Journal of Diabetes最新文献

{"title":"Commentary on “A Population-Based Correlation Analysis Between Hemoglobin A1c and Hemoglobin Levels”","authors":"Youyuan Hu, Tinghua Zhang","doi":"10.1111/1753-0407.70087","DOIUrl":"https://doi.org/10.1111/1753-0407.70087","url":null,"abstract":"<p>We read with interest the study by Zhang et al. [<span>1</span>], which explored the gender- and age-specific associations between hemoglobin A1c (HbA1c) and hemoglobin levels in a large Chinese cohort. While the authors provide valuable insights into the potential role of estrogen in modulating HbA1c, several methodological and interpretative limitations warrant discussion to strengthen the validity and generalizability of their conclusions.</p><p>The study's reliance on health examination data from Southwest China raises concerns about external validity. Regional variations in genetic, dietary, and socioeconomic factors may influence hemoglobin and HbA1c dynamics, limiting extrapolation to global populations. Furthermore, while the authors adjusted for basic covariates (e.g., age, gender), critical confounders such as iron status, inflammation markers (e.g., C-reactive protein), and nutritional deficiencies—known to affect both hemoglobin and HbA1c—were omitted. For instance, iron deficiency anemia disproportionately impacts women and could confound the observed correlations [<span>2</span>].</p><p>The use of a binary age cutoff (≤ 45 vs. > 45 years) to approximate menopausal status is problematic. Menopause timing varies widely across individuals and ethnicities, with a significant proportion of women experiencing it after 45. Without direct assessment of hormonal levels (e.g., estradiol, FSH) or menstrual history, the assumption that age alone accurately reflects estrogen status risks misclassification bias. This may obscure nuanced relationships, particularly in perimenopausal populations.</p><p>Although generalized additive models (GAMs) effectively capture non-linear trends, the absence of model diagnostics (e.g., residual plots, goodness-of-fit metrics) undermines confidence in their robustness. Additionally, the reported Pearson's correlation coefficients (figure 1) appear incongruent with the non-linear splines, suggesting potential overfitting. A sensitivity analysis comparing GAMs with simpler linear models adjusted for spline terms would clarify whether the observed associations are artifacts of modeling complexity.</p><p>The hypothesis linking estrogen decline to elevated HbA1c in postmenopausal women, while plausible, remains speculative. The study lacks direct measurements of estrogen or markers of insulin resistance (e.g., HOMA-IR), relying instead on indirect epidemiological inferences. Longitudinal data or subgroup analyses stratified by hormone replacement therapy (HRT) use could strengthen causal inference. Notably, HRT's glucose-lowering effects in diabetic women—a finding that aligns with the authors' hypothesis but was not leveraged in this cross-sectional design [<span>3</span>].</p><p>The gender-specific reference intervals (RIs) for hemoglobin, though aligned with WHO criteria, may not account for altitude-related variations in hemoglobin, prevalent in Southwest China's highland populations. This oversight could s","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883950","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":"Adverse Liver and Renal Outcomes After Initiating SGLT-2i and GLP-1RA Therapy Among Patients With Diabetes and MASLD","authors":"Arunkumar Krishnan, Carolin V. Schneider, Diptasree Mukherjee, Tinsay A. Woreta, Saleh A. Alqahtani","doi":"10.1111/1753-0407.70069","DOIUrl":"https://doi.org/10.1111/1753-0407.