Journal of Diabetes最新文献

{"title":"Clustering of health behaviors and their associations with cardiometabolic risk factors among adults at high risk for type 2 diabetes in India: A latent class analysis","authors":"Gabrielli T. de Mello,&nbsp;Sathish Thirunavukkarasu,&nbsp;Panniyammakal Jeemon,&nbsp;Kavumpurathu R. Thankappan,&nbsp;Brian Oldenburg,&nbsp;Yingting Cao","doi":"10.1111/1753-0407.13550","DOIUrl":"https://doi.org/10.1111/1753-0407.13550","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to identify clusters of health behaviors and study their associations with cardiometabolic risk factors in adults at high risk for type 2 diabetes in India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Baseline data from the Kerala Diabetes Prevention Program (<i>n</i> = 1000; age 30–60 years) were used for this study. Information on physical activity (PA), sedentary behavior, fruit and vegetable intake, sleep, and alcohol and tobacco use was collected using questionnaires. Blood pressure, waist circumference, 2-h plasma glucose, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides were measured using standardized protocols. Latent class analysis was used to identify clusters of health behaviors, and multilevel mixed-effects linear regression was employed to examine their associations with cardiometabolic risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two classes were identified, with 87.4% of participants in class 1 and 12.6% in class 2. Participants in both classes had a high probability of not engaging in leisure-time PA (0.80 for class 1; 0.73 for class 2) and consuming &lt;5 servings of fruit and vegetables per day (0.70 for class 1; 0.63 for class 2). However, participants in class 1 had a lower probability of sitting for &gt;=3 h per day (0.26 vs 0.42), tobacco use (0.10 vs 0.75), and alcohol use (0.08 vs 1.00) compared to those in class 2. Class 1 had a significantly lower mean systolic blood pressure (<i>β</i> = −3.70 mm Hg, 95% confidence interval [CI] −7.05, −0.36), diastolic blood pressure (<i>β</i> = −2.45 mm Hg, 95% CI −4.74, −0.16), and triglycerides (<i>β</i> = −0.81 mg/dL, 95% CI −0.75, −0.89).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementing intervention strategies, tailored to cluster-specific health behaviors, is required for the effective prevention of cardiometabolic disorders among high-risk adults for type 2 diabetes.</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 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140844696","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":"Clinical investigation of glucokinase activators for the restoration of glucose homeostasis in diabetes","authors":"Ping Li,&nbsp;Dalong Zhu","doi":"10.1111/1753-0407.13544","DOIUrl":"https://doi.org/10.1111/1753-0407.13544","url":null,"abstract":"<p>As a sensor, glucokinase (GK) controls glucose homeostasis, which progressively declines in patients with diabetes. GK maintains the equilibrium of glucose levels and regulates the homeostatic system set points. Endocrine and hepatic cells can both respond to glucose cooperatively when GK is activated. GK has been under study as a therapeutic target for decades due to the possibility that cellular GK expression and function can be recovered, hence restoring glucose homeostasis in patients with type 2 diabetes. Five therapeutic compounds targeting GK are being investigated globally at the moment. They all have distinctive molecular structures and have been clinically shown to have strong antihyperglycemia effects. The mechanics, classification, and clinical development of GK activators are illustrated in this review. With the recent approval and marketing of the first GK activator (GKA), dorzagliatin, GKA's critical role in treating glucose homeostasis disorder and its long-term benefits in diabetes will eventually become clear.</p><p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648092","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":"Acellular fish skin grafts in the treatment of diabetic wounds: Advantages and clinical translation","authors":"Chenyu Zhao,&nbsp;Mengyi Feng,&nbsp;Martin Gluchman,&nbsp;Xianghe Ma,&nbsp;Jinhao Li,&nbsp;Hui Wang","doi":"10.1111/1753-0407.13554","DOIUrl":"https://doi.org/10.1111/1753-0407.13554","url":null,"abstract":"<p>Diabetic wounds cannot undergo normal wound healing due to changes in the concentration of hyperglycemia in the body and soon evolve into chronic wounds causing amputation or even death of patients. Diabetic wounds directly affect the quality of patients and social medical management; thus researchers started to focus on skin transplantation technology. The acellular fish skin grafts (AFSGs) are derived from wild fish, which avoids the influence of human immune function and the spread of the virus through low-cost decellularization. AFSGs contain a large amount of collagen and omega-3 polyunsaturated fatty acids and they have an amazing effect on wound regeneration. However, after our search in major databases, we found that there were few research trials in this field, and only one was clinically approved. Therefore, we summarized the advantages of AFSGs and listed the problems faced in clinical use. The purpose of this paper is to enable researchers to better carry out original experiments at various stages.