Journal of Diabetes最新文献

{"title":"Glycated Albumin Guided Therapy in Newly Diagnosed Type 2 Diabetes A Randomized Controlled Trial","authors":"Qian Ren,&nbsp;Rui Zhang,&nbsp;Wei Huang,&nbsp;Xiaojie Yang,&nbsp;Jian Xu,&nbsp;Yufeng Li,&nbsp;Shanshan Lin,&nbsp;Junting Duan,&nbsp;Huixian Yan,&nbsp;Fang Chen,&nbsp;Zhihui Wang,&nbsp;Hongyu Liu,&nbsp;Jingjing Wang,&nbsp;Xiaoya Chen,&nbsp;Ling Chen,&nbsp;Ying Gao,&nbsp;Ping Zhang,&nbsp;Tianhao Ba,&nbsp;Kohzuma Takuji,&nbsp;Linong Ji","doi":"10.1111/1753-0407.70263","DOIUrl":"https://doi.org/10.1111/1753-0407.70263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glycated albumin (GA) has already been introduced in clinic for decades. However, it remains unclear whether routine measurement of GA could serve as a practical tool to improve the care of patients with type 2 diabetes (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter, randomized controlled trial enrolled 200 patients with newly diagnosed, poorly controlled type 2 diabetes from seven sites in China. Participants were randomly assigned (1:1) to either GA-guided therapy (treatment intensification if GA &gt; 16% at 4 weeks) or standard therapy, with a 12-weeks follow-up. The primary outcome was the proportion of patients achieving HbA1c &lt; 7%; secondary outcomes included HbA1c &lt; 6.5%, glycemic parameters, hypoglycemia, and β-cell function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 200 patients were included in this study. Therapy compliances were 97.4% (SD, 5.3%) and 98.0% (SD, 8.2%) in the GA-guided therapy group and standard therapy group, respectively. There was no significant difference in the achievement rate of HbA1c (&lt; 7%) between the GA-guided therapy group (64.3%) and the standard therapy group (64.4%) after the 12-week follow-up (<i>p</i> = 0.99). In the secondary outcome, the achievement rate of HbA1c (&lt; 6.5%) was higher in the GA-guided therapy group than in the standard therapy group (40.5% vs. 25.3%, <i>p</i> = 0.034). Furthermore, the changes in HbA1c, HOMA-β, HOMA-IR, body weight reduction were all better in the GA guided therapy group than in standard therapy group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GA-guided therapy did not enhance HbA1c &lt; 7% achievement; however, its potential benefits for more stringent glycemic targets and metabolic parameters in early diabetes management deserve further investigation.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov: NCT05227677</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 8","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784191","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":"Sex Differences in Combined Effects of Maternal Pre-Pregnancy BMI and OGTT Response Patterns on Early Neurodevelopment in Offspring: A Cohort Study","authors":"Kai Chen,&nbsp;Xiaoxuan Fan,&nbsp;Yuji Wang,&nbsp;Zhongqiang Cao,&nbsp;Luli Xu,&nbsp;Xiya Qin,&nbsp;Mingzhao Huang,&nbsp;Xiaofeng Mu,&nbsp;Chao Xiong,&nbsp;Aifen Zhou","doi":"10.1111/1753-0407.70261","DOIUrl":"10.1111/1753-0407.70261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Maternal pre-pregnancy overweight/obesity and gestational hyperglycemia are linked to adverse offspring neurodevelopment, but the role of oral glucose tolerance test (OGTT) response patterns remains unclear. We investigated the independent and combined effects of maternal pre-pregnancy BMI and OGTT response patterns on neurodevelopment in 2-year-old offspring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cohort study included 2639 mother–child pairs from Wuhan, China. A 75-g OGTT was performed at 24–28 gestational weeks, with glucose measured at fasting, 1 and 2 h. Group-based trajectory modeling identified distinct OGTT response patterns. Offspring neurodevelopment was assessed at 2 years using the Bayley Scales of Infant Development. Associations were examined with generalized linear and logistic regression models, and additive interaction was evaluated using RERI and AP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three OGTT response patterns were identified; pattern 3 showed the most pronounced glycemic response. Maternal pre-pregnancy overweight/obesity alone showed nominal associations with lower MDI scores in the overall population and in girls, but these associations did not remain significant after FDR correction. In girls exposed to both maternal overweight/obesity and pattern 3, MDI was markedly lower (<i>β</i> = −13.73, 95% CI: −23.06 to −4.39), and the risk of suboptimal mental development was higher (OR = 2.88, 95% CI: 1.03 to 8.09), with significant additive interaction (RERI = 0.76; AP = 0.42).