Journal of Diabetes最新文献

{"title":"Monitoring Sarcopenia With Incretin Receptor Activator Treatment","authors":"Zachary T. Bloomgarden","doi":"10.1111/1753-0407.70117","DOIUrl":"https://doi.org/10.1111/1753-0407.70117","url":null,"abstract":"<p>Obesity prevalence has increased over many decades, with one quarter of the adult population projected to be obese by 2035 [<span>1</span>]. The glucagon-like peptide 1 receptor agonists (GLP-1RA) and related agents are associated with effective and sustained weight loss and show evidence of reduction in a myriad of cardiovascular (CV) and renal outcomes [<span>2</span>], as well as improving metabolic, hepatic, respiratory, and musculoskeletal complications of obesity. An increasing concern, however, is whether concomitant reduction in skeletal muscle mass (SMM) with fat mass may have adverse consequences [<span>3</span>].</p><p>While there is normally a decrease in SMM of 10%–15% from age 20 to 80 [<span>4</span>], excessive loss in muscle mass and the accompanying reduction in strength is associated with increased mortality, both overall and that due to a variety of separate conditions, whether measured based on bioelectrical impedance [<span>5</span>], self-reported walking limitation [<span>6</span>], or reduction in maximum handgrip strength [<span>7</span>]. In the National Health and Nutrition Examination Survey, 17%, 26%, and 31% of obese people aged 60–70, 70–80, and ≥ 80 had evidence of sarcopenia based on the appendicular lean mass-to-BMI ratio using dual-energy X-ray absorptiometry [<span>8</span>]. In further evidence of the prevalence of sarcopenic obesity, reduced handgrip strength and walking speed was present in 30%, 62%, and 89% of obese persons at ages 45–60, 61–80, and ≥ 80 in the Longitudinal Aging Study in India [<span>9</span>].</p><p>Across studies of dietary weight loss, GLP-1RA, and bariatric surgery, the relationship between the fraction of body weight lost and the fraction of lean body mass lost is linear, with somewhat limited data showing approximately 5% such loss for every 10% body weight reduction [<span>10</span>]. In a meta-analysis of 36 studies of bariatric surgery, the mean decrease in SMM averaged 7.8 kg at 12 months, with the first, second, third, and fourth quartiles of decrease in SMM 11.0, 9.1, 6.7 and 4.4 kg, respectively [<span>11</span>].</p><p>About one in eight adults say they have at some point taken a GLP-1RA, with about half of these currently taking the medications [<span>12</span>]. It is, then, important to ask whether this widely used treatment is associated with a reduction in SMM. These agents on average are associated with an improvement in physical function [<span>13</span>], and some have suggested that clinical trials have not shown GLP-1RA to be associated with “clinically relevant” skeletal muscle loss [<span>14</span>]. However, clinical trial populations differ in important ways from individuals in clinical treatment [<span>15-17</span>], the latter typically older with greater degrees of frailty and multiple comorbidities. The largest meta-analysis allowing insight into the effect of GLP-1RA on SMM involves 27 studies, with the change in fat-free mass as a percentage of the cha","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308971","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":"Long-Term or Recurrent Antibiotic Use in Early Life and the Risk of Type 2 Diabetes: A Population-Based Prospective Cohort and a Case–Control Study","authors":"Zijun Li,&nbsp;Qiangsheng He,&nbsp;Xin He,&nbsp;Xin Xing,&nbsp;Songbo Fu,&nbsp;Xiaoping Sun,&nbsp;Mina Ma,&nbsp;Danni Wang,&nbsp;Ningning Mi,&nbsp;Jinyu Zhao,&nbsp;Jinqiu Yuan,&nbsp;Kehu Yang","doi":"10.1111/1753-0407.70113","DOIUrl":"https://doi.org/10.1111/1753-0407.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antibiotics in childhood are commonly used and have been linked to gut microbiome dysbiosis and metabolic disorders. However, direct evidence regarding the association between long-term or recurrent antibiotic use (LRAU) during early life and diabetes was scarce. We performed this study to investigate this association in two population-based studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We undertook a prospective analysis encompassing 147 010 participants from the UK Biobank. