Journal of Diabetes最新文献

{"title":"Type B insulin resistance syndrome induced by anti-PD-1 therapy","authors":"Xiaomin Shi, Mengyu He, Li Ni, Zhijuan Dai, Mengte Shi, Yingying Zhou, Huabing Zhang, Ming Li, Chaoming Wu","doi":"10.1111/1753-0407.13603","DOIUrl":"https://doi.org/10.1111/1753-0407.13603","url":null,"abstract":"<p>A 59-year-old man was diagnosed with Hodgkin lymphoma in May 2020 and began treatment with sintilimab in August 2020. The patient had a normal blood glucose test before receiving treatment with sintilimab, with no family history of diabetes. In September 2020, the patient developed diabetic ketoacidosis after receiving three cycles of sintilimab. Glycated hemoglobin A1c (HbA1c) was 7.0%, and C-peptide level was undetectable. Diabetes-related antibodies, including glutamic acid decarboxylase antibody, insulinoma-associated protein 2 antibodies, and insulin autoantibodies, were all negative. Based on these findings, he was diagnosed with fulminant type 1 diabetes caused by anti-programmed cell death-1 (anti-PD-1) therapy. Additionally, he was also diagnosed with destructive thyroiditis caused by anti-PD-1 therapy at the same time. After discharge, he received insulin therapy, and his glucose level fluctuated between 4 and 20 mmol/L. The treatment regimen for Hodgkin's lymphoma was modified, and sintilimab treatment was stopped. Two months later, the Hodgkin's lymphoma was resolved.</p><p>In November 2021, the patient was admitted to the endocrinology department due to significant weight loss. In the 3 months leading up to his admission, he had lost about 15 kg in weight, with a poor glucose control (often >33.3 mmol/L). He did not report any symptoms of nausea or vomiting. On physical examination, he weighed 47 kg and had a body mass index (BMI) of 16.65 kg/m<sup>2</sup>. On admission, his plasma glucose level was 29.9 mmol/L, and β-hydroxybutyric level was 0.3 mmol/L. Of note, his serum C-peptide was <0.05 ng/mL, while his serum insulin level was >300 mU/L, and his HbA1c level was 10.2%. He was commenced on intravenous regular insulin therapy, and the insulin dose was gradually increased. However, despite continuous intravenous infusion of up to 3200 U of regular insulin daily, his blood glucose was still above 15 mmol/L. Other examinations showed that serum triglyceride was 0.89 mmol/L, adiponectin was 25.15 μg/mL, and insulin-like growth factor-1 was <25 ng/mL. Diabetes-related antibodies were all negative as before.</p><p>We measured his serum insulin receptor antibody by using enzyme linked immunosorbent assay, which was developed in Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital. This patient had a positive result on the insulin receptor antibody test. He was therefore diagnosed with type B insulin resistance syndrome (TBIRS). During this admission, he was also diagnosed with Sjogren's syndrome and hemolytic anemia. We commenced him on an immunosuppressive regimen, combining iv rituximab (0.5 g), cyclophosphamide (0.4 g), and glucocorticoids. Glucocorticoids were administered as methylprednisolone 500 mg intravenously for 3 days, followed by a maintenance dose of 50 mg po daily, with a prolonged taper. Hydroxychloroquine was administered in a dose of 0.2 mg po daily continuo","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes mellitus in stable chronic heart failure and the combination with humoral activation, their association, and prediction of 2-year adverse outcomes. Data from the FAR NHL registry","authors":"Karel Labr,&nbsp;Jindrich Spinar,&nbsp;Jiri Parenica,&nbsp;Lenka Spinarova,&nbsp;Jan Krejci,&nbsp;Filip Malek,&nbsp;Petr Ostadal,&nbsp;Ondrej Ludka,&nbsp;Jiri Jarkovsky,&nbsp;Klara Benesova,&nbsp;Ruzena Labrova,&nbsp;Monika Spinarova","doi":"10.1111/1753-0407.13605","DOIUrl":"https://doi.org/10.1111/1753-0407.13605","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aim</h3>\u0000 \u0000 <p>The study aims to describe the role of diabetes in patients with heart failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In all, 1052 chronic heart failure patients were included in the FARmacology and NeuroHumoral Activation (FAR NHL) multicenter prospective registry. They had ejection fraction below 50% and were on stable medication for at least 1 month.