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Maternal pre-pregnancy overweight/obesity and OGTT response patterns alone showed limited independent associations with offspring neurodevelopment. However, combined exposure may be associated with poorer mental developmental performance, with more consistent evidence in girls.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 8","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704739","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 ELAVL1-PLAUR-suPAR Axis Exacerbates Diabetic Nephropathy by Promoting Podocyte Injury and Inflammation","authors":"DanDan Xu,&nbsp;Liang Xu,&nbsp;LinLin Li","doi":"10.1111/1753-0407.70254","DOIUrl":"10.1111/1753-0407.70254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetic nephropathy (DN) is a leading cause of end-stage renal disease. ELAVL1, an RNA-binding protein, is involved in the regulation of genes closely associated with DN pathogenesis, whereas suPAR acts as a circulating mediator that promotes podocyte damage and contributes to proteinuric kidney disorders. However, whether ELAVL1 regulates suPAR release in DN remains unexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical samples from patients with DN were collected and analyzed. In vitro, podocytes were treated with high glucose, and ELAVL1 or PLAUR (encoding uPAR) was knocked down or overexpressed using lentiviral transduction. In db/db mice, podocyte-specific manipulation of Elavl1 or Plaur was performed via adeno-associated virus-mediated delivery. Renal function was assessed by measuring the urinary albumin-to-creatinine ratio (UACR) and serum creatinine. Glomerular pathology and inflammatory markers were evaluated histologically and biochemically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ELAVL1 was upregulated in DN and positively correlated with podocyte injury. Knockdown of ELAVL1 mitigated hyperglycemia-induced podocyte damage and inflammatory responses. Mechanistically, ELAVL1 directly bound to and stabilized PLAUR mRNA, leading to increased uPAR protein expression and elevated suPAR secretion. The protective effects of ELAVL1 knockdown were reversed by PLAUR overexpression in podocytes. In diabetic mice, podocyte-specific knockdown of Elavl1 or Plaur markedly lowered circulating suPAR levels and alleviated renal dysfunction and histopathological injury. Moreover, restoration of the PLAUR-suPAR axis abolished the renoprotective benefits conferred by Elavl1 knockdown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hyperglycemia-induced ELAVL1 upregulates PLAUR and suPAR release from podocytes, promoting renal inflammation and injury. Targeting the ELAVL1-PLAUR-suPAR axis may offer a therapeutic strategy for DN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 8","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676370","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":"Family History and Adherence to Ideal Cardiovascular Health: Counteracting Impacts on the Onset Age of Type 2 Diabetes and Subsequent Cardiovascular Disease Risk","authors":"Lihong Zhang,&nbsp;Jinyue Li,&nbsp;Jianxin Li,&nbsp;Wanyue Wang,&nbsp;Shufeng Chen,&nbsp;Jie Cao,&nbsp;Keyong Huang,&nbsp;Jichun Chen,&nbsp;Xiaoqing Liu,&nbsp;Xueli Yang,&nbsp;Chong Shen,&nbsp;Ling Yu,&nbsp;Yingxin Zhao,&nbsp;Xianping Wu,&nbsp;Liancheng Zhao,&nbsp;Ying Li,&nbsp;Dongsheng Hu,&nbsp;Jianfeng Huang,&nbsp;Dongfeng Gu,&nbsp;Xiangfeng Lu,&nbsp;Fangchao Liu","doi":"10.1111/1753-0407.70256","DOIUrl":"10.1111/1753-0407.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To analyze the interplay between family history of type 2 diabetes (T2D) and cardiovascular health (CVH) in relation to T2D onset age and subsequent cardiovascular disease (CVD) risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 79 831 participants were included to investigate the association between family history and T2D onset age. Then, 7387 diagnosed T2D patients were 1:1 matched with non-T2D individuals to analyze the association of T2D onset age with subsequent CVD risk. The benefit of good CVH was further assessed. Stratified Cox regression and conditional Cox regression were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Family history was associated with younger T2D onset, with an approximately 2.4-year earlier onset of T2D, which further increased the subsequent risk of CVD. Compared with individuals without family history, those with family history had HRs (95% CIs) of 