</p><p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13554","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648175","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":"Epidemiology of type 1 diabetes mellitus in children and adolescents: A 50-year, single-center experience","authors":"Nurgun Kandemir,&nbsp;Dogus Vuralli,&nbsp;Alev Ozon,&nbsp;Nazlı Gonc,&nbsp;Didem Ardicli,&nbsp;Lala Jalilova,&nbsp;Omer Nazim Gulcek,&nbsp;Ayfer Alikasifoglu","doi":"10.1111/1753-0407.13562","DOIUrl":"https://doi.org/10.1111/1753-0407.13562","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Global variations in epidemiology of type 1 diabetes mellitus (T1DM) exist. This study is designed to examine demographic and clinical features of T1DM over the past 3 decades as well as evolving trends in epidemiology over last 50 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical characteristics of 925 patients with T1DM over last 30 years (1990–2019) were evaluated and compared to previously published data of 477 patients diagnosed between 1969 and 1990 from one of the major referral centers for diabetes in Turkey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean age at diagnosis decreased from 9.5 ± 4.0 to 7.1 ± 3.6 years within the past 50 years (<i>p</i> &lt; .001). Age at diagnosis peaked at 12–14 years between 1969 and 1990, then fell to 10–11.9 years between 1990 and 1999, and to 4–5.9 years between 2000–2009 and 2010–2019 (<i>p</i> = .005). Although the percentage of patients diagnosed &lt;6 years of age is gradually increasing, the percentage between the ages of 6 and 11.9 years is decreasing, and the percentage diagnosed ≥12 years remained stable. A total of 47.5% of patients had ketoacidosis, 38.2% had ketosis, and 14.3% had only hyperglycemia. 23% of patients had severe diabetic ketoacidosis (DKA), whereas 42% had moderate. Over last 3 decades, there has been no change in frequency of ketoacidosis at presentation, but there has been significant decline in severity (<i>p</i> = .865, and <i>p</i> &lt; .001, respectively). Although the frequency of patients with mild DKA increased over time, frequency of patients with moderate DKA decreased; however, no significant difference was observed among patients with severe ketoacidosis. DKA was more frequent and severe in patients &lt;6 years of age (<i>p</i> = .005, and <i>p</i> &lt; .001, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Age at diagnosis shifted to younger ages in T1DM in the past 50 years. Half of patients had ketoacidosis at diagnosis and frequency of presentation with DKA did not decrease, but severity decreased slightly. Increase in prevalence of T1DM in the younger age group and the fact that half of patients present with DKA indicate that awareness should be increased in terms of early diagnosis and treatment.</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 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648236","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":"Gamma-glutamyl transferase and the risk of all-cause and disease-specific mortality in patients with diabetes: A nationwide cohort study","authors":"Goh Eun Chung,&nbsp;Su-Min Jeong,&nbsp;Su Jong Yu,&nbsp;Jeong-Ju Yoo,&nbsp;Yuri Cho,&nbsp;Kyu-na Lee,&nbsp;Dong Wook Shin,&nbsp;Yoon Jun Kim,&nbsp;Jung-Hwan Yoon,&nbsp;Kyungdo Han,&nbsp;Eun Ju Cho","doi":"10.1111/1753-0407.13551","DOIUrl":"https://doi.org/10.1111/1753-0407.13551","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There exists a paucity of data regarding whether gamma-glutamyl transferase is associated with disease-specific mortality in patients with type 2 diabetes mellitus. This study aimed to investigate the association of serum gamma-glutamyl transferase levels with all-cause and disease-specific mortality in patients with diabetes mellitus using a Korean nationwide health-screening database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 9 687 066 patients without viral hepatitis or liver cirrhosis who underwent health examination in 2009 were included. These patients were divided into four groups according to sex-specific quartiles of serum gamma-glutamyl transferase levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up period of 8.1 years, 222 242 deaths were identified. The all-cause mortality rate increased as the serum gamma-glutamyl transferase levels became higher (highest quartile vs lowest quartile: hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.55–1.59; <i>p</i> for trend &lt;.001). Similar trends were observed for cardiovascular disease (HR, 1.57; 95% CI, 1.53–1.62), ischemic heart disease (HR, 1.40; 95% CI, 1.33–1.48), and stroke (HR, 1.72; 95% CI, 1.60–1.85) in the highest quartile, as compared with the lowest quartile (<i>p</i> for trend &lt;.001). As the gamma-glutamyl transferase quartiles became higher, mortality rates related to cancer (HR, 1.56; 95% CI, 1.52–1.60), liver disease (HR, 9.42; 95% CI, 8.81–10.07), respiratory disease (HR, 1.55; 95% CI, 1.49–1.62), and infectious disease (HR, 1.73; 95% CI, 1.59–1.87) also increased in the highest quartile, compared with the lowest quartile (<i>p</i> for trend &lt;.