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

{"title":"Population-based diagnostic prediction scores to identify undiagnosed type 2 diabetes mellitus in low- and middle-income countries in South and East Asia and the Pacific: A systematic Review and meta-analysis","authors":"Fadila Wirawan,&nbsp;Areej Almutairi,&nbsp;Regina Prigge,&nbsp;Sarah Wild","doi":"10.1016/j.dsx.2026.103483","DOIUrl":"10.1016/j.dsx.2026.103483","url":null,"abstract":"<div><h3>Introduction</h3><div>Undiagnosed diabetes prevalence is high in low- and middle-income countries (LMICs) in South Asia, East Asia &amp; Pacific (SAEA&amp;P). Non-invasive scores may be helpful for population screening to identify people for blood glucose testing.</div></div><div><h3>Aims</h3><div>To assess population-based diagnostic prediction scores’ performance to identify undiagnosed type 2 diabetes mellitus (T2D) in adults in SAEA&amp;P LMICs.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, OVID, and Cochrane Library in July 2025, followed by hand searches. We included studies that developed or validated T2D diagnostic prediction scores in adult general populations without known T2D from LMICs in SAEA&amp;P. A bivariate diagnostic accuracy meta-analysis was performed for scores with multiple validations across different countries in studies without a high risk of bias. Discriminative performance was measured based on the Area Under Curve (AUC). This review was registered with PROSPERO (CRD42024584501).</div></div><div><h3>Results</h3><div>We identified 9651 articles and assessed 85 full-text articles for eligibility. Thirty articles were included in the review: eleven that developed and 19 that validated population-based T2D diagnostic prediction scores across eight countries. The meta-analyses of Finnish Diabetes Risk Score (FINDRISC) variations and of the Indian risk score show fair pooled discriminative performance for both scores (AUC = 0.735 and AUC = 0.704, respectively). Scores adapted from those developed in Europe had higher specificity but lower sensitivity than those developed in SAEA&amp;P. No articles were considered to have a low risk of bias.</div></div><div><h3>Conclusions</h3><div>Some T2D diagnostic prediction scores could be useful in SAEA&amp;P LMICs; however, robust external validation in local settings is required before implementation.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 9","pages":"Article 103483"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072138","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":"Evaluation of a local healthy moderate carbohydrate (LHMC) diet and structured exercise for diabetes remission in early type 2 diabetes mellitus: A nutrition intervention study from India","authors":"Mayura Choudhari Kale,&nbsp;Vedavati Bharat Purandare,&nbsp;Shalbha Tiwari,&nbsp;Jaya Aherkar,&nbsp;Gayatri Kulkarni,&nbsp;Shital Manekar,&nbsp;A.G. Unnikrishnan","doi":"10.1016/j.dsx.2026.103487","DOIUrl":"10.1016/j.dsx.2026.103487","url":null,"abstract":"<div><h3>Background</h3><div>Lifestyle interventions can promote type 2 diabetes mellitus (T2D) remission, but prospective evidence on culturally adapted Indian Local Healthy Moderate Carbohydrate (LHMC) diets are limited.</div></div><div><h3>Objective</h3><div>To assess remission and metabolic changes associated with a tailored LHMC diet combined with structured physical activity in adults with early T2D.</div></div><div><h3>Methods</h3><div>This prospective, single-arm interventional study included adults with T2D duration ≤2 years from two centres in Maharashtra, India (n = 87). The 6-month intervention comprised a culturally adapted, LHMC diet and daily structured exercise. Glucose-lowering medications were discontinued at intervention initiation. The primary endpoint was diabetes remission, defined as HbA1c of &lt;6.5% measured at least 3 months after stopping glucose lowering medications. Secondary outcomes included anthropometry, biochemical and continuous glucose monitoring (CGM) measures; diet and exercise adherence were monitored.</div></div><div><h3>Results</h3><div>Seventy-five participants completed the 6-months intervention, with an estimated remission rate of 60.9% under the missing-at-random assumption. Clinically meaningful improvements were observed in weight, waist circumference, HbA1c, and lipid profile. Higher exercise adherence was independently associated with remission, in the context of baseline reduction of approximately 500 kcal/day. CGM metrics were more favourable in the remission group.