3.911 (3.041, 5.032), 3.785 (3.385, 4.233), 3.627 (3.340, 3.938), 3.465 (3.189, 3.764), and 3.169 (2.787, 3.603) for T2D onset at &lt; 40, 40–50, 50–60, 60–70, and ≥ 70 years old, respectively (<i>P</i>_interaction = 0.007). Among individuals with family history, HR (95% CI) for incident CVD was 3.598 (1.372, 9.433) for those diagnosed T2D &lt; 50 years compared with those without T2D, while the HR (95% CI) was 2.336 (1.232, 4.428) among those without family history. However, high CVH could mitigate risk of young-onset T2D, and could further decrease CVD risk after their T2D diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Having family history of T2D increased susceptibility to young-onset T2D and subsequent CVD risks, while ideal CVH could counteract these risks, highlighting the necessity of early screening and intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 8","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676339","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":"Limited Comparative Evidence Between Metabolic Bariatric Surgery and Incretin-Based Pharmacotherapy for Weight Loss in Type 2 Diabetes: A Systematic Review and Meta-Analysis","authors":"Oqab Baniowdeh,&nbsp;Ahmad Arar,&nbsp;Yusuf Muslih,&nbsp;Tala Obeidat,&nbsp;Eliana Marji,&nbsp;Shahed Elghandour,&nbsp;Jalal Jbara,&nbsp;Lela Shengelia","doi":"10.1111/1753-0407.70259","DOIUrl":"10.1111/1753-0407.70259","url":null,"abstract":"&lt;p&gt;We would like to share findings from our recent systematic review and meta-analysis evaluating the comparative evidence between metabolic bariatric surgery and incretin-based pharmacotherapy for weight loss in adults with type 2 diabetes mellitus.&lt;/p&gt;&lt;p&gt;The rapid expansion of incretin-based pharmacotherapy, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and newer dual incretin therapies, has transformed the management of obesity and type 2 diabetes mellitus (T2DM) [&lt;span&gt;1-3&lt;/span&gt;]. At the same time, metabolic bariatric surgery remains the most effective intervention for achieving substantial and sustained weight loss [&lt;span&gt;4, 5&lt;/span&gt;]. Despite increasing use of both approaches, direct comparative evidence remains limited.&lt;/p&gt;&lt;p&gt;To evaluate the current evidence, we conducted a systematic review and meta-analysis following PRISMA guidelines and prospectively registered the protocol in PROSPERO (CRD420251229824). PubMed, Scopus, and Web of Science were searched for studies published between January 2021 and January 2026 that directly compared incretin-based pharmacotherapy with metabolic bariatric surgery in adults with T2DM. Four studies met the eligibility criteria, including three retrospective cohort studies and one prospective non-randomized comparative study [&lt;span&gt;6-9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Two studies reporting outcomes between 12 and 24 months were included in the quantitative synthesis. Random-effects meta-analysis suggested greater percentage total body weight loss following metabolic bariatric surgery compared with incretin-based pharmacotherapy (mean difference 20.03%, 95% confidence interval −6.29 to 46.34), although statistical heterogeneity was substantial (&lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 72.5%) Figure 1. Two additional studies reporting longer-term follow-up were synthesized narratively and consistently demonstrated greater and more sustained weight reduction following surgical intervention [&lt;span&gt;6-9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;However, interpretation of these findings requires caution. Available studies were predominantly observational and susceptible to residual confounding. In addition, incretin-based pharmacotherapy encompassed heterogeneous agents with differing pharmacological potency, while variation in bariatric surgical procedures was not consistently reported. Patients selected for metabolic surgery may also differ systematically from those receiving pharmacotherapy with respect to obesity severity, comorbidity burden, and treatment history, limiting direct comparability between treatment groups [&lt;span&gt;6-9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The most important finding of our review may therefore be the scarcity of robust comparative evidence rather than the magnitude of the observed treatment effect. While the overall direction of evidence suggests greater weight loss following metabolic bariatric surgery, current data remain insufficient to establish definitive comparative effectiveness between these treatment strategies.