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>The management of metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) presents a significant clinical challenge, with a focus on preventing progression to liver and renal complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the liver and renal outcomes among new users of sodium-glucose cotransporter 2 inhibitors (SGLT2i) versus glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase-4 inhibitors (DPP4i) and other anti-diabetic medications in patients with MASLD and T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Electronic health records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>A total number of 88 306 patients with MASLD and T2DM were included in a propensity score-matched analysis comparing the effects of anti-diabetic drugs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Intervention</h3>\u0000 \u0000 <p>Patients were categorized into groups based on their initiation of anti-diabetic medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The primary outcomes were the incidence of cirrhosis, hepatic decompensations, and hepatocellular carcinoma. Secondary outcomes were a progression of chronic kidney disease (CKD), severity of CKD stages, and the need for hemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the SGLT2i versus DPP4i, a reduced risk of cirrhosis was observed in the SGLT2i (HR: 0.97), along with fewer hepatic decompensations (HR: 0.84) and a lower incidence of HCC (HR: 0.50). CKD progression, particularly to stages 4–5, was significantly lower in the SGLT2i (HR: 0.53), as was hemodialysis (HR: 0.38). However, SGLT2i exhibited a slightly lower risk of CKD progression (HR: 0.77) and a reduced need for hemodialysis (HR: 0.71) compared to the GLP-1RA, while there was no difference in hepatic outcomes between the GLP-1RA and SGLT2i.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SGLT2 inhibitors in patients with MASLD and T2DM ","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879856","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":"Predictive Capability of Dual Trajectories of Central Adiposity Indices Combined With Glucose for Cardiovascular Diseases","authors":"Gangjiao Zhu,&nbsp;Xiong Ding,&nbsp;Hui Zhou,&nbsp;Janis M. Nolde,&nbsp;Thomas Beaney,&nbsp;Dan Wu,&nbsp;Yulong Lan,&nbsp;Yan Tian,&nbsp;Ruolin Zhang,&nbsp;Bolu Yang,&nbsp;Shuohua Chen,&nbsp;Bifeng Yuan,&nbsp;Shouling Wu,&nbsp;Lijing L. Yan","doi":"10.1111/1753-0407.70081","DOIUrl":"https://doi.org/10.1111/1753-0407.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This aimed to quantify the association between dual trajectory patterns combining seven central adiposity (CA) indices and fasting plasma glucose (FPG) with cardiovascular disease (CVD) risk in adults, and to compare their predictive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Kailuan Study, a prospective study initiated in June 2006, included 39 772 adults without pre-existing CVD as of 2010. Dual trajectories of seven CA indices combined with FPG were recorded from 2006 to 2010 to predict CVD risk from 2010 to 2021. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CVD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 11.0 years, 2715 incident CVD events were recorded. Four distinct patterns of CA indices (waist circumference, waist-to-height ratio, abdominal volume index, body roundness index) and three distinct patterns of other CA indices (waist-to-hip ratio, conicity index, A body shape index) combined with FPG were identified. Compared with the lowest-risk group, the highest-risk group exhibited a significantly higher CVD risk (adjusted HRs [95% CIs]: 2.41 [2.02–2.86], 2.57 [2.18–3.05], 2.25 [1.92–2.63], 2.35 [2.01–2.73], 2.08 [1.74–2.49], 1.97 [1.72–2.26], 1.81 [1.58–2.07], respectively). Overall, the predictive capabilities were generally similar, with the combination of waist circumference and FPG showing a slightly better predictive performance compared with other patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Distinct patterns of dual trajectories involving seven CA indices combined with FPG were associated with CVD risk. The results suggest that the combination of waist circumference and FPG may have greater clinical significance in predicting CVD risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871639","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":"Correction to “Association of Glycaemia Risk Index With Indices of Atherosclerosis: A Cross-Sectional Study”","authors":"","doi":"10.1111/1753-0407.70092","DOIUrl":"https://doi.org/10.1111/1753-0407.70092","url":null,"abstract":"<p>K. Torimoto, Y. Okada, T. Mita, et al., “Association of Glycaemia Risk Index With Indices of Atherosclerosis: A Cross-Sectional Study,” <i>Journal of Diabetes</i> 17, no. 3 (2025): e70065, https://doi.org/10.1111/1753-0407.70065.