Journal of Diabetes最新文献

{"title":"A novel nonsense mutation c.747C>G in the NEUROD1 gene detected within a Chinese family affected by maturity-onset diabetes of the young type 6","authors":"Yuwen Li,&nbsp;Qian Wen,&nbsp;Huige Shao,&nbsp;Meng Hao,&nbsp;Yihu Sun,&nbsp;Ting Liu","doi":"10.1111/1753-0407.13607","DOIUrl":"https://doi.org/10.1111/1753-0407.13607","url":null,"abstract":"<p><b>Highlights</b></p><p>\u0000 </p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174221","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":"Glycated albumin levels are associated with adverse stroke outcomes in patients with acute ischemic stroke in China","authors":"Jiawen Mao,&nbsp;Meng Wang,&nbsp;Chunjuan Wang,&nbsp;Hongqiu Gu,&nbsp;Xia Meng,&nbsp;Yong Jiang,&nbsp;Xin Yang,&nbsp;Jing Zhang,&nbsp;Yunyun Xiong,&nbsp;Xingquan Zhao,&nbsp;Liping Liu,&nbsp;Yilong Wang,&nbsp;Yongjun Wang,&nbsp;Zixiao Li,&nbsp;Bihong Zhu","doi":"10.1111/1753-0407.13600","DOIUrl":"https://doi.org/10.1111/1753-0407.13600","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Glycated albumin (GA) is a biomarker monitoring glycemia 2–4 weeks before stroke onset. This study was designed to explore the association between GA levels with poststroke outcomes in patients with acute ischemic stroke or transient ischemic attack (TIA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Participants with ischemic stroke or TIA who had a baseline GA measurement were included in the Third China National Stroke Registry study. The effect of GA on stroke recurrence, poor functional outcomes, and combined vascular events was examined during the 1-year follow-up period. Multivariate Cox and logistic regression models were performed to evaluate the association. Discrimination tests were used to examine the incremental predictive value of GA when incorporating it into the conventional model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3861 participants were enrolled. At the 3-month follow-up, the elevated GA level was associated with an increased risk of poor functional outcomes (adjusted odds ratio [OR], 1.45; 95% confidence interval [CI], 1.01–2.09). A similar increase was observed for stroke recurrence (adjusted hazard ratio [HR], 1.56; 95% CI, 1.09–2.24), poor functional outcomes (adjusted OR, 1.62; 95% CI, 1.07–2.45), and combined vascular events (adjusted HR, 1.55; 95% CI, 1.09–2.20) at the 1-year follow-up. In nondiabetic patients, the association between GA and poor functional outcomes was more pronounced (adjusted OR, 1.62; 95% CI, 1.05–2.50). Adding GA into the conventional model resulted in slight improvements in predicting poor functional outcomes (net reclassification improvement [NRI]: 12.30% at 1 year).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that elevated GA levels in serum were associated with stroke adverse outcomes, including stroke recurrence, poor functional outcomes, and combined vascular events, in patients with ischemic stroke or TIA.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174305","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":"Fasting blood glucose level and risk of all-cause and cause-specific mortality in peritoneal dialysis patients","authors":"So Jin Lim,&nbsp;Ju Young Moon,&nbsp;Kyung Hwan Jeong,&nbsp;Gang Jee Ko,&nbsp;Yun Jin Choi,&nbsp;Hyeon Seok Hwang","doi":"10.1111/1753-0407.13601","DOIUrl":"https://doi.org/10.1111/1753-0407.13601","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glycemic control is crucial in peritoneal dialysis (PD) patients with diabetes. Although fasting blood glucose (FBG) is the most commonly used index to measure blood glucose levels, there is currently no evidence supporting the association between FBG level and mortality risk in PD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 3548 diabetic PD patients between 2002 and 2018 were enrolled from the National Health Insurance Service database of Korea. We investigated the association between FBG levels and the risk of all-cause and cause-specific mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with FBG levels 80–99 mg/dL exhibited the highest survival rates, whereas those with FBG levels ≥180 mg/dL had the lowest survival rates. Compared with FBG levels 80–99 mg/dL, the adjusted hazard ratios and 95% confidence interval for all-cause mortality significantly increased as follows: 1.02 (0.87–1.21), 1.41 (1.17–1.70), 1.44 (1.18–2.75), and 2.05 (1.73–2.42) for patients with FBG 100–124 mg/dL, FBG 125–149 mg/dL, FBG 150–179 mg/dL, and FBG ≥180 mg/dL, respectively. The risk for all-cause mortality also showed an increasing pattern in patients with FBG levels &lt;80 mg/L. The risk of cardiovascular death significantly increased as FBG levels exceeded 125 mg/dL. However, the risk of infection-related and malignancy-related deaths did not show a significant increase with increasing FBG levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was an increase in the risk of all-cause mortality as FBG levels exceeded 125 mg/dL in PD patients with diabetes, and the risk of cardiovascular death showed a strong correlation with FBG levels compared with other causes of death.