&lt;/p&gt;&lt;p&gt;Given the increasin","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 8","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148667875","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":"Serum 1,5-Anhydroglucitol Identifies Residual Mortality Risk Beyond Time in Range in Type 2 Diabetes: A Cohort Study","authors":"Jiaying Ni,&nbsp;Lei Chen,&nbsp;Hang Su,&nbsp;Jingyi Guo,&nbsp;Chunfang Wang,&nbsp;Yufei Wang,&nbsp;Jingyi Lu,&nbsp;Jian Zhou,&nbsp;Tian Xia,&nbsp;Feng Jiang","doi":"10.1111/1753-0407.70260","DOIUrl":"10.1111/1753-0407.70260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The combined prognostic value of continuous glucose monitoring (CGM) metrics and circulating glucose biomarkers for predicting mortality in type 2 diabetes has not been fully established, particularly regarding residual risk in patients achieving glycemic targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cohort study included 3677 patients with type 2 diabetes for a median of 7.4 years follow-up. Cox proportional hazards models evaluated the associations of baseline CGM-derived time in range (TIR) (target 70%) and serum 1,5-anhydroglucitol (1,5-AG) (threshold 6.0 μg/mL) with all-cause and cardiovascular mortality in the overall population. We further examined the relationship between 1,5-AG and mortality within TIR subgroups and compared its performance with metrics of glycemic variability derived from CGM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During follow-up, 522 all-cause deaths and 181 cardiovascular deaths occurred. TIR and 1,5-AG were moderately correlated and independently predicted mortality, with concurrent low TIR (≤ 70%) and low 1,5-AG (&lt; 6.0 μg/mL) yielding the highest risk (hazard ratio [HR] 1.82, 95% CI 1.40–2.37). In stratified analyses, reduced 1,5-AG was significantly associated with increased mortality risk in patients with TIR &gt; 70% (HR 1.69, 95% CI 1.25–2.28), whereas no significant association was observed in those with TIR ≤ 70%. Adding 1,5-AG improved traditional risk prediction in the former subgroup. Compared with 1,5-AG, CGM-derived glycemic variability indices such as mean amplitude of glycemic excursions, coefficient of variation, and standard deviation of glucose showed no significant association with mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TIR and serum 1,5-AG offer independent and complementary value, with low 1,5-AG identifying residual mortality risk despite achieving TIR targets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 8","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Resistance Emerges Early After Glucocorticoid Treatment in Adult Patients With 21-Hydroxylase Deficiency","authors":"Chenchen Dong,&nbsp;Wencui Wang,&nbsp;Sichang Zheng,&nbsp;Lingxin Deng,&nbsp;Rulai Han,&nbsp;Weiqing Wang,&nbsp;Guang Ning,&nbsp;Shouyue Sun,&nbsp;Lei Ye","doi":"10.1111/1753-0407.70258","DOIUrl":"https://doi.org/10.1111/1753-0407.70258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic disorders, particularly insulin resistance (IR), represent important complications in adults with 21-hydroxylase deficiency (21OHD). Glucocorticoid (GC) therapy is a known risk factor, yet evidence from longitudinal analyses remains scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, based on a large, genetically characterized, single-center cohort of Chinese adults with 21OHD, we performed both cross-sectional and longitudinal analyses to investigate the risk factors for IR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that nearly one-third of young adult 21OHD patients had IR. Current GC use remained independently associated with IR (OR 13.30, 95% CI 2.54–69.55; <i>p</i> = 0.002), whereas neither genotype nor androgen levels showed an association. We followed 52 patients without IR at baseline; incident IR occurred in 57.1% (4/7) of GC-naive patients and 68.9% (31/45) of previously GC-exposed patients, with median times to IR onset of 14.7 and 13.1 months, respectively. Importantly, dexamethasone use was independently associated with incident IR (HR 7.04, 95% CI 1.81–27.34; <i>p</i> = 0.005). Daily 1000 mg metformin therapy for 6 months did not significantly improve IR (median HOMA-IR, 2.50–2.82; <i>p</i> = 0.460) and only provided a modest benefit in body weight (median BMI, 23.6–22.5 kg/m²; <i>p</i> = 0.046).