Journal of Diabetes Investigation最新文献

The cholesterol-HDL-glucose (CHG) index and traditional adiposity markers in predicting diabetic retinopathy and nephropathy. 胆固醇-高密度脂蛋白-葡萄糖（CHG）指数和传统肥胖指标预测糖尿病视网膜病变和肾病。

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-28 DOI: 10.1111/jdi.70086

Merve Çatak, Şerife Gülhan Konuk, Sema Hepsen

{"title":"The cholesterol-HDL-glucose (CHG) index and traditional adiposity markers in predicting diabetic retinopathy and nephropathy.","authors":"Merve Çatak, Şerife Gülhan Konuk, Sema Hepsen","doi":"10.1111/jdi.70086","DOIUrl":"https://doi.org/10.1111/jdi.70086","url":null,"abstract":"Objective: To investigate the relationship between four metabolic indices-visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, and cholesterol-HDL-glucose (CHG) index-and the presence of diabetic nephropathy (DN) and diabetic retinopathy (DR) in patients with long-standing type 2 diabetes mellitus (T2DM).Materials and methods: This prospective cross-sectional study included 175 T2DM patients with disease duration >10 years who attended an endocrinology outpatient clinic between July 2021 and January 2022. DR was assessed via fundus photography, and DN was defined using the urinary albumin-to-creatinine ratio and eGFR. VAI, LAP, TyG, and CHG indices were calculated using anthropometric and biochemical parameters. Logistic regression was used to identify independent predictors.Results: The mean age was 60 ± 10.1 years; 63.4% were female. DR and DN were observed in 50.3% and 38.9% of patients, respectively. VAI, LAP, and TyG were significantly higher in patients with DN but not with DR. CHG was elevated in both DN and DR (P < 0.05), and was the only independent predictor of DN (P = 0.005). Notably, CHG was significantly higher in proliferative vs non-proliferative DR (P = 0.009), unlike the other indices.Conclusions: While VAI, LAP, and TyG were associated only with nephropathy, CHG was linked to both DN and DR. Its integration of glycemic and lipid parameters may offer greater sensitivity for microvascular risk stratification in T2DM.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of SHORT syndrome with a novel genetic mutation diagnosed 19 years after the onset of diabetes. 在糖尿病发病19年后诊断出一种新的基因突变的SHORT综合征病例。

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-27 DOI: 10.1111/jdi.70088

Kumiko Tajima, Yushi Hirota, Tomofumi Takayoshi, Wataru Ogawa

引用次数: 0

PIK3R1 mutations in individuals with insulin resistance or growth retardation: Case series and in silico functional analysis. 胰岛素抵抗或生长迟缓个体的PIK3R1突变：病例系列和计算机功能分析

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-27 DOI: 10.1111/jdi.70062

Tomofumi Takayoshi, Yushi Hirota, Aki Sugano, Kenji Sugawara, Takehito Takeuchi, Mika Ohta, Kai Yoshimura, Seiji Nishikage, Akane Yamamoto, Yu Mimura, Shinji Higuchi, Jun Mori, Rie Kawakita, Tohru Yorifuji, Yutaka Takaoka, Wataru Ogawa

{"title":"PIK3R1 mutations in individuals with insulin resistance or growth retardation: Case series and in silico functional analysis.","authors":"Tomofumi Takayoshi, Yushi Hirota, Aki Sugano, Kenji Sugawara, Takehito Takeuchi, Mika Ohta, Kai Yoshimura, Seiji Nishikage, Akane Yamamoto, Yu Mimura, Shinji Higuchi, Jun Mori, Rie Kawakita, Tohru Yorifuji, Yutaka Takaoka, Wataru Ogawa","doi":"10.1111/jdi.70062","DOIUrl":"https://doi.org/10.1111/jdi.70062","url":null,"abstract":"Aims/introduction: Phosphatidylinositol 3-kinase (PI3K) plays a key role in insulin signaling, and mutations in PIK3R1, which encodes a regulatory subunit (p85α) of this enzyme, are responsible for SHORT syndrome, which is associated with insulin-resistant diabetes. We here describe four Japanese individuals from three families with SHORT syndrome who harbor either a common or a previously unknown mutation in PIK3R1 as well as provide an in silico functional analysis of the mutant proteins.Materials and methods: Gene sequencing was performed to identify PIK3R1 mutations. 3D structural analysis of wild-type and mutant p85α proteins was performed by homology modeling, and structural optimization and molecular dynamics simulations confirmed stable trajectories. Docking simulations of p85α with a phosphopeptide were also conducted.Results: We identified two families with a common mutation (c.1945C>T, p.R649W) and one family with a previously unidentified mutation (c.1957A>T, p.K653*) of PIK3R1. In silico modeling revealed that both mutations impaired binding of p85α to phosphopeptide, with K653* resulting in the loss of amino acids that contribute to such binding. Docking simulations showed a significant loss of docking energy for the R649W mutant compared with the wild-type protein (P = 0.00329).Conclusions: The four cases of SHORT syndrome were associated with early-onset diabetes and intrauterine growth retardation, with the identified mutations likely disrupting the binding of p85α to phosphopeptide and thereby impairing insulin signaling. One case uniquely manifested diabetes without insulin resistance, emphasizing the need for further study of the clinical variability of SHORT syndrome, especially with regard to its associated diabetes.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diabetes advocacy in the Asia-Pacific region. 亚太地区的糖尿病宣传。