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174220","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 patient-centered self-management intervention on glycemic control, self-efficacy, and self-care behaviors in South Asian adults with type 2 diabetes mellitus: A multicenter randomized controlled trial","authors":"Kainat Asmat,&nbsp;Erika Sivarajan Froelicher,&nbsp;Khairunnisa Aziz Dhamani,&nbsp;Raisa Gul,&nbsp;Nazeer Khan","doi":"10.1111/1753-0407.13611","DOIUrl":"https://doi.org/10.1111/1753-0407.13611","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to test the efficacy of patient-centered self-management intervention (PACE-SMI) to improve HbA1c, self-efficacy, and self-care behaviors in adults with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter, parallel two-arm randomized controlled trial, 612 adults with T2DM and HbA1c ≥ 7% were enrolled and assigned to the control group (<i>n</i> = 310) and the intervention group (<i>n</i> = 302) using stratified permuted block randomization. The control group received usual care, whereas the intervention group received usual care plus nurse-led, theory-driven, culturally tailored PACE-SMI, comprising eight weekly sessions of individualized education, counseling, behavioral training, and home visit. Outcomes were assessed at baseline, postintervention, and 3 months follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data at 3 months were provided by 583 participants (control: <i>n</i> = 295, intervention: <i>n</i> = 288). Per-protocol analysis showed that the intervention group had a lower mean HbA1c (8.49% [standard deviation (SD), 1.58]) than the control group (8.74% [SD, 1.62]), with small yet statistically significant mean difference of 0.25% (95% confidence interval [CI], −0.01 to 0.51; Cohen's <i>d</i> = 0.16; <i>p</i> = 0.03). Self-efficacy and self-care behaviors significantly improved in the intervention group (116.89 [SD, 25.50] and 70.01 [SD, 17.97]) compared to the control group (75.43 [SD, 18.99] and 51.54 [SD, 12.04]), with mean differences of 41.48 (95% CI, 37.83–45.13; Cohen's <i>d</i> = 1.84; <i>p</i> &lt; 0.0001) and 18.56 (95% CI, 16.08–21.04; Cohen's <i>d</i> = 1.22; <i>p</i> &lt; 0.0001), respectively. Linear regression analysis indicated the effect of PACE-SMI on HbA1c was significantly mediated by improvements in self-efficacy and self-care behaviors (<i>R</i>² = 0.232, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PACE-SMI led to modest but significant improvement in HbA1c and substantial enhancements in self-efficacy and self-care behaviors in adults with T2DM.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13611","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174302","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":"Type B insulin resistance syndrome induced by anti-PD-1 therapy","authors":"Xiaomin Shi,&nbsp;Mengyu He,&nbsp;Li Ni,&nbsp;Zhijuan Dai,&nbsp;Mengte Shi,&nbsp;Yingying Zhou,&nbsp;Huabing Zhang,&nbsp;Ming Li,&nbsp;Chaoming Wu","doi":"10.1111/1753-0407.13603","DOIUrl":"https://doi.org/10.1111/1753-0407.13603","url":null,"abstract":"&lt;p&gt;A 59-year-old man was diagnosed with Hodgkin lymphoma in May 2020 and began treatment with sintilimab in August 2020. The patient had a normal blood glucose test before receiving treatment with sintilimab, with no family history of diabetes. In September 2020, the patient developed diabetic ketoacidosis after receiving three cycles of sintilimab. Glycated hemoglobin A1c (HbA1c) was 7.0%, and C-peptide level was undetectable. Diabetes-related antibodies, including glutamic acid decarboxylase antibody, insulinoma-associated protein 2 antibodies, and insulin autoantibodies, were all negative. Based on these findings, he was diagnosed with fulminant type 1 diabetes caused by anti-programmed cell death-1 (anti-PD-1) therapy. Additionally, he was also diagnosed with destructive thyroiditis caused by anti-PD-1 therapy at the same time. After discharge, he received insulin therapy, and his glucose level fluctuated between 4 and 20 mmol/L. The treatment regimen for Hodgkin's lymphoma was modified, and sintilimab treatment was stopped. Two months later, the Hodgkin's lymphoma was resolved.