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of self-reported LRAU during early life on diabetes risk. We also conducted a case–control study within the Chinese population, in which 263 diabetes cases and 526 controls were matched for age and living location. Odds ratios (ORs) and 95% CI were was calculated using logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 4314 incident cases of type 2 diabetes over 1 840 944 person-years of follow-up in the UK Biobank. LRAU during early life was associated with a 26% higher risk of diabetes after accounting for putative risk factors (HR, 1.26; 95% CI, 1.16–1.37) in the UK biobank. We observed a more evident association between LRAU and an elevated risk of diabetes in the case–control study (OR, 3.32; 95% CI, 2.06–5.38). The primary finding was robust to several subgroup analyses and sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LRAU during early life may increase the risk of type 2 diabetes. Caution should be exercised when prescribing long-term or recurrent antibiotics to children and adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315125","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 Effectiveness of Psychological Interventions for Families of Children With Type 1 Diabetes on Caregiver and Child Functioning: A Systematic Review and Meta-Analysis","authors":"Katherine E. Wakelin,&nbsp;Rebecca K. Read,&nbsp;Ashely Y. Williams,&nbsp;Rachel R. Francois-Walcott,&nbsp;Nicola O'Donnell,&nbsp;Rose-Marie Satherley,&nbsp;Megan P. Harrington,&nbsp;Mary John,&nbsp;Christina J. Jones","doi":"10.1111/1753-0407.70112","DOIUrl":"https://doi.org/10.1111/1753-0407.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Research suggests that the wellbeing of caregivers of children with Type 1 Diabetes can influence child health outcomes. Therefore, the aim was to conduct a systematic review and meta-analysis to estimate the effect of psychological interventions for families of children with Type 1 Diabetes on caregiver and child functioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of the literature identified 58 randomized controlled trials (RCTs) that met inclusion. Study quality was assessed using the Cochrane Risk-of-Bias Tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-one trials had sufficient data to be included in the meta-analysis, analyzing nine variables (caregiver and child psychological distress, diabetes distress, family conflict and child quality of life (QoL), diabetes QoL and blood glucose) over three timepoints (post-intervention, short-term and long-term follow-up). Results from 10 (<i>n</i> = 550), three (<i>n</i> = 347) and 16 RCTs (<i>n</i> = 1631) respectively indicated that psychological interventions significantly reduced caregiver psychological distress post-intervention (SMD = −0.64, 95% CI = −1.15, −0.12), child psychological distress post-intervention (SMD = −0.34, 95% CI = −0.55, −0.31) and child blood glucose at short-term follow-up (SMD = −0.11, 95% CI = −0.21, −0.01), relative to controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Participants allocated to controls showed greater reductions in caregiver diabetes family conflict at short-and long-term follow−up than those assigned to psychological interventions. This was explained by significant baseline differences influencing a small number of studies. Studies were highly heterogenous regarding outcome measures, follow-ups, and interventions, with high concerns of bias often observed, reflecting the complexity of real−world clinical practice. Findings are promising. Appropriately powered RCTs with robust randomization are recommended to investigate the significance of effects, whilst considering dose response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300168","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 New Era in Obesity Treatment: The Evolution of Antiobesity Medications (AOMs) Based on Clinical Trials","authors":"Danlu Liu,&nbsp;Yi Chen","doi":"10.1111/1753-0407.70115","DOIUrl":"https://doi.org/10.1111/1753-0407.70115","url":null,"abstract":"&lt;p&gt;Obesity represents a critical global health challenge, marked by escalating prevalence and comorbidities such as cardiovascular disease, type 2 diabetes, chronic kidney disease, musculoskeletal disorders, and certain cancers [&lt;span&gt;1&lt;/span&gt;]. The continuous development of antiobesity medications (AOMs), which demonstrate significant weight loss effects, presents new opportunities for the treatment of obesity [&lt;span&gt;2&lt;/span&gt;]. On August 8, 2024, a search of the Informa Database identified a total of 2120 trials for AOMs, indicating that the research on AOMs is active and receiving significant attention.&lt;/p&gt;&lt;p&gt;Over the past 30 years, the number of clinical trials on AOMs has experienced significant fluctuations, peaking in 2023–2024 (Figure 1A). The number of clinical trials entering phases III–IV and phases I–II/III was comparable (48.5% vs. 50.9%), underscoring the development of novel AOMs derived from established therapies. Eventually, a total of 20 indications were identified in these trials, of which the top 10 were listed in Figure 1B. The majority of indications were Non-diabetic overweight or obesity (41.6%), followed closely by Diabetes-related overweight or obesity (41.0%). Among trials targeting non-diabetic overweight or obesity, only 35.6% reached phase III/IV, indicating this field is still in early-stage exploration. Figure 1C illustrates the distribution of clinical trials for AOMs based on their mechanisms of action and targets. Nutrient-stimulated hormone (NuSH) single receptor agonists dominate the