Journal of Diabetes最新文献

{"title":"Insulin Resistance and Cancer","authors":"Zachary Bloomgarden","doi":"10.1111/1753-0407.70064","DOIUrl":"https://doi.org/10.1111/1753-0407.70064","url":null,"abstract":"<p>It has long been clear that Type 2 diabetes is associated with an increased likelihood of the development of a variety of malignancies. The Shanghai Standardized Diabetes Management System data set of more than 400 000 persons from 2011 to 2018 showed a 10% increase in overall malignancy rates over those in the nondiabetic population, with a particularly high risk of cancers of the pancreas [<span>1</span>], thyroid [<span>2</span>], bladder, kidney, breast, colorectum, and liver compared with the general population, and with a greater relative increase in younger persons [<span>3</span>]. Several mechanisms have been proposed for this association [<span>4</span>]. Hyperglycemia itself might predispose individuals to cancer [<span>5, 6</span>]. Obesity underlies the majority of instances of Type 2 diabetes and is associated with malignancy, with adipose tissue secretion of inflammatory cytokines and leptin, decreased production of adiponectin, and, particularly in postmenopausal women, adipose tissue estrogen production playing roles in specific tissues. An attractive hypothesis of the underlying mechanism for all of these is that insulin resistance itself gives rise to malignancy [<span>7</span>].</p><p>Certainly, it is plausible that insulin resistance may be a major underlying cause of cancer development. Insulin has mitogenic effects, which may particularly manifest in insulin resistance with hyperinsulinemia, and insulin may be pro-angiogenic, leading to an anti-apoptotic effect in DNA-damaged cells, furthering carcinogenesis; features of these mechanisms have been shown in breast cancer models, with the insulin receptor substrate receptor (IRS)-1 showing high expression, and with adipose tissue secretory proteins such as leptin stimulated by insulin and having mitogenic, angiogenic, and anti-apoptotic effects, while adiponectin levels are suppressed by insulin and lowered in obesity, leading to opposing effects [<span>8</span>]. In breast cancer development, factors related to insulin resistance produced in systemic adipose tissue may have endocrine effects, adipocytes in the tumor capsule would have paracrine effects, and factors directly produced by tumor cells could have autocrine effects in cancer promotion [<span>9</span>]. In the development of pancreatic cancer, insulin might act on pancreatic acinar cells to increase digestive enzyme production, leading to inflammation in pancreatic exocrine tissue, while insulin might also directly increase pancreatic cell mitosis and potentiate metaplasia [<span>9</span>].</p><p>Proxy measures of insulin resistance have been used to support this concept. In a study based on nearly 400 000 persons in the UK Biobank, the triglyceride-glucose-BMI product, an insulin resistance measure based on the metabolic syndrome, and the ratio of triglyceride to HDL cholesterol were analyzed to determine the relationship between insulin resistance and esophageal cancer risk [<span>10</span>], showing adenocarc","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489822","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":"A Population-Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels","authors":"Tingyu Zhang,&nbsp;Tianyi Shi,&nbsp;Min Cao,&nbsp;Yunxi Ji,&nbsp;Yanbin Xue,&nbsp;Huayan Yao,&nbsp;Qiaomei Yin,&nbsp;Bin Cui,&nbsp;Zhen Xie,&nbsp;Ping He","doi":"10.1111/1753-0407.70057","DOIUrl":"https://doi.org/10.1111/1753-0407.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glycated hemoglobin (HbA1c) is widely used to assess long-term glycemic control in individuals with diabetes. However, various conditions that affect hemoglobin levels or the lifespan of red blood cells can compromise the accuracy of HbA1c measurements. Despite extensive research, the relationship between HbA1c and hemoglobin remains unclear. This study aims to clarify this relationship by examining its correlation across diverse age and gender cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 217,991 participants aged 20 to 69 years were collected from health examination centers in Southwest China. Standardized methodologies were used to measure HbA1c and hemoglobin levels. Generalized additive models (GAM) were utilized to analyze non-linear relationships and adjust for potential confounding variables. Gender-specific reference intervals (RIs) for hemoglobin were also established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A gender-specific association was observed between HbA1c and hemoglobin levels. In men, HbA1c levels decreased with increasing hemoglobin. Among women, a negative correlation was observed in premenopausal women (aged ≤ 45 years), whereas postmenopausal women (aged &gt; 45 years) showed a positive correlation, with HbA1c levels increasing as hemoglobin levels rose. Additionally, HbA1c levels increased with age in both genders, with a more pronounced rise in women after the age of 45.