Journal of Diabetes最新文献

{"title":"Rationale and design for the Blood Pressure Control Target in Diabetes (BPROAD) study.","authors":"","doi":"10.1111/1753-0407.13411","DOIUrl":"10.1111/1753-0407.13411","url":null,"abstract":"<p><strong>Background: </strong>Diabetes and hypertension are major modifiable risk factors for cardiovascular disease. Previous clinical trials have demonstrated that intensive blood pressure reduction lowers the risk of cardiovascular disease and all-cause mortality compared to standard blood pressure reduction among patients without diabetes. However, optimal levels of blood pressure control in patients with diabetes remain uncertain.</p><p><strong>Methods: </strong>The Blood Pressure Control Target in Diabetes (BPROAD) study is a multicenter, randomized controlled trial conducted in mainland China. We plan to enroll 12 702 participants aged ≥50 years with type 2 diabetes, an increased cardiovascular risk, and systolic blood pressure ≥130 mm Hg from 150 study centers. Participants are randomly assigned to intensive (a systolic target of <120 mm Hg) or standard (a systolic target of <140 mm Hg) blood pressure treatment group. Participants will be followed monthly for blood pressure management in the first 3 months and then every 3 months afterward. The primary study outcome is a composite of major cardiovascular events including nonfatal myocardial infarction, nonfatal stroke, treated or hospitalized heart failure, and cardiovascular death. Data will be collected every 3 months for up to 5 years and a blinded outcome committee will adjudicate all clinical outcomes. The BPROAD study is designed to have 90% statistical power to detect a 20% reduction in the primary study outcome at a two-sided significance level of 0.05.</p><p><strong>Conclusions: </strong>The BPROAD study will provide important evidence as to whether intensive blood pressure management has additional benefits on cardiovascular disease and all-cause mortality among patients with type 2 diabetes.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":" ","pages":"1029-1040"},"PeriodicalIF":4.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9727243","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":"Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: A systematic review of qualitative studies.","authors":"Patrizia Natale, Sharon Chen, Clara K Chow, Ngai Wah Cheung, David Martinez-Martin, Corinne Caillaud, Nicole Scholes-Robertson, Ayano Kelly, Jonathan C Craig, Giovanni Strippoli, Allison Jaure","doi":"10.1111/1753-0407.13454","DOIUrl":"10.1111/1753-0407.13454","url":null,"abstract":"<p><strong>Aims: </strong>Blood glucose control is central to the management of diabetes, and continuous glucose monitoring (CGM) improves glycemic control. We aimed to describe the perspectives of people with diabetes using CGM.</p><p><strong>Materials and methods: </strong>We performed a systematic review of qualitative studies.</p><p><strong>Results: </strong>Fifty-four studies involving 1845 participants were included. Six themes were identified: gaining control and convenience (reducing pain and time, safeguarding against complications, achieving stricter glucose levels, and sharing responsibility with family); motivating self-management (fostering ownership, and increasing awareness of glycemic control); providing reassurance and freedom (attaining peace of mind, and restoring social participation); developing confidence (encouraged by the endorsement of others, gaining operational skills, customizing settings for ease of use, and trust in the device); burdened with device complexities (bewildered by unfamiliar technology, reluctant to rely on algorithms, overwhelmed by data, frustrated with malfunctioning and inaccuracy, distressed by alerts, and bulkiness of machines interfering with lifestyle); and excluded by barriers to access (constrained by cost, lack of suppliers).</p><p><strong>Conclusions: </strong>CGM can improve self-management and confidence in patients managing diabetes. However, the technical issues, uncertainty in readings, and cost may limit the uptake. Education and training from the health professionals may help to reduce the practical and psychological burden for better patient outcomes.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":" ","pages":"1048-1069"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954630","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":"Plasma mitochondrial DNA is elevated in maternal serum at first trimester and may serve as a biomarker for prediction of gestational diabetes mellitus.","authors":"Dushyant Kumar Sahu, Jessy Abraham","doi":"10.1111/1753-0407.13462","DOIUrl":"10.1111/1753-0407.13462","url":null,"abstract":"<p><strong>Background: </strong>We evaluated whether an abundance of first-trimester plasma mitochondrial DNA (mtDNA) fragments could predict the risk for the development of gestational diabetes mellitus (GDM) by the late second or early third trimester.