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

{"title":"The impact of glucose monitoring devices on relationships with food and eating behaviour for people with type 2 diabetes mellitus: A review of the literature","authors":"S. Mackie ,&nbsp;T. Wallace ,&nbsp;J. Heath","doi":"10.1016/j.dsx.2026.103376","DOIUrl":"10.1016/j.dsx.2026.103376","url":null,"abstract":"<div><h3>Background</h3><div>There is limited understanding of the impact of glucose monitoring technologies on relationships with food and eating behaviours for those with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Aims</h3><div>With previous reviews focused on T2DM treatment burden and self-management, this review aims to enhance understanding of the impact of flash or continuous glucose monitoring (FGM/CGM) on users’ eating behaviours and relationships with food as this can inform important recommendations for CGM use amongst those with T2DM.</div></div><div><h3>Method</h3><div>A systematic search was conducted across four databases: Scopus, Medline, CINAHL and PubMed, from October-November 2024, following PRISMA guidelines. Studies were quality appraised and qualitative data was synthesized using thematic synthesis.</div></div><div><h3>Findings</h3><div>Thirteen studies met inclusion criteria and their findings were included in the synthesis. The review revealed that F/CGM enhanced participants’ nutritional awareness, supported personalised dietary experimentation, and fostered intentional eating behaviours. However, data overload and emotional burden were also reported, with some users experiencing restrictive or distressing impacts on their relationship with food. These insights inform practical recommendations for CGM implementation with those with T2DM.</div></div><div><h3>Conclusion</h3><div>Further research should aim to identify factors that contribute to successful adaptation to CGM and explore the long-term effects of CGM use on food relationships.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103376"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260554","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":"Non-weight-bearing lower-limb simple resistance activities, soleus push-ups, and muscle stretching: Impact on glycemic control and metabolic–circulatory outcomes","authors":"Raju Vaishya ,&nbsp;Abhishek Vaish ,&nbsp;Patinharayil Gopinathan ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2026.103375","DOIUrl":"10.1016/j.dsx.2026.103375","url":null,"abstract":"<div><h3>Objective</h3><div>To review the role of lower-body skeletal muscle non-weight-bearing simple resistance activities (SRAs), soleus push-ups (SPUs), and stretching exercises (SEs) in improving glycemic control and metabolic/circulatory outcomes in those individuals who cannot do weight-bearing aerobic exercises due to musculoskeletal, cardiorespiratory and other reasons.</div></div><div><h3>Research design and methods</h3><div>We conducted a narrative review of randomized controlled trials, prospective cohorts, and pilot interventions identified through searches of PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, EBSCO, and ScienceDirect. We examined non-weight-bearing SRAs, SPUs, and SEs, focusing on pathophysiological mechanisms and clinical outcomes.</div></div><div><h3>Results</h3><div>Moderate lower-body strength is associated with 32–35% lower type 2 diabetes (T2D) risk (HR: 0.68, 95% CI: 0.49–0.94). Interrupting prolonged sitting with 3-min SRAs every 30 min reduces insulin response by 26%. SPUs—sustained, seated plantarflexion contractions—reduce postprandial glucose by 39–52% and insulin response by 60% during oral glucose tolerance tests. Passive SE for 40 min acutely lowered blood glucose by 24–28 mg/dL, chronically improves femoral blood flow by 30% and flow-mediated dilation by 25%. Benefits are likely mediated through AMPK-dependent GLUT4 translocation, myokine secretion, and improved endothelial function.