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

{"title":"Prediction of retinopathy risk: A prospective cohort study in China","authors":"Xiaohan Xu ,&nbsp;Duolao Wang ,&nbsp;Uazman Alam ,&nbsp;Shanhu Qiu ,&nbsp;Yuzhi Ding ,&nbsp;Zilin Sun ,&nbsp;Anupam Garrib","doi":"10.1016/j.dsx.2025.103251","DOIUrl":"10.1016/j.dsx.2025.103251","url":null,"abstract":"<div><h3>Aim</h3><div>To identify risk factors for retinopathy and to develop a nomogram for individualised risk prediction in a multi-ethnic Chinese cohort.</div></div><div><h3>Methods</h3><div>Data were derived from the SENSIBLE-Cohort, excluding participants with retinopathy at baseline. Two nomograms were constructed: one using baseline data only (Baseline), and one incorporating baseline and follow-up data (Combination). Predictor selection involved Cox regression, Boruta, least absolute shrinkage and selection operator (LASSO), and recursive feature elimination (RFE). Model performance was evaluated using Harrell's C-index, confusion matrix, and Brier Score. The receiver operating characteristic (ROC) curves, the area under the ROC curve (AUC), the DeLong test, and the decision curve analysis (DCA) were used for comparative assessment.</div></div><div><h3>Results</h3><div>A total of 2,447 participants were included (mean age: 53.0 ± 8.6 years; 66.1 % female; BMI: 25.4 ± 3.5 kg/m²), including 1,380 with normal glucose tolerance, 762 with prediabetes, and 305 with diabetes. During follow-up, 144 (5.9 %) people developed retinopathy. Key predictors included BMI, waist-to-hip ratio, triglycerides, systolic and diastolic blood pressure, hypertension history, and ethnicity.</div><div>The Combination nomogram showed superior discrimination compared to the Baseline nomogram (AUC: 0.75 vs. 0.64, P &lt; 0.001) and demonstrated balanced sensitivity and specificity. DCA demonstrated greater clinical utility of the Combination nomogram across a range of risk thresholds.</div></div><div><h3>Conclusion</h3><div>The Combination nomogram enables early retinopathy risk stratification using accessible clinical data. It may support personalised screening and introduces the broader concept of metabolic retinopathy.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103251"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240565","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 effect of flaxseed supplementation on anthropometric indices, blood pressure, and lipid profile in diabetic patients: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials","authors":"Vali Musazadeh ,&nbsp;Shokufeh Nezamoleslami ,&nbsp;Amir Hossein Faghfouri ,&nbsp;Farzad Shidfar ,&nbsp;Naheed Aryaeian","doi":"10.1016/j.dsx.2025.103241","DOIUrl":"10.1016/j.dsx.2025.103241","url":null,"abstract":"<div><h3>Background and aims</h3><div>Numerous clinical studies have suggested that flaxseed supplementation may be effective in diabetic patients, but the findings are controversial. Therefore, this study aimed to examine the effects of flaxseed on blood pressure, anthropometry, and lipid profile parameters in diabetic patients.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched until June 2024. A random-effects model was utilized to analyze standardized mean differences (SMDs).</div></div><div><h3>Results</h3><div>Meta-analysis of 16 trials with 1136 participants indicated significant improvements in weight (SMD: 0.81; 95 % CI: 1.54 to −0.09, p = 0.028; <em>I</em>² = 88.7 %, p &lt; 0.001), waist circumference (SMD: 1.54; 95 % CI: 2.77 to −0.31, p = 0.002; <em>I</em>² = 85.3 %, p &lt; 0.001), and triglyceride (SMD: 0.56; 95 % CI: 1.02 to −0.10, p = 0.016; <em>I</em>² = 87.4 %, p &lt; 0.001), but not BMI (SMD: 0.63; 95 % CI: 1.28 to 0.02, p = 0.058; <em>I</em>² = 87.9 %, p = 0.005), systolic blood pressure (SMD: 0.50; 95 % CI: 1.25, 0.25, p = 0.193; <em>I</em>² = 87.6 %, p &lt; 0.001), diastolic blood pressure (SMD: 0.74; 95 % CI: 1.51, 0.03, p = 0.060; <em>I</em>² = 88.1 %, p &lt; 0.001), total cholesterol (SMD: 0.43; 95 % CI: 0.99 to 0.12, p = 0.128; <em>I</em>² = 93.6 %, p &lt; 0.001), low-density lipoprotein cholesterol (SMD: 0.09; 95 % CI: 0.87 to 0.70, p = 0.830; <em>I</em>² = 96.3 %, p &lt; 0.001), and high-density lipoprotein cholesterol (SMD: 0.08; 95 % CI: 0.30 to 0.46, p = 0.673; <em>I</em>² = 87.2 %, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Flaxseed supplementation effectively reduces anthropometric indices and triglyceride levels in individuals with type 2 diabetes but does not suggest any benefit on blood pressure and other lipid profile parameters. Therefore, conducting more extensive, well-designed trials to validate these findings is crucial.