Journal of Diabetes最新文献

{"title":"Vertical Transmission of Gut Dysbiosis From Mothers With Gestational Diabetes to Infants","authors":"Jia Ming Low,&nbsp;Abhishek Gupta,&nbsp;Rachel Toh,&nbsp;Su Lin Lim,&nbsp;Shiao-Yng Chan,&nbsp;Sanjay Swarup,&nbsp;Le Ye Lee","doi":"10.1111/1753-0407.70148","DOIUrl":"https://doi.org/10.1111/1753-0407.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vertical transmission of microbes from a mother's gut to their offspring plays a crucial role in the genesis of the early life gut microbiome. Gestational Diabetes Mellitus (GDM) is the commonest metabolic disorder during pregnancy, which has adverse short- and long-term effects on both maternal and infant health. We aimed to capture the GDM-associated biosignatures in infants' gut microbiome from birth to the first 6 weeks of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>53 GDM mother-infant dyads and 16 healthy mother-infant dyads were recruited. We performed targeted 16S rRNA gene amplicon sequencing on stool samples. Various statistical analyses were performed to understand the changes in the microbiome profile of infants and identify GDM-associated bacterial biomarkers in mothers and their transfer to infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GDM altered the gut microbiome of pregnant women as compared to healthy counterparts (PERMANOVA, <i>p</i>.adjusted &lt; 0.05), with predominance of bacterial members associated with insulin resistance, proinflammatory conditions, and other metabolic processes. Infants born to GDM mothers have distinctive early life microbiome (meconium and six weeks stools) compared to infants born to control mothers (PERMANOVA, <i>p</i>.adjusted &lt; 0.05). We also identified the presence of various GDM-associated microbial signatures such as <i>Blautia</i> and <i>Collinsella</i> in both meconium and one-month-old stool samples of infants born to GDM mothers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides a better understanding of the impact of GDM on the seeding of a specific set of microbes during the early life colonization event in the infant gut that increases the risk of inflammatory and metabolic diseases in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 10","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196436","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":"History of Hypertension From Childhood and Fasting Blood Glucose Levels in Adulthood: The Bogalusa Study","authors":"Lingli Zhao,&nbsp;Jiahui Ouyang,&nbsp;Yewen Song,&nbsp;Hua Qu,&nbsp;Zhuye Gao","doi":"10.1111/1753-0407.70155","DOIUrl":"https://doi.org/10.1111/1753-0407.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fasting blood glucose (FBG) reflects cardiometabolic health, but the long-term effects of childhood hypertension (HTN) on adult FBG are unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the Bogalusa Heart Study, we examined the link between childhood HTN and FBG in early adulthood, adjusting for race, BMI, pulse rate, and blood pressure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Individuals with childhood HTN had higher FBG in early adulthood (mean difference 8.96 mg/dL) and a 4.16-fold higher risk of high FBG (≥ 126 mg/dL). The effect was stronger in African Americans, those with higher pulse rate, overweight individuals, or those with low diastolic BP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Childhood HTN is linked to elevated FBG in early adulthood. Early management of hypertensive children, especially those at metabolic risk, may help prevent diabetes and cardiovascular disease later.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 10","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196444","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":"Sitagliptin, a DPP-4 Inhibitor, Effectively Promotes the Healing of Diabetic Foot Ulcer: A Randomized Controlled Trial","authors":"Wei Gao,&nbsp;Dawei Chen,&nbsp;Hua He,&nbsp;Nenggang Jiang,&nbsp;Lihong Chen,&nbsp;Xingwu Ran","doi":"10.1111/1753-0407.70156","DOIUrl":"https://doi.org/10.1111/1753-0407.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This randomized controlled trial (RCT) was designed to evaluate the effects of sitagliptin on diabetic foot ulcers (DFUs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a randomized, open-label clinical trial. The participants were assigned to either the control group, which received standard conventional therapy alone, or the sitagliptin treatment group, which received an oral administration of sitagliptin (100 mg once daily) in conjunction with standard conventional therapy. The primary endpoints were the ulcer healing rate and adverse reactions. The secondary endpoints included the time to ulcer healing, peripheral blood CD34+ endothelial progenitor cells (EPCs) count, serum levels of stromal cell-derived factor-1α (SDF-1α), and glycosylated hemoglobin A1c (HbA1c).