</div></div><div><h3>Conclusions</h3><div>Lower-body SRAs, SPUs, and SEs are simple interventions that can be performed while seated and have the potential to significantly improve glucose regulation, insulin sensitivity, and vascular function in populations unable to engage in traditional weight-bearing aerobic exercise. Integration into clinical practice could provide cost-effective tools for the prevention and management of T2D. Finally, the effects of these exercises should be evaluated in long-term studies to determine their impact on glycaemic control and cardiovascular protection.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 2","pages":"Article 103375"},"PeriodicalIF":3.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146160089","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 of sodium-glucose cotransporter 2 inhibitors with the risk of incident anxiety and insomnia: a retrospective cohort study using the TriNetX database","authors":"Chen-I Chang ,&nbsp;Jun-Fu Lin ,&nbsp;I-Chieh Chen ,&nbsp;Ching-Heng Lin ,&nbsp;Hsin-Hua Chen ,&nbsp;Ming-Hong Chang ,&nbsp;Chien-Lun Tang ,&nbsp;Yen-Wei Pai","doi":"10.1016/j.dsx.2025.103373","DOIUrl":"10.1016/j.dsx.2025.103373","url":null,"abstract":"<div><h3>Aim</h3><div>Patients with type 2 diabetes have a higher prevalence of anxiety and insomnia. Comparative evidence on mental health outcomes of antihyperglycemic agents remains limited.</div></div><div><h3>Methods</h3><div>This retrospective, active-comparator, multicenter cohort study utilized data from the TriNetX US Collaborative Network. The study included adults with type 2 diabetes who were treated with metformin in combination with one of the following classes of antihyperglycemic agents: sodium-glucose cotransporter 2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, or glucagon-like peptide 1 receptor agonists (GLP-1 RAs). Propensity score matching was performed.</div></div><div><h3>Results</h3><div>Among 26,381 matched pairs of SGLT2 inhibitor and DPP-4 inhibitor users, SGLT2 inhibitor use was associated with lower risks of incident anxiety (3.73 % vs 4.82 %; HR 0.87, 95 % CI 0.80–0.95) and insomnia (2.14 % vs 2.73 %; HR 0.89, 95 % CI 0.80–0.99).</div><div>Among 24,794 matched pairs of SGLT2 inhibitor and GLP-1 RA users, SGLT2 inhibitor use was associated with a lower risk of anxiety (3.92 % vs 5.29 %; HR 0.79, 95 % CI 0.72–0.85), while the risk of insomnia did not differ significantly (HR 0.93, 95 % CI 0.83–1.05).</div></div><div><h3>Conclusion</h3><div>SGLT2 inhibitor use was associated with a lower risk of anxiety and, compared with DPP-4 inhibitors, a lower risk of incident insomnia. These findings suggest that mental health outcomes may be relevant when selecting antihyperglycemic agents and warrant further prospective investigation.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103373"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885561","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":"Efficacy and safety of finerenone in the treatment of primary aldosteronism: A prospective clinical study","authors":"Shuo Li ,&nbsp;Yifan Zhang ,&nbsp;Xuan Liu ,&nbsp;Yun Chai,&nbsp;Hongwei Jia,&nbsp;Hua Shu,&nbsp;Yuxin Fan,&nbsp;Li Ding,&nbsp;Ming Liu","doi":"10.1016/j.dsx.2025.103369","DOIUrl":"10.1016/j.dsx.2025.103369","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to evaluate the safety and efficacy of finerenone in the treatment of primary aldosteronism (PA).</div></div><div><h3>Methods</h3><div>A total of 15 patients with PA were enrolled. The primary endpoint was the proportion of patients achieving normal serum potassium levels without potassium supplementation at the 4-week (4W) follow-up. Secondary endpoints included changes in serum potassium, 24-h urinary potassium, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Serum creatinine, estimated glomerular filtration rate (eGFR), and hyperkalemia incidence were also assessed during follow-ups.