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-27 DOI: 10.1111/jdi.70084

Noriko Kodani, Asuka Kato, Moon-Kyu Lee, Ronald Ching Wan Ma, Anita Sabidi, Renza Scibilia, Zhiguang Zhou, Alicia Jenkins

{"title":"Diabetes advocacy in the Asia-Pacific region.","authors":"Noriko Kodani, Asuka Kato, Moon-Kyu Lee, Ronald Ching Wan Ma, Anita Sabidi, Renza Scibilia, Zhiguang Zhou, Alicia Jenkins","doi":"10.1111/jdi.70084","DOIUrl":"https://doi.org/10.1111/jdi.70084","url":null,"abstract":"Living with diabetes is challenging. From diagnosis, one has to deal with lifelong management of glycemia and other factors. Misunderstandings about diabetes persist. People with diabetes (PWD) are sometimes misperceived as having brought diabetes upon themself, being incapable of self-management, maintaining a healthy lifestyle, or appropriate dietary habits, among other negative attributes. As a result, PWD can face difficulties at school, at home, in the workplace, and in the community. PWD also face financial burden with medical costs, health insurance, and loans. There has been growing awareness of diabetes-related stigma, highlighting the prevalence and consequences of biased, one-sided, and inaccurate information. Stigma can negatively affect the self-esteem, self-confidence, and self-care of PWD, and adversely affect their clinical outcomes. Therefore, advocacy to reduce the burden is essential. The situation varies within and between countries. There are still countries with limited access to insulin, more powerful glucose-lowering, cardio- and reno-protective drugs for type 2 diabetes, glucose monitoring strips, let alone technologies including continuous glucose monitoring (CGM) and insulin pumps. As members of the Asia-Pacific region, we strive to improve the quality of life for PWD within our countries and to enhance the global advocacy movement to achieve sustainable health equity worldwide. Herein, we share information from some Asia-Pacific countries: Australia, China, Korea, Indonesia, and Japan, including some aspects of the advocacy movement in each country. Through mutual understanding and collaboration, we aim to strengthen advocacy efforts across the Asia-Pacific region and contribute to global initiatives that enhance health outcomes for PWD.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical use and monitoring of adverse effects of sodium-glucose cotransporter-2 inhibitors in persons with type 1 diabetes mellitus. 钠-葡萄糖共转运蛋白-2抑制剂在1型糖尿病患者中的临床应用及不良反应监测

