Journal of Diabetes最新文献

{"title":"Magnitude of A1C improvement in relation to baseline A1C and amount of weight loss in response to intensive lifestyle intervention in real-world diabetes practice: 13 years of observation\u0000 真实世界糖尿病实践中强化生活方式干预对与基线HbA1C相关的HbA1C改善幅度以及体重减轻的影响:13年观察","authors":"Ahmed H. Eldib,&nbsp;Shilton Dhaver,&nbsp;Marwa Al-Badri,&nbsp;Tareq Salah,&nbsp;Karim Kibaa,&nbsp;Omnia Elenani,&nbsp;Shaheen Tomah,&nbsp;Hannah Gardner,&nbsp;Osama Hamdy","doi":"10.1111/1753-0407.13395","DOIUrl":"https://doi.org/10.1111/1753-0407.13395","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effect of intensive lifestyle intervention (ILI) on A1C in participants with diabetes is underestimated. A1C improvement is presumed to be dependent on the amount of weight loss. Here, we evaluate the magnitude of A1C change in relation to baseline A1C and the amount of weight loss in participants with diabetes who underwent ILI over 13 years in real-world clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 590 participants with diabetes were enrolled in the Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week multidisciplinary ILI program designed for real-world clinical practice between September 2005 and May 2018. We stratified participants based on baseline A1C into three groups: group A: A1C ≥ 9%, group B: A1C 8 to &lt;9%, and group C: A1C ≥6.5% to &lt;8%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 12-weeks of intervention, body weight decreased in all groups, and pairwise comparisons of A1C changes showed that: group A had 1.3% greater A1C reduction than group B (<i>p</i> = 0.0001) and 2% greater than group C (<i>p</i> = 0.0001), while group B had 0.7% greater A1C reduction than group C (<i>p</i> = 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We conclude that ILI may decrease A1C by up to 2.5% in participants with diabetes. At similar magnitude of weight loss, A1C reduction was more prominent in participants with higher baseline A1C. This may be valuable for clinicians to set a realistic expectation of A1C change in response to ILI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 6","pages":"532-538"},"PeriodicalIF":4.5,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5689491","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 young-onset type 2 diabetic Chinese girl with familial renal glycosuria caused by a novel mutation in SLC5A2: A case report","authors":"Yuqing Qu,&nbsp;Limei Hao,&nbsp;Xianling Wang","doi":"10.1111/1753-0407.13410","DOIUrl":"https://doi.org/10.1111/1753-0407.13410","url":null,"abstract":"&lt;p&gt;The pathogenesis of youth-onset type 2 diabetes is different from that of maturity-onset diabetes of the young (MODY) and from type 1 diabetes, but there are many overlapped clinical manifestations among these three types of diabetes. Delays in differential diagnosis and incorrect treatment will definitely cause worse prognosis. If hyperglycemia cannot be well controlled in diabetic patients, hyperglycosuria and even ketonuria will be present.&lt;/p&gt;&lt;p&gt;Proximal tubules in the kidneys can reabsorb 180 g glucose every day in physiological conditions. If plasma glucose concentrations are in the normal range (&lt; 200 mg/dL), all the filtered glucose will be reabsorbed in the proximal renal tubules. As a result, no urinary glucose is excreted.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Familial renal glycosuria (FRG) is a rare genetic disorder of proximal tubular glucose transport, characterized by excessive urinary glucose excretion even if blood glucose level is in normal range. It has been confirmed that mutations in the solute carrier family 5 members 2 (&lt;i&gt;SLC5A2&lt;/i&gt;) gene, which encodes sodium-glucose cotransporter 2 (SGLT2), are responsible for this disease.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The &lt;i&gt;SLC5A2&lt;/i&gt; gene is a 7.7 kb gene containing 14 exons and encoding protein SGLT2, with 672 amino acids and an inferred secondary structure consisting of 14 transmembrane-spanning domains and expressed in the S1 and S2 segments of the proximal convoluted tubule, which account for 90% of renal glucose reabsorption.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; FRG may be transmitted in an autosomal dominant pattern, although current studies demonstrated that its inheritance may be codominant with incomplete penetrance. FRG is a benign condition, which does not need any treatment, and the prognosis of patients with this disorder is usually favorable.&lt;/p&gt;&lt;p&gt;There is no report about youth-onset type 2 diabetes associated with FRG. Herein we described the clinical characteristics of a Chinese girl with youth-onset type 2 diabetes coexisting with FRG, in whom a novel mutation (NM_003041.4:c.1129 + 2 T &gt; C) of the &lt;i&gt;SLC5A2&lt;/i&gt; gene might explain FRG occurrence.