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 62 subjects were enrolled in this trial, with 31 individuals assigned to each group. One participant from each group was lost to follow-up. Posttrial analysis revealed that, compared with the control group, the sitagliptin group demonstrated a significantly greater reduction in ulcer area and improved efficacy in terms of ulcer healing (<i>p</i> &lt; 0.05). Although not statistically significant (<i>p</i> = 0.071), the sitagliptin group also tended to have a shorter ulcer healing time. Additionally, the sitagliptin group presented significantly greater numbers of CD34+ EPCs and higher SDF-1α levels compared to the control group (<i>p</i> &lt; 0.05). No statistically significant difference in HbA1c levels was observed between the two groups (<i>p</i> &gt; 0.05). No adverse events associated with sitagliptin treatment were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The DPP-4 inhibitor sitagliptin may facilitate the healing of DFUs independent of its glucose-lowering effects, potentially by enhancing the mobilization of CD34 + EPCs in peripheral blood.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Registration number: ChiCTR 2000029230, Approval date: 2020/01/19</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 9","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062792","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 Contribution of Genetic Risk and Lifestyle Factors in the Progression of Diabetes to Diabetic Kidney Disease: A Prospective Cohort Study","authors":"Yujiao Wang,&nbsp;Chunyang Li,&nbsp;Nongbu Cili,&nbsp;Jing Chen,&nbsp;Huazhen Yang,&nbsp;Ping Fu,&nbsp;Xiaoxi Zeng","doi":"10.1111/1753-0407.70141","DOIUrl":"10.1111/1753-0407.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetes is a global public health crisis, especially when it is accompanied by microvascular complications such as diabetic kidney disease (DKD). The purpose of this study was to explore the relationship between the combined lifestyle factors of diabetes patients and their joint effects with genetic risk and the risk of DKD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We included individuals diagnosed with diabetes at baseline from UK Biobank. Their lifestyle information was collected through a baseline questionnaire. Favorable lifestyle scores were constructed based on 5 common lifestyle factors and categorized into three levels. Genetic susceptibility to CKD was estimated by polygenic risk scores and further categorized into high, and low genetic risk categories. Cox proportional hazards regression model was used to estimate the hazard ratios (HR) and 95% confidence interval (CI) for their associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>By the end of follow-up, 1335 of 11 981 diabetes patients progressed to diabetes nephropathy. The COX regression results indicate that BMI ≥ 25 mg/m² and current or past smoking were risk factors for DKD, while alcohol consumption and moderate to high-intensity pysical exercise were protective factors. High genetic risk is significantly associated with increased risk of DKD (HR1.29, 95% CI 1.13–1.47, <i>p</i> &lt; 0.001), while a favorable lifestyle had a protective effect (HR0.47, 95% CI 0.37–0.59, <i>p</i> &lt; 0.001). Interaction analysis shows that there was neither additive nor multiplicative interaction between genetic risk and lifestyle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lifestyle factors and genetics are independently associated with susceptibility to incident DKD. A healthy lifestyle may attenuate elevated DKD risks due to genetic vulnerability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 9","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032341","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":"Diabetic Kidney Disease Update","authors":"Christian Mende,&nbsp;Zachary Bloomgarden","doi":"10.1111/1753-0407.70150","DOIUrl":"https://doi.org/10.1111/1753-0407.70150","url":null,"abstract":"&lt;p&gt;The major determinants of the development of chronic kidney disease (CKD) in people with diabetes are hyperglycemia, hypertension, genetic susceptibility, dyslipidemia, and inflammation. By better understanding these factors, we can modify the risk of kidney damage and subsequent complications among people with diabetes. Elevation in glucose levels leads to both metabolic and hemodynamic changes, including glomerular hyperfiltration, podocyte injury, and progressive albuminuria, while hypertension accelerates glomerular damage [&lt;span&gt;1&lt;/span&gt;]. Genetic predisposition, along with lifestyle factors such as obesity and smoking, further increases the risk. Dyslipidemia and oxidative stress contribute to endothelial dysfunction and tubulointerstitial injury [&lt;span&gt;2&lt;/span&gt;], and inflammation [&lt;span&gt;3&lt;/span&gt;] and activation of fibrotic pathways play important roles in disease progression [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;CKD is defined operationally by estimated glomerular filtrate rate (eGFR) &lt; 60 mL/min and urine albumin/creatinine ratio (UACR) ≥ 30 mg/g present for 90 days or longer. Diabetes is responsible for roughly one-quarter to one-half of all CKD cases, with the proportion varying by region, population demographics, and