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest that ongoing GC therapy, particularly dexamethasone, is a risk factor for IR in adults with 21OHD, and new onset IR generally emerged within approximately 1 year after regular treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 8","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616978","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":"Effect of Topical Application of Antimicrobial Peptide PL-5 (Peceleganan) Spray on Mild to Moderate Infection of Diabetic Foot Ulcers: A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial","authors":"Li Qian,&nbsp;Xinjuan Sun,&nbsp;Rourou Chen,&nbsp;Qiuyu Lin,&nbsp;Chen Yu,&nbsp;Guofeng Wang,&nbsp;Wen Hu,&nbsp;Jianfang Che,&nbsp;Aiping Wang,&nbsp;Yuxin Chen,&nbsp;Yu Liu","doi":"10.1111/1753-0407.70255","DOIUrl":"10.1111/1753-0407.70255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate the clinical efficacy and safety of topical antimicrobial peptide PL-5 (Peceleganan) spray combined with standard debridement in the treatment of mildly to moderately infected diabetic foot ulcers (DFUs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This multicenter, randomized, double-blind, placebo-controlled trial was conducted in four tertiary hospitals. Eligible patients were randomized to PL-5 spray or placebo, both receiving standardized debridement. The primary endpoint was clinical response rate at 1 day after end of treatment (EOT1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline characteristics were balanced between groups. The clinical response rate at EOT1 was significantly higher in the PL-5 group than in the placebo group (<i>p</i> &lt; 0.05). The clearance rate of drug-resistant bacteria at EOT1 was 71.43% in the PL-5 group versus 50% in the control group (<i>p</i> &lt; 0.05). No significant differences were observed in overall microbiological eradication rates at EOT1 (57.89% vs. 33.33%) or EOT7 (64.71% vs. 40.00%) (both <i>p</i> &gt; 0.05). Adverse event rates were 24.24% in the PL-5 group and 33.33% in the placebo group (<i>p</i> &gt; 0.05), with no serious drug-related adverse events. PL-5 showed a significant improvement in clinical effective rate, but overall microbiological eradication was not significantly different between groups. However, in the subset of patients with drug-resistant bacteria, PL-5 demonstrated a significantly higher clearance rate, suggesting potential for treatment of resistant infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Topical PL-5 spray improves clinical outcomes in mild-to-moderate infected diabetic foot ulcers and achieves superior pathogen clearance among drug-resistant infection subgroups. It represents a promising low-resistance topical option for managing mild to moderate DFU infections.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Chinese Clinical Trial Registry Identifier: ChiCTR2300068632</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 7","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148596989","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":"Hemoglobin Glycation Index and Prognosis in Patients With Acute Myocardial Infarction Without Reduced Left Ventricular Ejection Fraction: A Multicenter Retrospective Cohort Study","authors":"Shangjian Luo,&nbsp;Huan Liu,&nbsp;Xuesong Wen","doi":"10.1111/1753-0407.70257","DOIUrl":"10.1111/1753-0407.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prognostic value of the hemoglobin glycation index (HGI) in patients with acute myocardial infarction (AMI) without reduced left ventricular ejection fraction (LVEF) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective cohort study included 1706 patients with AMI without reduced LVEF. HGI was calculated as measured HbA1c minus predicted HbA1c. Restricted cubic spline (RCS) analysis was used to evaluate nonlinear associations between HGI and outcomes and identify the cutoff value. Piecewise Cox regression and subgroup analyses were also performed. The primary endpoint was major adverse cardiovascular events (MACEs), defined as a composite of rehospitalization for heart failure (HF), recurrent myocardial infarction (MI), and cardiovascular death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up was 3.86 (2.30–4.98) years. RCS analysis showed a non-linear association between HGI and adverse outcomes, with a cutoff at −0.174. In patients with HGI ≤ −0.174, higher HGI was associated with lower risks of rehospitalization for HF (HR = 0.600, 95% CI: 0.464–0.776), recurrent MI (HR = 0.599, 95% CI: 0.365–0.983), cardiovascular death (HR = 0.627, 95% CI: 0.458–0.859), all-cause death (HR = 0.552, 95% CI: 0.428–0.713), and MACEs (HR = 0.603, 95% CI: 0.483–0.753) after multivariable adjustment. In contrast, no significant associations were observed in patients with HGI &gt; −0.174 after adjustment. Within the lower-HGI subgroup, severely low HGI was associated with a higher risk of rehospitalization for HF and MACEs compared with mildly low HGI. Subgroup analyses were generally consistent with the main results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In AMI patients without reduced LVEF, HGI showed a non-linear association with adverse outcomes, mainly in the lower-HGI range. These exploratory findings require prospective validation before clinical application.