&lt;/p&gt;&lt;p&gt;The patient presented with polydipsia, polyuria, and weight loss at age 14 years. Endocrinological evaluations showed fasting and postprandial serum insulin and C-peptide in the normal range, with negative islet autoantibodies, thus excluding type 1 diabetes diagnosis and presuming the MODY one.&lt;/p&gt;&lt;p&gt;MODY is a special type of diabetes mellitus, representing a small but very important fraction of diabetic patients (1%–5%),&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; and 1%–6% of cases in pediatric age.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; In this patient, no mutations in 14 genes associated with MODY have been detected, and its diagnosis was also excluded.&lt;/p&gt;&lt;p&gt;The clinical presentation of youth-onset type 2 diabetes resembles that of MODY, but these patients are usually overweight or obese. The diagnosis of youth-onset type 2 diabetes was confirmed in the pr","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 7","pages":"622-626"},"PeriodicalIF":4.5,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5674762","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":"Developmental origins of diabetes mellitus: Environmental epigenomics and emerging patterns\u0000 糖尿病的发育起源:环境表观基因组学和新模式","authors":"Hong Zhu,&nbsp;Guolian Ding,&nbsp;Xinmei Liu,&nbsp;Hefeng Huang","doi":"10.1111/1753-0407.13403","DOIUrl":"https://doi.org/10.1111/1753-0407.13403","url":null,"abstract":"<p>Mounting epidemiological evidence indicates that environmental exposures in early life have roles in diabetes susceptibility in later life. Additionally, environmentally induced diabetic susceptibility could be transmitted to subsequent generations. Epigenetic modifications provide a potential association with the environmental factors and altered gene expression that might cause disease phenotypes. Here, we bring the increasing evidence that environmental exposures early in development are linked to diabetes through epigenetic modifications. This review first summarizes the epigenetic targets, including metastable epialleles and imprinting genes, by which the environmental factors can modify the epigenome. Then we review the epigenetics changes in response to environmental challenge during critical developmental windows, gametogenesis, embryogenesis, and fetal and postnatal period, with the specific example of diabetic susceptibility. Although the mechanisms are still largely unknown, especially in humans, the new research methods are now gradually available, and the animal models can provide more in-depth study of mechanisms. These have implications for investigating the link of the phenomena to human diabetes, providing a new perspective on environmentally triggered diabetes risk.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 7","pages":"569-582"},"PeriodicalIF":4.5,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5689483","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":"Response to: Critical commentary on the association between thiazolidinedione use and dementia risk in patients with type 2 diabetes","authors":"Houyu Zhao,&nbsp;Lin Zhuo,&nbsp;Yexiang Sun,&nbsp;Peng Shen,&nbsp;Hongbo Lin,&nbsp;Siyan Zhan","doi":"10.1111/1753-0407.13408","DOIUrl":"https://doi.org/10.1111/1753-0407.13408","url":null,"abstract":"&lt;p&gt;We thank Wasif et al for their comments&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; on our article that explored the association between thiazolidinedione (TZD) use and dementia risk in patients with type 2 diabetes mellitus (T2DM).&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In their letter, the authors addressed the potential confounding effects of age of diabetes onset and mental disorders, which were suggested to be associated with dementia risk in recent studies,&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; and thus they suggested subgroup analyses according to participants' age at T2DM onset and status of mental disorders.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In our analyses we controlled age and years of T2DM at baseline&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;; thus the issue of collinearity would arise in the multivariate and inverse probability weighted model if we controlled age of T2DM onset, which was the difference between baseline age and diabetes duration. Moreover, comorbidities were adjusted using the Charlson comorbidity index, which did not contain mental disorders.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In response to the authors' concerns, we conducted subgroup analyses according to their suggestions&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; (Table 1). Age of diabetes onset was defined as the age when the patient was first diagnosed with T2DM. In addition, history of mental disorders was identified using the &lt;i&gt;International Classification of Diseases, Tenth Revision&lt;/i&gt; (all codes of F10–F99 except F70–F79) according to a previous study.