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More than one-third (38.9%) of the patients had diabetes mellitus (DM). Diabetic patients (<i>N</i> = 409) were older (median 67 vs. 64, <i>p</i> &lt; 0.001), had higher body mass index (BMI) (30 vs. 28 kg/m², <i>p</i> &lt; 0.001), much more frequently had ischemic heart disease (71 vs. 47%, <i>p</i> &lt; 0.001), hypertension (80 vs. 67%, <i>p</i> &lt; 0.001), dyslipidemia (89 vs. 69%, <i>p</i> &lt; 0.001), worse renal function (estimated glomerular filtration rate [eGFR] median 63 vs. 73 mL/min/1.73 m², <i>p</i> &lt; 0.001), and higher N-terminal pro-brain natriuretic peptide (NT-proBNP) (median 681 vs. 463 pg/mL, <i>p</i> = 0.003). All-cause death, left ventricle assist device implantation, and orthotopic heart transplantation were set as the combined primary end point, which was present in 15.5% (163 patients) within the 2-year follow-up. In the 2-year follow-up, 81.0% of patients with diabetes survived without a primary end point, while 85.4% of the patients without diabetes survived, the difference being on the verge of statistical significance (<i>p</i> = 0.089). DM is a statistically significant predictor of NT-proBNP value in univariate analysis, but it is not an independent predictor in a multivariate analysis. When the NT-proBNP level was high, the presence of DM did not influence the prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combination of diabetes and NT-proBNP levels may better stratify the prognosis of patients with chronic heart failure.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum β2-microglobulin and left ventricular hypertrophy in patients with type 2 diabetes mellitus: A cross-sectional study","authors":"Yuling Zhang,&nbsp;Guiliang Peng,&nbsp;Weiling Leng,&nbsp;Ying Li,&nbsp;Haiyan Li,&nbsp;Ling Zhou,&nbsp;Lichao Ge,&nbsp;Jiaqing Shao,&nbsp;Xing Li,&nbsp;Min Long","doi":"10.1111/1753-0407.13599","DOIUrl":"10.1111/1753-0407.13599","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Beta 2-microglobulin (β2-MG) is a component of the class I major histocompatibility complex (MHCI) and has recently been reported to be involved in type 2 diabetes mellitus (T2DM) and cardiovascular disease. However, the association of β2-MG with left ventricular hypertrophy (LVH) in T2DM patients remains unknown. This study aims to investigate the correlation between serum β2-MG and LVH in T2DM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The retrospective analysis included 4602 eligible T2DM patients, divided into LVH and non-LVH groups based on echocardiography results. Serum β2-MG levels were measured, and participants were categorized into four groups (Q1–Q4) by their serum β2-MG quartile. The relationship of serum β2-MG level with LVH was evaluated using logistic regression, restricted cubic spline (RCS), subgroup analysis, and machine learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of LVH in T2DM patients was 31.12%. Each standard deviation increase in serum β2-MG level corresponded to a 1.17-fold increase in the prevalence of LVH [OR = 1.17, (95% CI: 1.05–1.31); <i>p</i> = 0.006]. When considering β2-MG as a categorical variable (quartile), Q3 [OR = 1.36, (95% CI: 1.09–1.69); <i>p</i> = 0.007] and Q4 [OR = 1.77, (95% CI: 1.36–2.31); <i>p</i> &lt; 0.001] had a significantly higher prevalence of LVH than Q1. RCS analysis found a nonlinear association between β2-MG and LVH prevalence (<i>p</i> for nonlinearity &lt;0.05). Additionally, machine learning results confirmed the importance of β2-MG for LVH in T2DM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated serum β2-MG levels were likely to be associated with an increased prevalence of LVH in T2DM patients, suggesting its potential role in LVH development.