stage of kidney disease [&lt;span&gt;6-8&lt;/span&gt;]. This underscores the critical importance of diabetes prevention and optimal management to reduce the global burden of CKD. Albuminuria with normal renal function and/or an eGFR &lt; 60 mL/min is associated with considerable cardiovascular mortality and heart failure risk. This has been underappreciated compared to the risk of progression of CKD and ESKD. In diabetic CKD, the risk of cardiovascular death is twice as great with eGFR &lt; 60 mL/min and four times as great with eGFR &lt; 45 mL/min, compared to normal renal function [&lt;span&gt;9&lt;/span&gt;]. Compared to no albuminuria, mortality and heart failure admissions are four- and five-fold more likely in the presence of albuminuria, even when the eGFR is normal [&lt;span&gt;10, 11&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Pharmacologic therapy is the cornerstone of treatment of diabetic CKD, with improvement in outcome seen with Renin-Angiotensin-Aldosterone system (RAAS) blockade, including mineralocorticoid inhibitors (MRA), sodium glucose transporter (SGLT) 2 inhibitors, and glucagon-like peptide (GLP)-1 receptor agonists (RA); significant therapeutic benefits also have been shown with aggressive therapy of comorbidities (hypertension, obesity and dyslipidemia) [&lt;span&gt;12&lt;/span&gt;]. However, lifestyle modifications (diet/weight management, physical activity, smoking) and genetic risk have not received as much attention in clinical practice [&lt;span&gt;13&lt;/span&gt;]. In a Dutch observational study, only 2% of patients adhered to all recommended lifestyle recommendations [&lt;span&gt;14&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Three publications in the current Journal of Diabetes evaluate the aspects of the effects of lifestyle, social factors, genetic risks, and comorbidities as risk factors for the progression ","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 9","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990708","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":"Indobufen Versus Aspirin Plus Clopidogrel in Patients After Coronary Stenting in Patients With Diabetes: A Post Hoc Analysis of the OPTION Trial","authors":"Shujing Wu,&nbsp;Huajie Xu,&nbsp;Lili Xu,&nbsp;Huanyi Zhang,&nbsp;Kang Cheng,&nbsp;Xiaoyan Wang,&nbsp;Manhua Chen,&nbsp;Guangping Li,&nbsp;Jiangnan Huang,&nbsp;Jun Lan,&nbsp;Guanghe Wei,&nbsp;Xin Zhao,&nbsp;Zhiyong Qi,&nbsp;Juying Qian,&nbsp;Hongyi Wu,&nbsp;Junbo Ge,&nbsp;the OPTION investigators","doi":"10.1111/1753-0407.70152","DOIUrl":"https://doi.org/10.1111/1753-0407.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite increased risk of ischemic events in diabetes, the optimal anti-thrombotic strategy for secondary prevention has not been defined. We aimed to assess the efficacy and safety of optimal antiplatelet agents such as indobufen-based dual antiplatelet therapy (DAPT) in patients with diabetes after coronary stenting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>OPTION trial was a randomized, open-label, noninferiority, and multicentric study in China. Enrolled subjects were randomized 1:1 to indobufen-based DAPT or aspirin-based DAPT. This post hoc analysis from OPTION trial was performed by the presence of diabetes. The primary endpoint was a 1-year composite of cardiovascular death, nonfatal myocardial infarction, ischemic stroke, definite or probable stent thrombosis, or Bleeding Academic Research Consortium (BARC) criteria type 2, 3, or 5 bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4551 OPTION patients, the primary endpoint occurred in 93/1570 patients with diabetes (5.92%), as compared to 148/2981 without diabetes (4.96%) (HR: 0.72, 95% CI: 0.47–1.08, and HR: 0.73, 95% CI: 0.53–1.01, respectively), without significant interaction between diabetes status and treatment effect (<i>P</i>_interaction = 0.935). The secondary efficacy endpoint was comparable between patients with (HR: 1.31, 95% CI: 0.60–2.84) and without diabetes (HR: 0.95, 95% CI: 0.51–1.76) (<i>P</i>_interaction = 0.526). Similarly, both subgroups derived similar benefits for the safety endpoint (HR, 0.56; 95% CI, 0.34–0.92 for subjects with diabetes vs. HR, 0.66; 95% CI, 0.45–0.98 for those without diabetes; <i>P</i>_interaction = 0.609).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients receiving DES implantation, indobufen-based DAPT might be considered as a reasonable alternative to aspirin-based DAPT in the secondary prevention for those with diabetes, especially in patients at high bleeding risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 9","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990709","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":"Associations of Stressful Life Events With Diabetes Incidence in China: Insights From the China Kadoorie Biobank","authors":"Jing Qian,&nbsp;Huiying Cheng,&nbsp;Xuening Dai,&nbsp;Dianjianyi Sun,&nbsp;Pei Pei,&nbsp;Meng Wang,&nbsp;Yingjun Li","doi":"10.1111/1753-0407.70149","DOIUrl":"https://doi.org/10.1111/1753-0407.