</p><p>In Results of the “ABSTRACT” section, the text “GRI was significantly associated with mean GSM (regression coefficient, <i>β</i> = −0.1277; 95% confidence interval: CI: −0.2165 to −0.0390, <i>p</i> = 0.005) and baPWV (regression coefficient, <i>β</i> = −3.1568; 95% CI: 1.5058 to 4.8079, <i>p</i> &lt; 0.001) after adjustment for various cardiovascular risk factors.” was incorrect. This should have read: “GRI was significantly associated with mean GSM (regression coefficient, <i>β</i> = −0.1392; 95% confidence interval: CI: −0.2323 to −0.0460, <i>p</i> = 0.003) and baPWV (regression coefficient, <i>β</i> = 3.1692; 95% CI: 1.4085 to 4.9299, <i>p</i> &lt; 0.001) after adjustment for various cardiovascular risk factors.”</p><p>We apologize for this error.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871825","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 Circulating Gremlin 2 and β-Cell Function Among Participants With Prediabetes and Type 2 Diabetes","authors":"Mengshan Ni,&nbsp;Yanru Chen,&nbsp;Weiqiong Gu,&nbsp;Yifei Zhang,&nbsp;Min Xu,&nbsp;Yanyun Gu,&nbsp;Yufei Chen,&nbsp;Yinmeng Zhu,&nbsp;Xiao Wang,&nbsp;Yaogan Luo,&nbsp;Yu Xu,&nbsp;Xu Lin,&nbsp;Yi Arial Zeng,&nbsp;Ruixin Liu,&nbsp;Jiqiu Wang","doi":"10.1111/1753-0407.70090","DOIUrl":"https://doi.org/10.1111/1753-0407.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Circulating Gremlin 2 (Grem2) has recently been linked to human obesity, but its role in type 2 diabetes (T2D) remains unclear. This study aims to explore the association of circulating Grem2 with β-cell function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A post hoc analysis was conducted using data from three clinical trials, in which all participants underwent the oral glucose tolerance test (OGTT). Circulating Grem2 levels were measured at 0, 1, and 2 h during the OGTT. In Trial 1, Grem2 levels were compared between participants with T2D (<i>n</i> = 59) and without T2D (<i>n</i> = 119). We further examined changes in Grem2 levels in response to oral antidiabetic drugs in participants with T2D in Trial 2 (<i>n</i> = 67) and calorie restriction in participants with prediabetes in Trial 3 (<i>n</i> = 231). The relationship between Grem2 levels and β-cell function was analyzed across all trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fasting and 1-h Grem2 levels were lower in participants with T2D compared with those without T2D (728 ± 25 vs. 649 ± 31 pg/mL, <i>p</i> = 0.020; 631 ± 26 vs. 537 ± 31 pg/mL, <i>p</i> = 0.007). Fasting Grem2 levels were restored after antidiabetic treatment (550 ± 12 vs. 575 ± 12 pg/mL, <i>p</i> = 0.019), and 1-h Grem2 levels increased following calorie restriction (1118 ± 89 vs. 1144 ± 90 vs. 1253 ± 89 pg/mL, <i>p</i> for trend = 0.002). The 1-h Grem2 levels were positively associated with β-cell function assessed by the oral disposition index and HOMA-β.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Reduced circulating Grem2 levels are associated with impaired β-cell function in T2D, and could be restored through antidiabetic interventions.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov: NCT01959984, NCT01758471, NCT03856762</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865878","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":"New Evidence, Creative Insights, and Strategic Solutions: Advancing the Understanding and Practice of Diabetes Osteoporosis","authors":"Bei Tao,&nbsp;Ximei Shen,&nbsp;Guangfei Li,&nbsp;Xiyu Wu,&nbsp;Yuying Yang,&nbsp;Chunxiang Sheng,&nbsp;Yun Zhang,&nbsp;Ling Wang,&nbsp;Zhiyun Zhao,&nbsp;Qi Song,&nbsp;Dewen Yan,&nbsp;Sunjie Yan,&nbsp;Youjia Xu,&nbsp;Huijuan Yuan,&nbsp;Houde Zhou,&nbsp;Jianmin Liu","doi":"10.1111/1753-0407.70091","DOIUrl":"https://doi.org/10.1111/1753-0407.