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103241"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240566","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":"Adiposity at the core of the rising tide of young-onset type 2 diabetes worldwide","authors":"Naveed Sattar FMedSci ,&nbsp;Anoop Misra MD","doi":"10.1016/j.dsx.2025.103249","DOIUrl":"10.1016/j.dsx.2025.103249","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103249"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263209","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 effectiveness of telemedicine in the prevention of type 2 diabetes mellitus: a systematic review and meta-analysis of interventions","authors":"Laura Suhlrie ,&nbsp;Raga Ayyagari ,&nbsp;Camille Mba ,&nbsp;Kjell Olsson ,&nbsp;Harold Torres-Aparcana ,&nbsp;Steven James ,&nbsp;Elpida Vounzoulaki ,&nbsp;Daniel B. Ibsen","doi":"10.1016/j.dsx.2025.103252","DOIUrl":"10.1016/j.dsx.2025.103252","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of telemedicine-delivered diet and/or exercise interventions to prevent type 2 diabetes (T2D) in people at risk.</div></div><div><h3>Methods</h3><div>Embase (via Ovid), Medline (via Ovid), Web of Science, CINAHL, Scopus and SciELO were searched from January 2010–December 2020 for intervention studies using a diet and/or exercise intervention delivered through telemedicine for T2D prevention in people at risk. Parallel randomised controlled trials were meta-analysed, and other intervention designs narratively synthesized.</div></div><div><h3>Results</h3><div>We identified 11,645 studies via database searches, of which 226 were full-text screened, and 52 interventions included; 32 were included in the meta-analysis and 20 in the narrative synthesis. Telemedicine interventions reduced body weight (mean difference (MD): −1.66 kg, 95 % confidence interval (CI) −2.48,-0.90, I² = 81 %, n_studies = 17), body mass index (MD -0.71 kg/m², 95 % CI -1.06,-0.37, I² = 70 %, n_studies = 11), waist circumference (MD -2.82 cm, 95 % CI -5.16,-2.35, I² = 84 %, n_studies = 8) and HbA1c (MD -0.07 %, 95 % CI -0.14,0.00, I² = 71 %, n_studies = 11). No significant effects were found for other clinical outcomes. The narrative synthesis supported the results. The longest follow-up time was up to 24 months.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates effectiveness for telemedicine-delivered interventions in preventing T2D in people at risk, specifically in people with overweight/obesity.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103252"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291007","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":"Prevalence of cardiovascular risk and atherosclerotic cardiovascular disease in people with type 2 diabetes in the United Arab Emirates: Results from the prevalence of atherosclerotic cardiovascular disease in patients with type 2 diabetes across Middle East and African countries (PACT-MEA) study","authors":"Fatheya Al. Awadi ,&nbsp;Fauzia Rashid ,&nbsp;Ghada Awada ,&nbsp;Haitham Seifeldin ,&nbsp;Hani Sabbour ,&nbsp;Hazem Aly ,&nbsp;Jalal Nafach ,&nbsp;Khadija Hafidh ,&nbsp;Loai Abudaqa ,&nbsp;Mahir K. Jallo ,&nbsp;Wael Almahmeed ,&nbsp;Zufana Nazir","doi":"10.1016/j.dsx.2025.103224","DOIUrl":"10.1016/j.dsx.2025.103224","url":null,"abstract":"<div><h3>Aim</h3><div>Atherosclerotic cardiovascular disease (ASCVD) is a significant cause of morbidity and mortality in type-2 diabetes mellitus (T2D) patients. This subset analysis of the PACT-MEA study compares T2D data from the UAE with data from other Middle Eastern and African (MEA) countries.</div></div><div><h3>Methods</h3><div>Data were extracted from the participants' medical charts from March 2022 to August 2022 across nine centers in the UAE (n = 542). The prevalence and 10-year CVD risk estimates were evaluated and categorized according to European Society of Cardiology (ESC) 2021 guidelines and compared between MEA (regional) and UAE populations.</div></div><div><h3>Results</h3><div>Participants with T2D from the UAE, enrolled in secondary care, had a median age of 55.7 years. The estimated 10-year CVD risk was 99.8 % in the UAE and 99.3 % in the MEA. Established ASCVD prevalence (eASCVD) was 29.7 % in the UAE and 20.9 % in the MEA. Coronary artery disease was the most common ASCVD type (95.0 %).</div></div><div><h3>Conclusion</h3><div>Nearly one-third of T2D patients had eASCVD in UAE, compared to one-fifth in MEA. Most participants were at high or very high risk for ASCVD, but none met all ESC 2021 guidelines, highlighting the need for developing regional strategies to reduce ASCVD risk.