Therapeutic Advances in Endocrinology and Metabolism最新文献

{"title":"Bone health in cancer: perspective on the use of osteoanabolic agents.","authors":"Tariq Chukir, Hanna Taipaleenmäeki, Melody Cheung, Azeez Farooki","doi":"10.1177/20420188251367252","DOIUrl":"10.1177/20420188251367252","url":null,"abstract":"<p><p>Cancer negatively impacts bone health through various mechanisms, including treatment-induced bone loss and malignant bone lesions, often leading to increased fracture risk and higher morbidity and mortality. Antiresorptive agents (bisphosphonates and denosumab) are the current standard of care to reduce the risk of skeletal-related events and prevent treatment-related fragility fractures in patients with cancer. While there is strong evidence to support their benefits in cancer, there is potential room for further reduction in the risk of pathologic and fragility fractures. This narrative review explores the potential role and theoretical concerns regarding the use of osteoanabolic agents in cancer. We also discuss management challenges, such as recurrent pathologic fractures, fragility fractures, and osteonecrosis of the jaw that may arise in clinical practice, prompting consideration of the use of osteoanabolic agents in patients with a history of cancer. Preclinical studies have shown conflicting outcomes regarding the effects on cancer with parathyroid hormone treatment, but promising results with the use of anti-sclerostin antibody in cancer models. Definitive conclusions cannot be drawn from available preclinical and clinical data. Theoretical risks exist for both cancer survivors and patients with advanced cancer in the bone. Therefore, the risk-benefit ratio should be carefully considered when evaluating the use of an osteoanabolic agent in the cancer context.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251367252"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993491","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":"Ultrasound therapy for exercise-induced muscle soreness and fatigue relief in women with type 2 diabetes: a randomized controlled trial.","authors":"Tahereh Bameri, Mohammadreza Rezaeipour, Javad Nakhzari Khodakheir","doi":"10.1177/20420188251362091","DOIUrl":"10.1177/20420188251362091","url":null,"abstract":"<p><strong>Background: </strong>Exercise-induced muscle soreness and fatigue are significant barriers to physical activity in middle-aged women with type 2 diabetes (T2D), exacerbated by impaired tissue healing and chronic inflammation.</p><p><strong>Objectives: </strong>To evaluate whether post-exercise therapeutic ultrasound (TUS) effectively reduces exercise-induced muscle soreness and fatigue while improving metabolic and inflammatory biomarkers in women with T2D.</p><p><strong>Design: </strong>Randomized controlled trial.</p><p><strong>Methods: </strong>Thirty sedentary women with T2D (aged 41-49 years, glycated hemoglobin (HbA1c) 6.5%-9.0%) were randomized to a TUS group (<i>n</i> = 15) or control (<i>n</i> = 15). Both groups completed an 8-week aerobic cycling program (3 sessions/week, 45 min/session, 60%-70% VO₂max). The TUS group received post-exercise ultrasound (3 MHz, 1 W/cm², 7 min/leg) using the Intellect Mobile 2 device. Primary outcomes were pain (Von Korff scale) and fatigue (Borg scale), while secondary outcomes included fasting blood sugar (FBS), HbA1c, inflammatory markers (tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6)), and creatine kinase (CK), assessed at baseline and post-intervention. Linear mixed-effects models adjusted for baseline pain differences.</p><p><strong>Results: </strong>The TUS group showed marked decreases in pain (-2.2, 95% CI: -2.8 to -1.6, <i>p</i> < 0.001) and fatigue (-1.8, 95% CI: -2.4 to -1.2, <i>p</i> = 0.004) compared to controls. Secondary outcomes substantially improved: HbA1c (-0.5%, <i>p</i> = 0.03), FBS (-19.8 mg/dL, <i>p</i> = 0.01), TNF-α (-24.9 pg/mL, <i>p</i> < 0.001), IL-6 (-11.9 pg/mL, <i>p</i> < 0.001), and CK (-30 U/L, <i>p</i> = 0.01). No adverse events were reported.</p><p><strong>Conclusion: </strong>TUS is a safe, effective adjunct for reducing exercise-induced muscle soreness and fatigue in women with T2D, with benefits in glycemic control and inflammation. Larger trials with sham controls are needed.</p><p><strong>Trial registration: </strong>This trial was registered at the Iranian Registry of Clinical Trials (IRCT20211201053244N1) on June 21, 2022.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251362091"},"PeriodicalIF":4.