</p><p><strong>Methods: </strong>It was a prospective study wherein we enrolled 150 women in their first trimester of gestation. Oral glucose tolerance test (OGTT) was administered both in the first and second trimesters to diagnose GDM.</p><p><strong>Results: </strong>Among our cohort, 23 women were diagnosed with GDM in the first trimester and excluded from the study. Of the remaining 127, 29 women were diagnosed with GDM in the second trimester, and 98 women who did not develop GDM served as controls. We amplified blood drawn from each participant during the first trimester for three distinct mtDNA gene sequences: COX, ND4, and D-loop. An abundance of each mtDNA sequence, estimated by the ΔCt method between mtDNA and 18S rRNA, correlated with GDM occurrence in the late second or early third trimester. There was a significant difference in ΔCt COX between controls and those with GDM occurrence in the second trimester (p = .006). These levels were not associated with age or fasting plasma glucose levels in the first trimester. ΔCt COX could predict GDM with a sensitivity of 90% and a specificity of 40%. Though ΔCt ND4 was higher in the GDM-positive group, the levels did not reach statistical significance. ΔCt D-loop was similar in GDM-positive cases and controls who did not develop GDM during pregnancy.</p><p><strong>Conclusions: </strong>These results were in plasma samples collected 3 to 4 months before overt hyperglycemia diagnosis suggestive of GDM. The abundance of plasma mtDNA fragments represents a promising cost-effective, convenient early-stage biomarker for predicting GDM development. Importantly, it can be administered irrespective of the fasting status of the subject. Further assessment of the predictive capacity of these biomarkers within large, diverse populations is needed for effective clinical utility.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":" ","pages":"1095-1102"},"PeriodicalIF":4.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194658","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":"Fatty acid β-oxidation and mitochondrial fusion are involved in cardiac microvascular endothelial cell protection induced by glucagon receptor antagonism in diabetic mice.","authors":"Peng Wang, Rui Wei, Xiaona Cui, Zongzhe Jiang, Jin Yang, Lingyun Zu, Tianpei Hong","doi":"10.1111/1753-0407.13458","DOIUrl":"10.1111/1753-0407.13458","url":null,"abstract":"<p><strong>Introduction: </strong>The role of cardiac microvascular endothelial cells (CMECs) in diabetic cardiomyopathy is not fully understood. We aimed to investigate whether a glucagon receptor (GCGR) monoclonal antibody (mAb) ameliorated diabetic cardiomyopathy and clarify whether and how CMECs participated in the process.</p><p><strong>Research design and methods: </strong>The db/db mice were treated with GCGR mAb or immunoglobulin G (as control) for 4 weeks. Echocardiography was performed to evaluate cardiac function. Immunofluorescent staining was used to determine microvascular density. The proteomic signature in isolated primary CMECs was analyzed by using tandem mass tag-based quantitative proteomic analysis. Some target proteins were verified by using western blot.</p><p><strong>Results: </strong>Compared with db/m mice, cardiac microvascular density and left ventricular diastolic function were significantly reduced in db/db mice, and this reduction was attenuated by GCGR mAb treatment. A total of 199 differentially expressed proteins were upregulated in db/db mice versus db/m mice and downregulated in GCGR mAb-treated db/db mice versus db/db mice. The enrichment analysis demonstrated that fatty acid β-oxidation and mitochondrial fusion were the key pathways. The changes of the related proteins carnitine palmitoyltransferase 1B, optic atrophy type 1, and mitofusin-1 were further verified by using western blot. The levels of these three proteins were upregulated in db/db mice, whereas this upregulation was attenuated by GCGR mAb treatment.</p><p><strong>Conclusion: </strong>GCGR antagonism has a protective effect on CMECs and cardiac diastolic function in diabetic mice, and this beneficial effect may be mediated via inhibiting fatty acid β-oxidation and mitochondrial fusion in CMECs.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":" ","pages":"1081-1094"},"PeriodicalIF":4.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10030133","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 link between obesity and insulin resistance among children: Effects of key metabolites.","authors":"Wu Yan, Su Wu, Qianqi Liu, Qingqing Zheng, Wei Gu, Xiaonan Li","doi":"10.1111/1753-0407.13460","DOIUrl":"10.1111/1753-0407.13460","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity became a severe public health challenge, and insulin resistance (IR) was one of the common complications. Both obesity and IR were considered as the basis of metabolic disorders. However, it is unclear which common key metabolites are associated with childhood obesity and IR.