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of impaired glucose tolerance alone and combined with metabolic syndrome on long-term risk of cardiovascular events and mortality","authors":"Fei Chen,&nbsp;Yifan He,&nbsp;Jinping Wang,&nbsp;Liping Yu,&nbsp;Qiuhong Gong,&nbsp;Yanyan Chen,&nbsp;Yali An,&nbsp;Siyao He,&nbsp;Guangwei Li,&nbsp;Bo Zhang","doi":"10.1111/1753-0407.13598","DOIUrl":"10.1111/1753-0407.13598","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate the potential differences in the influence of impaired glucose tolerance (IGT) with and without metabolic syndrome (MetS) on cardiovascular (CV) events and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants having IGT with MetS (IGT_MetS), those having IGT without MetS (IGT_non_MetS), and those having normal glucose tolerance (NGT) without MetS (NGT_non_MetS) (<i>N</i> = 246, <i>N</i> = 294, and <i>N</i> = 471, respectively) were included in this study. Cox proportional hazards regression was used to examine the relationship among these three groups and CV events and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the 30-year follow-up period, 57 (12.1%) participants having NGT_non_MetS, 55 (18.71%) with IGT_non_MetS, and 74 (30.08%) with IGT_MetS experienced CV mortality. After adjusting for risk factors, the hazard ratios for CV mortality were 2 (95% confidence interval [CI], 1.38–2.91) for the IGT_non_MetS group and 2.96 (95% CI, 2.09–4.19) for the IGT_MetS group, compared with the NGT_non_MetS group. Similar patterns were observed for CV events, with hazard ratios of 1.49 (95% CI, 1.19–1.88) for the IGT_non_MetS group and 1.97 (95% CI, 1.58–2.47) for the IGT_MetS group. Sensitivity analysis revealed that the hazard ratios of the IGT_non_MetS and IGT_MetS groups indicated a higher risk of all-cause mortality, myocardial infarction events or myocardial infarction mortality, and stroke events or stroke mortality compared with that of the NGT_non_MetS group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IGT_non_MetS increased the risk of CV mortality and events. Furthermore, when it occurred in conjunction with MetS, it further increased the risk of CV mortality and events. This suggested that active intervention is required.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic kidney disease—Recent updates","authors":"Zachary Bloomgarden","doi":"10.1111/1753-0407.13612","DOIUrl":"10.1111/1753-0407.13612","url":null,"abstract":"&lt;p&gt;The ramifications of the effects of diabetes on the kidney and the relationships of renal disease to the complications of diabetes are manifold, and several recent studies have addressed important aspects of the implications and the management of diabetic kidney disease (DKD).&lt;/p&gt;&lt;p&gt;An estimate of the prevalence of DKD among persons with type 1 diabetes (T1D) was made based on the National Health and Nutrition Examination Survey (NHANES) database of 19 225 adults in the United States from 2015 to 2018; 47 had T1D, among whom 20 had estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; or urine albumin/creatinine ratio (UACR) ≥30 mg/g, allowing estimates of 1 202 739 adults in the United States with T1D and a weighted estimate that 21.5% of people with T1D in the United States have DKD.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; A report from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database mortality statistics from 1999 to 2020 reflected the dramatic increase in mortality associated with DKD; more than 500 000 deaths were reported among adults with DKD during this period, with an age-adjusted annual mortality rate per 100 000 persons of approximately 2.0 in 1999–2005, increasing to approximately 4.0 in 2007–2010, but then to 22.0 in 2012–2019 and to 25.0 in 2020.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In an analysis suggesting interrelationships between DKD and cognitive function (CF), among 2977 people with type 2 diabetes (T2D) in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) memory in diabetes trial, there was a greater decline over 40 months in CF with standard than with intensive glycemic treatment among those with urine albumin &lt;0.4 mg/dL, whereas those with higher levels of albuminuria had no evidence of benefit with intensive treatment, and for those with eGFR &lt; 60, CF decline was greater with intensive than with standard glycemic treatment. Similarly, CF decline was greater with standard than intensive glycemic treatment in the subset age &lt;60 years, suggesting that T2D with better renal function and lower age might particularly benefit from more intensive glycemic treatment.