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetes osteoporosis is a debilitating condition that significantly impacts human health. However, it is often underdiagnosed and not addressed in a timely or appropriate manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Recent studies were reviewed to explore the roles of energy metabolism, sarcopeina, low-grade inflammation and gut microbiota in the development of diabetes osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Osteoporosis in diabetic patients differs from primary osteoporosis. Novel biomarkers and risk factors that are biologically, physiologically, and pathologically linked to the development of diabetes osteoporosis are emerging, necessitating a shift in strategies for diagnosis, risk stratification, and prevention of diabetes osteoporosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is an urgent need to approach this disorder from a fresh perspective, initiating a range of basic research and clinical investigations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861863","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 and Disparities in the Burden of Chronic Kidney Disease due to Type 2 Diabetes in China From 1990 to 2021: A Population-Based Study","authors":"Yifei Wang,&nbsp;Shiya Gu,&nbsp;Zhixuan Xie,&nbsp;Zhiyong Xu,&nbsp;Wenfang He,&nbsp;Yexiang Chen,&nbsp;Juan Jin,&nbsp;Qiang He","doi":"10.1111/1753-0407.70084","DOIUrl":"https://doi.org/10.1111/1753-0407.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study analyzes the trends in the burden of chronic kidney disease due to type 2 diabetes (CKD-T2D) in China from 1990 to 2021, evaluates variations in risk factors, and projects the disease burden through 2036.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Estimates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for CKD-T2D were retrieved along with their 95% uncertainty intervals (UIs). Age-period-cohort analysis was used to assess burden trends from 1990 to 2021, identify risk factor population attributable fractions (PAFs), and project the burden through 2036.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, there were 20 911 520 CKD-T2D cases in China, with an age-standardized prevalence rate (ASPR) of 1053.92 per 100 000, an incidence rate (ASIR) of 23.07, an age-standardized mortality rate (ASMR) of 5.72, and an age-standardized DALY rate (ASDR) of 122.15. Although the overall burden showed a slow decline from 1990 to 2021, incidence continued to rise. The 2021 data revealed a marked age effect, with the burden rising with age. Period effects also contributed to an increased risk, with metabolic risk factors such as high fasting plasma glucose and BMI contributing the most. Projections suggest a decline in mortality and DALYs by 2036, while incidence will keep increasing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite declines in ASMR and ASDR, CKD-T2D incidence and cases continue to rise, especially among males and the elderly. This increasing burden is driven by aging and metabolic risk factors. Early screening, education, and risk management are essential for addressing CKD-T2D in China.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861864","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":"Semaglutide and the Retina","authors":"Zachary T. Bloomgarden","doi":"10.1111/1753-0407.70085","DOIUrl":"https://doi.org/10.1111/1753-0407.70085","url":null,"abstract":"&lt;p&gt;Globally, diabetic retinopathy (DR) is estimated to have affected 103 persons in 2020, with projections of 130 and 161 million in 2030 and 2045, respectively. The respective prevalences of vision-threatening DR, are 29, 36, and 45 million persons in 2020, 2030, and 2045, and of clinically significant diabetic macular edema (DME), 19, 24, and 29 million persons [&lt;span&gt;1&lt;/span&gt;]. Glucagon-like peptide-1 Receptor Activators (GLP-1RA) have become more widely used in the treatment of type 2 diabetes (T2D), with analysis of the TriNetX dataset showing that the prevalence of GLP-1RA use in the US increased from 6.4% in 2018 to 14.9% in 2022 among T2D with ASCVD [&lt;span&gt;2&lt;/span&gt;]. 