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Consistent with previous studies, we observed higher incidence of dementia in patients of older age and with history of mental disorders.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; But no significant effect modification was observed. Compared with use of alpha-glucosidase inhibitors, TZD use was significantly associated with dementia incidence in different age groups, with a hazard ratio (HR) of 0.44 (95% confidence interval [CI], 0.21–0.91), 0.62 (95% CI, 0.39–0.98), and 0.47 (95% CI, 0.31–0.71) for T2DM patients aged &lt;55 years, 55–65 years, and &gt;65 years, respectively. Similarly, TZD use was consistently associated with dementia risk in terms of history of mental disorders, with an HR of 0.53 (95% CI, 0.30–0.94) and 0.50 (95% CI, 0.36–0.69) for T2DM patients with and without history of any mental disorders, respectively.&lt;/p&gt;&lt;p&gt;We agree with the authors that we cannot fully rule out biases caused by unmeasured confounding and inaccurate information.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Therefore, we conducted several sensitivity analyses using different dementia identification rules combing diagnosis and prescriptions of antidementia drugs. Results under various outcome definitions were consistent (the Table 1), suggesting that our results were robust against potential outcome misclassification.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Furthermore, we did not adjust full medication history and some other potential confounders, such as dietary patterns, hence we calculate the E-value as a sensitivity anal","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 7","pages":"629-631"},"PeriodicalIF":4.5,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6209766","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":"Development and validation of a multivariable risk prediction model for identifying ketosis-prone type 2 diabetes\u0000 酮症倾向2型糖尿病多变量风险预测模型的建立与验证","authors":"Jia Zheng,&nbsp;Shiyi Shen,&nbsp;Hanwen Xu,&nbsp;Yu Zhao,&nbsp;Ye Hu,&nbsp;Yubo Xing,&nbsp;Yingxiang Song,&nbsp;Xiaohong Wu","doi":"10.1111/1753-0407.13407","DOIUrl":"https://doi.org/10.1111/1753-0407.13407","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To develop and validate a multivariable risk prediction model for ketosis-prone type 2 diabetes mellitus (T2DM) based on clinical characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 964 participants newly diagnosed with T2DM were enrolled in the modeling and validation cohort. Baseline clinical data were collected and analyzed. Multivariable logistic regression analysis was performed to select independent risk factors, develop the prediction model, and construct the nomogram. The model's reliability and validity were checked using the receiver operating characteristic curve and the calibration curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A high morbidity of ketosis-prone T2DM was observed (20.2%), who presented as lower age and fasting C-peptide, and higher free fatty acids, glycated hemoglobin A_1c and urinary protein. Based on these five independent influence factors, we developed a risk prediction model for ketosis-prone T2DM and constructed the nomogram. Areas under the curve of the modeling and validation cohorts were 0.806 (95% confidence interval [CI]: 0.760–0.851) and 0.856 (95% CI: 0.803–0.908). The calibration curves that were both internally and externally checked indicated that the projected results were reasonably close to the actual values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study provided an effective clinical risk prediction model for ketosis-prone T2DM, which could help for precise classification and management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 9","pages":"753-764"},"PeriodicalIF":4.5,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24850022","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":"Effects of first-line antidiabetic drugs on the improvement of arterial stiffness: A Bayesian network meta-analysis\u0000 一线降糖药物对动脉硬化改善的影响:贝叶斯网络荟萃分析","authors":"Jincheng Wang,&nbsp;Yuhan Wang,&nbsp;Yueheng Wang,&nbsp;Yu Li,&nbsp;Jiamei Zhang,&nbsp;Han Zhang,&nbsp;Xiaomin Fu,&nbsp;Zhiqin Guo,&nbsp;Ying Yang,&nbsp;Kaining Kang,&nbsp;Wei Zhang,&nbsp;Li Tian,&nbsp;Yanqiang Wu,&nbsp;Shuanli Xin,&nbsp;Hongzhou Liu","doi":"10.1111/1753-0407.13405","DOIUrl":"https://doi.org/10.1111/1753-0407.13405","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Changes in vascular function are closely associated with the development of cardiovascular disease (CVD). Pulse wave velocity (PWV) is a potential indicator of vascular dysfunction; it allows noninvasive assessment of arterial stiffness. Currently, evidence for the effects of different classes of antidiabetic drugs on arterial stiffness remains limited. In this study, a network