&lt;/p&gt;&lt;p&gt;In November 2021, the patient was admitted to the endocrinology department due to significant weight loss. In the 3 months leading up to his admission, he had lost about 15 kg in weight, with a poor glucose control (often &gt;33.3 mmol/L). He did not report any symptoms of nausea or vomiting. On physical examination, he weighed 47 kg and had a body mass index (BMI) of 16.65 kg/m&lt;sup&gt;2&lt;/sup&gt;. On admission, his plasma glucose level was 29.9 mmol/L, and β-hydroxybutyric level was 0.3 mmol/L. Of note, his serum C-peptide was &lt;0.05 ng/mL, while his serum insulin level was &gt;300 mU/L, and his HbA1c level was 10.2%. He was commenced on intravenous regular insulin therapy, and the insulin dose was gradually increased. However, despite continuous intravenous infusion of up to 3200 U of regular insulin daily, his blood glucose was still above 15 mmol/L. Other examinations showed that serum triglyceride was 0.89 mmol/L, adiponectin was 25.15 μg/mL, and insulin-like growth factor-1 was &lt;25 ng/mL. Diabetes-related antibodies were all negative as before.&lt;/p&gt;&lt;p&gt;We measured his serum insulin receptor antibody by using enzyme linked immunosorbent assay, which was developed in Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital. This patient had a positive result on the insulin receptor antibody test. He was therefore diagnosed with type B insulin resistance syndrome (TBIRS). During this admission, he was also diagnosed with Sjogren's syndrome and hemolytic anemia. We commenced him on an immunosuppressive regimen, combining iv rituximab (0.5 g), cyclophosphamide (0.4 g), and glucocorticoids. Glucocorticoids were administered as methylprednisolone 500 mg intravenously for 3 days, followed by a maintenance dose of 50 mg po daily, with a prolonged taper. Hydroxychloroquine was administered in a dose of 0.2 mg po daily continuo","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174192","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":"Diabetes mellitus in stable chronic heart failure and the combination with humoral activation, their association, and prediction of 2-year adverse outcomes. Data from the FAR NHL registry","authors":"Karel Labr,&nbsp;Jindrich Spinar,&nbsp;Jiri Parenica,&nbsp;Lenka Spinarova,&nbsp;Jan Krejci,&nbsp;Filip Malek,&nbsp;Petr Ostadal,&nbsp;Ondrej Ludka,&nbsp;Jiri Jarkovsky,&nbsp;Klara Benesova,&nbsp;Ruzena Labrova,&nbsp;Monika Spinarova","doi":"10.1111/1753-0407.13605","DOIUrl":"https://doi.org/10.1111/1753-0407.13605","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aim</h3>\u0000 \u0000 <p>The study aims to describe the role of diabetes in patients with heart failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In all, 1052 chronic heart failure patients were included in the FARmacology and NeuroHumoral Activation (FAR NHL) multicenter prospective registry. They had ejection fraction below 50% and were on stable medication for at least 1 month.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More than one-third (38.9%) of the patients had diabetes mellitus (DM). Diabetic patients (<i>N</i> = 409) were older (median 67 vs. 64, <i>p</i> &lt; 0.001), had higher body mass index (BMI) (30 vs. 28 kg/m², <i>p</i> &lt; 0.001), much more frequently had ischemic heart disease (71 vs. 47%, <i>p</i> &lt; 0.001), hypertension (80 vs. 67%, <i>p</i> &lt; 0.001), dyslipidemia (89 vs. 69%, <i>p</i> &lt; 0.001), worse renal function (estimated glomerular filtration rate [eGFR] median 63 vs. 73 mL/min/1.73 m², <i>p</i> &lt; 0.001), and higher N-terminal pro-brain natriuretic peptide (NT-proBNP) (median 681 vs. 463 pg/mL, <i>p</i> = 0.003). All-cause death, left ventricle assist device implantation, and orthotopic heart transplantation were set as the combined primary end point, which was present in 15.5% (163 patients) within the 2-year follow-up. In the 2-year follow-up, 81.0% of patients with diabetes survived without a primary end point, while 85.4% of the patients without diabetes survived, the difference being on the verge of statistical significance (<i>p</i> = 0.089). DM is a statistically significant predictor of NT-proBNP value in univariate analysis, but it is not an independent predictor in a multivariate analysis. When the NT-proBNP level was high, the presence of DM did not influence the prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combination of diabetes and NT-proBNP levels may better stratify the prognosis of patients with chronic heart failure.