Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献

{"title":"The relevance of remnant cholesterol as a guide for lipid management in Indian subjects undergoing coronary revascularization.","authors":"Manish Bansal, Ravi R Kasliwal, Praveen Chandra, Rajneesh Kapoor, Nagendra Chouhan, Anil Bhan, Naresh Trehan","doi":"10.1016/j.dsx.2024.103183","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103183","url":null,"abstract":"<p><strong>Background: </strong>The atherogenic potential of remnant cholesterol, which refers to the cholesterol content of triglyceride-rich, non-low-density lipoprotein (LDL) particles in circulation, has gained increasing attention recently. Unfortunately, very limited information is available regarding remnant cholesterol levels in Indian subjects.</p><p><strong>Methods: </strong>This was a retrospective study conducted at a premier, tertiary care center in North India. A total of 3064 consecutive subjects [mean age 61.3 ± 10.3 years, 2550 (83.2%) men] with newly diagnosed coronary artery disease (CAD) undergoing coronary revascularization were included. Enzymatic assays were used for measuring various lipid parameters. Remnant cholesterol was calculated by subtracting LDL cholesterol (LDL-C) and high-density lipoprotein cholesterol from total cholesterol. A value >30 mg/dL was considered elevated.</p><p><strong>Results: </strong>The mean LDL-C was 79.1 ± 33.1 mg/dL with 46.4% of all subjects having LDL-C <70 mg/dL and only 16.9% having LDL-C <50 mg/dL. The median remnant cholesterol level was 17.0 mg/dL (interquartile range 12.0-24.0 mg/dL) with only 11.9% of subjects having values >30 mg/dL. Only 4.5% of the patients with LDL-C <70 mg/dL and 2.9% of those with LDL-C <50 mg/dL had elevated remnant cholesterol. These proportions were significantly greater in patients with serum triglycerides >200 mg/dL.</p><p><strong>Conclusion: </strong>Our study shows that in a North-Indian population with CAD, elevated remnant cholesterol was present in only a small proportion. The prevalence of elevated remnant cholesterol decreased further as the LDL-C control improved. These findings suggest that elevated remnant cholesterol may not be a clinically relevant therapeutic target in most patients with LDL-C below the currently recommended goals.</p>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 1","pages":"103183"},"PeriodicalIF":4.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of estimated glucose disposal rate for all-cause and cardiovascular mortality in the US non-diabetic population aged ≥60 years: A population-based cohort study.","authors":"Botao Zhu, Chenghui Cao, Wenwu Liu, Yuxuan Liu, Yonghong Luo, Daoquan Peng","doi":"10.1016/j.dsx.2024.103182","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103182","url":null,"abstract":"<p><strong>Aims: </strong>This study seeks to evaluate the prognostic significance of eGDR in predicting mortality outcomes within non-diabetic older adults.</p><p><strong>Methods: </strong>8131 non-diabetic participants aged ≥60 years from the National Health and Nutrition Examination Survey (2001-2018) was included in this study. eGDR was calculated as: eGDR (mg/kg/min) = 21.158 - [0.09 × waist circumference (cm)] - [3.407 × Hypertension (Yes = 1/No = 0)] - [0.551 × HbA1c (%)]. Weighted Cox proportional hazards models, cumulative hazard curves, restricted cubic spline (RCS), and threshold effects analyses were performed to explore the relationship between eGDR and mortality outcomes. Subgroup analyses and mediation effects analyses were conducted.</p><p><strong>Results: </strong>2566 all-cause deaths and 689 cardiovascular deaths were recorded. Lower eGDR was associated with higher all-cause (HR = 0.76, 95 % CI: 0.63-0.91) and cardiovascular mortality (HR = 0.56, 95 % CI: 0.40-0.80). Inflection points were identified through RCS curve analyses, and the threshold effect was significant. The eGDR-mortality association remained consistent across subgroups. Mediation analyses showed that neutrophil to high-density lipoprotein cholesterol ratio mediated the association.</p><p><strong>Conclusions: </strong>Lower eGDR levels are linked to higher risk of both all-cause and cardiovascular mortality in non-diabetic older adults, suggesting its potential utility for risk assessment among this population.</p>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 1","pages":"103182"},"PeriodicalIF":4.