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights significant gender- and age-related differences in the relationship between HbA1c and hemoglobin. The findings suggest that estrogen-related metabolic changes may influence HbA1c levels, with potential implications for diabetes management and hormone therapy in postmenopausal women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455881","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":"Cerebral Small Vessel Disease Outperforms Brain Atrophy as an Imaging Biomarker in Diabetic Retinopathy","authors":"Xinyi Shen,&nbsp;Wen Zhang,&nbsp;Xin Li,&nbsp;Xin Zhang,&nbsp;Qian Li,&nbsp;Min Wu,&nbsp;Linqing Fu,&nbsp;Jiaming Lu,&nbsp;Zhengyang Zhu,&nbsp;Bing Zhang","doi":"10.1111/1753-0407.70058","DOIUrl":"https://doi.org/10.1111/1753-0407.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to examine microvascular lesions and neurodegenerative changes in diabetic retinopathy (DR) compared to type 2 diabetes mellitus (T2DM) without DR (NDR) using structural MRI and to explore their associations with DR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>243 patients with NDR and 122 patients with DR were included. Participants underwent conventional brain MRI scans, clinical measurements, and fundus examinations. Cerebral small vessel disease (CSVD) imaging parameters were obtained using AI-based software, manually verified, and corrected for accuracy. Volumes of major cortical and subcortical regions representing neurodegeneration were assessed using automated brain segmentation and quantitative techniques. Statistical analysis included <i>T</i>-test, chi-square test, Mann–Whitney <i>U</i> test, multivariate analysis of variance (MANCOVA), multivariate logistic regression, area under the receiver operating characteristic curve (AUC), and Delong test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DR group exhibited significant differences in 11 CSVD features. Meanwhile, DR showed an atrophy trend in the frontal cortex, occipital cortex, and subcortical gray matter (GM) compared to NDR. After adjustment, DR patients exhibited greater perivascular spaces (PVS) numbers in the parietal lobe (OR = 1.394) and deep brain regions (OR = 1.066), greater dilated perivascular spaces (DPVS) numbers in the left basal ganglia (OR = 2.006), greater small subcortical infarcts (SSI) numbers in the right hemisphere (OR = 3.104), and decreased left frontal PVS (OR = 0.824), total left DPVS (OR = 0.714), and frontal cortex volume (OR = 0.959) compared to NDR. Further, the CSVD model showed a larger AUC (0.823, 95% CI: 0.781–0.866) than the brain atrophy model (AUC = 0.757, 95% CI: 0.706–0.808).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Microvascular and neurodegeneration are significantly associated with DR. CSVD is a better imaging biomarker for DR than brain atrophy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438962","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":"Iron-Deficiency Anemia Elevates Risk of Diabetic Kidney Disease in Type 2 Diabetes Mellitus","authors":"Bin Huang,&nbsp;Wenjie Wen,&nbsp;Shandong Ye","doi":"10.1111/1753-0407.70060","DOIUrl":"https://doi.org/10.1111/1753-0407.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to explore the link between iron deficiency anemia (IDA) and diabetic kidney disease (DKD) and assess the safety of iron supplementation. It also investigates key mechanisms and molecules involved in iron deficiency's role in disease development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on 1,398 T2DM patients using propensity score matching to identify risk factors for DKD. Mendelian randomization (MR) was used to explore causal relationships between IDA, iron supplementation, liver iron content, and DKD. The GSE27999 dataset was analyzed to examine how an iron-deficient diet affects kidney-related gene expression. Key pathways and molecules were identified through GSEA, GO/KEGG, and PPI analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Retrospective data showed a correlation between hemoglobin levels and DKD risk. Logistic regression confirmed that IDA increased DKD risk independently of other factors. MR revealed a causal link between IDA and DKD, with no significant effect from iron supplementation. GSE27999 analysis identified 580 differentially expressed genes, enriched in pathways like cytokine signaling, oxidative biology, and small molecule transport. PPI analysis highlighted 10 key hub genes, including Cyp2d26 and Fgf4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IDA increases susceptibility to DKD, possibly through oxidative stress and altered small molecule transport. However, iron supplementation does not appear to increase the