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174303","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":"Association between serum β2-microglobulin and left ventricular hypertrophy in patients with type 2 diabetes mellitus: A cross-sectional study","authors":"Yuling Zhang,&nbsp;Guiliang Peng,&nbsp;Weiling Leng,&nbsp;Ying Li,&nbsp;Haiyan Li,&nbsp;Ling Zhou,&nbsp;Lichao Ge,&nbsp;Jiaqing Shao,&nbsp;Xing Li,&nbsp;Min Long","doi":"10.1111/1753-0407.13599","DOIUrl":"10.1111/1753-0407.13599","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Beta 2-microglobulin (β2-MG) is a component of the class I major histocompatibility complex (MHCI) and has recently been reported to be involved in type 2 diabetes mellitus (T2DM) and cardiovascular disease. However, the association of β2-MG with left ventricular hypertrophy (LVH) in T2DM patients remains unknown. This study aims to investigate the correlation between serum β2-MG and LVH in T2DM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The retrospective analysis included 4602 eligible T2DM patients, divided into LVH and non-LVH groups based on echocardiography results. Serum β2-MG levels were measured, and participants were categorized into four groups (Q1–Q4) by their serum β2-MG quartile. The relationship of serum β2-MG level with LVH was evaluated using logistic regression, restricted cubic spline (RCS), subgroup analysis, and machine learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of LVH in T2DM patients was 31.12%. Each standard deviation increase in serum β2-MG level corresponded to a 1.17-fold increase in the prevalence of LVH [OR = 1.17, (95% CI: 1.05–1.31); <i>p</i> = 0.006]. When considering β2-MG as a categorical variable (quartile), Q3 [OR = 1.36, (95% CI: 1.09–1.69); <i>p</i> = 0.007] and Q4 [OR = 1.77, (95% CI: 1.36–2.31); <i>p</i> &lt; 0.001] had a significantly higher prevalence of LVH than Q1. RCS analysis found a nonlinear association between β2-MG and LVH prevalence (<i>p</i> for nonlinearity &lt;0.05). Additionally, machine learning results confirmed the importance of β2-MG for LVH in T2DM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated serum β2-MG levels were likely to be associated with an increased prevalence of LVH in T2DM patients, suggesting its potential role in LVH development.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999075","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":"Influence of impaired glucose tolerance alone and combined with metabolic syndrome on long-term risk of cardiovascular events and mortality","authors":"Fei Chen,&nbsp;Yifan He,&nbsp;Jinping Wang,&nbsp;Liping Yu,&nbsp;Qiuhong Gong,&nbsp;Yanyan Chen,&nbsp;Yali An,&nbsp;Siyao He,&nbsp;Guangwei Li,&nbsp;Bo Zhang","doi":"10.1111/1753-0407.13598","DOIUrl":"10.1111/1753-0407.13598","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate the potential differences in the influence of impaired glucose tolerance (IGT) with and without metabolic syndrome (MetS) on cardiovascular (CV) events and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants having IGT with MetS (IGT_MetS), those having IGT without MetS (IGT_non_MetS), and those having normal glucose tolerance (NGT) without MetS (NGT_non_MetS) (<i>N</i> = 246, <i>N</i> = 294, and <i>N</i> = 471, respectively) were included in this study. Cox proportional hazards regression was used to examine the relationship among these three groups and CV events and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the 30-year follow-up period, 57 (12.1%) participants having NGT_non_MetS, 55 (18.71%) with IGT_non_MetS, and 74 (30.08%) with IGT_MetS experienced CV mortality. After adjusting for risk factors, the hazard ratios for CV mortality were 2 (95% confidence interval [CI], 1.38–2.91) for the IGT_non_MetS group and 2.96 (95% CI, 2.09–4.19) for the IGT_MetS group, compared with the NGT_non_MetS group. Similar patterns were observed for CV events, with hazard ratios of 1.49 (95% CI, 1.19–1.88) for the IGT_non_MetS group and 1.97 (95% CI, 1.58–2.47) for the IGT_MetS group. Sensitivity analysis revealed that the hazard ratios of the IGT_non_MetS and IGT_MetS groups indicated a higher risk of all-cause mortality, myocardial infarction events or myocardial infarction mortality, and stroke events or stroke mortality compared with that of the NGT_non_MetS group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IGT_non_MetS increased the risk of CV mortality and events. Furthermore, when it occurred in conjunction with MetS, it further increased the risk of CV mortality and events. This suggested that active intervention is required.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic kidney disease—Recent updates","authors":"Zachary Bloomgarden","doi":"10.1111/1753-0407.13612","DOIUrl":"10.1111/1753-0407.13612","url":null,"abstract":"&lt;p&gt;The ramifications of the effects of diabetes on the kidney and the relationships of renal disease to the complications of diabetes are manifold, and several recent studies have addressed important aspects of the implications and the management of diabetic kidney disease (DKD).&lt;/p&gt;&lt;p&gt;An estimate of the prevalence of DKD among persons with type 1 diabetes (T1D) was made based on the National Health and Nutrition Examination Survey (NHANES) database of 19 225 adults in the United States from 2015 to 2018; 47 had T1D, among whom 20 had estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; or urine albumin/creatinine ratio (UACR) ≥30 mg/g, allowing estimates of 1 202 739 adults in the United States with T1D and a weighted estimate that 21.5% of people with T1D in the United States have DKD.