landscape, accounting for 26.14% of trials, highlighting their significant research focus. Other AOMs, which target leptin, ghrelin, mitochondrial uncouplers, and growth differentiation factor 15 (GDF15), follow closely at 19.94%. In recent years, as the number of clinical trials on AOMs has steadily increased, the proportion of combined therapies has also risen, suggesting that this will be a future trend (Figure 1D). Recent advancements have been characterized by a surge in clinical trials targeting various mechanisms of action, as depicted in Figure 1E. Glucagon-like peptide-1 (GLP-1) receptor agonists have emerged as a leading class, with Semaglutide and Liraglutide being the most extensively studied drugs classified as NuSH single receptor agonists. Meanwhile, peptides and molecular conjugates with dual-agonist and triple-agonist actions, such as Tirzepatide and Retatrutide, are currently under investigation and appear to have the strongest potential as anti-obesity medications [&lt;span&gt;3&lt;/span&gt;]. Advances in incretin biology have driven the development of approved GLP-1 receptor agonists over recent decades. To date, the FDA has approved three NuSH-based AOMs: Liraglutide, Semaglutide, and Tirzepatide.&lt;/p&gt;&lt;p&gt;Additionally, further management of obesity necessitates personalized therapies and multimodal strategies, as long-term maintenance of weight loss is challenging for most people. Combination therapies, like the integration ","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300169","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":"Phenotypic Spectrum at Diagnosis of Age-Related Endotypes of Type 1 Diabetes Mellitus: A Cross-Sectional Study in China","authors":"Qiaoli Zhou,&nbsp;Xueqin Zheng,&nbsp;Chenguang Ma,&nbsp;Wei Gu","doi":"10.1111/1753-0407.70111","DOIUrl":"https://doi.org/10.1111/1753-0407.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emerging evidence suggests the presence of distinct endotypes of Type 1 diabetes mellitus (T1DM): T1DE1 in individuals diagnosed at age &lt; 7 years in contrast to T1DE2 in those diagnosed at ≥ 13 years of age. We aimed to comprehensively explore the phenotypic heterogeneity of T1DM with respect to the age-related endotypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study was conducted in China and involved 1204 children newly diagnosed with T1DM who were admitted to the pediatric department of a tertiary hospital from January 1, 2010 to December 31, 2023. The patients were divided into three age groups: &lt; 7 years (T1DE1), 7–12 years, and ≥ 13 years (T1DE2). A comparison was made among the age groups regarding demographic characteristics, glucose metabolism, β-cell autoimmunity, and metabolic decompensation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients under 7 years exhibited a shorter symptom duration before diagnosis, along with the lowest fasting and postprandial C-peptide and C-peptide to glucose ratio levels and the highest postprandial glucose levels. They also showed the highest insulin autoantibody positivity rate and creatine kinase-MB levels. In contrast, patients aged 13 and older had the highest HbA1c levels and glutamate decarboxylase antibody positivity rate. In addition, this group showed the highest prevalence of TPOAb and TgAb positivity, as well as the largest proportion of abnormal liver function cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study illustrates age-specific phenotypic heterogeneity in pediatric T1DM, indicating the presence of distinct endotypes. Further investigation of these endotypes may offer more evidence for the precise treatment of T1DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264421","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":"Nonlinear Association Between Serum 25-Hydroxyvitamin D and Cardiac Autonomic Dysfunction in Diabetic Foot: A Threshold Effect on Heart Rate Variability","authors":"Mingxin Bai,&nbsp;Donge Yan,&nbsp;Ruixue Feng,&nbsp;Xingwu Ran,&nbsp;Dawei Chen,&nbsp;Chun Wang,&nbsp;Lihong Chen,&nbsp;Shuang Lin,&nbsp;Sen He,&nbsp;Yan Liu,&nbsp;Murong Wu,&nbsp;Zhiyi Lei,&nbsp;Yun Gao","doi":"10.1111/1753-0407.70109","DOIUrl":"https://doi.org/10.1111/1753-0407.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have shown that vitamin D deficiency was associated with both cardiac autonomic dysfunction and the development of diabetic foot (DF). However, the impact of vitamin D levels on heart rate variability (HRV) in individuals with DF, a high-risk group, remains unclear. We explored the association between vitamin D status and HRV in individuals with DF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 458 individuals with DF were assessed for vitamin D levels by 25-hydroxyvitamin D (25(OH)D) and evaluated for cardiovascular autonomic function using both time and frequency domains of the HRV measures. Multivariate regression analysis and restricted cubic spline regression were employed to examine the associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vitamin D levels were positively associated with HRV indices in people with DF, including standard deviation of the normal sinus interval (SDNN), standard deviation of the 5-min average RR intervals (SDANN), low-frequency power (LF), high-frequency power (HF), and the LF/HF ratio (all <i>p</i> &lt; 0.05). The associations between serum 25(OH)D and cardiac autonomic dysfunction were nonlinear. When 25(OH)D levels were &lt; 50 nmol/L, the odds ratio (OR) for predicted cardiac autonomic dysfunction per SD increase in 25(OH)D was 0.56 (95% CI, 0.44–0.72). However, no significant effect was observed when 25(OH)D levels exceeded 50 nmol/L.