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Limited empirical evidence exists on the link between exposure to various stressful life events (SLEs) and the heightened risk of Diabetes Mellitus (DM) within the mainland Chinese population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted this prospective cohort study with 455,464 participants from the China Kadoorie Biobank (CKB); we examined associations between SLEs exposures and DM outcomes. We employed multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a median follow-up of 10.1 years, 14,218 DM cases were identified. A dose–response relationship was observed between the number of SLEs, personal-related events, and the risk of DM. The higher the number of SLEs experienced, the higher the risk of developing diabetes (HR = 1.06, 95% CI = 1.01–1.12); individuals who experienced personal-related events had a higher risk of developing DM (HR = 1.17, 95% CI = 1.01–1.36), and those who experienced marital separation/divorce had a 53% increased risk of DM (HR = 1.53, 95% CI = 1.12–2.09). Subgroup analyses revealed effect modifications based on birth cohort, sex, and area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By exploring the association of multiple SLEs with the development of DM, we identified marital separation/divorce as a driver of increased DM risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 9","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of GLP-1 Receptor Agonists on Suicide Behavior: A Meta-Analysis Based on Randomized Controlled Trials","authors":"Jingqi Chen,&nbsp;Qiufeng Zhang,&nbsp;Qingping Wu,&nbsp;Xiaoming Zhang,&nbsp;Zhiyi Xiang,&nbsp;Sidong Zhu,&nbsp;Tianfu Dai,&nbsp;Yuexiu Si","doi":"10.1111/1753-0407.70151","DOIUrl":"https://doi.org/10.1111/1753-0407.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This meta-analysis aims to assess the association between exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the incidence of suicidal behavior in patients with type 2 diabetes mellitus (T2DM)/obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of electronic databases, including PubMed, Web of Science, the Cochrane Library, and ClinicalTrials.gov, was conducted from the inception of the databases. The risk ratio (RR) and 95% confidence intervals (95% CI) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This meta-analysis included data from 25 randomized controlled trials (RCTs). The results indicated no significant difference in the incidence of suicidal behavior between the GLP-1 RA exposure group and the control group (RR = 0.84, 95% CI: 0.54–1.32, <i>p</i> = 0.46, <i>I</i>² = 0%). Subgroup analysis showed no significant differences in the incidence of suicidal behavior among participants with T2DM (RR = 0.74), obesity (RR = 1.07), adolescents (RR = 0.91), and adults (RR = 0.84). Additionally, no significant differences were observed between the two groups in any type of suicidal behavior, including suicidal ideation (RR = 1.04), suicide attempts (RR = 0.68), depression-related suicides (RR = 0.65), and completed suicides (RR = 1.06). There were also no significant differences between the groups for any type of GLP-1 RA, including dulaglutide (RR = 0.46), exenatide (RR = 0.98), semaglutide (RR = 0.82), lixisenatide (RR = 1.25), and liraglutide (RR = 0.92). No significant differences were observed between the exposure group and control group according to different comparators, including placebo (RR = 0.91) and others (RR = 1.08). All subgroup analyses showed <i>p</i>-values greater than 0.05 (two-sided tests) and <i>I</i>² values of 0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that there is no significant association between GLP-1 RA exposure and suicidal behaviors in patients with T2DM or obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 9","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923805","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":"Response to Commentary on “Sleep Phenotypes, Genetic Susceptibility, and Risk of Obesity in Patients With Type 2 Diabetes: A National Prospective Cohort Study”","authors":"Lei Xi,&nbsp;Juan Shi,&nbsp;Ying Peng,&nbsp;Yifei Zhang,&nbsp;Yanan Cao,&nbsp;Weiqing Wang","doi":"10.1111/1753-0407.70145","DOIUrl":"https://doi.org/10.1111/1753-0407.70145","url":null,"abstract":"<p>We thank the authors for their insightful comments and for recognizing that our manuscript provides valuable details about behavioral and genetic factors affecting the risk of obesity in people with type 2 diabetes (T2D) [<span>1</span>].</p><p>Firstly, as mentioned in our article, there may be recall bias based on patient self-reported sleep duration, and objectively measuring habitual sleep duration using actigraphy can provide more reliable data. However, considering its simplicity, practicality, and correlation with instrument measurement results, patients' self-reported sleep duration is still internationally recognized and widely used in population-based studies [<span>2, 3</span>].