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970147","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":"Risk factor management over two decades in hospitalised patients with chronic limb-threatening ischaemia with and without diabetes mellitus.","authors":"Sofia Bodinger, Tove Wikström, Anders Gottsäter, Stefan Acosta","doi":"10.1177/20420188251362729","DOIUrl":"10.1177/20420188251362729","url":null,"abstract":"<p><strong>Background: </strong>Chronic limb-threatening ischaemia (CLTI) causes high rates of amputation and mortality.</p><p><strong>Objectives: </strong>To compare incidence, management and prognosis in hospitalised patients with CLTI with and without diabetes mellitus (DM) in 2001 and 2023. A secondary objective was to compare adherence to global vascular guidelines on risk factors between patients with and without DM in 2023.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Group differences were tested using the Mann-Whitney <i>U</i> test, independent sample <i>t</i> test or the Chi-square test, as appropriate. The effects of DM on major amputation or mortality at 1 year were evaluated in a multivariable logistic regression model according to a directed acyclic graph.</p><p><strong>Results: </strong>The incidence of hospitalisations for CLTI was reduced from 37.4 (95% confidence interval (CI), 33.3-41.6) in 2001 to 22.8 (95% CI, 19.7-25.8) per 100,000 person-years in 2023. The proportion of patients on full-dose oral anticoagulant therapy (<i>p</i> < 0.001) and lipid-lowering treatment (<i>p</i> < 0.001) increased significantly between the two time periods. In 2023, Wounds, Ischemia and foot Infection-classification in all patients with foot ulcers was documented in 6.9%. Anaemia was present at hospital admission in 67.0% and 52.5% of patients with CLTI with and without DM, respectively (<i>p</i> = 0.031). Endovascular therapy was performed more often in those with DM compared to those without DM (<i>p</i> = 0.004). Antiplatelet therapy (<i>p</i> = 0.008) and smoking cessation interventions (<i>p</i> = 0.033) were offered less often to those with DM. DM (odds ratio (OR), 1.7 (95% CI, 1.02-2.83)) was independently associated with increased mortality at 1 year, whereas period 2023 as opposed to 2001 (OR, 0.62 (95% CI, 0.38-0.99)) was associated with decreased mortality.</p><p><strong>Conclusion: </strong>The incidence of hospitalisation for CLTI appears to have been reduced, and medical care of patients with CLTI has improved prognosis. Nevertheless, there is still room for large improvements of secondary prevention care in patients with CLTI, particularly in those with DM.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251362729"},"PeriodicalIF":4.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970215","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":"Combined metformin and exenatide versus only metformin treatments in polycystic ovary syndrome with abdominal obesity and network pharmacology of gene expression: evidence from a randomized clinical trial.","authors":"Ding Xuesong, Tao Tao, Wang Weilu, Xiong Wei, Xue Wei, Deng Yan, Wang Yanfang, Ma Ruilin, Guo Yingying, Wang Yue, Faustino R Pérez-López, Wang Yang","doi":"10.1177/20420188251355411","DOIUrl":"10.1177/20420188251355411","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate (1) the metabolic and endocrine effects of metformin combined with exenatide versus only metformin treatments in patients with polycystic ovary syndrome (PCOS) and abdominal obesity (AO) and (2) to determine the molecular mechanisms by which the combined treatment acts on PCOS patients.</p><p><strong>Design: </strong>Randomized controlled trial of PCOS patients with AO to receive combined treatment with metformin-exenatide or metformin alone, and network pharmacology of gene expression in PCOS patients under the combined exposure.</p><p><strong>Setting: </strong>Tertiary teaching hospital.</p><p><strong>Patients: </strong>Women with PCOS and AO who fulfilled the Rotterdam Criteria under combined treatment with daily cyclical ethinylestradiol (35 μg/day) and cyproterone acetate (2 mg/day).</p><p><strong>Intervention: </strong>Patients were randomized to either combined oral metformin (1500 mg/day) and exenatide (2 mg weekly subcutaneous injection, <i>n</i> = 35 women) treatment or metformin alone (<i>n</i> = 31 women) for 12 weeks. Network pharmacological prediction of gene expression under the combined exposure was studied.</p><p><strong>Main outcome measures: </strong>(1) Basal and after both treatments anthropometric, endocrine, and metabolic changes were compared. (2) Network pharmacological prediction and gene expression were studied in patients under metformin-exenatide treatment. Venn diagram and Markov Cluster Algorithm diagram of core targets for AO were applied to identify key targets.