meta-analysis (NMA) was performed to explore the associations between changes in arterial stiffness and first-line antidiabetic drugs by evaluating PWV in patients with different metabolic abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched several electronic databases for randomized controlled trials (RCTs) published from inception until 25 August 2022, without language restrictions. The primary outcome was the change in PWV (ΔPWV) in all included studies; subgroup analysis was performed for patients with abnormal glucose metabolism, including prediabetes and diabetes mellitus. NMA was performed to calculate the mean differences (MDs) with 95% confidence intervals (CIs) as effect sizes to evaluate the ΔPWV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 2257 candidate articles identified in the initial search, 18 RCTs were eventually included in the analysis. In all studies, two classes of new antidiabetic drugs, glucagon-like peptide-1 receptor (GLP-1R) agonists and sSodium-glucose co-transporter 2 (SGLT-2) inhibitors, improved arterial stiffness by decreasing PWV compared with placebo (MD = −1.11, 95% CI: −1.94 to 0.28) and (MD = −0.76, 95% CI: −1.45 to −0.08). A conventional antidiabetic drug, metformin, also showed similar efficacy compared with placebo (MD = −0.73, 95% CI: −1.33 to −0.12). Finally, in subgroup studies of patients with abnormal glucose metabolism diseases, GLP-1R agonists (MD = −1.06, 95% CI: −2.05 to −0.10) significantly decreased PWV compared with placebo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Three classes of antidiabetic drugs—GLP-1R agonists, SGLT-2 inhibitors, and metformin—have the potential to improve arterial stiffness. Among the six classes of antidiabetic drugs analyzed, GLP-1R agonists constitute the only class of drugs that improves arterial stiffness in patients with abnormal glucose metabolism diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 8","pages":"685-698"},"PeriodicalIF":4.5,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6229740","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 gamma-glutamyl transferase concentrations with all-cause and cause-specific mortality in Chinese adults with type 2 diabetes\u0000 中国成人2型糖尿病患者γ -谷氨酰转移酶浓度与全因死亡率及病因特异性死亡率的关系","authors":"Haoyu Guan,&nbsp;Ke Liu,&nbsp;Xikang Fan,&nbsp;Hao Yu,&nbsp;Yu Qin,&nbsp;Jie Yang,&nbsp;Zheng Zhu,&nbsp;Chong Shen,&nbsp;Enchun Pan,&nbsp;Yan Lu,&nbsp;Jinyi Zhou,&nbsp;Jian Su,&nbsp;Ming Wu","doi":"10.1111/1753-0407.13399","DOIUrl":"https://doi.org/10.1111/1753-0407.13399","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evidence links gamma-glutamyl transferase (GGT) to mortality in the general population. However, the relationship of GGT with all-cause and cause-specific mortality risk has been little explored in type 2 diabetes mellitus (T2DM) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 20 340 community-dwelling T2DM patients between 2013 and 2014 in Jiangsu, China. Cox regression models were used to assess associations of GGT with all-cause and specific-cause mortality. Restricted cubic splines were used to analyze dose–response relationships between GGT and mortality. Stratified analysis was conducted to examine potential interaction effects by age, sex, smoking status, body mass index (BMI), diabetes duration, and dyslipidemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up period of 7.04 years (interquartile range: 6.98–7.08), 2728 deaths occurred, including 902 (33.09%) due to cardiovascular disease (CVD), and 754 (27.58%) due to cancer. GGT concentrations were positively associated with all-cause, CVD, and cancer mortality. Multivariable hazard ratios (HRs) for the highest (Q5) vs. the lowest quintile (Q1) were 1.63 (95% confidence intervals [CI]: 1.44–1.84) for all-cause mortality, 1.87 (95% CI: 1.49–2.35) for CVD mortality, and 1.43 (95% CI: 1.13–1.81) for cancer mortality. Effect modification by BMI and dyslipidemia was observed for all-cause mortality (both <i>p</i> for interaction &lt;.05), and HRs were stronger in the BMI &lt;25 kg/m² group and those without dyslipidemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that, in Chinese T2DM patients, elevated serum GGT concentrations were associated with mortality for all-cause, CVD, and cancer, and further research is needed to elucidate the role of obesity, nonalcoholic fatty liver disease, and lipids in this association.