</div></div><div><h3>Results</h3><div>At baseline, all patients had hypokalemia (serum potassium &lt;3.5 mmol/L). At 4W, 47 % (7/15) of patients achieved normal serum potassium without supplementation. Serum potassium levels significantly increased at the 2W, 4W, and 8W follow-ups compared to baseline (all p &lt; 0.05). SBP significantly decreased at the 4W and 8W follow-ups (all p &lt; 0.05), while DBP showed no significant changes. Increases in serum creatinine and decreases in eGFR were observed, particularly in patients with PA and chronic kidney disease (CKD), although these changes were not statistically significant. No instances of hyperkalemia or unexpected safety concerns were reported.</div></div><div><h3>Conclusion</h3><div>Finerenone effectively increased serum potassium levels and reduced SBP in PA, demonstrating its potential as a promising treatment option.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103369"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879802","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":"Impact of diabetes mellitus on dental pulp tissue pathosis – A scoping review","authors":"Nandita Suresh ,&nbsp;Osama Adeel Khan Sherwani ,&nbsp;Namrata Suresh ,&nbsp;Priyanka Porwal ,&nbsp;Vishnupriya K. Sweety ,&nbsp;Betsy Joseph ,&nbsp;Tuomas Waltimo ,&nbsp;Sukumaran Anil","doi":"10.1016/j.dsx.2025.103361","DOIUrl":"10.1016/j.dsx.2025.103361","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes mellitus alters dental pulp tissue response through complex inflammatory and calcification processes, yet the full scope of these effects remains incompletely mapped.</div></div><div><h3>Objectives</h3><div>To chart the evidence regarding diabetes mellitus' impact on dental pulp tissue pathosis, identify patterns in inflammatory, vascular, and mineralization changes, examine differences between Type 1 Diabetes and Type 2 Diabetes effects, assess the influence of glycemic control on pulpal outcomes, and identify knowledge gaps for future research.</div></div><div><h3>Methods</h3><div>This scoping review followed PRISMA-ScR guidelines and searched Medline, Scopus, Web of Science, and Ebscohost up to August 2024. Two independent reviewers screened studies and extracted data, with a third resolving discrepancies.</div></div><div><h3>Results</h3><div>Of 609 identified records, 30 met inclusion criteria (13 human, 17 animal studies). Human studies revealed increased inflammatory responses characterized by elevated cytokine levels, thickened blood vessels, and reduced endothelial cells. Older people living with diabetes showed a higher incidence of pulp stones and symptomatic irreversible pulpitis. Animal studies demonstrated severe inflammatory responses, decreased antioxidant activity, and increased calcification. Poorly controlled diabetes was associated with more pronounced pathological changes.</div></div><div><h3>Conclusions</h3><div>Diabetes mellitus significantly impacts dental pulp through multiple pathways affecting inflammation, vascular structure, and mineralization. Glycemic control emerges as a key modifiable factor, supporting the integration of diabetes status into endodontic treatment planning.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103361"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013917","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":"Ketosis-prone type 2 diabetes in Caucasian adults: a follow-up cohort analysis","authors":"Adrienn Kovács ,&nbsp;Brigitta Teutsch ,&nbsp;Dániel S. Veres ,&nbsp;Pál Pánczél ,&nbsp;Krisztina Lukács ,&nbsp;Emese Sipter ,&nbsp;Péter Hegyi ,&nbsp;Nóra Hosszúfalusi","doi":"10.1016/j.dsx.2025.103360","DOIUrl":"10.1016/j.dsx.2025.103360","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the prevalence, baseline features, and long-term clinical course of ketosis-prone type 2 diabetes in adult Caucasians presenting with new-onset diabetic ketoacidosis or ketosis.</div></div><div><h3>Methods</h3><div>Clinical data were retrospectively retrieved from electronic medical records, with longitudinal follow-up available. Participants were classified as type 1, latent autoimmune diabetes of adults, ketosis-prone type 2, or non-ketotic type 2 diabetes according to ketosis status, diabetes-related autoantibodies, and fasting C-peptide (within the reference range for ketosis-prone type 2 diabetes). Descriptive statistics and regression models were applied to compare clinical characteristics across diabetes groups.