</p><p><strong>Results: </strong>Both treatments displayed (1) reductions of total testosterone, insulin, and lipoprotein levels and (2) increases of high-density lipoprotein cholesterol and apolipoprotein A1. We identified PCOS, AO, and comorbid genes further intersected with 269 combination therapy genes. Network pharmacology identified 154 key PCOS genes for drug regulation, including 29 closely related to AO and metabolism.</p><p><strong>Conclusion: </strong>Both treatments improved glucose and lipid metabolism, weakening insulin resistance and improving some biochemical indexes. Network pharmacology identified genes related to AO and metabolism in patients with PCOS under the metformin-exenatide treatment.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04029272.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251355411"},"PeriodicalIF":4.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970212","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 database study of the safety and effectiveness of daily growth hormone in treating more than 80,000 children with growth disorders worldwide: a plain language summary of publication.","authors":"Mohamad Maghnie, Michael B Ranke, Mitchell E Geffner, Elpis Vlachopapadopoulou, Lourdes Ibáñez, Martin Carlsson, Wayne Cutfield, Raoul Rooman, Roy Gomez, Michael P Wajnrajch, Agnès Linglart, Renata Stawerska, Peter E Clayton, Feyza Darendeliler, Anita C S Hokken-Koelega, Reiko Horikawa, Toshiaki Tanaka, Helmuth-Günther Dörr, Michel Polak, Adda Grimberg","doi":"10.1177/20420188251345556","DOIUrl":"10.1177/20420188251345556","url":null,"abstract":"<p><p>Researchers looked at data from the largest and longest-running database of children with growth disorders who were treated with daily injections of a brand of growth <b>hormone</b> called <b>Genotropin</b>. The researchers used these data to better understand the safety and effectiveness of daily growth <b>hormone</b> treatment. Researchers showed that daily growth <b>hormone</b> treatment: ○ Increased the children's heights, measured after 1 year of treatment. This was seen for all of the growth disorders studied. ○ Increased growth in children of different ages, with higher growth seen in children who had begun treatment before they started puberty. ○ Allowed short children to reach an adult height within the normal range. This was true even for children who did not begin treatment until early adolescence. ○ Was safe. Only a very small percentage (3%) of children had any side effects related to growth <b>hormone</b> treatment, the most common of which was headaches. When children reach the end of puberty, their growth plates close and they are unable to grow any taller. Once this happens, growth <b>hormone</b> treatment cannot increase their growth further and treatment should be stopped. The purpose of this plain language summary is to help you to understand the findings from recent research. <b>Somatropin</b> is used to treat the conditions under study that are discussed in this summary. Approval varies by country; please check with your local healthcare provider for more details.The results of this study may differ from those of other studies. Health professionals should make treatment decisions based on all available evidence and not on the results of a single study.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251345556"},"PeriodicalIF":4.6,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883779","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":"Global epidemiology and burden of type 2 diabetes in adults aged 55 and older: insights from 1990 to 2021.","authors":"Xiao Yu, Chengxia Kan, Kexin Zhang, Xiaofei Zhang, Jiayi Ren, Jinyan Chen, Yuqun Wang, Yang Zhang, Guangdong Zhang, Xiaodong Sun","doi":"10.1177/20420188251362011","DOIUrl":"10.1177/20420188251362011","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) poses a growing global health challenge, particularly among individuals aged 55 years and above, placing significant pressure on healthcare systems.</p><p><strong>Objectives: </strong>This study aims to assess long-term trends in T2DM burden and its risk factors in this demographic from 1990 to 2021.</p><p><strong>Design: </strong>We conducted a retrospective analysis of T2DM based on the latest 2021 Global Burden of Disease (GBD) database.</p><p><strong>Methods: </strong>Utilizing data from the 2021 GBD Study, we analyzed T2DM incidence, prevalence, and disability-adjusted life years (DALYs) among individuals aged ⩾55 years, stratified by sex and age group. An autoregressive integrated moving average model was applied to forecast trends for 2022-2036.