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; There may be a different relationship between age and renal outcome with intensive lifestyle intervention (ILI); in a 12-year follow-up of the Look AHEAD (Action for Health in Diabetes) trial, prespecified analysis of the relationship between the ILI and age showed that among 5112 participants with baseline eGFR ≥ 45, those aged &gt;60 years at baseline randomized to ILI had a 25% lower likelihood of eGFR decreasing to &lt;45 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;, whereas this was not seen in the younger participants.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The optimal blood pressure treatment target is still not certain. The 11 255-person Effects of Intensive Systolic Blood Pressure Lowering Treatment in Reducing Risk of Vascular Events (ESPRIT) trial included 4359 persons with diabetes with systolic b","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of diabetic ketoacidosis in children: Does early insulin glargine help improve outcomes?","authors":"Rebecca Ohman-Hanson,&nbsp;G. Todd Alonso,&nbsp;Laura Pyle,&nbsp;Ryan McDonough,&nbsp;Mark Clements","doi":"10.1111/1753-0407.13597","DOIUrl":"10.1111/1753-0407.13597","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rebound hyperglycemia following the resolution of diabetic ketoacidosis (DKA) is common in pediatric patients with type 1 diabetes, increasing the risk of recurrent DKA and complicating the transition to subcutaneous insulin. Multiple studies suggest that early administration of long-acting insulin analogs during DKA management safely improves this transition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine whether early insulin glargine administration in children with DKA prevents rebound hyperglycemia and recurrent ketosis without increasing the rate of hypoglycemia or hypokalemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged &lt;21 years presenting with DKA to Children's Mercy Kansas City between October 2012 and October 2016 were reviewed. They were categorized as Early (&gt;4 h of overlap with intravenous [IV] insulin) and Late (&lt;2 h of overlap) cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We reviewed 546 DKA admissions (365 Early and 181 Late). Rebound hyperglycemia (&gt;180 mg/dL) was lower in the Early group (66% vs. 85%, <i>p</i> ≤ 0.0001). Hypoglycemia (&lt;70 mg/dL) during IV insulin administration was higher in the Early group than in the Late group (27% vs. 19%, <i>p</i> = 0.042). Hypoglycemia within 12 h of IV insulin discontinuation was lower in the Early group (16% vs. 26%, <i>p</i> = 0.012). Recurrent ketosis, hypokalemia, and cerebral edema were not different between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early glargine administration in pediatric DKA management is safe, decreases the rate of rebound hyperglycemia, and improves the transition to subcutaneous insulin. Hypoglycemia is less frequent following IV insulin discontinuation with early glargine, but the IV insulin rate may need to be reduced to minimize hypoglycemia during IV insulin infusion.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The combined effect of triglyceride–glucose index and high-sensitivity C-reactive protein on cardiovascular outcomes in patients with chronic coronary syndrome: A multicenter cohort study","authors":"Qinxue Li,&nbsp;Ying Song,&nbsp;Zheng Zhang,&nbsp;Jingjing Xu,&nbsp;Zhenyu Liu,&nbsp;Xiaofang Tang,&nbsp;Xiaozeng Wang,&nbsp;Yan Chen,&nbsp;Yongzhen Zhang,&nbsp;Pei Zhu,&nbsp;Xiaogang Guo,&nbsp;Lin Jiang,&nbsp;Zhifang Wang,&nbsp;Ru Liu,&nbsp;Qingsheng Wang,&nbsp;Yi Yao,&nbsp;Yingqing Feng,&nbsp;Yaling Han,&nbsp;Jinqing Yuan","doi":"10.1111/1753-0407.13589","DOIUrl":"10.1111/1753-0407.13589","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The triglyceride–glucose (TyG) index and high-sensitivity C-reactive protein (hsCRP) are the commonly used biomarkers for insulin resistance and systemic inflammation, respectively. We aimed to investigate the combined association of TyG and hsCRP with the major adverse cardiovascular events (MACE) in patients with chronic coronary syndrome (CCS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 9421 patients with CCS were included in this study. The primary endpoint was defined as a composite of MACE covering all-cause death, nonfatal myocardial infarction, and revascularization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the 2-year follow-up period, 660 (7.0%) cases of MACE were recorded. Participants were divided equally into three groups according to TyG