</div></div><div><h3>Conclusion</h3><div>In this single-arm cohort of adults with early T2D, a culturally tailored LHMC diet combined with consistent exercise was associated with a 60.9% remission rate and improvements in metabolic parameters. The absence of a comparator limits causal inference; therefore, findings are hypothesis-generating and warrant confirmation in controlled studies. The results support the potential of scalable, region-specific lifestyle interventions in routine care.</div></div><div><h3>Clinical trial registry number and website</h3><div>This study is registered with Clinical Trial Registry of India. (CTRI Reg. Date 18/08/2023 CTRI Reg. No. CTRI/2023/08/056,621).</div></div><div><h3>Statement of novelty</h3><div>This work is the first to demonstrate more than 60% diabetes remission rates in recent-onset T2D using a culturally tailored, moderate calorie (around 1200 kcals) moderate-carbohydrate Indian diet and a simple, scalable walking-based regimen, rather than very low-calorie or highly restrictive diets that dominate existing remission trials. It is also novel in prospectively evaluating exercise adherence alongside CGM-derived metrics as practical, significantly associated predictors of remission in a real-world setting, despite not being prespecified.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 9","pages":"Article 103487"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187545","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":"Trends in type 2 diabetes burden in rapidly aging East Asian populations: Age-period-cohort analysis of disability-adjusted life years, 1994–2023","authors":"Hsiao-Mei Tsao,&nbsp;Cheng-Yi Wang,&nbsp;Li-Ying Huang,&nbsp;Wei-Lun Liu,&nbsp;Chun-Hou Liao","doi":"10.1016/j.dsx.2026.103470","DOIUrl":"10.1016/j.dsx.2026.103470","url":null,"abstract":"<div><h3>Aims</h3><div>Despite the rising type 2 diabetes (T2D) burden in rapidly aging populations, the contributions of age, period, and cohort effects remain unclear. We aimed to quantify the contributions of age-period-cohort modeling to T2D-related disability-adjusted life years (DALYs) in rapidly aging East Asian societies to interpret trends in T2D burden and inform public health efforts.</div></div><div><h3>Methods</h3><div>Age- and sex-specific DALYs and population data for Japan, South Korea, and Taiwan (1994–2023) were extracted from the Global Burden of Disease Study 2023. Adults aged 20–79 years were grouped into five-year intervals, and age-period-cohort (APC) models were fitted to separate age, period, and cohort effects.</div></div><div><h3>Results</h3><div>T2D-related DALY rates declined significantly across all three societies, with South Korea showing the steepest decline and Japan the smallest. Period effects indicated consistent declines in South Korea and gradual reductions in Taiwan and Japan since 2009. Cohort patterns diverged: steady gains in South Korea, modest improvements in Japan among those born after 1960, and a plateau in Taiwan, where DALY rates showed no improvement among adults younger than 40 years.</div></div><div><h3>Conclusions</h3><div>Declines in South Korea and Taiwan occurred alongside universal health coverage, which may have strengthened secondary prevention. Taiwan's stalled cohort improvements before age 40 suggest that gaps in primary prevention, alongside rising obesity prevalence and other lifestyle factors, may have constrained gains among younger generations. Sustained T2D burden reduction in aging societies will likely require effective secondary prevention and population-level primary prevention.