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates that lower 25(OH)D levels are associated with reduced HRV in individuals with DF. Specifically, when 25(OH)D levels fall below 50 nmol/L, the risk of cardiac autonomic dysfunction in people with DF significantly increases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244780","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":"Disease Progression Modeling of Estimated Glomerular Filtration Rate (eGFR): A Pharmacometrics Approach","authors":"Sohail Aziz,&nbsp;Sabariah Noor Harun,&nbsp;Siti Maisharah Sheikh Ghadzi","doi":"10.1111/1753-0407.70104","DOIUrl":"https://doi.org/10.1111/1753-0407.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Estimated glomerular filtration rate (eGFR) is a key clinical marker for assessing kidney complications in type 2 diabetes mellitus (T2DM). This study aimed to develop and validate a disease progression model of eGFR in Malaysian T2DM patients, with and without diabetic nephropathy (DN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective data from 251 patients (3241 observations) were analyzed using NONMEM software. Baseline eGFR was assessed without covariates, and both linear and non-linear models were tested. Model selection was based on the likelihood ratio test (5% significance level), objective function value (OFV), visual predictive check (VPC), relative standard error, and scientific plausibility. External validation was performed using data from 109 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A linear model best described disease progression, with a baseline eGFR of 84.6 mL/min/1.73 m² and a decline rate of −0.0041 mL/min/1.73 m²/year. Cardiovascular disease (CVD) reduced eGFR by 1.05 mL/min/1.73 m²/year, while fasting blood sugar (FBS) above 7.4 mmol/L correlated with an additional decline of 0.043 mL/min/1.73 m²/year. Angiotensin receptor blockers (ARBs) improved eGFR by 0.4 mL/min/1.73 m²/year, whereas statins and metformin contributed improvements of 0.34 and 0.32 mL/min/1.73 m²/year, respectively. External validation confirmed model consistency with observed data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Glycaemic control and CVD significantly impact eGFR decline. ARBs, statins, and metformin help preserve kidney function. Effective glycaemic management is crucial in slowing kidney deterioration, especially in T2DM patients at risk for DN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220305","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":"Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline Landscape","authors":"William Hou,&nbsp;Katherine R. Tuttle,&nbsp;Weining Shen,&nbsp;Andrew Reikes,&nbsp;Jonathan H. Watanabe","doi":"10.1111/1753-0407.70108","DOIUrl":"https://doi.org/10.1111/1753-0407.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In patients with new onset type 2 diabetes, this study aimed to analyze glucose-lowering medication use patterns between 2014 and 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective study included adults with incident type 2 diabetes in the University of California Health System between 2014 and 2022. We determined medications used within 1 year of diagnosis and evaluated statistical evidence of use pattern changes via Mann–Kendall trend tests. Four categories of high-risk patients requiring cardio-kidney-metabolic protection were also evaluated in stratified analyses based on 2024 ADA guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 40 150 patients with incident type 2 diabetes, 38.5% initiated glucose-lowering medication within 1 year. Metformin remained the most used medication from 2014 to 2022. From 2014 to 2022, usage of GLP-1 receptor agonists and SGLT-2 inhibitors increased exponentially. GLP-1 receptor agonist use increased from below 2.5%–21%. While SGLT-2 inhibitor use increased from less than 2.5%–14%. This growth coincided with a decline in sulfonylurea usage. Among high-risk, insulin was most prevalent in those with heart failure or chronic kidney disease. However, usage of insulin declined overall in all groups. Utilization of SGLT-2 inhibitors was particularly high in patients with prior heart failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In adults with new onset type 2 diabetes, GLP-1 receptor agonist and SGLT-2 inhibitor utilization has