levels. Compared with the TyG T1 group, the risk of MACE was significantly higher in the TyG T3 group. It is noteworthy that among patients in the highest tertile of TyG, hsCRP &gt;3 mg/L was significantly associated with an increased risk of MACE, whereas the results were not significant in the medium to low TyG groups. When patients were divided into six groups according to hsCRP and TyG, the Cox regression analysis showed that patients in the TyG T3 and hsCRP &gt;3 mg/L group had a significantly higher risk of MACE than those in the TyG T1 and hsCRP ≤3 mg/L group. However, no significant interaction was found between TyG and hsCRP on the risk of MACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study suggests that the concurrent assessment of TyG and hsCRP may be valuable in identifying high-risk populations and guiding management strategies among CCS patients.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970227","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 efficacy of interventions to prevent type 2 diabetes among women with recent gestational diabetes mellitus—A living systematic review and meta-analysis","authors":"Vivian Y. Lee,&nbsp;Mohammad R. Monjur,&nbsp;Joseph Alvin Santos,&nbsp;Anushka Patel,&nbsp;Rong Liu,&nbsp;Gian Luca Di Tanna,&nbsp;Yashdeep Gupta,&nbsp;Alpesh Goyal,&nbsp;Saumiyah Ajanthan,&nbsp;Devarsetty Praveen,&nbsp;J. K. Lakshmi,&nbsp;H. Asita de Silva,&nbsp;Nikhil Tandon","doi":"10.1111/1753-0407.13590","DOIUrl":"10.1111/1753-0407.13590","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While previously considered a transient condition, with no lasting adverse impact, gestational diabetes mellitus (GDM) is now a well-established risk factor for developing type 2 diabetes mellitus (T2DM). The risk of developing T2DM appears to be particularly high in the first few years after childbirth, providing a compelling case for early intervention. This review provides an up-to-date systematic review and meta-analysis to assess the effectiveness of interventions to reduce incidence of T2DM in women with a recent history of GDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The search was conducted on October 20, 2023 with an annual surveillance planned for the next 5 years to maintain a living systematic review. The inclusion criteria were randomized controlled trials of any type in women within 5 years of GDM-complicated pregnancy that reported outcomes of T2DM diagnosis or measures of dysglycemia with a follow-up of at least 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies met our inclusion criteria and have been included in this review. There were 3 pharmacological and 14 lifestyle interventions. Intervention was not associated with significant reduction in the primary outcome of T2DM (risk ratio, 0.78; 95% confidence interval [CI]: 0.43–1.41; <i>p</i> = 0.41; <i>I</i>² = 79%) compared with the control group (placebo or usual care). However, meta-analysis of the four studies reporting hazard ratios suggested a reduction in diabetes incidence (hazard ratio, 0.68; 95% CI: 0.48–0.97; <i>p</i> = 0.03; <i>I</i>² = 31%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review provides equivocal evidence about the efficacy of interventions to reduce the risk of T2DM in women within 5 years of GDM-complicated pregnancy and highlights the need for further studies, including pharmacotherapy.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13590","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970228","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 estimated glucose disposal rate control level and stroke incidence in middle-aged and elderly adults","authors":"Jiangnan Yao,&nbsp;Feng Zhou,&nbsp;Lingzhi Ruan,&nbsp;Yiling Liang,&nbsp;Qianrong Zheng,&nbsp;Jiaxin Shao,&nbsp;Fuman Cai,&nbsp;Jianghua Zhou,&nbsp;Hao Zhou","doi":"10.1111/1753-0407.13595","DOIUrl":"10.1111/1753-0407.13595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To estimate glucose disposal rate (eGDR) as a newly validated surrogate marker of insulin resistance. Few studies have explored the association between changes in eGDR levels and stroke incidence. This study aims to explore the effect of the level of eGDR control on stroke and events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were obtained from the