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-26 DOI: 10.1111/jdi.70085

Chinatsu Sakai, Shinichi Tamaru, Keiji Sugai, Hironori Takeuchi, Ryo Suzuki

{"title":"Clinical use and monitoring of adverse effects of sodium-glucose cotransporter-2 inhibitors in persons with type 1 diabetes mellitus.","authors":"Chinatsu Sakai, Shinichi Tamaru, Keiji Sugai, Hironori Takeuchi, Ryo Suzuki","doi":"10.1111/jdi.70085","DOIUrl":"https://doi.org/10.1111/jdi.70085","url":null,"abstract":"Aims: This study aimed to evaluate the factors contributing to insulin dosage adjustment and the risk of sodium-glucose cotransporter-2 inhibitor (SGLT2i) discontinuation in persons with type 1 diabetes mellitus (T1DM) starting SGLT2i therapy in clinical practice.Materials and methods: This retrospective study used the electronic medical record-based survey data of 49 patients attending our hospital between December 2018 and October 2021 to investigate the clinical use and adverse effects of SGLT2i in persons with T1DM starting SGLT2i.Results: Upon SGLT2i initiation, there were five patients in the favorable glycemic control group (HbA1c < 7.5%) and 44 patients in the poor glycemic control group (HbA1c ≥ 7.5%); few patients in the favorable glycemic control group reduced total daily insulin dose according to the recommendation, while 75% of patients in the group with poor glycemic control followed the guideline. Moreover, 60% of patients had hypoglycemia before the introduction of SGLT2i; additionally, among patients with no hypoglycemia before introduction, 50% had hypoglycemia after introduction. The group with hypoglycemia after induction tended to have longer diabetes duration and lighter body weight compared to the group without hypoglycemia. Multiple regression analysis revealed that diuretic use was an independent risk factor for discontinuation of SGLT2i (partial regression coefficient = 0.819, P = 0.001).Conclusions: When initiating SGLT2i in T1DM patients, it is important to evaluate glycemic control and adjust insulin dosage based on weight and diabetes duration to reduce hypoglycemia frequency.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Young-onset type 2 diabetes-Epidemiology, pathophysiology, and management. 年轻发病的2型糖尿病——流行病学、病理生理学和管理。

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-24 DOI: 10.1111/jdi.70081

Andrea O Y Luk, Hongjiang Wu, Yingnan Fan, Baoqi Fan, Chun Kwan O, Juliana C N Chan

{"title":"Young-onset type 2 diabetes-Epidemiology, pathophysiology, and management.","authors":"Andrea O Y Luk, Hongjiang Wu, Yingnan Fan, Baoqi Fan, Chun Kwan O, Juliana C N Chan","doi":"10.1111/jdi.70081","DOIUrl":"https://doi.org/10.1111/jdi.70081","url":null,"abstract":"The prevalence and incidence of young-onset type 2 diabetes is increasing globally, especially in low- and middle-income countries, and predominantly affects non-White ethnic and racial populations. Young-onset type 2 is heterogeneous in terms of the genetic and environmental contributions to its underlying pathophysiology, which poses challenges for glycemic management. Young at-risk individuals remain underrepresented in clinical trials, including diabetes prevention studies, and there is still an insufficient evidence base to inform practice for this age group. Improvements in diabetes care delivery have not reached young people who will progress to have disabling complications at an age when they are most productive. This review summarizes recent studies on the epidemiology of young-onset type 2 diabetes and its complications. We discuss the genetic and environmental risk factors that act in concert to promote glycemic dysregulation and early onset of type 2 diabetes. We provide perspectives on diabetes prevention and management, and propose strategies to address the unique medical and psychosocial issues associated with young-onset type 2 diabetes. The Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes Randomized Controlled Trial (PRISM-RCT) is the first large-scale clinical trial designed to evaluate the effect of a structured care model that integrates biogenetic markers with communication and information technology on attaining strict metabolic targets and improving clinical outcomes in individuals with young-onset type 2 diabetes. The results of this study will inform the scientific community about the impact of multifactorial intervention and precision care in young patients, for whom the legacy effect is particularly significant.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A 90 g/day low-carbohydrate diet improved glycemic control without decreasing frailty in older patients with type 2 diabetes: A secondary analysis of a randomized controlled trial. 90克/天的低碳水化合物饮食改善了老年2型糖尿病患者的血糖控制，但没有减少虚弱：一项随机对照试验的二次分析。

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-24 DOI: 10.1111/jdi.70083

Yu-Ting Wang, Chin-Ying Chen, Wei-Sheng Huang, Hui-Chuen Chen, Long-Teng Lee, Chyi-Feng Jan, Hsien-Liang Huang, Jaw-Shiun Tsai