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the disproportionate risk factor landscape of global type 2 diabetes burden in adults: An attribution analysis from 1990 to 2050.","authors":"Yue Huang, Jingxuan Wang, Lan Xu, Nannan Feng, Xihao Du, Meng Chen, Yiyuan Li, Guangrui Yang, Hui Wang, Victor W Zhong","doi":"10.1016/j.dsx.2024.103181","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103181","url":null,"abstract":"<p><strong>Introduction: </strong>Limited systematic assessments of risk factor contributions to the global burden of type 2 diabetes (T2D) across subpopulations hinder targeted policies and resource allocation.</p><p><strong>Materials and methods: </strong>Utilizing the Global Burden of Disease study (GBD) 2019, we analyzed the disability-adjusted life-years (DALYs) for T2D attributable to 15 risk factors in adults (aged 25+ years) globally and by sex, age, Socio-demographic Index (SDI), and GBD region, from 1990 to 2019. Additionally, we assessed future trends of these risk factors through 2050.</p><p><strong>Results: </strong>High body-mass index (BMI) emerged as the predominant risk factor in all subpopulations in 2019, with its impact projected to double by 2050. During 1990-2019, males were more affected by smoking, while females by secondhand smoke and household air pollution. The related DALYs increased with age, except for high BMI and smoking peaking at 60-74 years. In 2019, diet high in processed meat ranked second in high SDI regions, contrasting with household air pollution in low SDI regions. National disparities were observed, with Fiji recording the highest rates of DALYs related to both high BMI and dietary risks in 2019, which were approximately 50 and 15 times higher than those observed in Japan, respectively.</p><p><strong>Conclusions: </strong>Tailored interventions targeting major contributing risk factors specific to each subpopulation are key to the success of the global combat against T2D.</p>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 1","pages":"103181"},"PeriodicalIF":4.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of prune products consumption on anthropometric measurements and blood pressure in adults: A systematic review and dose-response meta-analysis.","authors":"Azadeh Heydarian, Shima Moradi, Omid Asbaghi, Negin Tahvilian, Sahar Cheshmeh, Maryam Nadery, Naheed Aryaeian","doi":"10.1016/j.dsx.2024.103173","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103173","url":null,"abstract":"<p><strong>Introduction: </strong>The positive impact of prunes on body measurements and blood pressure has been suggested in previous research.</p><p><strong>Purpose: </strong>The purpose of this extensive meta-analysis and systematic review was to examine the effects of adult consumption of prunes on anthropometric parameters and blood pressure.</p><p><strong>Methods: </strong>To identify relevant randomized controlled trials (RCTs) (till August 9th, 2024), databases from ISI Web of Science, Scopus, and PubMed/Medline were searched. The current systematic review and meta-analysis covered 14 studies that met the eligibility requirements. The weighted mean difference was used to compute the effect size. The Cochrane Q test and I2 index were used to measure study heterogeneity. The random effects model was utilized to get the overall effect magnitude.</p><p><strong>Results: </strong>The meta-findings analysis's showed that eating prunes had no appreciable effects on, body mass index (BMI) (p = 0.267), waist circumference (WC) (p = 0.562), fat mass (FM) (p = 0.840), systolic blood pressure (SBP) (p = 0.338), or diastolic blood pressure (DBP) (p = 0.233). However, we observed significantly reduction in body weight (p < 0.001) after prunes consumption.</p><p><strong>Conclusion: </strong>Our findings showed that the consumption of prune leads to a significant reduction in body weight, but the results indicated non-significant effects on blood pressure, BMI, WC and FM.</p>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 1","pages":"103173"},"PeriodicalIF":4.3,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placenta-derived biomaterials vs. standard care in chronic diabetic foot ulcer healing: A systematic review and meta-analysis.","authors":"Maria Ruiz-Muñoz, Francisco-Javier Martinez-Barrios, Eva Lopezosa-Reca","doi":"10.1016/j.dsx.2024.103170","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103170","url":null,"abstract":"<p><strong>Introduction: </strong>This study explored the effectiveness of current placenta-derived biomaterials therapies in ulcer healing in DFU compared to standard of care (SOC).