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; A report from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database mortality statistics from 1999 to 2020 reflected the dramatic increase in mortality associated with DKD; more than 500 000 deaths were reported among adults with DKD during this period, with an age-adjusted annual mortality rate per 100 000 persons of approximately 2.0 in 1999–2005, increasing to approximately 4.0 in 2007–2010, but then to 22.0 in 2012–2019 and to 25.0 in 2020.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In an analysis suggesting interrelationships between DKD and cognitive function (CF), among 2977 people with type 2 diabetes (T2D) in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) memory in diabetes trial, there was a greater decline over 40 months in CF with standard than with intensive glycemic treatment among those with urine albumin &lt;0.4 mg/dL, whereas those with higher levels of albuminuria had no evidence of benefit with intensive treatment, and for those with eGFR &lt; 60, CF decline was greater with intensive than with standard glycemic treatment. Similarly, CF decline was greater with standard than intensive glycemic treatment in the subset age &lt;60 years, suggesting that T2D with better renal function and lower age might particularly benefit from more intensive glycemic treatment.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; There may be a different relationship between age and renal outcome with intensive lifestyle intervention (ILI); in a 12-year follow-up of the Look AHEAD (Action for Health in Diabetes) trial, prespecified analysis of the relationship between the ILI and age showed that among 5112 participants with baseline eGFR ≥ 45, those aged &gt;60 years at baseline randomized to ILI had a 25% lower likelihood of eGFR decreasing to &lt;45 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;, whereas this was not seen in the younger participants.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The optimal blood pressure treatment target is still not certain. The 11 255-person Effects of Intensive Systolic Blood Pressure Lowering Treatment in Reducing Risk of Vascular Events (ESPRIT) trial included 4359 persons with diabetes with systolic b","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999076","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":"Management of diabetic ketoacidosis in children: Does early insulin glargine help improve outcomes?","authors":"Rebecca Ohman-Hanson,&nbsp;G. Todd Alonso,&nbsp;Laura Pyle,&nbsp;Ryan McDonough,&nbsp;Mark Clements","doi":"10.1111/1753-0407.13597","DOIUrl":"10.1111/1753-0407.13597","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rebound hyperglycemia following the resolution of diabetic ketoacidosis (DKA) is common in pediatric patients with type 1 diabetes, increasing the risk of recurrent DKA and complicating the transition to subcutaneous insulin. Multiple studies suggest that early administration of long-acting insulin analogs during DKA management safely improves this transition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine whether early insulin glargine administration in children with DKA prevents rebound hyperglycemia and recurrent ketosis without increasing the rate of hypoglycemia or hypokalemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged &lt;21 years presenting with DKA to Children's Mercy Kansas City between October 2012 and October 2016 were reviewed. They were categorized as Early (&gt;4 h of overlap with intravenous [IV] insulin) and Late (&lt;2 h of overlap) cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We reviewed 546 DKA admissions (365 Early and 181 Late). Rebound hyperglycemia (&gt;180 mg/dL) was lower in the Early group (66% vs. 85%, <i>p</i> ≤ 0.0001). Hypoglycemia (&lt;70 mg/dL) during IV insulin administration was higher in the Early group than in the Late group (27% vs. 19%, <i>p</i> = 0.042). Hypoglycemia within 12 h of IV insulin discontinuation was lower in the Early group (16% vs. 26%, <i>p</i> = 0.012). Recurrent ketosis, hypokalemia, and cerebral edema were not different between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early glargine administration in pediatric DKA management is safe, decreases the rate of rebound hyperglycemia, and improves the transition to subcutaneous insulin. Hypoglycemia is less frequent following IV insulin discontinuation with early glargine, but the IV insulin rate may need to be reduced to minimize hypoglycemia during IV insulin infusion.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970224","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}