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum gamma-glutamyl transferase levels may be useful for the risk assessment of all-cause and disease-specific mortality among patients with type 2 diabetes mellitus.</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 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13551","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648237","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":"Cost saving analysis of prediabetes intervention modalities in comparison with inaction using Markov state transition model—A multiregional case study","authors":"Hussain Abdulrahman Al-Omar,&nbsp;Marcin Czech,&nbsp;Tran Quang Nam,&nbsp;Ulrike Gottwald-Hostalek,&nbsp;Nikola Vesic,&nbsp;James Whitehouse,&nbsp;Maddy Dawson","doi":"10.1111/1753-0407.13553","DOIUrl":"https://doi.org/10.1111/1753-0407.13553","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prediabetes management is a priority for policymakers globally, to avoid/delay type 2 diabetes (T2D) and reduce severe, costly health consequences. Countries moving from low to middle income are most at risk from the T2D “epidemic” and may find implementing preventative measures challenging; yet prevention has largely been evaluated in developed countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Markov cohort simulations explored costs and benefits of various prediabetes management approaches, expressed as “savings” to the public health care system, for three countries with high prediabetes prevalence and contrasting economic status (Poland, Saudi Arabia, Vietnam). Two scenarios were compared up to 15 y: “inaction” (no prediabetes intervention) and “intervention” with metformin extended release (ER), intensive lifestyle change (ILC), ILC with metformin (ER), or ILC with metformin (ER) “titration.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>T2D was the highest-cost health state at all time horizons due to resource use, and inaction produced the highest T2D costs, ranging from 9% to 34% of total health care resource costs. All interventions reduced T2D versus inaction, the most effective being ILC + metformin (ER) “titration” (39% reduction at 5 y). Metformin (ER) was the only strategy that produced net saving across the time horizon; however, relative total health care system costs of other interventions vs inaction declined over time up to 15 y. Viet Nam was most sensitive to cost and parameter changes via a one-way sensitivity analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Metformin (ER) and lifestyle interventions for prediabetes offer promise for reducing T2D incidence. Metformin (ER) could reduce T2D patient numbers and health care costs, given concerns regarding adherence in the context of funding/reimbursement challenges for lifestyle interventions.</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 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The metabolic effects of habitual leg shaking: A randomized crossover trial","authors":"Riqiang Bao,&nbsp;Yixiang Hu,&nbsp;Rui Xu,&nbsp;Chong Gao,&nbsp;Yuhan Guo,&nbsp;Yashu Zhu,&nbsp;Shijia Pan,&nbsp;Weiqing Wang","doi":"10.1111/1753-0407.13556","DOIUrl":"https://doi.org/10.1111/1753-0407.13556","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The adverse effects of sedentary behavior on obesity and chronic diseases are well established. However, the prevalence of sedentary behavior has increased, with only a minority of individuals meeting the recommended physical activity guidelines. This study aimed to investigate whether habitual leg shaking, a behavior traditionally considered unfavorable, could serve as an effective strategy to improve energy metabolism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A randomized crossover study was conducted, involving 15 participants (mean [SD] age, 25.4 [3.6]; mean [SD] body mass index, 22 [3]; 7 women [46.7%]). The study design involved a randomized sequence of sitting and leg shaking conditions, with each condition lasting for 20 min. Energy expenditure, respiratory rate, oxygen saturation, and other relevant variables were measured during each condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to sitting, leg shaking significantly increased total energy expenditure [1.088 kj/min, 95% confidence interval, 0.69–1.487 kj/min], primarily through elevated carbohydrate oxidation. The average metabolic equivalent during leg shaking exhibited a significant increase from 1.5 to 1.8. Leg shaking also raised respiratory rate, minute ventilation, and blood oxygen saturation levels, while having no obvious impact on heart rate or blood pressure. Electromyography data confirmed predominant activation of lower leg muscles and without increased muscle fatigue. Intriguingly, a significant correlation was observed between the increased energy expenditure and both the frequency of leg shaking and the muscle mass of the legs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study provides evidence that habitual leg shaking can boost overall energy expenditure by approximately 16.3%. This simple and feasible approach offers a convenient way to enhance physical activity levels.</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 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648184","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":"Prevalence of nonalcoholic fatty liver disease and liver cirrhosis in Chinese adults with type 2 diabetes mellitus","authors":"Xinyu Han,&nbsp;Xin Zhang,&nbsp;Zhenqiu Liu,&nbsp;Hong Fan,&nbsp;Chengnan Guo,&nbsp;Haili Wang,&nbsp;Yu Gu,&nbsp;Tiejun Zhang","doi":"10.1111/1753-0407.13564","DOIUrl":"https://doi.org/10.1111/1753-0407.13564","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nonalcoholic fatty liver disease (NAFLD) and liver cirrhosis are significant clinical concerns, especially among individuals with type 2 diabetes mellitus (T2DM). However, in China, there is a paucity of reliable evidence detailing the characteristics of NAFLD and liver cirrhosis in T2DM. Furthermore, the relationship between blood glucose levels and NAFLD prevalence remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Shanghai Suburban Adult Cohort and Biobank were analyzed, including 6621 participants with T2DM. NAFLD was diagnosed by ultrasonography and liver cirrhosis was performed according to the health information systems. Logistic regression and restricted cubic spline analysis were used to explore the potential risk factors for NAFLD and liver cirrhosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of NAFLD was 59.36%, and liver cirrhosis was 1.43% among T2DM patients. In these patients, factors like age, being female, marital status, and obesity significantly increased the risk of NAFLD. Specifically, obesity had a strong positive association with NAFLD (odds ratio [OR] = 4.70, 95% confidence interval [CI]: 4.13–5.34). The higher glycated hemoglobin (HbA1c) quartile was associated with a heightened NAFLD risk compared to the lowest quartile (all <i>p</i> &lt; .001). The HbA1c-NAFLD relationship displayed a linear that mimicked an inverted L-shaped pattern. A significant positive association existed between HbA1c levels and NAFLD for HbA1c &lt;8.00% (OR = 1.59, 95% CI: 1.44–1.75), but this was not observed for HbA1c &gt;8.00% (OR = 1.03, 95% CI: 0.92–1.15).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Systematic screening for NAFLD is essential in T2DM patients, especially with poor glucose control and obesity in female.</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 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13564","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648183","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":"Continuous subcutaneous insulin infusion versus multiple daily injection therapy in pregnant women with type 1 diabetes","authors":"Yixin Gong,&nbsp;Tian Wei,&nbsp;Yujie Liu,&nbsp;Jing Wang,&nbsp;Jinhua Yan,&nbsp;Daizhi Yang,&nbsp;Sihui Luo,&nbsp;Jianping Weng,&nbsp;Xueying Zheng","doi":"10.1111/1753-0407.13558","DOIUrl":"https://doi.org/10.1111/1753-0407.13558","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The study aimed to compare glycemic control and pregnancy outcomes in women with type 1 diabetes mellitus (T1DM) using multiple daily injection therapy (MDI) and continuous subcutaneous insulin infusion (CSII) and to compare outcomes of women treated with long-acting insulin or neutral protamine Hagedorn (NPH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter prospective cohort study involved women with pregestational T1DM treated with MDI and CSII. Primary outcome was glycated hemoglobin (HbA1c) before and during pregnancy. Secondary outcomes included maternal and neonatal outcomes and quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 121 studied women, the average age was 28.48 years, and the average body mass index was 21.29 kg/m² at conception and 26.32 kg/m² at delivery. Of the studied women, 78.51% had planned pregnancy. Women treated with MDI and CSII