12% of US adults say they have taken a GLP-1 agonist, and 6% say they are taking this currently; the prevalence of such use is 43% among people with diabetes, 25% among those who have been told of heart disease, and 22% among those who have been told by a doctor about being overweight or obese [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We generally would anticipate excellent glycemic treatment to be associated with improved outcomes of most diabetes complications. Indeed, a meta-analysis of 11 randomized controlled trials (RCT) involving 51 469 patients with T2D showed a 15% reduction in DR risk [&lt;span&gt;4&lt;/span&gt;]. The GLP-1RA are among the most effective agents used in T2D treatment, having at least as great a glycemic effect as basal insulin [&lt;span&gt;5&lt;/span&gt;], with weight loss rather than weight gain and with a lower likelihood of hypoglycemia. A caveat is the recognized potential that with rapid improvement of poorly controlled diabetes conditions similar to the microvascular complications of diabetes can occur. Acute painful peripheral diabetic neuropathy is one such syndrome [&lt;span&gt;6&lt;/span&gt;]. Another such condition was seen in the analysis of the initial outcome of the Diabetes Complications and Control Trial (DCCT) of type 1 diabetes, in which early worsening of DR was observed at the 6- and 12-month DCCT visits in 13.1% of 711 patients assigned to intensive treatment and in 7.6% of 728 patients assigned to conventional treatment, particularly in those with higher baseline HbA1c and in those with a greater 6-month reduction in HbA1c [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The effect of GLP-1RA on DR is less clear. Using the TriNetX global research network to assess the development of DR and DME in ~2 million individuals with type 2 diabetes taking insulin, one study using propensity score matching suggested that those receiving GLP-1RA had a 31% increased risk of DR, without significant change in the risk of DME, compared with those receiving neither sodium-glucose co-transporter 2 inhibitors (SGLT2i) nor GLP-1RA, while compared with those receiving SGLT2i, those receiving GLP-1RA had a 20% higher risk of DR and a 13% higher risk of DME [&lt;span&gt;8&lt;/span&gt;]. However, another study using TriNetX among 9.9 million patients with T2D, over a 2-year period of observation, found that DME was 23% and 17% less likely w","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831065","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 of Lifestyle-Induced Weight Loss With Gene Expression in Subcutaneous Adipose Tissue in Metabolic Syndrome","authors":"Silke Zimmermann,&nbsp;Kirsten Roomp,&nbsp;Hans-Jonas Meyer,&nbsp;Akash Mathew,&nbsp;Manuel Florian Struck,&nbsp;Matthias Blüher,&nbsp;Hugo N. G. Martin,&nbsp;Maria Keller,&nbsp;Kathrin Landgraf,&nbsp;Antje Körner,&nbsp;Anne Hoffmann,&nbsp;Yvonne Böttcher,&nbsp;Kathleen Biemann,&nbsp;Adhideb Ghosh,&nbsp;Christian Wolfrum,&nbsp;Falko Noé,&nbsp;Berend Isermann,&nbsp;Jochen G. Schneider,&nbsp;Ronald Biemann","doi":"10.1111/1753-0407.70083","DOIUrl":"https://doi.org/10.1111/1753-0407.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Lifestyle-induced weight loss (LIWL) is considered an effective therapy for the treatment of metabolic syndrome (MetS). The role of differentially expressed genes (DEGs) in adipose tissue function and in the success of LIWL in MetS is still unclear. We investigated the effect of 6 months of LIWL on transcriptional regulation in subcutaneous adipose tissue (SAT). Aiming to identify a LIWL-associated “gene signature” in SAT, DEGs were fitted into a linear regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The study is embedded in a prospective, two-arm, controlled, monocentric, randomized, 6-month interventional trial in individuals with MetS following LIWL. The trial included 43 nonsmoking, nondiabetic men aged 45–55 years with MetS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, we identified 642 DEGs in SAT after 6 months of LIWL. The identified DEGs were validated in two cross-sectional cohorts analyzing SAT from individuals with and without obesity. Gene enrichment analysis of the DEGs revealed the strongest association with cholesterol metabolic processes. Accordingly, DEGs were correlated with the lipid parameters HDL cholesterol, LDL cholesterol, and triglycerides in corresponding serum samples. We identified 3 genes with an AUC of 0.963 (95% CI: 0.906–1.0) associated with a loss of more than 10% of initial body weight that was maintained for at least 12 months after LIWL, namely <i>SUMO3</i> (<i>Small ubiquitin-related modifier 3</i>), <i>PRKG2</i> (<i>Protein Kinase CGMP-Dependent 2</i>), and <i>ADAP2 (ArfGAP with Dual PH Domains 2</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In summary, we have identified DEGs in SAT after LIWL, which may play an important role in metabolic functions. In particular, altered gene expression in SAT may predict sustained weight loss.