Journal of Diabetes Investigation最新文献

{"title":"Comment on \"Physiological phenotypes of obstructive sleep apnea identified by cluster analysis: Association with type 2 diabetes\".","authors":"Huijuan Cheng, Zhe Zhang, Feng Lu","doi":"10.1111/jdi.70425","DOIUrl":"10.1111/jdi.70425","url":null,"abstract":"","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and low body mass index as key determinants of sodium-glucose cotransporter 2 inhibitor-specific adverse event-related discontinuation in adults aged ≥75 years: A multicenter real-world retrospective cohort study.","authors":"Taisuke Uchida, Hiroaki Ueno, Ayaka Konagata, Hiroki Nabekura, Yuki Kikuchi, Takumi Beppu, Akari Sekishima, Hirotaka Sekishima, Takayuki Nakamura, Fumiko Kogo, Yudai Uehira, Yuri Tanaka, Hideki Yamaguchi, Kazuya Shimoda","doi":"10.1111/jdi.70424","DOIUrl":"https://doi.org/10.1111/jdi.70424","url":null,"abstract":"<p><strong>Aims/introduction: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are increasingly prescribed to older adults; however, data regarding their tolerability and drug-specific adverse events (AEs) in very elderly Asian populations, particularly among individuals with frailty or low body mass index (BMI), remain limited. We aimed to determine the incidence of SGLT2i-specific AE-related treatment discontinuation and to identify associated risk factors among Japanese adults aged ≥75 years.</p><p><strong>Materials and methods: </strong>We conducted a multicenter retrospective cohort study including Japanese adults aged ≥75 years who newly initiated SGLT2is between 2014 and 2024. Medical records were reviewed for 180 days. SGLT2i-specific AEs were defined as genitourinary infection, volume depletion, acute kidney function decline, and diabetic ketoacidosis or hyperosmolar hyperglycemic syndrome. Cox proportional hazards models were used for identifying predictors.</p><p><strong>Results: </strong>A total of 616 patients were included (mean age, 81.3 years; mean BMI, 24.0 kg/m²). The 180-day cumulative incidence of SGLT2i-specific AE-related discontinuation was 9.1%. Multivariable analysis identified Clinical Frailty Scale ≥5 (hazard ratio [HR], 4.67; P < 0.001) and BMI <22 kg/m² (HR, 2.53; P = 0.003) as independent predictors of discontinuation.</p><p><strong>Conclusions: </strong>SGLT2 inhibitors were generally well tolerated among adults aged ≥75 years. Frailty and low BMI were the principal determinants of AE-related treatment discontinuation, whereas chronological age was not independently associated with the risk. Assessment of physiological reserve may help identify patients requiring closer monitoring and support the safe use of SGLT2 inhibitors in older adults.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effectiveness and acceptability of an animated educational tool for diabetic foot care: A randomized controlled trial and mixed-methods study in patients with active, in-remission and high-risk diabetic foot disease.","authors":"Michael Lockhart, Jack Cosgrave, Pir Zainulabdeen Jan Sarhandi, Kellie Fortune, Eimear Daly, Tommy Kyaw Tun, Colin Davenport, Seamus Sreenan, Derek T O'Keeffe, John H McDermott","doi":"10.1111/jdi.70419","DOIUrl":"https://doi.org/10.1111/jdi.70419","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with diabetes have a 2% annual risk of developing a Diabetic Foot Ulcer (DFU). Novel methods of reducing the risk of re-ulceration could reduce the cost of diabetic foot disease.</p><p><strong>Materials and methods: </strong>Fifty-two patients with active foot disease, a history of prior DFU and/or high-risk feet were included in this study. Patients were randomly assigned 50:50 to be educated conventionally by a podiatrist or to view a bespoke foot self-care educational animation developed by the research team for this exploratory pilot study. A modified Nottingham Assessment of Functional Footcare (NAFF) questionnaire was used to record knowledge of safe foot care behaviors pre- and post-intervention. The primary outcome was change in self-care knowledge score. In parallel, a mixed-methods acceptability study was carried out for the 26 patients in the intervention arm, with quantitative data obtained using a 20-item technology acceptance model. Qualitative data were obtained by face-to-face interviews in the clinic setting and examined using thematic analysis.