</p><p><strong>Methods: </strong>The systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. The electronic databases of PubMed, EMBASE, and Web of Science (WoS) internet were searched for the outcome rate of complete ulcer healing. The risk of bias assessment was conducted using the tool recommended by the Cochrane Collaboration. Statistical analysis included the individual and combined result of the studies, heterogeneity test, the effect size, sensitivity analysis, and publication bias tests.</p><p><strong>Results: </strong>Twelve randomized controlled trials (RCTs) with a total of 833 patients were included in this study. This meta-analysis showed a higher rate of complete ulcer healing in groups receiving placenta-derived biomaterials therapies (OR = 6.247 [4.425, 8.819], p < 0.01, I² = 41 %) compared to control groups.</p><p><strong>Conclusion: </strong>Placenta-derived biomaterials therapies have been shown to be more effective for achieving complete ulcer healing compared to current conventional treatments in DFU.</p><p><strong>Implications for clinical practice: </strong>The utilization of placenta-derived biomaterials in therapies for wound healing, particularly in chronic DFU, presents promising implications for clinical practice. These biomaterials offer a rich source of growth factors, cytokines, and extracellular matrix components, which can stimulate tissue regeneration and angiogenesis. Incorporating such therapies into clinical practice holds the potential to accelerate wound closure, reduce infection rates, and improve overall healing outcomes in people with diabetic chronic foot ulcers. Furthermore, the availability of these biomaterials can offer clinicians a readily-accessible and cost-effective alternative to traditional wound care approaches, ultimately enhancing patient care and quality of life. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 1","pages":"103170"},"PeriodicalIF":4.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An upward trend of dyslipidemia among adult population in Vietnam: Evidence from a systematic review and meta-analysis.","authors":"Anh Kim Dang, Linh Thao Thi Le, Ngoc Minh Pham, Dung Quang Nguyen, Ha Thu Thi Nguyen, Son Cong Dang, Anh Tuan Le Nguyen, Huong Thi Le, Abdullah A Mamun, Dung Phung, Phong K Thai","doi":"10.1016/j.dsx.2024.103171","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103171","url":null,"abstract":"<p><strong>Introduction: </strong>It is critical to assess the progress toward achieving the national goal of reducing premature mortality from non-communicable diseases (NCDs) by one-third by 2030 in Vietnam. This study aimed to examine the pooled prevalence of dyslipidemia among the Vietnamese adult population.</p><p><strong>Method: </strong>Five databases, PubMed, Web of Science, Embase, CINAHL, Google Scholar, and local peer-reviewed journals were searched from inception to May 2024 without language restrictions. Pooled percentages of all dyslipidemia indicators were derived by random-effect model meta-analysis. We also estimated the pooled crude odds ratio and confidence interval (CI) for factors associated with dyslipidemia and calculated Hedges's g standardized mean for each dyslipidemia component.</p><p><strong>Results: </strong>Sixty-nine studies were identified as relevant for systematic review, with 41 studies included in the meta-analysis. The overall prevalence of having at least one component of dyslipidemia was 49 % (95%CI = 38%-60 %), and figures for high total cholesterol, elevated triglycerides, increased low-density lipoprotein-cholesterol and low high-density lipoprotein-cholesterol were 31 % (95%CI = 25 %; 37 %), 38 % (95%CI = 31 %; 44 %), 21 % (95%CI = 12 %; 32 %), 23 % (95%CI = 16 %; 30 %), respectively. The pooled percentage of overall dyslipidemia was higher in males, in the Southeast region and in studies reported in Vietnamese than those in English. Having diabetes, hypertension, abdominal obesity and overweight/obesity were significantly positively associated with dyslipidemia.</p><p><strong>Conclusion: </strong>The prevalence of dyslipidemia was substantially high and increased in the Vietnamese adult population. Findings from this up-to-date review reinforce the necessity of effective implementation of NCDs prevention to achieve the national goal.