</p><p><strong>Methods: </strong>The children were divided into normal weight and overweight/obese groups. Fasting blood glucose and fasting insulin were measured, and homeostasis model assessment of insulin resistance was calculated. Liquid chromatography-tandem mass spectrometry was applied for metabonomic analysis. Multiple linear regression analysis and correlation analysis explored the relationships between obesity, IR, and metabolites. Random forests were used to rank the importance of differential metabolites, and relative operating characteristic curves were used for prediction.</p><p><strong>Results: </strong>A total of 88 normal-weight children and 171 obese/overweight children participated in the study. There was a significant difference between the two groups in 30 metabolites. Childhood obesity was significantly associated with 10 amino acid metabolites and 20 fatty acid metabolites. There were 12 metabolites significantly correlated with IR. The ranking of metabolites in random forest showed that glutamine, tyrosine, and alanine were important in amino acids, and pyruvic-ox-2, ethylmalonic-2, and phenyllactic-2 were important in fatty acids. The area under the curve of body mass index standard deviation  score (BMI-SDS) combined with key amino acid metabolites and fatty acid metabolites for predicting IR was 80.0% and 76.6%, respectively.</p><p><strong>Conclusions: </strong>There are common key metabolites related to IR and obese children, and these key metabolites combined with BMI-SDS could effectively predict the risk of IR.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":" ","pages":"1020-1028"},"PeriodicalIF":4.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10071857","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":"Blood pressure targets for prevention of cognitive decline in patients with diabetes and hypertension: Design of the Blood Pressure Control Target in Diabetes (BPROAD) Cognitive Study.","authors":"","doi":"10.1111/1753-0407.13412","DOIUrl":"10.1111/1753-0407.13412","url":null,"abstract":"<p><strong>Background: </strong>Both hypertension and diabetes are risk factors of dementia. Proper management of blood pressure (BP) and blood glucose is critical in delaying cognitive decline in the elderly. However, little is known regarding the optimal BP target in type 2 diabetes (T2DM) for the management of cognitive decline.</p><p><strong>Methods: </strong>The Blood Pressure Control Target in Diabetes (BPROAD) study is a nationwide, multicenter, randomized controlled trial that will enroll 12 702 T2DM patients with elevated systolic BP and increased cardiovascular risk from approximately 150 study centers across mainland China to undergo randomly antihypertensive treatment achieving systolic BP <120 mm Hg or systolic BP <140 mm Hg for up to 5 years. All BPROAD participants will take part in the BPROAD Cognitive Study for the assessment of cognitive function at baseline and annual visits by blinded outcome assessors to determine whether intensive BP treatment reduces risk of dementia and mild cognitive impairment (MCI) compared with standard BP treatment in patients with T2DM. In addition, approximately 1000 BPROAD participants will be enrolled in the magnetic resonance imaging (MRI) substudy to receive brain MRI at baseline and at closeout. The primary outcome of BPROAD Cognitive Study is a composite of all-cause dementia and MCI.</p><p><strong>Conclusions: </strong>The BPROAD Cognitive Study will provide crucial clinical trial data on the possible benefit of an intensive systolic BP lowering strategy in reducing dementia and MCI in patients with T2DM.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":" ","pages":"1041-1047"},"PeriodicalIF":4.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10755604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41093368","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":"Washed microbiota transplantation reduces glycemic variability in unstable diabetes","authors":"Yangyang Li,&nbsp;Qing Liu,&nbsp;Lingyu Zhang,&nbsp;Jing Zou,&nbsp;Rongbo He,&nbsp;Ying Zhou,&nbsp;Chen Qian,&nbsp;Yuxiao Zhu,&nbsp;Rourou Chen,&nbsp;Ying Zhang,&nbsp;Pengpeng Cai,&nbsp;Miao Wang,&nbsp;Wei Shao,&nbsp;Minjun Ji,&nbsp;Hao Wu,&nbsp;Faming Zhang,&nbsp;Zejian Liu,&nbsp;Yu Liu","doi":"10.1111/1753-0407.13485","DOIUrl":"10.1111/1753-0407.13485","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dysbiosis of gut microbiota is causally linked to impaired host glucose metabolism. We aimed to study effects of the new method of fecal microbiota transplantation, washed microbiota transplantation (WMT), on reducing glycemic variability (GV) in unstable diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fourteen