{"title":"A 90 g/day low-carbohydrate diet improved glycemic control without decreasing frailty in older patients with type 2 diabetes: A secondary analysis of a randomized controlled trial.","authors":"Yu-Ting Wang, Chin-Ying Chen, Wei-Sheng Huang, Hui-Chuen Chen, Long-Teng Lee, Chyi-Feng Jan, Hsien-Liang Huang, Jaw-Shiun Tsai","doi":"10.1111/jdi.70083","DOIUrl":"https://doi.org/10.1111/jdi.70083","url":null,"abstract":"Aims: This study explored the glycemic control and Fried frailty criteria of a 90 g/day low-carbohydrate diet (LCD) in older patients with type 2 diabetes over 18 months.Methods: Forty-four older patients with type 2 diabetes and HbA1c ≥ 7.5% (58 mmol/mol) at the outpatient clinics were randomly assigned to a 90 g/day LCD or traditional diabetic diet (TDD). The analysis was performed using an intention-to-treat analysis.Results: A total of 42 (95.5%) patients completed the trial. The 18-month mean change from baseline was statistically significant for 2-h glucose (-100.0 ± 57.7 vs -18.6 ± 86.2 mg/dL) and waist circumference (-6.3 ± 7.9 vs -1.7 ± 4.7 cm) between the LCD and TDD groups (P < 0.05). The 18-month mean change from baseline was not significantly different in HbA1c (-1.55 ± 1.0 vs -0.97 ± 1.2; P = 0.097). After intervention, the proportions of robust, pre-frailty, and frailty in the TDD and LCD groups were 20.0% vs 13.6%, 75.0% vs 86.4%, and 5.0% vs 0.0%, respectively (P > 0.05).Conclusions: A 90 g/d LCD reflected improved glycemic control with significantly lower waist circumference without decreasing frailty in older patients with type 2 diabetes.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Elevated amputation rates in COVID-19 survivors: Insights from a large-scale Japanese cohort study. 2019冠状病毒病幸存者截肢率升高：来自日本大规模队列研究的见解

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-23 DOI: 10.1111/jdi.70078

Daisuke Miyamori, Shuhei Yoshida, Masanori Ito

{"title":"Elevated amputation rates in COVID-19 survivors: Insights from a large-scale Japanese cohort study.","authors":"Daisuke Miyamori, Shuhei Yoshida, Masanori Ito","doi":"10.1111/jdi.70078","DOIUrl":"https://doi.org/10.1111/jdi.70078","url":null,"abstract":"Objective: COVID-19 has been linked to increased vascular complications, but its long-term impact on amputation rates is unclear. This study evaluated amputation risk post-COVID-19 using a nationwide insurance claims database in Japan.Methods: We conducted a retrospective cohort study using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. COVID-19 cases were identified via insurance payment waivers, and amputations were defined by procedure codes. Propensity score matching created balanced cohorts of COVID-19 exposed and unexposed individuals. Matched cohorts were compared for amputation incidence, calculating incidence rate ratios (IRRs), and differences (IRDs). Sensitivity analyses examined outcomes at different time points, and subgroup analyses stratified results by key characteristics.Results: This study included 3,098,948 matched pairs. Over a median follow-up of 7 months, 286 amputations occurred in the COVID-19 group vs 123 in controls (IRR 2.33, 95% CI 1.88-2.90; IRD 5.57 per 1,000,000 person-months, 95% CI 4.22-6.92). The elevated risk persisted beyond 2 years post infection (IRR 2.03, 95% CI 1.31-3.20). Subgroup analyses showed higher risks in individuals with higher comorbidity burden (Charlson Comorbidity Index [CCI] ≥2; IRR 2.45 95% CI 1.92, 2.79) vs lower comorbidity burden (CCI 0-1; IRR 0.71 95%CI 0.29, 1.71) with significant interaction (P = 0.04).Conclusions: Amputation rates increased among COVID-19 survivors, persisting for over 2 years post infection. The interaction between COVID-19 and comorbidity burden highlights the need for vigilant long-term monitoring and management of vascular complications in COVID-19 survivors, particularly those with multiple comorbidities.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uhrf1 downregulation promotes β-cell dedifferentiation by decreasing Foxo1 expression in type 2 diabetes. Uhrf1下调通过降低Foxo1在2型糖尿病中的表达促进β细胞去分化。