risk of DKD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438963","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":"Pyruvate Carboxylase as a Moonlighting Metabolic Enzyme Protects β-Cell From Senescence","authors":"Yumei Yang,&nbsp;Baomin Wang,&nbsp;Xiaomu Li","doi":"10.1111/1753-0407.70050","DOIUrl":"https://doi.org/10.1111/1753-0407.70050","url":null,"abstract":"<p>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404462","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":"Glucokinase Regulatory Protein as a Putative Target for Gestational Diabetes Mellitus and Related Complications: Evidence From the Mendelian Randomization Study","authors":"Weian Mao,&nbsp;Guiquan Wang,&nbsp;Xiao Wang,&nbsp;Yan Shen,&nbsp;Shuai Yuan,&nbsp;Lin Wang,&nbsp;Haiyan Yang,&nbsp;Yan Li,&nbsp;Kai Chen,&nbsp;Jun Liu,&nbsp;Xi Dong,&nbsp;Yue Zhao,&nbsp;Liangshan Mu","doi":"10.1111/1753-0407.70056","DOIUrl":"https://doi.org/10.1111/1753-0407.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is highly associated with adverse perinatal outcomes and long-term health problems for the mother and offspring. However, there are respective limitations in the pharmacological strategies for the current treatment of GDM. Glucokinase regulatory protein (GCKR) has been associated with GDM in observational studies and animal experiments and thus represents a potential drug target of interest for investigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We applied two-sample Mendelian randomization (MR) and colocalization analysis using summary-level data from genome-wide association studies of GCKR and GDM. Two-step MR was used to explore the mediating effects of several metabolic factors on the association. We also applied MR to explore the associations of GCKR levels with GDM-related outcomes. Finally, we performed a phenome-wide association study (PheWAS) to query the potential effects of altered GCKR levels across multiple health categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found a significant association between elevated GCKR levels and GDM (OR = 3.466, 95% CI = 2.401–5.002, <i>p</i> = 3.16 × 10⁻¹¹), also supported by the colocalization analysis ([<i>P</i>_coloc] = 0.997). The estimates were replicated in an independent study (OR = 2.640, 95% CI = 1.983–3.513, <i>p</i> = 2.84 × 10⁻¹¹, <i>P</i>_coloc = 0.983). Elevated GCKR levels were also associated with higher risk of type 2 diabetes (OR = 2.183, 95% CI = 1.846–2.581, <i>p</i> = 6.53 × 10⁻²⁰). Two-step MR suggested that fasting glucose, fasting insulin, and triglycerides partly mediated the causal relationship. PheWAS found that targeting GCKR may improve renal function and glucose homeostasis but cause dyslipidemia and uric acid abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provided novel evidence that circulating GCKR levels are causally implicated in GDM and related complications, suggesting that it may be a promising target for treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362642","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":"Inverse Relationship Between Serum Carotenoid Levels and Cardiovascular-Kidney-Metabolic Syndrome Among the General Adult Population","authors":"Mengli Chen,&nbsp;Shuyue Cai,&nbsp;Qinfeng Jia,&nbsp;Yifang Suo,&nbsp;Yuan Tang,&nbsp;Yanping Shi,&nbsp;Xu Zhu,&nbsp;Haifeng Zhang","doi":"10.1111/1753-0407.70046","DOIUrl":"10.1111/1753-0407.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the relationship between serum carotenoid levels and cardiovascular-kidney-metabolic (CKM) syndrome in a representative sample of US adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the fasting subsample of the NHANES 2017–2018 were analyzed using a survey-weighted approach to ensure the findings are representative of the broader US adult population. Serum levels of α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, and lycopene were measured using high-performance liquid chromatography. CKM syndrome stages were defined according to the 2023 American Heart Association guidelines, with advanced CKM syndrome categorized as stages 3 or 4. Associations between serum carotenoids and advanced CKM syndrome were assessed using logistic regression and weighted quantile sum (WQS) regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 1671 adults aged 20 years and older, with a mean age of 48.7 years and a gender distribution of 50.9% female and 49.1% male. Higher serum levels of α-carotene, β-carotene, α-cryptoxanthin, lutein/zeaxanthin, and lycopene were inversely associated with advanced CKM syndrome. Specifically, compared to the lowest quartile, the highest quartile of α-carotene had an odds ratio (OR) of 0.29 (95% CI: 0.16–0.55), β-carotene 0.35 (95% CI: 0.16–0.78), α-cryptoxanthin 0.23 (95% CI: 0.11–0.49), lutein/zeaxanthin 0.26 (95% CI: 0.14–0.48), and lycopene 0.58 (95% CI: 0.35–0.98). However, β-cryptoxanthin did not show a significant