had comparable HbA1c before pregnancy or in the first and second trimesters. In the third trimester, women on CSII therapy had significantly lower HbA1c (6.07 ± 0.62 vs 6.20 ± 0.88%, <i>p</i> = .017), higher HbA1c on-target rate (71.43% vs 64.62%, <i>p</i> = .030), and greater decline of HbA1c from preconception to the third trimester (−0.65 vs −0.30%, <i>p</i> = .047). Fewer daily insulin requirements were observed in those used CSII compared with MDI-treated women (0.60 ± 0.22 vs 0.73 ± 0.25 U/kg/day, <i>p</i> = .004). Newborns born of mothers treated with the CSII method were more likely to have neonatal jaundice (adjusted odds ratio [OR] 2.76, 95% confidence interval [CI] 1.16–6.57) and neonatal intensive care unit (adjusted OR 3.73, 95%CI 1.24–11.16), and women on CSII had lower scores in patient-reported quality of life (<i>p</i> = .045). In the MDI group, those receiving long-acting insulin had nonsignificant lower HbA1c and higher HbA1c on-target rate in the second and third trimesters, compared with those treated with NPH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Insulin pump users may achieve better glycemic control than multiple daily insulin injections, which did not substantially improve pregnancy outcome.</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 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13558","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140648185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2023 WCIRDC: Obesity","authors":"Zachary T. Bloomgarden","doi":"10.1111/1753-0407.13568","DOIUrl":"https://doi.org/10.1111/1753-0407.13568","url":null,"abstract":"&lt;p&gt;The 21st annual World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease, held in Los Angeles, California on December 7–9, 2023, included 69 presentations spanning a myriad of aspects of diabetes and its complications, atherosclerosis, renal disease, liver disease, and novel therapeutic approaches. This second summary focuses on presentations at the meeting pertaining to obesity.&lt;/p&gt;&lt;p&gt;Philipp Scherer (Dallas, Texas) noted that, similarly to the importance of fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD), which may persist after steatosis has been treated and which underlies the development of cirrhosis, obesity is associated with increased localized fibrosis and disrupted angiogenesis in adipose tissue, mediated by low levels of adiponectin and increased production of leptin, steroid hormones, and inflammatory mediators.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Scherer highlighted the role of endotrophin, a cleavage product of collagen that may mediate fibrosis in the liver, kidneys, and heart. Development of agents to neutralize this peptide might have therapeutic benefits. He also showed studies suggesting that the greater clinical potency of tirzepatide than of the glucagon-like peptide (GLP)-1 receptor agonist (RA) semaglutide may be an effect of glucose-dependent insulinotropic polypeptide (GIP) receptor activation in increasing energy expenditure.&lt;/p&gt;&lt;p&gt;Richard Bergman (Los Angeles, California) discussed the use of the body mass index (BMI) in quantitating obesity, explaining that the measure derives from the work of Adolphe Quetelet, who developed the concept of the “Average Man” in the nineteenth century. He proposed use of an index based on the observation that weight varied in proportion to the square of height. During the twentieth century the term BMI was popularized by Ancel Keys, based on studies showing that the Quetelet index correlated with direct measurements of body fat. The BMI does not, however, give information about fat distribution, and Bergman suggested that it is not a good measure of body fat, giving no information about the mechanisms operative in a given individual. Measurement of skinfold thicknesses, the use of BMI in conjunction with waist circumference, underwater weighing, and the more recent body adiposity index (calculated as hip/height^1.48) have been proposed. Bergman reviewed his work in population studies with dual-energy X-ray absorptiometry measurement of fat mass. Analysis of a variety of possible relationships between sex, height, weight, and waist circumference led Bergman to propose a new measure, relative fat mass (RFM), calculated as: RFM = 64 – (20*Height/WC) + (12*sex), with sex = 0 in men and sex = 1 (women).&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; Bergman reviewed studies showing good prediction of risks of diabetes, heart failure, and coronary disease with this measure.&lt;/p&gt;&lt;p&gt;Samuel Klein (St. Louis, Missouri) discussed the complex relationships between BMI and cardiovascula","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13568","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140639535","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}