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov Identifier: NCT04485988 and NCT04564365</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 7","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534698","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 Prospective Multicenter Assessment of the Accuracy and Safety of the Yuwell CT3 Real-Time Continuous Glucose Monitoring System in Patients With Diabetes Over 14 Days","authors":"Lingli Zhou,&nbsp;Yufeng Li,&nbsp;Xingguang Zhang,&nbsp;Hongwei Ling,&nbsp;Yibing Lu,&nbsp;Linong Ji","doi":"10.1111/1753-0407.70246","DOIUrl":"10.1111/1753-0407.70246","url":null,"abstract":"&lt;p&gt;To the Editor.&lt;/p&gt;&lt;p&gt;Accurate and timely glucose monitoring is essential for diabetes management to prevent life-threatening hypoglycemia and long-term hyperglycemia-related complications [&lt;span&gt;1, 2&lt;/span&gt;], and to guide treatment adjustments [&lt;span&gt;3&lt;/span&gt;]. Compared with intermittent self-monitoring, real-time continuous glucose monitoring (CGM) provides dynamic glucose profiles and detects otherwise unrecognized glycemic fluctuations [&lt;span&gt;4&lt;/span&gt;]. The CT3 CGM system (Zhejiang POCTech Co. Ltd., Huzhou, China), developed by a company focused on biosensor-based portable medical monitoring systems, is designed to improve signal stability and reduce electrochemical interference. It consists of an enzyme-based sensor, a transmitter, and a mobile app (Figure S1). Interstitial glucose is oxidized by glucose oxidase, generating hydrogen peroxide that is electrochemically detected, with the resulting current proportional to glucose concentration. Data are transmitted via Bluetooth to a smart device, providing real-time glucose readings and alerts for hypo- and hyperglycemia. The system supports flexible wear sites (upper arm or abdomen), is calibration-free, and enables continuous use for up to 14 days. In this study, we evaluated its accuracy, safety, and alarm performance in adults with diabetes using venous blood glucose as the reference.&lt;/p&gt;&lt;p&gt;This prospective, multicenter, self-controlled study (March–May 2022, five Chinese sites) enrolled 71 adults with type 1 or type 2 diabetes (T1D/T2D). Major inclusion criteria included age ≥ 18 years and willingness to wear the device for ≥ 14 days; key exclusions were skin diseases, allergies, bleeding tendency, pregnancy, or recent trial participation. A sample size ≥ 60 (per guidelines) ensured validity for primary outcomes [&lt;span&gt;5&lt;/span&gt;]. Ethical approval (Peking University People's Hospital, No. 2021PHA165-001) and informed consent were obtained.&lt;/p&gt;&lt;p&gt;Participants wore four CT3 sensors on bilateral upper arms and abdomen from day 1 and were randomly assigned to one 7-h clinic session on Day 1/2, 7/8, or 14. During sessions, venous blood was collected every 15 min and measured using the Biosen Lactate and Glucose Analyzer (EKF Diagnostics GmbH, Leipzig, Germany), with each value paired to the nearest CGM reading within 5 min. Standardized meals were provided, and glucose levels were not intentionally manipulated. Insertion sites, adverse events, and usability were assessed on the final day.&lt;/p&gt;&lt;p&gt;Outcomes included accuracy (mean absolute relative difference [MARD], %15/15–%30/30, Clarke error grid [CEG], mean absolute difference [MAD], median absolute relative difference [ARD]) and hypo−/hyperglycemia detection and alert rates (sensitivity/specificity). Analyses were performed using R and SAS 9.4.&lt;/p&gt;&lt;p&gt;All 71 participants (54.9% male, mean age 52.65 years [range 19–73]) completed the study; 22.5% had T1D and 77.5% had T2D (Table S1). A total of 8174 matched CGM-EKF glucose pairs were obtained.","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 7","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434517","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}