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103224"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834272","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":"Highlights of the current issue","authors":"Ningjian Wang ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2025.103240","DOIUrl":"10.1016/j.dsx.2025.103240","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103240"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184439","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":"Quantitative assessment of metabolic memory and its prediction of renal function decline in patients with type 2 diabetes: A retrospective observational study","authors":"Kentaro Oniki ,&nbsp;Takuro Shigaki ,&nbsp;Ayami Kajiwara-Morita ,&nbsp;Keiichi Shigetome ,&nbsp;Akira Yoshida ,&nbsp;Hideaki Jinnouchi ,&nbsp;Junji Saruwatari","doi":"10.1016/j.dsx.2025.103225","DOIUrl":"10.1016/j.dsx.2025.103225","url":null,"abstract":"<div><h3>Aims</h3><div>This study quantitatively assesses metabolic memory by modeling the relationship between hyperglycemic exposure and renal function decline in patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This retrospective longitudinal study included 381 Japanese patients with T2D. Hyperglycemic exposure was presented by calculating the area under the curve (AUC) for HbA1c ≥ 6 % (AUC_{HbA1c ≥ 6 %}) during the observation period. A non-linear mixed-effects model was constructed to predict changes in estimated glomerular filtration rate (eGFR) based on AUC_{HbA1c ≥ 6 %}.</div></div><div><h3>Results</h3><div>The relationship between AUC_{HbA1c ≥ 6 %} and eGFR changes was shown by a sigmoidal curve, with sex, age, diabetic retinopathy, dyslipidemia, and hypertension incorporated as covariates. The predictive utility of the model was validated using goodness-of-fit plot, visual predictive check, and bootstrap methods.</div></div><div><h3>Conclusions</h3><div>We developed an AUC_{HbA1c ≥ 6 %}-based model to predict renal function decline in patients with T2D, showing that AUC_{HbA1c ≥ 6 %} may serve as a quantitative indicator of metabolic memory.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103225"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834273","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":"Composite renal outcome in prospectively performed biopsy proven diabetic kidney disease versus non-diabetic kidney disease: A longitudinal follow up","authors":"Subhasis Neogi ,&nbsp;Madhurima Basu ,&nbsp;Pradip Mukhopadhyay ,&nbsp;Arpita Ray Chaudhury ,&nbsp;Nitai P. Bhattacharyya ,&nbsp;Sujoy Ghosh","doi":"10.1016/j.dsx.2025.103237","DOIUrl":"10.1016/j.dsx.2025.103237","url":null,"abstract":"<div><h3>Aims</h3><div>This study was undertaken to evaluate differences in composite renal outcomes between diabetic kidney disease (DKD) and non-diabetic kidney disease (NDKD) (prospectively performed, biopsy proven), along with predictors of renal outcome in subjects with DKD.</div></div><div><h3>Methods</h3><div>A composite renal outcome comprising of doubling of creatinine, end stage renal disease (ESRD) or renal death was documented in biopsy proven DKD and NDKD subjects. Differences in outcome (DKD vs. NDKD) were compared. Clinical, biochemical and histopathological parameters were evaluated as possible predictors of composite renal outcome in DKD.</div></div><div><h3>Results</h3><div>91 subjects (72 DKD and 19 NDKD) were included for analysis. The hazard ratio (HR) for composite renal outcome was 0.27 (0.08–0.9) (p = 0.03) in favour of NDKD. Kaplan-Meier analysis demonstrated NDKD subjects had better composite renal outcome compared to DKD (log rank chi-square 6.69, p = 0.009). Degree of proteinuria and renal pathology society (RPS) class (III/IV) predicted worse outcome in those with DKD.</div></div><div><h3>Conclusions</h3><div>Composite renal outcomes in NDKD was better as compared to those with DKD. RPS class III/IV on histopathology and degree of proteinuria was associated with poorer composite renal outcome in patients with DKD.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103237"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123409","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":"Association between metabolically healthy obesity and atrial fibrillation: A systematic review and meta-analysis of longitudinal studies","authors":"Xiao Liu ,&nbsp;Jitao Ling ,&nbsp;Yifan Wu ,&nbsp;Huilei Zhao ,&nbsp;Yuzhe Hu ,&nbsp;Zhiwei Yan ,&nbsp;Wengen Zhu ,&nbsp;Peng Yu ,&nbsp;Jinfeng Wang ,&nbsp;Yuling Zhang ,&nbsp;Tommaso Bucci ,&nbsp;Gregory Y.H. Lip","doi":"10.1016/j.dsx.2025.103228","DOIUrl":"10.1016/j.dsx.2025.103228","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is not a single diagnosis, and the association of ‘metabolically unhealthy’ obesity with cardiovascular disease is well-described. However, the relationship between metabolically healthy obesity (MHO) and atrial fibrillation (AF) is still debated.