eligible patients received three allogenic WMTs and were followed up at 1 week, 1 month, and 3 months. Primary outcomes were daily insulin dose, glucose excursions during meal tests, and GV indices calculated from continuous monitoring or self-monitoring glucose values. Secondary outcomes were multiomics data, including 16S rRNA gene sequencing, metagenomics, and metabolomics to explore underlying mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Daily insulin dose and glucose excursions markedly dropped, whereas GV indices significantly improved up to 1 month. WMT increased gut microbial alpha diversity, beta diversity, and network complexity. Taxonomic changes featured lower abundance of genera <i>Bacteroides</i> and <i>Escherichia</i>-<i>Shigella</i>, and higher abundance of genus <i>Prevotella</i>. Metagenomics functional annotations revealed enrichment of distinct microbial metabolic pathways, including methane biosynthesis, citrate cycle, amino acid degradation, and butyrate production. Derived metabolites correlated significantly with improved GV indices. WMT did not change circulating inflammatory cytokines, enteroendocrine hormones, or C-peptide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WMT showed strong ameliorating effect on GV, raising the possibility of targeting gut microbiota as an effective regimen to reduce GV in diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41230968","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":"Ten-year clinical characteristics of patients with early-onset type 2 diabetes: A single-center experience in China","authors":"Ruiqi Yu,&nbsp;Xiaoyu Liu,&nbsp;Ruochen Li,&nbsp;Xinhua Xiao","doi":"10.1111/1753-0407.13477","DOIUrl":"10.1111/1753-0407.13477","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The incidence of type 2 diabetes in China has exhibited an increasing trend, including younger individuals, over the past years. Early-onset type 2 diabetes (EOT2D) refers to diabetes diagnosed before 40 years of age. These patients have poor metabolic control and are highly susceptible to diabetic complications, which poses challenges for treatment. However, few studies have reported on the treatment of EOT2D. We determined clinical features and trends in drug use in patients with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective study was performed at the Endocrinology Ward, Peking Union Medical College Hospital (PUMCH). “Diabetes” was used when searching PUMCH's Electronic Medical Record Analytical Database to obtain clinical data of patients between January 2013 and May 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 1590 patients with T2DM. Among them, 609 (38.3%) had EOT2D. Compared with late-onset type 2 diabetes (LOT2D) patients, EOT2D patients exhibited worse glycemic control and higher body weight and lipid levels despite significant age differences. EOT2D patients also had a higher risk of diabetic retinopathy and nephropathy. Under the general trend of increasing use of dipeptidylpeptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, and glucagon-like peptide-1 agonists, patients with EOT2D were more likely to use organ-protective drugs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with LOT2D patients, EOT2D patients have a longer course of diabetes, worse metabolic control, and a higher rate of developing microvascular complications. The administration of combined therapy, including new agents, may require consideration when selecting hypoglycemic agents for treating EOT2D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13477","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41092431","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":"Adrenal limb thickness is associated with metabolism profiles in patients with diabetes: A cross-sectional study","authors":"Yingning Liu,&nbsp;Xiantong Zou,&nbsp;Wei Zhao,&nbsp;Xun Yao,&nbsp;Lexuan Wang,&nbsp;LingLi Zhou,&nbsp;Rui Zhang,&nbsp;Yingying Luo,&nbsp;Meng Li,&nbsp;Xiuying Zhang,&nbsp;Yu Zhu,&nbsp;Xiaoling Cai,&nbsp;Xianghai Zhou,&nbsp;Xueyao Han,&nbsp;Linong Ji","doi":"10.1111/1753-0407.13479","DOIUrl":"10.1111/1753-0407.13479","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between adrenal size and metabolic profiles in patients with diabetes mellitus (DM) is unclear. This study was conducted to determine whether the adrenal thickness measured by computed tomography (CT) is correlated with the metabolic profiles of patients with DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional study including 588 Chinese hospitalized patients with DM without comorbidities or medications known to affect adrenal morphology or hormone secretion. Adrenal limb thickness was measured on unenhanced chest CT. Participants were stratified into tertiles according to their total adrenal limb thickness. Linear and logistic regression models were used to estimate