</p>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 1","pages":"103171"},"PeriodicalIF":4.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising trends of diabetes in South Asia: A systematic review and meta-analysis","authors":"Priyanga Ranasinghe ,&nbsp;Nethmini Rathnayake ,&nbsp;Sameera Wijayawardhana ,&nbsp;Hajanthy Jeyapragasam ,&nbsp;V. Jithmal Meegoda ,&nbsp;Ranil Jayawardena ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2024.103160","DOIUrl":"10.1016/j.dsx.2024.103160","url":null,"abstract":"<div><h3>Background</h3><div>South Asians are known for their increased predisposition for type 2 diabetes (T2D). We describe the most recent prevalence and trends of diabetes, prediabetes, and undiagnosed diabetes in South Asia based on surveys conducted from 2000 to 2024.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Web of Science and Scopus databases for population-based studies describing diabetes/prediabetes prevalence. Including STEPS surveys, 7261 records were screened for eligibility, of which 89 were included in this analysis. Prevalences and trends of diabetes, undiagnosed diabetes and prediabetes were analysed by country, making male/female and urban/rural comparisons.</div></div><div><h3>Results</h3><div>Prevalence of diabetes in South Asia has increased from 11.29 % in 2000–2004 to 22.30 % in 2020–2024. Sri Lanka and Pakistan have demonstrated a steep rise in diabetes over the two decades. India and Bangladesh, have also shown a rise in prevalence from 2.5 % (2015–16) to 8.1 % (2019–21) and 5.5 % (2006) to 8.3 % (2018), respectively. Diabetes prevalence among males was higher. Urban prevalence was higher than rural throughout the region, with both sectors showing a rising trend. Prediabetes followed a similar pattern. Despite the high burden, a large proportion remained undiagnosed, being as high as 17.5 % in Delhi, India (2010–11).</div></div><div><h3>Conclusion</h3><div>Pooled prevalences show a rising burden of diabetes over the past decade, with a considerable proportion being undiagnosed, in South Asia. Urban prevalence is higher than rural prevalence throughout the region. Prediabetes also shows a similar rising trend, with a notable proportion o being undiagnosed, alerting the need for coordinated efforts for early diagnosis, and prevention.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103160"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating role of the food environment, greenspace, and walkability in the association between socioeconomic position and type 2 diabetes - The Maastricht Study.","authors":"Jeroen D Albers, Annemarie Koster, Bengisu Sezer, Rachelle Meisters, Miranda T Schram, Simone J P M Eussen, Nicole H T M Dukers, Maria W J Jansen, Coen D A Stehouwer, Jeroen Lakerveld, Hans Bosma","doi":"10.1016/j.dsx.2024.103155","DOIUrl":"10.1016/j.dsx.2024.103155","url":null,"abstract":"<p><strong>Aims: </strong>This study investigates the interplay between socioeconomic position (SEP), the residential food environment, walkability, greenspace, and type 2 diabetes (T2D), particularly whether the environmental factors mediate the association between SEP and T2D.</p><p><strong>Methods: </strong>SEP, T2D status, residential Food Environment Healthiness Index (FEHI), number of fast-food outlets (FF), walkability index (WI), and proportion of greenspace (GS) were ascertained in 9188 participants. The associations between SEP, the environment and T2D were modeled with logistic regression and survival analysis. The proportion of mediation of the association between SEP and T2D was estimated with causal mediation analysis.</p><p><strong>Results: </strong>Lower SEP was associated with higher risk of T2D. Hazard ratios (HR) were 2.03 (95 % CI 1.60-2.58), 1.79 (1.40-2.30) and 1.77 (1.21-2.58) for an interquartile range decrease (IQR) of education, income, and occupation, respectively. HRs for IQR changes of the environmental factors were: FEHI 1.20 (1.00-1.43), FF 0.87 (0.76-0.99), WI 1.23 (0.95-1.58) and GS 1.16 (0.96-1.43). Regression on prevalent T2D yielded similar results. Lower socioeconomic position was associated with a less healthy environment (e.g., FEHI -0.10 (-0.12--0.07) for education). Environmental exposures mediated between 0.1 % (-0.7-0.9) and 2.6 % (0.4-5.2) of the cross-sectional associations and 0.3 % (-8.6-8.6) and 8.5 % (2.3-27.4) of the longitudinal associations.