</div></div><div><h3>Results</h3><div>Of 183 newly diagnosed patients, 86 presented with ketosis, including 22 with ketosis-prone type 2 diabetes. Compared with those with type 1 diabetes, these individuals were older (mean ± SD; 54.9 ± 12.6 vs. 34.8 ± 12.6 years, p &lt; 0.0001), had higher body mass index (31.5 ± 5.6 kg/m² vs. 22.5 ± 3.7 kg/m², p &lt; 0.0001), higher glycated hemoglobin (13.3 ± 3.1 % vs. 10.8 ± 3.2 %, p = 0.0047), and greater hepatic steatosis (hepatic steatosis index: 45.4 ± 6.2 vs. 34.7 ± 4.7, p &lt; 0.0001). In ketosis-prone type 2 diabetes, beta-cell function remained preserved long after the index episode (5–10 years: 4.37 ± 2.45 ng/mL; 10–15 years: 2.85 ± 1.54 ng/mL).</div></div><div><h3>Conclusion</h3><div>One-fourth of adult Caucasian patients with new-onset diabetic ketosis had ketosis-prone type 2 diabetes, characterised by negative autoantibodies, preserved C-peptide, and sustained long-term endogenous insulin secretion.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103360"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802151","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.2026.103377","DOIUrl":"10.1016/j.dsx.2026.103377","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103377"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078587","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":"Diabetes with low body mass index in India: A secondary analysis of NFHS-5 data","authors":"Saurav Basu ,&nbsp;Vansh Maheshwari","doi":"10.1016/j.dsx.2025.103371","DOIUrl":"10.1016/j.dsx.2025.103371","url":null,"abstract":"<div><h3>Background</h3><div>The International Diabetes Federation (IDF) recently recognized “Type 5 Diabetes” (“T5DM”) as a distinct entity. Proponents estimate a burden of 6 million cases in India. However, the applicability of this classification in the Indian context, which is dominated by Lean Type 2 Diabetes (T2D), remains debated.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of the National Family Health Survey-5 (2019–2021), comprising 788,974 respondents, to estimate the prevalence of young and middle-aged people (15–49 years) with low BMI Diabetes in India. The proxy phenotype was defined as: BMI &lt;18.5 kg/m² (or age-appropriate z-scores for adolescents), and either Fasting Blood Glucose ≥126 mg/dL, Random Blood Glucose (RBG) ≥200 mg/dL, or self-reported diabetes.</div></div><div><h3>Results</h3><div>The analysis identified 1351 individuals meeting the low BMI diabetes phenotypic criteria. The weighted prevalence of low BMI Diabetes was 0.19 (95 % CI: 0.18 to 0.21). While the raw sample was predominantly female due to survey design, weighted analysis revealed significantly higher prevalence in males (Female: 0.18 vs. Male: 0.25; p = 0.006). Cases were significantly concentrated in the poorest wealth quintiles (54 %), contrasting with the affluent demographic typically associated with T2D. Extrapolating to the national population and adjusting for 50 % undiagnosed cases, we estimate 2.42 million Indians aged &lt;50 years have low BMI diabetes.</div></div><div><h3>Conclusion</h3><div>The prevalence of “T5DM” is likely to be substantially lower than previous estimates, even after accounting for underdiagnosis. The primary diabetes burden in non-obese Indian adults is likely Lean T2D driven by visceral adiposity rather than malnutrition.