linolenic acid (ALA) regulates lipid metabolism and insulin sensitivity, but few studies have investigated the association between ALA and the risk of mortality among adults with type 2 diabetes (T2D). This study examines whether increasing dietary ALA intake contributes to the long-term survival of adults with T2D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cohort study included 9603 participants with T2D, including 7953 adults from the National Health and Nutrition Examination Survey (NHANES; 1999–2018) and 1650 adults from the China Health and Nutrition Survey (CHNS; 1997–2011). Dietary information was collected through 24-h dietary recalls. Cox proportional hazards regression was employed to estimate hazard ratios (HRs) and 95% CIs for mortality from all-cause and cardiovascular disease (CVD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During 75 535 person-years of follow-up, a total of 2468 deaths were documented. After multivariate adjustment, the pooled HRs (95% CIs) of all-cause mortality were 1.00, 0.87 (0.76–0.99), and 0.79 (0.67–0.94) across tertiles of ALA (<i>p</i>_trend = 0.01). There was a linear inverse relationship between ALA intake and all-cause mortality, demonstrating a 9% (HR: 0.91;95% CI: 0.85_0.97) lower risk of all-cause mortality with each 1 g/day increase of dietary ALA intake in the pooled analysis (<i>p</i>_nonlinear &gt; 0.05). In addition, ALA intake was inversely associated with CVD mortality, and HR comparing the highest with the lowest tertile was 0.68 (0.50–0.91; <i>p</i>_trend = 0.01). Consistent results were observed in both the stratified and sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher dietary ALA intake was associated with a lower risk of all-cause and CVD mortality among adults with T2D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339258","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}