</p><p><strong>Results: </strong>While foot self-care knowledge scores were numerically higher in both groups, only the intervention group showed a statistically significant within-group improvement. There was a trend toward a greater magnitude of increase in the knowledge score in favor of the intervention group, but this did not reach statistical significance. Among the 26 patients who completed the technology acceptability study, the majority of responses were in favor of the educational video.</p><p><strong>Conclusions: </strong>This randomized controlled and mixed-methods study demonstrated positive results in terms of improvements in foot self-care knowledge and acceptability.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A holistic approach to type 1 diabetes: From advances in science and technology to equity in diabetes care.","authors":"Noriko Kodani","doi":"10.1111/jdi.70423","DOIUrl":"10.1111/jdi.70423","url":null,"abstract":"<p><p>Over the past century, the discovery of insulin transformed type 1 diabetes from a fatal disease into a manageable chronic condition, and the subsequent recognition of its autoimmune basis laid the foundation for screening and intervention before clinical onset. Building on these milestones, recent advances in science and technology have transformed the approach to type 1 diabetes across the disease spectrum. Screening for type 1 diabetes is conducted in many research programs, and more people with presymptomatic type 1 diabetes are now identified and monitored, enabling access to disease-modifying therapy. However, screening remains geographically limited, resulting in inequity in access to future opportunities for type 1 diabetes prevention. For glucose management in established type 1 diabetes, continuous glucose monitoring (CGM) and automated insulin delivery (AID) have improved the safety of insulin therapy, glycemic outcomes, and, importantly, everyday quality of life. Nevertheless, access to these technologies remains limited, with inequities between and within countries. Model-based economic evaluations suggest that type 1 diabetes screening and diabetes technologies are projected to be cost-effective, providing evidence to inform reimbursement, resource allocation, and national health policy. Yet, evidence of cost-effectiveness alone will not ensure equitable access. The next challenge is to reduce disparities and achieve equity by addressing differences in access to specialist care, socioeconomic circumstances, geographic location, racial and ethnic background, age, education, and clinical support system. Achieving this goal will require close collaboration among people with type 1 diabetes, healthcare professionals, and all stakeholders. Through these advocacy efforts, we can help ensure equitable implementation of science and technology for all people who may benefit.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148756751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noncoding RNAs as novel diagnostic biomarkers for diabetic retinopathy: A systematic review and meta-analysis.","authors":"Ting Zhang, Donghong Xu","doi":"10.1111/jdi.70395","DOIUrl":"10.1111/jdi.70395","url":null,"abstract":"<p><strong>Background and aims: </strong>Diabetic retinopathy (DR), a frequent microvascular complication of diabetes, requires early detection to mitigate progression. Noncoding RNAs (ncRNAs) have emerged as promising diagnostic biomarkers. This meta-analysis evaluates their overall diagnostic accuracy for DR.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple electronic databases, including PubMed, Embase, and Web of Science, to identify relevant studies published until August 2025. Data on study characteristics, quality, and diagnostic performance were pooled. Pooled effect sizes were calculated using a random effects model. Heterogeneity was explored via subgroup analysis and meta-regression; publication bias was assessed using Deck's funnel plot.</p><p><strong>Results: </strong>Twenty-four studies from 17 articles (1,983 patients, 1,437 controls) were included. The pooled analysis demonstrated that ncRNAs achieved a sensitivity of 0.81 and a specificity of 0.84. The area under the curve (AUC) was 0.89, whereas the positive and negative likelihood ratios were 4.96 and 0.23, respectively. LncRNAs demonstrated superior diagnostic performance compared to miRNAs (P = 0.03). Control type, region, and expression trend did not significantly influence outcomes. Significant heterogeneity was observed (I² > 50%), but sensitivity analysis confirmed robustness, and no notable publication bias was detected.