</p><p><strong>Results: </strong>In 2021, there were 9,179,347 (95% uncertainty interval (UI), 7,905,452-10,626,325) T2DM cases among those aged 55 years and above. From 1990 to 2021, global incidence increased from 409.06 (95% UI, 349.86-477.48) to 617.73 (95% UI, 532.00-715.10) per 100,000 population; diabetes-related mortality rose from 81.55 (95% UI, 76.57-85.44) to 96.19 (95% UI, 88.62-102.11) per 100,000, and DALYs climbed from 2562.71 (95% UI, 2293.81-2926.77) to 3552.41 (95% UI, 3041.94-4200.97) per 100,000. The highest mortality increase was in low-middle sociodemographic index (SDI) regions, while high SDI regions saw declines. Eastern Europe reported the highest incidence rate among 21 regions, at 1218.43 per 100,000 (95% UI, 1083.02-1370.82). Environmental, occupational, and behavioral risks were major contributors to diabetes-related mortality in this age group. Projections estimate T2DM cases will rise from 9.3 million in 2022 to 12.3 million by 2036.</p><p><strong>Conclusion: </strong>The global burden of diabetes in adults aged ⩾55 years has risen substantially from 1990 to 2021. As the population continues to age, urgent action is needed to address this growing disease burden.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251362011"},"PeriodicalIF":4.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822603","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":"The missing piece in post-transplant bone health: tertiary hyperparathyroidism management.","authors":"Burçak Cavnar Helvacı, Özant Helvacı","doi":"10.1177/20420188251359790","DOIUrl":"10.1177/20420188251359790","url":null,"abstract":"","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251359790"},"PeriodicalIF":3.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675629","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":"Effective blood glucose control in Chinese children with type 1 diabetes via a do-it-yourself artificial pancreas system: a single-center study.","authors":"Lihong Yang, Fei Xie, Linqi Han, Fengyan You, Zhiqiang Wei, Caihong Liu, Chao Xu, Yan Sun","doi":"10.1177/20420188251347028","DOIUrl":"10.1177/20420188251347028","url":null,"abstract":"<p><strong>Background/purpose: </strong>The artificial pancreas system is among the most advanced devices for blood glucose management and is known to improve patients' glycated hemoglobin levels and time spent within the target glucose range. However, the use of an artificial pancreas in children with type 1 diabetes (T1D) in China has not yet been reported.</p><p><strong>Methods: </strong>A retrospective study was conducted involving patients diagnosed with T1D who used a do-it-yourself artificial pancreas system (DIYAPS). The main inclusion criteria were as follows: T1D diagnosis, age between 3 and 18 years, usage of an insulin pump, and continuous glucose monitoring records for at least 3 months. The exclusion criterion was any comorbid conditions that could interfere with the study. The primary outcomes measured were changes in hemoglobin A1c (HbA1c) and time in range (TIR) before and after the DIYAPS was used.</p><p><strong>Results: </strong>A total of 41 people were included in the study, including 21 males and 20 females, with a mean age of 9.4 years (standard deviation: 2.9 years), a median duration of T1D of 1.5 years (1.1-2.3), and a median duration of insulin pump use of 1.1 years (0.8-1.7). Compared with the baseline period (pre-DIYAPS), after using a DIYAPS, the TIR increased from 72.4% (57.9-82.4) to 80.8% (73.6-87.5; <i>p</i> < 0.01), the TAR (>10 mmol/L) decreased from 16.0% (8.2-21.2) to 8.8% (5.2-14.4; <i>p</i> < 0.01), the fasting blood glucose decreased from 8.2 mmol/L (7.2-9.4) to 6.7 mmol/L (6.3-7.6; <i>p</i> < 0.01), and the HbA1c decreased from 6.6% (6.1-7.6) to 6.3% (5.9-6.9; <i>p</i> < 0.05). No diabetic ketoacidosis, severe hypoglycemia, or other adverse events occurred during the use of the DIYAPS.</p><p><strong>Conclusion: </strong>DIYAPS is safe and effective in Chinese children with T1D, particularly in improving TIR.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251347028"},"PeriodicalIF":3.9,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638165","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":"Effectiveness of open-source Android artificial pancreas systems for glucose management in patients with type 1 diabetes: a real-world study.","authors":"Qin Wang, Xianming Li, Wenhao Zhang, Hao Wang, Jie Tang, Yu Ding, Xueying Zheng, Sihui Luo","doi":"10.1177/20420188251350210","DOIUrl":"10.1177/20420188251350210","url":null,"abstract":"<p><strong>Background: </strong>Practice of Open-source Android artificial pancreas systems (AAPS) among Chinese patients is increasing, but data on their effectiveness is lacking.</p><p><strong>Objectives: </strong>This study evaluates the effectiveness of AAPS compared with sensor-augmented pump (SAP) therapy among people with type 1 diabetes (T1D) in China.</p><p><strong>Design: </strong>A real-world, case-control study.