markedly increased, coordinating with evolving guidelines that emphasize cardiovascular and chronic kidney disease management. However, overall adoption rates of these medications remain low based on indicated populations. Sulfonylurea use declined while metformin remains the most frequently initiated treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206933","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":"Taurine Alleviates Pancreatic β-Cell Senescence by Inhibition of p53 Pathway","authors":"Baomin Wang,&nbsp;Ziyan Wang,&nbsp;Yumei Yang,&nbsp;Melody Yuen Man Ho,&nbsp;Runyue Yang,&nbsp;Huizi Yang,&nbsp;Siyi Liu,&nbsp;Huige Lin,&nbsp;Kenneth King Yip Cheng,&nbsp;Xiaomu Li","doi":"10.1111/1753-0407.70100","DOIUrl":"https://doi.org/10.1111/1753-0407.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pancreatic β-cells function deteriorates during aging, leading to increased risk of type 2 diabetes. We and others previously demonstrated that p53 activation triggers β-cell senescence and dysfunction in aging, but how its activity is controlled remains incompletely understood. Metabolites are not only by-products of metabolic pathways but also function as messengers to regulate various biological pathways. Taurine, a non-proteinogenic amino acid derived from cysteine, has demonstrated anti-aging effects in multiple cell types and tissues. Nevertheless, its role in β-cell senescence remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Untargeted metabolomic analysis was used to determine differential metabolites in pancreatic islets of mice during aging. In vitro, β-cell lines MIN6 and INS-1E were treated with taurine and its transporter inhibitor, followed by measurement of senescence-related markers. Multiple experimental techniques, such as LC–MS/MS, co-immunoprecipitation, DARTS analysis, and LiP-MS, were used to study the mechanistic actions of taurine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Untargeted metabolomic analysis showed that taurine and taurocholic acid were significantly upregulated in aged islets. Pretreatment with taurine inhibited naturally aging, chemically induced senescent and inflammatory program, oxidative stress, and defective insulin secretion in pancreatic β-cells. SLC6A6 transporter was required to mediate exogenous taurine uptake, and inhibition of SLC6A6 abolished the anti-senescent effects of taurine. Taurine bound with CKDN2AIP and inhibited its interaction with p53, thereby promoting p53 degradation and suppressing the p53-dependent senescent program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that increasing β-cell taurine uptake might be a feasible approach to preserve β-cell function by targeting the p53-dependent senescent response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197211","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":"Time Trends in Cardiovascular Event Incidence in New-Onset Type 2 Diabetes: A Population-Based Cohort Study From Germany","authors":"Theresia Sarabhai,&nbsp;Karel Kostev","doi":"10.1111/1753-0407.70099","DOIUrl":"https://doi.org/10.1111/1753-0407.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Events of cardiovascular disease (CVD) remain a critical concern in patients with Type 2 diabetes mellitus (T2D). Over 17 years, this study analyzed time changes in the 5-year incidence of myocardial infarction (MI), chronic coronary heart disease (CHD), transient ischemic attack (TIA), and ischemic stroke (IS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study was conducted using the Disease Analyzer database, including patients aged ≥ 18 years with at least 12 months of no prior CVD with new-onset T2D in 2001–2006 (<i>n</i> = 10 162) and in 2013–2018 (<i>n</i> = 30 486), matched 1:3 by age and sex. Kaplan–Meier survival analysis estimated the 5-year cumulative incidence of the outcomes. Multivariable Cox regression models assessed temporal changes, adjusted for comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of CHD and TIA significantly declined in 2013–2018 compared to 2001–2006, with HRs of 0.68 (95% CI: 0.63–0.73; <i>p</i> &lt; 0.001) and 0.63 (95% CI: 0.52–0.76; <i>p</i> &lt; 0.001), respectively. Reductions were more pronounced in women and older patients. Surprisingly, MI incidence showed only a trend of reduction (HR: 0.82; 95% CI: 0.68–0.99; <i>p</i> = 0.045) and IS incidence was not different (HR: 0.97; 95% CI: 0.85–1.12; <i>p</i> = 0.722) between time periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first to report time trends in CVD incidence in new-onset T2D in Germany. From 2001 to 2018, the 5-year incidence of CHD and TIA decreased in new-onset T2D, reflecting demographic-specific advancements in diabetes and cardiovascular care. However, the stable incidence of IS and MI underscores a persistent challenge in prevention strategies in patients with prediabetes and T2D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190835","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}