</p><p><strong>Conclusion: </strong>Circulating ncRNAs, particularly lncRNAs, show high diagnostic potential for DR and represent promising noninvasive biomarkers for early screening and differential diagnosis.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of glucagon in metabolic diseases.","authors":"Tadahiro Kitamura, Yoko Tabei, Masaki Kobayashi","doi":"10.1111/jdi.70416","DOIUrl":"10.1111/jdi.70416","url":null,"abstract":"<p><p>Currently, diabetes is defined as \"a chronic hyperglycemic state resulting from the absolute or relative insufficiency of insulin action,\" emphasizing its characterization as an insulin-related disease. However, glucagon dysregulation should also play a critical role in the pathophysiology of type 2 diabetes. The pathophysiological relevance of glucagon in type 2 diabetes has long remained uncertain, largely owing to the lack of a reliable assay for measuring plasma glucagon concentrations. We recently developed a highly accurate glucagon sandwich enzyme-linked immunosorbent assay, demonstrating its utility in characterizing patients with type 2 diabetes and its potential for near-term clinical application. In parallel, glucagon has emerged as a promising therapeutic target. Although glucagon receptor antagonists produce potent glucose-lowering effects without increasing the risk of hypoglycemia, their clinical development has not progressed to phase 3 trials because of adverse effects, including weight gain and worsening hepatic steatosis. In contrast, we demonstrated that α-methyl D-glucopyranoside, an endogenous glucagon secretagogue, reduces body weight and improves hepatic steatosis and glucose intolerance in an obese diabetic mouse model. Furthermore, dual glucagon/glucagon-like peptide 1 (GLP-1) receptor agonists and triple glucagon/GLP-1/glucose-dependent insulinotropic polypeptide receptor agonists are currently undergoing phase 3 clinical trials for the treatment of obesity and metabolic dysfunction-associated steatotic liver disease. Taken together, glucagon plays a key role in the pathophysiology, diagnosis, and treatment of metabolic diseases.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal distribution of acute kidney injury-related hospitalizations after initiation of sodium-glucose cotransporter 2 inhibitors: A nationwide claims database analysis in older adults with an independent complementary single-center eGFR analysis.","authors":"Kazuya Hiura, Ayana Tatsuno, Yamato Noto, Ryosuke Wakamatsu, Masayuki Sakunami, Ryu Kobayashi, Miki Yamashita","doi":"10.1111/jdi.70417","DOIUrl":"10.1111/jdi.70417","url":null,"abstract":"<p><strong>Aims/introduction: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce the risk of acute kidney injury (AKI). However, an initial decline in estimated glomerular filtration rate (eGFR) may occur after initiation, and factors associated with sustained early eGFR decline remain unclear. We evaluated the temporal distribution of AKI-related hospitalizations in older adults using claims data and, in an independent single-center cohort, factors associated with sustained early eGFR decline.</p><p><strong>Materials and methods: </strong>A Japanese nationwide claims database identified patients aged ≥75 years emergently hospitalized with AKI after SGLT2i initiation. Intervals were categorized as 1-30, 31-90, and 91-180 days. Baseline characteristics were compared across groups, followed by adjusted comparisons of the 1-30-day group with each later group. An independent single-center analysis without age restriction evaluated early eGFR changes and associated factors as indirect complementary evidence.</p><p><strong>Results: </strong>Among 190 patients, 59 (31.1%) were hospitalized within 1-30 days, 67 (35.3%) within 31-90 days, and 64 (33.7%) within 91-180 days. After inverse-probability-of-treatment weighting, all propensity-score covariates were balanced, and no additionally adjusted medication-related factor was associated with 1- to 30-day-group assignment. Sustained early eGFR decline was associated with older age and use of one or two triple-whammy (TW)-related drug classes.