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 8","pages":"Article 103470"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698972","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":"Effectiveness of education on carbohydrate counting (intervention) on HbA1c, cardio-metabolic profile and KAP (knowledge, attitude & practice) parameters among adults with type 1 diabetes","authors":"Lovely Gupta,&nbsp;Priti Rishi Lal,&nbsp;Yashdeep Gupta,&nbsp;Kalaivani Mani,&nbsp;Alpesh Goyal,&nbsp;Hem Chandra Sati,&nbsp;Veenu Seth,&nbsp;Nikhil Tandon","doi":"10.1016/j.dsx.2026.103484","DOIUrl":"10.1016/j.dsx.2026.103484","url":null,"abstract":"<div><h3>Aims</h3><div>Education pertaining carbohydrate counting can improve glycemic control but evidence on its effectiveness from South Asia is limited. This study evaluated the effectiveness of education on carbohydrate counting (intervention) in addition to usual care on key parameters of diabetes management among adults with type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>This single-centre, open-label, two-arm, parallel randomized controlled trial (RCT) enrolled 134 individuals with T1D between 18 and 40 years of age and with HbA1c of ≥7.5% at baseline. Participants were randomized in a 1:1 ratio to the Enhanced Usual Care (EUC) group (control arm) or Enhanced Usual Care focused on carbohydrate counting (EUC-CC) group (intervention arm). The primary outcome was the difference in proportions of individuals between the two groups who achieved HbA1c reduction of ≥0.5% from baseline at 6 months.</div></div><div><h3>Results</h3><div>The participants had a mean (±SD) age of 25.3 (±5.7) years and HbA1c of 9.9 ± 1.8% (85 mmol/mol). A ≥0.5% reduction in HbA1c was observed in 75.8% of participants in the EUC-CC group compared to 60.9% in the EUC group (p = 0.081). EUC-CC group had additional HbA1c reduction [of 0.34 ± 0.27%; 95% CI (−0.87, 0.19), p = 0.210] compared to the EUC group. The participants in the EUC-CC group had a significantly greater increase in KAP scores by 5.3 ± 0.77 (4.01, 6.67), p &lt; 0.001.</div></div><div><h3>Conclusions</h3><div>In this randomized controlled trial, both the groups showed significant improvement in HbA1c, while structured carbohydrate counting education resulted in favorable glycemic trends with significant improvements in knowledge, attitude and practice scores, suggesting potential behavioral benefits.</div></div><div><h3>Trial registration number</h3><div>CTRI/2019/08/020793.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 8","pages":"Article 103484"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077348","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":"Household sharps injuries and unsafe injection practices among insulin-treated patients in eastern India","authors":"Anuradha Agarwal,&nbsp;Sandeep Jain","doi":"10.1016/j.dsx.2026.103480","DOIUrl":"10.1016/j.dsx.2026.103480","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 8","pages":"Article 103480"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877216","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":"Global, Regional and National burden of dementia attributable to metabolic dysregulation from 1990 to 2021, with projections of burden to 2050: An analysis of the global burden of disease study 2021","authors":"Kaichen Wang,&nbsp;Meijin Song,&nbsp;Jing Lu,&nbsp;Dongxu Li,&nbsp;Huijing Cui,&nbsp;Ying Zhang,&nbsp;Li Jiang,&nbsp;Tong Wu,&nbsp;Yibin Zhang,&nbsp;Hanying Xu,&nbsp;Qiaoying Li,&nbsp;Jian Wang,&nbsp;Hongmei Nan,&nbsp;Peng Xu","doi":"10.1016/j.dsx.2026.103486","DOIUrl":"10.1016/j.dsx.2026.103486","url":null,"abstract":"<div><h3>Background and aims</h3><div>We quantified dementia burden attributable to high fasting plasma glucose (FPG) and high body mass index (BMI), projected trends to 2050, and examined metabolic traits using Mendelian randomization (MR).</div></div><div><h3>Methods</h3><div>Global Burden of Disease (GBD) 2021 data from 204 countries and territories were analyzed by age, sex, and Socio-demographic Index. Future burden was projected using time-series and Bayesian age-period-cohort models. Two-sample MR used European-ancestry genetic summary data with inverse-variance weighted estimates and sensitivity analyses.</div></div><div><h3>Results</h3><div>Metabolic-attributable dementia burden increased, with a steeper rise for high BMI than high FPG. Genetically predicted hypertension was associated most clearly with vascular dementia (odds ratio 2.72, 95% confidence interval 1.66–4.45; P = 0.0001) and was supported by the weighted-median estimator. Genetically predicted high-density lipoprotein cholesterol (HDL-C) showed only a nominal association with Alzheimer disease (odds ratio 1.09, 95% confidence interval 1.00–1.19; P = 0.0459) that was not consistently supported across MR methods. Mediation analyses were not significant.