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831064","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":"Efficacy and Safety of Dulaglutide Biosimilar LY05008 Versus the Reference Product Dulaglutide (Trulicity) in Chinese Adults With Type 2 Diabetes Mellitus: A Randomized, Open-Label, Active Comparator Study","authors":"Li Liu,&nbsp;Zhifeng Cheng,&nbsp;Lianwei Wang,&nbsp;Lili Zhang,&nbsp;Shunbin Li,&nbsp;Shu Li,&nbsp;Shuguang Pang,&nbsp;Qifu Li,&nbsp;Fang Bian,&nbsp;Junling Gu,&nbsp;Jie Shen,&nbsp;Liujun Fu,&nbsp;Baiping Sun,&nbsp;Yanyan Zhao,&nbsp;Changlin Dou,&nbsp;Zhaoyang Zeng,&nbsp;Lixin Guo","doi":"10.1111/1753-0407.70077","DOIUrl":"https://doi.org/10.1111/1753-0407.70077","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Dulaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has been approved for improving glycemic control and reducing the risk of cardiovascular (CV) adverse events. A previous result in healthy Chinese male subjects demonstrated the pharmacokinetic (PK) similarity of LY05008 and the licensed product dulaglutide, with comparable safety and immunogenicity profiles. A well-controlled phase 3 study with an adequate sample size was subsequently conducted for safety and efficacy evaluation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In a multicenter, randomized, open-label, active comparator phase 3 study, Chinese adults diagnosed with type 2 diabetes mellitus (T2DM) were randomly assigned 1:1 to receive a subcutaneous injection of 1.5 mg LY05008 or dulaglutide once weekly for 24 weeks. The primary endpoint was the mean change in HbA1c from baseline to Week 24. The secondary endpoints included the mean change in HbA1c from baseline to Week 12; the proportion of patients who had achieved HbA1c ≤ 6.5% at Weeks 12 and 24; and the mean change in body weight, fasting plasma glucose (FPG) level, and 2-h postprandial plasma glucose (PPG) level from baseline to Weeks 12 and 24. Safety, PK, and immunogenicity profiles were also included for data analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 440 patients were randomized to receive LY05008 (&lt;i&gt;n&lt;/i&gt; = 222) or dulaglutide (&lt;i&gt;n&lt;/i&gt; = 218). The mean changes in HbA1c from baseline to Week 24 in the LY05008 group and dulaglutide group were −1.44% and −1.41%, respectively, with a least square mean difference (LSMD) and 95% confidence interval (CI) of 0.06% (−0.08, 0.19) (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Efficacy equivalence could be demonstrated since the 95% CI between the reference drug and a biosimilar fell entirely within the range of (−0.4%, 0.4%). The mean changes in HbA1c from baseline to Week 12 in the LY05008 group and dulaglutide group were −1.47% and −1.39% (&lt;i&gt;p&lt;/i&gt; &gt; 0.05), respectively. At Week 12, 40.1% of patients who received LY05008 and 42.2% of those who received dulaglutide had a decrease in the HbA1c level to 6.5% or less, and 60.4% and 60.6% of patients in the LY05008 group and the dulaglutide group had a decrease in the HbA1C level &lt; 7%, respectively. At Week 24, 41.0% and 43.6% of patients achieved an HbA1c ≤ 6.5%. 55.9% and 66.5% of patients in the LY05008 group and the dulaglutide group achieved the HbA1c goal of &lt; 7%, respectively. The mean changes in body weight from baseline to Weeks 12 and 24 in the LY05008 group and dulaglutide group were −2.01 and −1.71 kg (&lt;i&gt;p&lt;/i&gt; &gt; 0.05) and −2.68 and −2.42 kg (&lt;i&gt;p&lt;/i&gt; &gt; 0.05","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818770","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}