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 8","pages":"674-684"},"PeriodicalIF":4.5,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5781485","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":"Critical commentary on the association between thiazolidinedione use and dementia risk in patients with type 2 diabetes","authors":"Uzayr Wasif,&nbsp;Usmaan Al-Shehab,&nbsp;David F. Lo","doi":"10.1111/1753-0407.13409","DOIUrl":"https://doi.org/10.1111/1753-0407.13409","url":null,"abstract":"&lt;p&gt;We read with pleasure the article by Zhao et al&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; titled “Thiazolidinedione use is associated with reduced risk of dementia in patients with type 2 diabetes mellitus: A retrospective cohort study” and would like to provide critical commentary on the inclusion of modifiable and nonmodifiable risk factors for dementia in subgroup analyses for patients taking thiazolidinediones (TZDs). We hope that these insights may guide further research and improvement in the association between TZDs and dementia risk.&lt;/p&gt;&lt;p&gt;Zhao et al investigated the association between TZD use and the risk of dementia. The article presents a retrospective population-based cohort study conducted in mainland China to evaluate the association between TZD use and the risk of dementia in a Chinese population with T2DM. The study used an active-comparator new-user design to evaluate the association between TZD use and the risk of dementia in the Chinese population with T2DM. The study included new users of TZDs and alpha-glucosidase inhibitors (AGIs), commonly used oral glucose-lowering agents at the same stage of T2DM in China. New use of TZDs or AGIs was defined as the first prescription of a drug from either class with no fill of TZDs and AGIs in a baseline washout period of 6 months. The date of the first prescription was defined as the index date. Participants aged &lt;18 years old were excluded from the cohort, as were participants who received combination treatment of TZDs and AGIs at the index date and who had received a diagnosis of any dementia before the index date. Patients who had no consecutive prescriptions of these drugs within 6 months of the index date were also excluded.&lt;/p&gt;&lt;p&gt;First, it is important to consider that recent studies have highlighted the association between age of diabetes onset and increased risk of dementia.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; To better understand this relationship, it is essential to account for potential confounding variables such as age at diagnosis. Therefore, we propose conducting a subgroup analysis of study participants based on their age at diabetes diagnosis to determine whether this variable influences the risk of dementia. By doing so, we can assess the extent to which age of diabetes onset may be an independent risk factor for dementia and potentially inform strategies for early intervention and prevention.&lt;/p&gt;&lt;p&gt;Second, it is important to consider the effect that mental health may have on the onset of dementia. A recent study conducted in New Zealand provides evidence that mental health is a risk factor for dementia, and the study further concludes that the association between mental disorders and dementia was larger than the association between physical diseases and dementia.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Additional research is required, where a subgroup analysis would be implemented to compare the onset of dementia in patients with a history of mental illness and patients without a history of mental illness","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 7","pages":"627-628"},"PeriodicalIF":4.5,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6143584","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":"Stress hyperglycemia ratio is associated with systemic inflammation and clinical outcomes in diabetic inpatients with pneumonia on admission\u0000 糖尿病合并肺炎住院患者的应激性高血糖率与全身性炎症和临床结局相关","authors":"Bing Liu,&nbsp;Yu Chen,&nbsp;Liping Yu,&nbsp;Min Zhou","doi":"10.1111/1753-0407.13398","DOIUrl":"https://doi.org/10.1111/1753-0407.13398","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Backgrounds&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Stress hyperglycemia ratio (SHR) reflects the acute blood glucose change in response to acute illnesses or injuries, including pneumonia. We aimed to investigate the associations of SHR with systemic inflammation and clinical outcomes in diabetic inpatients with pneumonia on admission.&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;A multicenter and retrospective study was conducted among diabetic inpatients with pneumonia on admission via electronic medical records from 2013 to 2019 in Ruijin Hospital, Shengjing Hospital, and China-Japan Friendship Hospital.