</div></div><div><h3>Conclusions</h3><div>Metabolic-attributable dementia burden is increasing globally. High BMI was a prominent contributor in GBD analyses, whereas MR most strongly supported hypertension and vascular dementia. The HDL-C finding is exploratory, and MR does not directly validate the BMI or FPG burden estimates.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 8","pages":"Article 103486"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077424","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":"Prevalence, socio-demographic, and socio-economic factors associated with gestational diabetes in Australia: A population study","authors":"Tesfaye Regassa Feyissa,&nbsp;Vidanka Vasilevski,&nbsp;Ayele Geleto Bali,&nbsp;Linda Sweet","doi":"10.1016/j.dsx.2026.103485","DOIUrl":"10.1016/j.dsx.2026.103485","url":null,"abstract":"<div><h3>Aims</h3><div>To examine the prevalence of gestational diabetes mellitus and associated socio-demographic and socio-economic factors in Victoria, Australia.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from the Victorian Perinatal Data Collection, a population-based dataset. The analysis included all women who gave birth in Victoria in 2020, excluding those with pre-existing diabetes. Associations between socio-demographic, obstetric, and area-level factors and gestational diabetes mellitus were assessed using mixed-effects Poisson regression to estimate relative risks with 95% confidence intervals.</div></div><div><h3>Results</h3><div>Overall, 18% of women who gave birth in Victoria in 2020 reported being diagnosed with gestational diabetes mellitus. Higher prevalence was reported in the most disadvantaged areas compared with the most advantaged areas. About of 19% of gestational diabetes mellitus cases were diagnosed before 20 weeks of gestation. Women in the least disadvantaged areas had a significantly lower risk compared to those in the most disadvantaged areas (adjusted prevalence ratio (aPR) 0.62, 95% CI 0.57–0.67). Compared with women &gt;35 years, younger women had lower gestational diabetes mellitus prevalence ratio: ≤20 (aPR 0.32, 95% CI 0.26–0.4), 21–25 (0.48, 0.45–0.52), 26–30 (0.61, 0.58–0.64), and 31–35 (0.77, 0.74–0.8). Grand multigravida women had a higher prevalence ratio than primigravida women (aPR 1.14, 95% CI 1.07–1.22). Spatial analysis identified gestational diabetes mellitus hotspots in south-eastern Melbourne and western Victoria.</div></div><div><h3>Conclusions</h3><div>Gestational diabetes mellitus prevalence in Victoria shows geographic and area level disparities, highlighting the need for targeted public health interventions.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 8","pages":"Article 103485"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149051361","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":"Feto-maternal safety of statins in pregnancy: An updated systematic review and meta-analysis","authors":"Deep Dutta,&nbsp;Kunal Mahajan,&nbsp;Sweekruti Jena,&nbsp;A.B.M. Kamrul-Hasan,&nbsp;Meha Sharma,&nbsp;Saptarshi Bhattacharya","doi":"10.1016/j.dsx.2026.103472","DOIUrl":"10.1016/j.dsx.2026.103472","url":null,"abstract":"<div><h3>Background</h3><div>Statins were historically contraindicated in pregnancy over teratogenicity concerns, but accumulating human evidence prompted the FDA to remove the Category X designation in 2021. This updated systematic review and meta-analysis assessed the feto-maternal safety of statin use in pregnancy, incorporating data published since the last review in 2022.</div></div><div><h3>Methods</h3><div>Following Cochrane and PRISMA guidance (PROSPERO CRD420251139343), Cochrane, ISI Web of Science, PubMed, Scopus were searched through 31 August 2025. RCTs and controlled observational studies comparing statin-exposed and unexposed pregnancies were included. Cohort data were analyzed after propensity-score matching for confounders. The primary outcome was any congenital malformation; secondary outcomes included low birth weight (LBW), stillbirth, neonatal respiratory distress, Apgar score, NICU admission, organ-specific malformations, preterm birth, gestational diabetes, and cesarean delivery. Random-effects models generated pooled odds ratios (OR).