</p><p><strong>Conclusions: </strong>A substantial proportion of AKI-related hospitalizations occurred within 30 days after SGLT2i initiation. In the single-center analysis, sustained early eGFR decline was associated with older age and TW-related drug use. These hypothesis-generating findings require cautious interpretation because the case-only design precludes estimation of early AKI risk.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular preventive role of thiazolidinedione in patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention.","authors":"Jinkwon Kim, Jimin Jeon, Joonsang Yoo, Minyoul Baik, Seok-Jae Heo, Ji Woong Roh","doi":"10.1111/jdi.70385","DOIUrl":"10.1111/jdi.70385","url":null,"abstract":"<p><strong>Background: </strong>Thiazolidinediones (TZD) are a class of oral antidiabetic medications that improve glycemic control and insulin sensitivity. We evaluated the cardiovascular outcomes according to thiazolidinedione (TZD) use in patients with type 2 diabetes mellitus (T2DM) undergoing percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>Using the national health claims database in South Korea, we constructed a cohort of type 2 diabetes mellitus patients who underwent PCI between 2015 and 2022. Patients were classified as TZD users or nonusers and matched at a 1:3 ratio using propensity score matching. Stratified Cox regression analysis was performed to evaluate the risk for the primary composite outcome, which included myocardial infarction (MI), stroke, and all-cause death.</p><p><strong>Results: </strong>Among 169,747 patients with type 2 diabetes mellitus who underwent PCI, 7.4% were TZD users. During a mean follow-up of 3.63 ± 2.30 years, 31,813 patients (18.7%) experienced the primary outcome. In the stratified Cox regression analysis, which consisted of 12,597 TZD users and 37,791 nonusers, TZD treatment was associated with a lower risk of primary outcome (HR 0.87, 95% CI: 0.83-0.92, P < 0.001). No difference was observed in the risk of heart failure admission between TZD nonusers and users.</p><p><strong>Conclusions: </strong>TZD treatment in type 2 diabetes mellitus patients undergoing PCI was associated with a reduced risk of adverse cardiovascular events.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifying frailty-associated factors in type 2 diabetes and coronary heart disease.","authors":"Zhe Zhang, Suhua Xu","doi":"10.1111/jdi.70418","DOIUrl":"10.1111/jdi.70418","url":null,"abstract":"","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Close relationship between β2-microglobulin and type 2 diabetes-associated peripheral neuropathy.","authors":"Jingfang Shao, Jinpeng Xu, Lili Zhou, Panruo Jiang","doi":"10.1111/jdi.70413","DOIUrl":"10.1111/jdi.70413","url":null,"abstract":"<p><strong>Aims/introduction: </strong>This study aimed to elucidate the correlation between β2-microglobulin (β2-MG) and peripheral neuropathy in type 2 diabetes mellitus (T2DM).</p><p><strong>Materials and methods: </strong>Diabetic peripheral neuropathy (DPN) was defined on the nerve conduction study (NCS). The general information and relevant clinical data of patients with T2DM were retrospectively analyzed using logistic regression to identify independent risk factors. The discriminative ability of individual and combined risk factors was evaluated using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>A total of 1,219 patients with T2DM who received medical care at Dongyang People's Hospital between January 2023 and December 2023 were included in this study. Of the 954 patients with abnormal NCS findings, 899 exhibited sensory abnormalities, whereas 492 exhibited motor abnormalities. Multivariate analysis showed that DPN was positively correlated with age (P < 0.001), β2-MG (P = 0.022), uric acid (P = 0.028), and male sex (P < 0.001), but negatively correlated with albumin (P < 0.001). The combined discriminative power of these risk factors was 0.754, with β2-MG showing the highest individual diagnostic performance (AUC = 0.710).</p><p><strong>Conclusions: </strong>T2DM patients with advanced age, elevated β2-MG and uric acid levels, and hypoalbuminemia have higher DPN possibilities; follow-up confirmation with NCS may facilitate the early diagnosis and management of peripheral neuropathy.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}