</p><p><strong>Methods: </strong>We conducted this study among patients with T1D who had used AAPS or SAP therapy for >3 months. Propensity score matching (1:1) based on onset age, duration, gender, and baseline tight glucose range (time in the tight glucose range (TITR) 70-140 mg/dL) was performed. Key glycemic outcomes were analyzed.</p><p><strong>Results: </strong>One hundred forty-two T1D people using AAPS and 142 matched people receiving SAP therapy were included (56.00% female). Age and duration of T1D were 26.40 (interquartile range (IQR) 11.30-34.70) and 3.20 (IQR 0.87-9.12) years, respectively. Baseline TITR and time in the target glucose range (TIR) of 70-180 mg/dL were 57.10 ± 18.30% and 79.30% (IQR 68.50-88.30), respectively. After 3 months, the AAPS group had better TITR (60.52 ± 14.57% vs 56.20 ± 17.22%, adjusted difference, 3.91%; <i>p</i> < 0.05) and TIR (79.12 ± 11.24% vs 77.37% (IQR 64.51-85.87), adjusted difference, 3.42%; <i>p</i> < 0.001) compared with the control group. In addition, time in hypoglycemia was shorter in the AAPS group than in the control group during the study (4.05% (IQR 2.52-6.78) vs 5.68% (IQR 2.69-10.11); adjusted difference, -1.17%; <i>p</i> < 0.05). Stratified analysis showed females, with a baseline glucose management indicator (GMI) < 7% and those aged over 18 years benefit more in the AAPS group. After adjusting for age, gender, duration of T1D, and baseline GMI, logistic regression analysis showed the AAPS group had a higher percentage of TITR improvement >5% than that in the control group (odds ratio = 1.73, 95% confidence interval (1.03, 2.92), <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>AAPS is associated with significant improvements in glycemic control, without increasing hypoglycemia, compared to SAP therapy.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251350210"},"PeriodicalIF":3.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529655","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":"The legacy effect of early HbA1c control on microvascular complications and hospital admissions in type 2 diabetes: findings from a large UK study.","authors":"Rami Aldafas, Yana Vinogradova, Thomas S J Crabtree, Jason Gordon, Iskandar Idris","doi":"10.1177/20420188251350897","DOIUrl":"10.1177/20420188251350897","url":null,"abstract":"<p><strong>Introduction: </strong>There is conflicting evidence regarding optimal glycaemic targets to reflect the legacy effect of hyperglycaemia in people with type 2 diabetes (T2D). We examined the risks of microvascular complications and hospital admission with glycated haemoglobin (HbA1c) levels from the diagnosis of T2D.</p><p><strong>Methods: </strong>We identified individuals with incident T2D from 1998 to 2007 from the Clinical Practice Research Datalink and Hospital Episode Statistics. A composite microvascular outcome was defined as a new diagnosis of neuropathy, nephropathy or retinopathy. A multivariate time-varying Cox regression analysis was performed to assess the risk of microvascular disease associated with HbA1c at five different levels (1.0% (11 mmol/mol) intervals). HbA1c 6.5%-7.5% (48.0-58.9 mmol/mol) was defined as the reference.</p><p><strong>Results: </strong><i>N</i> = 172,869 (mean age 62.6 ± 14.0 years, 54.6% female) were analysed. Average follow-up was 11.2 years. The risk of microvascular disease increased with higher HbA1c levels, the highest risk in the ⩾9.6% (⩾81 mmol/mol; hazard ratio (HR): 1.29, 95% confidence interval (CI): 1.11-1.51) and the lowest in the <6.5% (<48.0 mmol/mol; HR: 0.94, 95% CI: 0.83-1.08). The risk of hospital admission suggested a U-shaped association with HbA1c, highest risk in the lowest (<6.5% (<48.0 mmol/mol); HR: 1.04, 95% CI: 1.01-1.07) followed by HbA1c groups (8.6%-9.6% (70.0-81.0 mmol/mol); HR: 1.02, 95% CI: 0.97-1.08) while the lowest risk for hospital admission was observed for targets with the reference group (target between 6.5% and 7.5%, (48.0-58.9 mmol/mol)).</p><p><strong>Conclusion: </strong>The risk of microvascular complications was lowest when HbA1c levels were within the non-diabetic range and increased with higher HbA1c levels. The risk of hospital admission was significantly elevated in individuals with HbA1c levels below 6.5%, suggesting a potential U-shaped association, although the increased risk at higher HbA1c levels did not reach statistical significance. This highlights the importance of maintaining individualised HbA1c targets in the management of T2D from diagnosis to prevent these complications.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"16 ","pages":"20420188251350897"},"PeriodicalIF":3.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476775","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}