China Longitudinal Study on Health and Retirement (CHARLS). The eGDR control level was classified using K-means cluster analysis. Logistic regression analysis was used to explore the association between different eGDR control levels and incident stroke. Restrictive cubic spline regression was used to test the potential nonlinear association between cumulative eGDR and stroke incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 4790 participants, 304 (6.3%) had a stroke within 3 years. The odds ratio (OR) was 2.34 (95% confidence interval [CI], 1.42–3.86) for the poorly controlled class 4 and 2.56 (95% CI, 1.53–4.30) for the worst controlled class 5 compared with class 1 with the best controlled eGDR. The OR for well-controlled class 2 was 1.28 (95% CI, 0.79–2.05), and the OR for moderately controlled class 3 was 1.95 (95% CI, 1.14–3.32). In restrictive cubic spline regression analysis, eGDR changes are linearly correlated with stroke occurrence. Weighted quartile and regression analysis identified waist circumference and hypertension as key variables of eGDR for predicting incident stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Poorly controlled eGDR level is associated with an increased risk of stroke in middle-aged and elderly people. Monitoring changes in eGDR may help identify individuals at high risk of stroke early.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970222","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 characteristics and complication risks in data-driven clusters among Chinese community diabetes populations","authors":"Binqi Li,&nbsp;Zizhong Yang,&nbsp;Yang Liu,&nbsp;Xin Zhou,&nbsp;Weiqing Wang,&nbsp;Zhengnan Gao,&nbsp;Li Yan,&nbsp;Guijun Qin,&nbsp;Xulei Tang,&nbsp;Qin Wan,&nbsp;Lulu Chen,&nbsp;Zuojie Luo,&nbsp;Guang Ning,&nbsp;Weijun Gu,&nbsp;Yiming Mu","doi":"10.1111/1753-0407.13596","DOIUrl":"10.1111/1753-0407.13596","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Novel diabetes phenotypes were proposed by the Europeans through cluster analysis, but Chinese community diabetes populations might exhibit different characteristics. This study aims to explore the clinical characteristics of novel diabetes subgroups under data-driven analysis in Chinese community diabetes populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used K-means cluster analysis in 6369 newly diagnosed diabetic patients from eight centers of the REACTION (Risk Evaluation of cAncers in Chinese diabeTic Individuals) study. The cluster analysis was performed based on age, body mass index, glycosylated hemoglobin, homeostatic modeled insulin resistance index, and homeostatic modeled pancreatic β-cell functionality index. The clinical features were evaluated with the analysis of variance (ANOVA) and chi-square test. Logistic regression analysis was done to compare chronic kidney disease and cardiovascular disease risks between subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 2063 (32.39%), 658 (10.33%), 1769 (27.78%), and 1879 (29.50%) populations were assigned to severe obesity-related and insulin-resistant diabetes (SOIRD), severe insulin-deficient diabetes (SIDD), mild age-associated diabetes mellitus (MARD), and mild insulin-deficient diabetes (MIDD) subgroups, respectively. Individuals in the MIDD subgroup had a low risk burden equivalent to prediabetes, but with reduced insulin secretion. Individuals in the SOIRD subgroup were obese, had insulin resistance, and a high prevalence of fatty liver, tumors, family history of diabetes, and tumors. Individuals in the SIDD subgroup had severe insulin deficiency, the poorest glycemic control, and the highest prevalence of dyslipidemia and diabetic nephropathy. Individuals in MARD subgroup were the oldest, had moderate metabolic dysregulation and the highest risk of cardiovascular disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The data-driven approach to differentiating the status of new-onset diabetes in the Chinese community was feasible. Patients in different clusters presented different characteristics and risks of complications.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"16 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.13596","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970223","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}