</div></div><div><h3>Objective</h3><div>Our objective is to investigate the association between MHO and the risk of AF.</div></div><div><h3>Methods</h3><div>A comprehensive search of databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library regarding longitudinal studies of MHO and risk of AF was performed. Random effects were used to pool the effect estimates.</div></div><div><h3>Results</h3><div>Nine cohort studies comprising 4,250,557 participants were included. The pooled results revealed that individuals with MHO were associated with a greater incidence of AF than those with a metabolically healthy normal weight (HR: 1.34, 95 % CI: 1.26 to 1.42) with moderate certainty according to the Grading of Recommendations Assessment, Development, and Evaluation assessment. Individuals with MHO were associated with a lower risk of AF compared with participants with metabolically unhealthy obesity (RR: 0.48, 95 % CI: 0.36 to 0.64). Individuals with MHO were not significantly associated with the risk of AF as compared to metabolically unhealthy normal weight (HR: 1.04, 95 % CI: 0.89 to 1.22).</div></div><div><h3>Conclusion</h3><div>MHO is associated with a greater incidence of AF, highlighting the importance of weight reduction in individuals without metabolic disorders in reducing the risk of AF.</div></div><div><h3>Registration</h3><div>PROSPERO - registration number CRD42023432195.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103228"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882965","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":"Glucagon-Like Peptide-1 receptor agonists, dual GIP/GLP-1 receptor agonist tirzepatide and suicidal ideation and behavior: A systematic review of clinical studies and pharmacovigilance reports","authors":"Ramona Di Stefano ,&nbsp;Lorenzo V. Rindi ,&nbsp;Valentina Baldini ,&nbsp;Rodolfo Rossi ,&nbsp;Francesca Pacitti ,&nbsp;Emmanuele A. Jannini ,&nbsp;Alessandro Rossi","doi":"10.1016/j.dsx.2025.103238","DOIUrl":"10.1016/j.dsx.2025.103238","url":null,"abstract":"<div><h3>Aims</h3><div>Suicide is a global public health concern, accounting for nearly 700,000 deaths annually. Although well-established risk factors, including mental health disorders, are widely recognized, emerging concerns have surfaced regarding a potential association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs), the dual Gastric Inhibitory Polypeptide (GIP)/GLP-1 Receptor Agonist tirzepatide and suicidal behavior. This systematic review aims to synthesize the available evidence on the potential association between these drugs and suicidal behavior.</div></div><div><h3>Methods</h3><div>This review was conducted following PRISMA guidelines. A systematic search was performed in MEDLINE, Embase, and APA PsycInfo up to September 24, 2024, using terms related to GLP-1 RAs/GIP/GLP-1 RAs and suicidal behavior.Three independent reviewers conducted article screening and data extraction. Risk of bias was evaluated using the Newcastle-Ottawa Scale for cohort studies and ROB2 for RCTs.</div></div><div><h3>Results</h3><div>The review identified 16 studies published between 2017 and 2024, consisting of 5 observational studies, 2 randomized controlled trials, 8 pharmacovigilance analyses, and 1 post-hoc analysis of RCTs. No consistent evidence indicated an increased suicide risk among GLP-1 RA users. Pharmacovigilance analyses produced mixed findings; while some disproportionality analyses reported higher rates relative to other antihyperglycemic drugs, no causal link was confirmed. Cohort studies involving diabetic and obese populations generally did not demonstrate a significant increase in suicidal behavior.</div></div><div><h3>Conclusions</h3><div>Although current data do not warrant changes in prescribing practices, further research is needed before definitive conclusions can be drawn. Moreover, the generalizability and reliability of these findings should be interpreted in light of the methodological limitations of the included studies.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103238"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072478","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}