</p><p><strong>Conclusions: </strong>People with lower SEP had higher risk and prevalence of T2D and lived in a slightly less healthy residential environment. The association between SEP and T2D is not strongly mediated by FEHI, FF, WI, or GS.</p>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11-12","pages":"103155"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifying the timing of breakfast improves postprandial glycaemia in people with type 2 diabetes: A randomised controlled trial","authors":"Ana Paula Bravo-Garcia,&nbsp;Anjana J. Reddy,&nbsp;Bridget E. Radford,&nbsp;John A. Hawley,&nbsp;Evelyn B. Parr","doi":"10.1016/j.dsx.2024.103157","DOIUrl":"10.1016/j.dsx.2024.103157","url":null,"abstract":"<div><h3>Aims</h3><div>Investigate the effects of breakfast timing on postprandial glycaemia in adults with type 2 diabetes (T2D), and the impact of a 20-min walk after breakfast.</div></div><div><h3>Methods</h3><div>Eleven adults with T2D (57 ± 7 y; HbA1c 7.4 ± 1%) participated in a six-week randomised crossover controlled trial comprising three 4-day conditions: Early (0700 h), Mid (0930 h) and Delayed (1200 h). After each condition, a second 4-day intervention of 20-min walk after each condition was undertaken. Standardised breakfast was provided. Interstitial glucose and physical activity were measured. Incremental area under the curve (iAUC) 2-h post-breakfast, 24-h iAUC, and fasting glucose were analysed with linear mixed-effects models. Cohen's d of the 2-h iAUC post-breakfast 20-min walk was calculated.</div></div><div><h3>Results</h3><div>Mid and Delayed had lower 2-h post-breakfast iAUC (p &lt; 0.002, −57 mmol/L×2h; p &lt; 0.02, −41 mmol/L×2h) compared to Early. There were no differences in fasting (0600 h) glucose or 24-h iAUC. There was a small effect of the 20-min walk on lowering 2-h post-breakfast iAUC for Early (d = 0.35) and Delayed (d = 0.37), with no effect in Mid.</div></div><div><h3>Conclusion</h3><div>In people with T2D, delaying breakfast from 0700 h to mid-morning or midday reduced postprandial glycaemia. Additional post-meal walking for 20 min had a small effect in lowering postprandial glycaemia when breakfast was at 0700 h or midday, but provided no additional benefit when breakfast was at mid-morning.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103157"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning algorithms mimicking specialists decision making on initial treatment for people with type 2 diabetes mellitus in Japan diabetes data management study (JDDM76).","authors":"Jenny Elizabeth Price, Kazuya Fujihara, Satoru Kodama, Katsuya Yamazaki, Hiroshi Maegawa, Tatsuya Yamazaki, Hirohito Sone","doi":"10.1016/j.dsx.2024.103168","DOIUrl":"10.1016/j.dsx.2024.103168","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether typical machine learning models that mimic specialists' care can successfully reproduce information, not only on whether to prescribe medications but also which hypoglycemic agents to prescribe as initial treatment for type 2 diabetes.</p><p><strong>Research design and methods: </strong>A medical records database containing prescriptions for medications for 16,005 patients who visited a diabetologist's office for the first time was utilized to train five typical machine learning models as well-as a model used for logistic analysis. Prescribed were no medications (diet and exercise therapy), insulin, biguanides (BG), sulfonylureas (SU), dipeptidyl peptidase-4 inhibitors (DPP-4I), alpha-glucosidase inhibitors (α-GI) or glinides. Models were compared based on the F1 score and ROC/AUC scores.</p><p><strong>Results: </strong>XGBoost, which splits decision-making into three sections, was the top performing model (42 % accuracy) among five models and conventional logistic regression (35 % accuracy). The second highest scoring model was Support Vector Machines, which had an accuracy of 40 %. When using XGBoost to compare decisions on no medication needed vs. needing medication the AUC was 0.96. Insulin vs. oral medications had an AUC of 0.78. With all remaining oral medications removed, the AUC was 0.76.</p><p><strong>Conclusions: </strong>Among the five models investigated, XGBoost outperformed the other machine learning models examined as well as the traditional logistic model, suggesting that its accuracy had the potential to assist non-specialists in decision-making regarding treatment of patients with type 2 diabetes in the future.</p>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11-12","pages":"103168"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}