the correlations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After adjustment for sex and age, the adrenal thickness was positively associated with body mass index (BMI), waist circumference (WC), urinary albumin/creatinine ratio, and 24-h urinary free cortisol (UFC) and negatively correlated with high-density lipoprotein cholesterol. The sequential equation model (SEM) suggested UFC partially mediated the effect of adrenal limb thickness on WC by 12%. Adrenal thickness, but not UFC, was associated with a higher risk of existing hypertension (odds ratio [OR] = 3.78, 95% confidence interval [CI] 1.58, 9.02) and hyperlipidemia (OR = 2.76, 95% CI 1.03, 7.38), independent of age, gender, BMI, and WC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The adrenal thickness is independently associated with BMI, WC, cortisol levels, urinary albumin/creatinine ratio, hypertension, and dyslipidemia but not glycemic parameters in patients with diabetes. Our study encourages further studies to investigate the role of adrenal physiology in patients with diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13479","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41096402","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":"Risks and benefits of vaccines in diabetes","authors":"Zachary Bloomgarden","doi":"10.1111/1753-0407.13481","DOIUrl":"10.1111/1753-0407.13481","url":null,"abstract":"&lt;p&gt;We are approaching 4 years from the onset of the COVID-19 pandemic, and it is appropriate to review the topic of recommended vaccines for persons with diabetes. Infections are important causes of adverse outcome among persons with diabetes and are associated with morbidity and mortality substantially above rates among persons not having diabetes. Analysis of &gt;500 000 UK Biobank participants showed that diabetes was associated with 1.5-fold and 1.8-fold greater COVID mortality in women and in men, respectively, but also with 2.2-fold and 1.9-fold greater influenza/pneumonia mortality in women and in men.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The 2014 US Medical Expenditure Panel Surveys, representing 24 million persons with and 218 million without diabetes, showed that diabetes was associated with nearly a doubling in the likelihood of pneumonia and with a 2.6-fold increase in hospitalization for pneumonia.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Diabetes was associated with a nearly 4-fold increase in likelihood of herpes zoster,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; with these infections in turn associated with increases in myocardial infarction (MI) and stroke.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The response of “social media” to COVID, however, has been associated with considerable misinformation about many healthcare recommendations.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Many of my patients now question the benefit of routinely recommended vaccination to prevent influenza, COVID-19, pneumonia, zoster, and the many other infections for which effective preventative measures are available. We will review some of these considerations and how they apply to the treatment of diabetes.&lt;/p&gt;&lt;p&gt;A number of vaccines are considered “must-haves” for people with diabetes: vaccines for influenza, COVID-19, hepatitis B, pneumococcal pneumonia, tetanus, and at age 50 or greater herpes zoster.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; New vaccines being developed may be appropriate, for example, that for respiratory syncytial virus (RSV).&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;For influenza vaccination, manufacturer product information in studies of &lt;2000 persons receiving vaccine versus placebo, most not having diabetes or other medical conditions, suggests moderate efficacy of 68% in reducing infection.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; There is evidence of benefit in at-risk persons such as those with diabetes. An epidemiologic study of vaccinated persons with diabetes showed a 46% lower mortality than among those not vaccinated and an 11% lower rate of hospitalization for pneumonia.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; In two studies from Taiwan, one of persons with chronic kidney disease (CKD) not known to have underlying (Cardiovascular disease (CVD) showed that those who had received one, two, three, and four influenza vaccines between 1997 and 2008 had likelihood of acute coronary syndrome reduced 38%, 61%, and 87% in comparison to those who had not received the vaccine,&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt; and another study of persons with CKD showed &gt; 50% red","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 10","pages":"806-807"},"PeriodicalIF":4.5,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41092810","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}