</div></div><div><h3>Results</h3><div>Twenty-one studies (6 RCTs, 14 cohorts, 1 case-control) were analyzed, comprising 9016 exposed and 3,112,561 unexposed women. Statin-exposed women were older with higher rates of diabetes, hypertension, smoking, and cardiovascular disease. Statin exposure was not associated with congenital malformations (OR 1.05, 95%CI 0.92–1.21), including organ-specific anomalies, nor with stillbirth, neonatal respiratory distress, low Apgar, preterm birth, or gestational diabetes. LBW was increased in cohort studies and with non-pravastatin statins used for dyslipidaemia. Cesarean section appeared higher and NICU admission lower, but both lost significance on prediction interval.</div></div><div><h3>Conclusion</h3><div>Statin exposure in pregnancy was not associated with increased congenital malformation risk. Potential LBW and cesarean signals, largely confined to non-pravastatin use for dyslipidaemia, warrant individualized risk-benefit assessment rather than routine use.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 8","pages":"Article 103472"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148774021","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":"Methodological considerations on the meta-analysis of alpha-lipoic acid in diabetic neuropathy","authors":"Héctor Fuentes-Barría","doi":"10.1016/j.dsx.2026.103479","DOIUrl":"10.1016/j.dsx.2026.103479","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 8","pages":"Article 103479"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835930","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":"Music medicine for diabetes, hypertension, and perceived stress: An open labelled randomized control trial in Sri Lanka","authors":"Balapuwaduge Isuru Layan Madusanka Mendis,&nbsp;Palihaderu Arachchige Dineth Supasan Palihaderu,&nbsp;Panduka Karunanayake,&nbsp;Dilan Amila Satharasinghe,&nbsp;Iyanthimala Harshini Rajapakse,&nbsp;Jayasekara Mudiyanselage Krishanthi Jayarukshi Kumari Premarathne,&nbsp;Wajjakkara Kankanamlage Ruwin Rangeeth Dias,&nbsp;Avanti Sulochana Hapugalle,&nbsp;Wanasinghe Ranhettige Sasanka Anjalee Karunaratne,&nbsp;Agulugaha Gamage Yohan Nipuna Binendra,&nbsp;Upul Senarath,&nbsp;Swee Keong Yeap,&nbsp;Wan Yong Ho,&nbsp;Arosha Sampath Dissanayake","doi":"10.1016/j.dsx.2026.103481","DOIUrl":"10.1016/j.dsx.2026.103481","url":null,"abstract":"<div><h3>Background</h3><div>Chronic stress is a recognized risk factor for poor glycemic control in type 2 diabetes mellitus (T2DM). Music has shown promise as a low-cost intervention for stress reduction, but evidence in T2DM remains limited.</div></div><div><h3>Methods</h3><div>We conducted an open-label, parallel-arm randomized controlled trial among adults with T2DM attending the National Hospital of Sri Lanka, Colombo. Participants were randomized to customized music medicine with usual care (n = 172) or usual care alone (n = 177) and followed for 3 and 6 months. Primary outcomes were HbA1c, blood pressure, pulse rate, and perceived stress measured by the Perceived Stress Scale (PSS-10). The primary analysis used a complete-case approach, with intention-to-treat sensitivity analysis using last-observation-carried-forward.</div></div><div><h3>Results</h3><div>At 3 months, the treatment group showed a significantly greater reduction in HbA1c (−0.87, 95% CI -1.46 to −0.28) and perceived stress (−3.23, 95% CI -5.26 to −1.20) than the control group. At 6 months, although HbA1c remained numerically lower in the treatment group, the between-group difference in the primary complete-case analysis was not statistically significant (−0.61, 95% CI -1.44 to 0.22). Age-stratified exploratory analyses suggested greater HbA1c reduction in the &lt;60-year subgroup at 3 months, but these findings should be interpreted cautiously because no multiplicity adjustment was applied. No significant between-group differences were observed for systolic blood pressure, diastolic blood pressure and pulse rate.</div></div><div><h3>Conclusion</h3><div>Customized music medicine may be a useful complementary intervention for reducing perceived stress and improving short-term glycemic control in adults with T2DM.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 8","pages":"Article 103481"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907893","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}