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103371"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885560","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":"Economic evaluation of diabetes prevention interventions in Bangladesh: A modelling study","authors":"Damon Mohebbi ,&nbsp;Sanjit Kumar Shaha ,&nbsp;Abdul Kuddus ,&nbsp;Md Alimul Reza Chowdhury ,&nbsp;Hannah Jennings ,&nbsp;Naveed Ahmed ,&nbsp;Joanna Morrison ,&nbsp;Kohenour Akter ,&nbsp;Tasmin Nahar ,&nbsp;Carina King ,&nbsp;Tom Palmer ,&nbsp;Rachael Hunter ,&nbsp;Ali Kiadaliri ,&nbsp;Kishwar Azad ,&nbsp;Edward Fottrell ,&nbsp;Hassan Haghparast-Bidgoli","doi":"10.1016/j.dsx.2025.103370","DOIUrl":"10.1016/j.dsx.2025.103370","url":null,"abstract":"<div><h3>Aim</h3><div>To model the long-term cost-effectiveness of scaling up two prevention interventions against type 2 diabetes mellitus (T2DM), i.e. community mobilisation through participatory learning and action (PLA) and mHealth mobile phone messaging, implemented in rural Bangladesh as part of the “DMagic” trial.</div></div><div><h3>Methods</h3><div>A health-economic Markov model of the three-arm, cluster-randomised controlled DMagic trial was developed. A cohort of individuals aged 50 years entered the model with impaired glucose tolerance (IGT). Outcomes included the costs (provider perspective), quality-adjusted life-years gained (QALY), incremental cost-effectiveness ratios (ICERs) and incidence of T2DM in a lifetime period. Deterministic and probabilistic sensitivity analyses were performed to reflect uncertainty.</div></div><div><h3>Results</h3><div>PLA yielded substantial reductions in diabetes incidence with only 25 % of the IGT population developing T2DM (versus 46 % in the control arm). The intervention was cost-effective against control with an ICER of 167 INT$ per QALY gained. The mHealth intervention revealed limited effectiveness at low cost, leading to an ICER of 189 INT$ per QALY gained. At willingness-to-pay ranges between 3 % and 45 % of Bangladesh GDP per capita, PLA demonstrated up to 90 % probability of being cost-effective.</div></div><div><h3>Conclusions</h3><div>PLA is a low-cost, effective strategy to reduce the burden of T2DM, offering good value for money.</div></div><div><h3>Trial registration</h3><div>The DMagic trial was registered with the ISRCTN registry, number ISRCTN41083256.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103370"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978303","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":"Insulin resistance is associated with incident prediabetes and type 2 diabetes in normoglycemic individuals","authors":"Judy Z. Louie ,&nbsp;Dov Shiffman ,&nbsp;James B. Meigs ,&nbsp;Steven W. Taylor ,&nbsp;Olle Melander ,&nbsp;Fahim Abbasi ,&nbsp;Michael J. McPhaul","doi":"10.1016/j.dsx.2025.103372","DOIUrl":"10.1016/j.dsx.2025.103372","url":null,"abstract":"<div><h3>Aims</h3><div>Testing insulin resistance could help improve physician assessment of patients’ risk of prediabetes or type 2 diabetes (T2D), even among normoglycemic individuals.</div></div><div><h3>Methods</h3><div>The longitudinal study followed 16,333 normoglycemic participants in a nation-wide employer-sponsored health assessment program starting in August 2020 with a median follow-up time of 2.9 years for incident prediabetes or T2D. The probability of insulin resistance <strong>(</strong>IRRS) was calculated from fasting intact insulin and C-peptide serum levels. Incident events had fasting plasma glucose level ≥100 mg/dL (≥5.6 mmol/L), HbA1c ≥ 5.7 % (≥38.8 mmol/mol), or a self-reported physician diagnosis of T2D.</div></div><div><h3>Results</h3><div>The study population had a median age of 43 years at baseline (31 % men). IRRS was &lt;8 % for participants in the bottom tertile of the distribution compared with &gt;20 % for those in the top tertile. Participants in the top tertile of IRRS had 43 % greater risk of incident prediabetes or T2D (adjusted hazard ratio, aHR = 1.43 [95 % CI, 1.31–1.57], <em>P</em> &lt; 0.001) compared with those in the bottom tertile, in a model that adjusted for age, sex, BMI, and HbA1c.</div></div><div><h3>Conclusions</h3><div>Elevated IRRS is associated with incident prediabetes or T2D regardless of established risk factors. Evaluating insulin resistance in normoglycemic patients may improve T2D prevention efforts.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103372"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885467","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}