association. Moreover, the combined effect of all carotenoids was significantly negatively correlated with advanced CKM syndrome (OR = 0.67, 95% CI: 0.53–0.86), with lutein/zeaxanthin contributing the most (44.56%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elevated serum carotenoid levels are inversely associated with the prevalence of advanced CKM syndrome in a dose-dependent manner, with this association remaining consistent across diverse demographic and health subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Period-Cohort Analysis of Diabetes Incidence and Mortality in China and Globally, 1990–2019","authors":"Jinli Liu,&nbsp;Mingwang Shen,&nbsp;Guihua Zhuang,&nbsp;Lei Zhang","doi":"10.1111/1753-0407.70051","DOIUrl":"10.1111/1753-0407.70051","url":null,"abstract":"&lt;p&gt;Diabetes has rapidly emerged as a critical global health emergency of the 21st century [&lt;span&gt;1, 2&lt;/span&gt;]. China, bearing the highest global burden of diabetes, witnessed its prevalence rise from 10.6% in 2002 to 12.4% in 2018 [&lt;span&gt;3, 4&lt;/span&gt;]. Liu et al. [&lt;span&gt;5&lt;/span&gt;] reported a 0.89% annual increase in global diabetes incidence during 1990–2017. Diabetes mortality has remained stable in China, with an increase from 10.1/100 000 in 1990 to 10.3/100 000 in 2013 [&lt;span&gt;6&lt;/span&gt;]. Diabetes risk factors are diverse, including genetic, environmental, and metabolic elements [&lt;span&gt;7, 8&lt;/span&gt;], as well as family history [&lt;span&gt;7&lt;/span&gt;], socioeconomic development [&lt;span&gt;9&lt;/span&gt;], physical inactivity [&lt;span&gt;10&lt;/span&gt;], overweight and obesity [&lt;span&gt;11&lt;/span&gt;], and dietary changes [&lt;span&gt;12-15&lt;/span&gt;]. In recent years, these factors have evolved, shaping distinct temporal trends in diabetes-related diseases and influencing age, period, and cohort trends in diabetes incidence and mortality in both China and globally.&lt;/p&gt;&lt;p&gt;Previous studies have focused on the overall changes in the disease burden of diabetes over time [&lt;span&gt;16&lt;/span&gt;]. The present study aimed to explore the overall trends in diabetes incidence and mortality in China from 1990 to 2019, and then further analyze the age, period, and cohort-specific trends, comparing these with corresponding trends across the three dimensions at the global level. This study collected data from the Global Burden of Disease Study 2019, which includes only type 1 and type 2 diabetes among individuals aged 20 years and older. A log-linear model was used to analyze overall trends in diabetes incidence and mortality, followed by an age-period cohort model to examine age, period, and cohort trends in both China and globally, with comparisons made between the two populations.&lt;/p&gt;&lt;p&gt;The study highlighted similar age-related patterns in diabetes incidence risk in both China and globally, with an initial increase followed by a decline. However, the peak age for diabetes incidence risk in China was in the 50–54 age group, whereas in the global population, it occurred in the 55–59 age group (Figure 1a). China's peak age for diabetes incidence risk was approximately 5 years younger than the global peak age, consistent with previous findings [&lt;span&gt;17&lt;/span&gt;]. Before 2010, diabetes incidence risk in China was higher than the global average, but after 2010, it fell below the global average (Figure 1b). This suggests that diabetes prevention and control measures in China have been notably effective since 2010, highlighting the success of preventive policies [&lt;span&gt;18&lt;/span&gt;]. The diabetes incidence risk in individuals born in China between 1985 and 1999 has significantly increased compared to earlier cohorts and is also higher than that of the global population born in the same period (Figure 1c). This cohort likely experienced a sharp rise in diabetes risk due to China's rapid economic development and improved l","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062626","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":"Is Weight Loss the Main Driver for A1C Improvement by Glucagon-Like Peptide 1 (GLP-1) Receptor Agonists? A 2.5-Year Analysis in Real-World Clinical Practice","authors":"Marwa Al-Badri,&nbsp;Shilton Dhaver,&nbsp;Osama Hamdy","doi":"10.1111/1753-0407.70054","DOIUrl":"10.1111/1753-0407.