</p><p>Secondly, the relationship between sleep, diabetes and obesity is really complex and challenging. As mentioned by the authors, most exploratory experiments on sleep are temporary, especially for sleep deprivation. There are interactions among sleep, diabetes and obesity that impact cardiovascular and metabolic health, just like the intertwined trio. To avoid the potential impact of sleep related diseases, we excluded patients who reported implausible values of sleep duration (i.e., &lt; 3 or &gt; 12 h/night), use of sleeping aids, or psychiatric medications at baseline. It should be pointed out that the above efforts cannot completely eliminate the potential impact of sleep disorders on our study results, and how to reduce their potential effects is also one of the key considerations in our future research. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are indeed effective tools.</p><p>As we mentioned in the article, we acknowledge that “although we have adjusted for several covariates, there are potential confounders that could influence the results, such as dietary habits, physical activity, socioeconomic biases, and glucose-lowering medications, which we did not include in this study, and further research is needed to strengthen our understanding of these complex associations”, when it comes to both clinical and genetic analysis. In addition, a more complex and precise polygenic risk score (PRS) model for body mass index (BMI) is also under consideration.</p><p>In conclusion, we thank the authors for the wise and valuable comments and suggestions. We hope these clarifications address the issues raised and we intend to use more complex and appropriate models to explore their associations in future research.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 8","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891692","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":"An Update on GLP-1 Receptor Agonists","authors":"Zachary Bloomgarden","doi":"10.1111/1753-0407.70147","DOIUrl":"https://doi.org/10.1111/1753-0407.70147","url":null,"abstract":"<p>The glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) are a class of medications primarily developed for the management of type 2 diabetes (T2D) and are increasingly being used for various other health effects. Here's a simplified overview of their history, effects, and future prospects:</p><p>Glucose-dependent insulinotropic polypeptide (GIP) and then GLP-1 were identified in the 1970s as peptides potentiating the insulin secretory response to nutrient ingestion. In the early 1980s, the proglucagon amino acid sequence and gene were mapped, leading to the recognition of the common derivation of GLP-1 and GLP-2, produced in the L-cells of the distal small intestine, while GIP is produced in the K-cells of the proximal small intestine. The first therapeutically used GLP-1RA was isolated as exendin-4 from the saliva of a venomous lizard, <i>Heloderma suspectum</i> (the “Gila monster”), in 1992, with initial preclinical studies reported in 1996; although FDA approval for its use in treatment of T2D as exenatide was not granted until 2005. The next GLP-1RA used therapeutically was liraglutide, receiving approval in 2010, with dulaglutide receiving approval in 2014, semaglutide approval in 2017, and tirzepatide (a combined agonist of GLP-1 and GIP) approval in 2022; FDA approvals of liraglutide, semaglutide, and tirzepatide for treatment of obesity were granted in 2014, 2021, and 2023, respectively.</p><p>Both the GLP-1 and GIP receptor agonists enhance insulin production when glucose levels are elevated. This physiological insulin-secretory effect contrasts with the action of the older sulfonylureas, which activate the ATP-sensitive potassium channels of the pancreatic beta cells, mimicking the cellular process that physiologically acts to link insulin production to the beta cell's energy state. The consequent increase in endogenous insulin production leads the GLP-1RAs to have glucose-lowering action comparable to that of daily treatment with basal insulin [<span>1</span>]; with weight loss rather than weight gain and with lower likelihood of hypoglycemia [<span>2, 3</span>].</p><p>In addition to their glycemic benefits, GLP-1RAs are associated with improvement in mortality and in CV and renal outcomes in clinical trials [<span>4, 5</span>], both in people having and not having T2D [<span>6</span>], as well as in real-world studies of people with T2D [<span>7</span>] and of people with obesity without T2D [<span>8</span>]. In a study from the US Veteran's Affairs hospitals with mean followup of nearly 4 years comparing more than 200 000 persons receiving GLP-1RA with more than 1.2 million receiving usual care, benefits of GLP-1RAs included reduction in risk of stroke, myocardial infarction, pulmonary embolism, phlebitis, heart failure, hepatic failure, chronic kidney disease, bacterial infections, postprocedural respiratory complications, aspiration pneumonitis, chronic obstructive pulmonary disease, pneumonia and respiratory failure, a","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 8","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888188","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}