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-22 DOI: 10.1111/jdi.70082

Lanfang Fu, Juyun Zhang, Zhu Lin, Xubiao Meng

{"title":"Uhrf1 downregulation promotes β-cell dedifferentiation by decreasing Foxo1 expression in type 2 diabetes.","authors":"Lanfang Fu, Juyun Zhang, Zhu Lin, Xubiao Meng","doi":"10.1111/jdi.70082","DOIUrl":"https://doi.org/10.1111/jdi.70082","url":null,"abstract":"Background: Islet β-cell dedifferentiation is a major pathological mechanism of type 2 diabetes (T2D). Forkhead box o1 (Foxo1) is a master regulator of β-cell dedifferentiation. The mechanisms by which Foxo1 expression is regulated remain unexplored. Epigenetic modification is involved in the occurrence and development of T2D. Ubiquitin-like with PDH and ring finger domains 1 (Uhrf1), as an important epigenetic regulator, is associated with the maintenance of DNA methylation and histone modification.Purpose: This study aimed to discover whether Uhrf1 regulates Foxo1 expression and β-cell dedifferentiation of rat insulinoma (INS-1) cells.Methods: RT-qPCR and Western blot were performed to detect the levels of Uhrf1, Foxo1, β-cell dedifferentiation, and proliferation and apoptosis related indicators. ChIP-qPCR was used to analyze the relative lysine trimethylation at positions 4, 9, and 27 on histone H3 (H3K4/9/27me3) enrichment on the Foxo1 promoter. Dual-luciferase reporter assay was performed to assess the interaction between Uhrf1 and Foxo1. Finally, a diabetic rat model was established and the rat islet β-cells were isolated.Results: Glucolipotoxicity-induced β-cell dedifferentiation of INS-1 cells, which was restored after Uhrf1 overexpression. Mechanistically, Uhrf1 regulated the H3K4/9/27me3 of the Foxo1 promoter region. Besides, Foxo1 overexpression suppressed β-cell dedifferentiation of INS-1 cells. Moreover, islet β-cells isolated from diabetic model rats showed increased dedifferentiation.Conclusion: Uhrf1 knockdown promoted H3K27me3 and H3K9me3 and reduced H3K4me3 level in INS-1 cells, resulting in the downregulation of Foxo1 expression, thus promoting β-cell dedifferentiation.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of HbA1c variability and time-in-range fluctuations on large and small nerve fiber dysfunction in well-controlled type 2 diabetes: A prospective cohort observational study. 控制良好的2型糖尿病患者HbA1c变异性和时间范围波动对大、小神经纤维功能障碍的影响：一项前瞻性队列观察研究

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2025-05-21 DOI: 10.1111/jdi.70079

Yun-Ru Lai, Wen-Chan Chiu, Ben-Chung Cheng, I-Hsun Yu, Ting-Yin Lin, Hui-Ching Chiang, Chun-En Aurea Kuo, Cheng-Hsien Lu

{"title":"Impact of HbA1c variability and time-in-range fluctuations on large and small nerve fiber dysfunction in well-controlled type 2 diabetes: A prospective cohort observational study.","authors":"Yun-Ru Lai, Wen-Chan Chiu, Ben-Chung Cheng, I-Hsun Yu, Ting-Yin Lin, Hui-Ching Chiang, Chun-En Aurea Kuo, Cheng-Hsien Lu","doi":"10.1111/jdi.70079","DOIUrl":"https://doi.org/10.1111/jdi.70079","url":null,"abstract":"Aims/introduction: Glycemic variability (GV) is a critical factor in the development of diabetic sensorimotor polyneuropathy (DSPN). This study aimed to evaluate the association of long-term GV, measured by glycated hemoglobin (HbA1c) average real variability (ARV), and short-term GV, assessed by time-in-range (TIR) ARV, with large and small nerve fiber dysfunction in individuals with well-controlled Type 2 Diabetes (T2D).Materials and methods: A prospective study conducted at a tertiary hospital in Taiwan included 82 T2D participants. Long-term GV was assessed using HbA1c ARV from visit-to-visit measurements at three-month intervals over 1 year. Short-term GV was evaluated as TIR ARV from seven-day fingerstick data collected quarterly. Large and small nerve functions were assessed using the Toronto Clinical Neuropathy Score (TCNS), nerve conduction studies, quantitative thermal testing, and Sudoscan.Results: Linear regression analysis adjusted for age, diabetes duration, and renal function revealed strong correlations between HbA1c ARV, TIR ARV, and diabetes duration. At baseline, high HbA1c ARV and TIR ARV groups exhibited higher TCNS and composite nerve conduction amplitude scores but lower cold detection thresholds compared to the low median groups. At one-year follow-up, TCNS significantly increased in the high HbA1c ARV (P = 0.001) and TIR ARV (P = 0.003) groups compared to the low median groups.Conclusions: Both long-term and short-term GV significantly contribute to small and large nerve fiber dysfunction in T2D, yielding similar neurological outcomes despite stable mean glucose levels. Combining GV minimization strategies with standard glycemic control may be essential in reducing DSPN risk.","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0