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are established treatment options for type 2 diabetes (T2D). In addition to their glycemic benefit, GLP-1 RAs also induce weight loss by suppressing appetite via hypothalamic pathways. However, it remains unclear whether weight reduction is the primary driver of glycemic improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively evaluated 256 patients with T2D who were treated with exenatide (<i>n</i> = 84), dulaglutide (<i>n</i> = 99), or semaglutide (<i>n</i> = 73) for 2.5 years without interruption in real-world clinical practice. Body weight and A1C were measured every 6 months. Baseline characteristics included an average age of 61.8 ± 11.9 years, 51.5% female, diabetes duration of 12.9 ± 8.3 years, weight of 103.1 ± 20.7 kg, BMI of 35.7 ± 7.5 kg/m², and A1C of 8.2% ± 1.5%. Patients were stratified into tertiles based on percentage weight change at 2.5 years within the overall cohort and for each GLP-1 RA group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The first tertile experienced an average weight loss of −12.2% ± 5.7% (<i>p</i> &lt; 0.0001), the second tertile lost −3.5% ± 1.4% (<i>p</i> &lt; 0.0001), and the third tertile gained +2.8% ± 3.4% (<i>p</i> &lt; 0.0001). The average changes in A1C were − 0.98 ± 1.8% (<i>p</i> &lt; 0.0001), −0.56% ± 1.4% (<i>p</i> &lt; 0.001), and −0.19% ± 1.9% (<i>p</i> = 0.4), respectively. A1C strongly correlated with weight change (<i>p</i> &lt; 0.001). The same observations were reproducible in each medication group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that the long-term improvement in glycemic control associated with GLP-1 RA therapy is primarily driven by weight loss rather than any other intrinsic effect of GLP-1 RA. This highlights the importance of weight reduction as a key therapeutic target for optimizing glycemic outcomes in patients with T2D receiving GLP-1 RAs.</p>\u0000 \u0000 <div>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031769","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":"“Path of the Heart” (The BPROAD Study) Addresses Optimal Systolic Blood Pressure for Patients With Diabetes","authors":"Ning Guang","doi":"10.1111/1753-0407.70053","DOIUrl":"10.1111/1753-0407.70053","url":null,"abstract":"&lt;p&gt;Awaiting my presentation at the centennial gathering of the American Heart Association (AHA) in Chicago, I opened my diary once again, particularly the one dated February 23, 2019, which reads, “After two years of meticulous preparation, the Path of the Heart research initiative has finally commenced.” The Path of the Heart refers to the BPROAD study, which has garnered significant acclaim due to its presentation at the Late-Breaking Science session of the AHA and concurrent publication in the prestigious &lt;i&gt;New England Journal of Medicine&lt;/i&gt; [&lt;span&gt;1&lt;/span&gt;]. Yet, few are acquainted with the trepidation that marked the inception of this endeavor 5 years prior, the indecision that lingered during the 2-year preparation phase, or the challenges posed by the COVID-19 pandemic throughout the study's execution. I extend my profound admiration and gratitude to the team led by Prof. Wang Weiqing, with Bi Yufang, Xu Yu, and Li Mian at the helm of the core research group, for their indomitable spirit and the resounding success of the study.&lt;/p&gt;&lt;p&gt;Hypertension affects 23.2% of the adult Chinese population, with a staggering half of diabetes patients also suffering from hypertension. Hypertension has emerged as the preeminent cause of mortality and disability among diabetes. Consequently, blood pressure management has become equally as imperative as glycemic control in the therapeutic strategies for diabetes in China. However, the optimal target for blood pressure reduction remains elusive. While the SPRINT study demonstrated a significant reduction in cardiovascular events with systolic blood pressure below 120 mmHg in hypertensive patients without diabetes [&lt;span&gt;2, 3&lt;/span&gt;], the ACCORD study failed to observe similar benefits in diabetes patients. Besides, the ACCORD study was a 2 × 2 factorial-design study examining both blood pressure and glucose control [&lt;span&gt;4&lt;/span&gt;]. Therefore, the target for blood pressure reduction in diabetes patients has become an unresolved issue, casting a shadow of confusion over clinical practice.&lt;/p&gt;&lt;p&gt;In light of this, the team led by Wang Weiqing and Bi Yufang from Ruijin Hospital has spearheaded the BPROAD study [&lt;span&gt;5, 6&lt;/span&gt;]. This nationwide, multicenter, open-label, parallel-group, randomized controlled clinical trial made its debut as the opening presentation at the 2024 AHA Scientific Session, marking a historic milestone for Chinese researchers in the field of cardiovascular and metabolic clinical research.&lt;/p&gt;&lt;p&gt;The BPROAD study has established that intensive blood pressure management targeting a systolic blood pressure below 120 mmHg, as opposed to conventional management aiming for below 140 mmHg, results in a 21% reduction in the primary composite endpoint of major cardiovascular events, including non-fatal stroke, non-fatal myocardial infarction, heart failure requiring treatment or hospitalization, and cardiovascular death, in type 2 diabetes patients with elevated systolic blood pressure and inc","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031757","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}