&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;The study included 1631 diabetic inpatients with pneumonia on admission. Patients of the fourth quartile (Q4) of SHR on admission showed significantly elevated systemic inflammation compared with those of the first quartile (Q1), second quartile (Q2), or third quartile (Q3) of SHR, including more white blood cells (9.1 × 10&lt;sup&gt;9&lt;/sup&gt;/L in Q4 vs 7.6 × 10&lt;sup&gt;9&lt;/sup&gt;/L in Q1, 7.9 × 10&lt;sup&gt;9&lt;/sup&gt;/L in Q2, and 8.0 × 10&lt;sup&gt;9&lt;/sup&gt;/L in Q3, &lt;i&gt;p&lt;/i&gt; &lt; .001), higher neutrophil-to-lymphocyte ratio (7.0 in Q4 vs 3.6 in Q1, 3.8 in Q2, and 4.0 in Q3, &lt;i&gt;p&lt;/i&gt; &lt; .001), higher C-reactive protein (52.8 mg/L in Q4 vs 18.9 mg/L in Q1, &lt;i&gt;p&lt;/i&gt; &lt; .001; 52.8 mg/L in Q4 vs 28.6 mg/L in Q2, &lt;i&gt;p&lt;/i&gt; = .002), higher procalcitonin (0.22 ng/mL in Q4 vs 0.10 ng/mL in Q1, 0.09 ng/mL in Q2, and 0.11 ng/mL in Q3, &lt;i&gt;p&lt;/i&gt; &lt; .001), and higher D-dimer (0.67 mg/L in Q4 vs 0.47 mg/L in Q1, 0.50 mg/L in Q2, and 0.47 mg/L in Q3, &lt;i&gt;p&lt;/i&gt; &lt; .001). Excluding patients with hypoglycemia on admission in the analyses, there were still distinct J-shaped associations between SHR and adverse clinical outcomes in patients with different severity of pneumonia, especially in those with CURB-65 score for pneumonia severity (Confusion, blood Urea nitrogen, Respiratory rate, Blood pressure) ≥ 2. In the multivariable regression model, predictive value for adverse clinical outcomes was higher when SHR was taken as a spline term than as quartiles in all patients (area under curve 0.831 vs 0.822, &lt;i&gt;p&lt;/i&gt; = .040), and when SHR as a spline term instead of fasting blood glucose was included in patients with CURB-65 ≥ 2 (area under curve 0.755 vs 0.722, &lt;i&gt;p&lt;/i&gt; = .027).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;SHR was correlated with systematic inflammation and of J-shaped associations with adverse clinical outcomes in diabetic inpatients with pneumonia of different severity. The inclusion of SHR in the blood glucose management of dia","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 7","pages":"545-556"},"PeriodicalIF":4.5,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13398","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6104212","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":"Relative contributions of fasting and postprandial glucose increments, glycemic variability, and non-glycemic factors to HbA1c in individuals with type 1 diabetes\u0000 基于1型糖尿病患者的空腹和餐后血糖增量、血糖变异性和非血糖因素对HbA1C的相对贡献","authors":"Yongwen Zhou,&nbsp;Mao Zheng,&nbsp;Hongrong Deng,&nbsp;Xueying Zheng,&nbsp;Sihui Luo,&nbsp;Daizhi Yang,&nbsp;Xiaodong Mai,&nbsp;Wen Xu,&nbsp;Jinhua Yan,&nbsp;Jianping Weng","doi":"10.1111/1753-0407.13388","DOIUrl":"https://doi.org/10.1111/1753-0407.13388","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Evidence for contribution of basal and postprandial glucose increment, and glycemic variability to glycated hemoglobin (HbA1c) among adults with type 1 diabetes (T1D) is limited. This study aimed to capture glycemic fluctuation patterns and quantify contributions of these factors to HbA1c levels among adults with T1D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>HbA1c, continuous glucose monitoring (CGM), and diet diaries were collected and pooled from two clinical trials. Available data sets were divided into HbA1c quartiles: group 1 (≤6.7%), group 2 (6.7%–7.3%), group 3 (7.3%–7.8%), and group 4 (≥7.8%). Area under curve above 110 mg/dL (AUC_&gt;110mg/dL) in 24-h profile was defined as overall hyperglycemia and stratified with postprandial hyperglycemia (PHG, AUC_&gt;110mg/dL in 3-h period after meals) and basal hyperglycemia (BHG, AUC_&gt;110mg/dL in remaining period). Linear regression analysis was used to estimate the proportion of variance in HbA1c explained by BHG, preprandial glucose, PHG, glycemic variability, and non-glycemic factors (age, body mass index, hemoglobin, and duration).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 169 550 glucose data in 2409 meals recorded from 102 patients (male/female, 34/68) were included. Age and duration were 35.2 ± 12.6 and 8.9 (2.9, 13.0) years, with 51.0% using pumps. Overall, BHG was four times higher than PHG (<i>p</i> all &lt;.05) and between-group comparisons showed BHG exhibited a progressive increase (group 1 vs. 2, 3, 4, <i>p</i> = .053, .086, .006) with fasting contribution of 76.1%, 82.6%, 81.5%, and 84.3% from group 1 to 4. The increment was not significant among groups 2, 3, and 4 (<i>p</i> &gt; .05). Factors included in analysis explained a total of 74% of the variance in HbA1c, in which BHG accounted for 32.1% of variance whereas PHG accounted for 24.4%. In group with HbA1c &gt;7.3%, BHG accounted for a higher percentage with 33.8% of the variance in HbA1c.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In our study, basal hyperglycemia better predicts overall glycemic control than postprandial hyperglycemia among adults with T1D. The relative contribution of basal hyperglycemia increased gradually with HbA1c increasing and predominant strategy for insulin titration among T1D is different among different levels of glycemic control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"15 6","pages":"465-473"},"PeriodicalIF":4.5,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5700887","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}