The Lancet Diabetes & Endocrinology最新文献

{"title":"The need for improved diabetes detection and treatment.","authors":"Henrik Toft Sørensen","doi":"10.1016/S2213-8587(25)00250-5","DOIUrl":"10.1016/S2213-8587(25)00250-5","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"899-901"},"PeriodicalIF":41.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national cascades of diabetes care, 2000-23: a systematic review and modelling analysis using findings from the Global Burden of Disease Study.","authors":"Lauryn K Stafford, Anna Gage, Yvonne Yiru Xu, Madeleine Conrad, Ismael Barreras Beltran, Edward J Boyko, Bruce B Duncan, Simon I Hay, Hailey Lenox, Rafael Lozano, Dianna J Magliano, Carlos A Aguilar Salinas, Nikhil Tandon, Pedro Zitko, Christopher J L Murray, Theo Vos, Annie Haakenstad, Kanyin Liane Ong","doi":"10.1016/S2213-8587(25)00217-7","DOIUrl":"10.1016/S2213-8587(25)00217-7","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a serious global health challenge, with a rising prevalence and substantial effect on disability and mortality worldwide. Despite medical advancements, gaps in the cascade of diabetes care-comprising diagnosis, treatment, and glycaemic management-persist, hindering effective management. We aimed to comprehensively assess the state of the diabetes cascade of care globally, identifying areas of strength and needs for improvement in diabetes management.</p><p><strong>Methods: </strong>Using data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), this modelling analysis spanned the years 2000 to 2023 and covered 204 countries and territories. We systematically reviewed cross-sectional surveys that are representative of the general population and the published and grey literature to estimate the proportion of people with diabetes who are undiagnosed, diagnosed but untreated, receiving treatment with suboptimal glycaemic concentrations, and receiving treatment with optimal glycaemic concentrations. Treatment was defined as current use of insulin or other hypoglycaemic medication. We separately modelled these quantities by location, year, age, and sex using DisMod-MR 2.1, a hierarchical Bayesian meta-regression modelling tool, then scaled the estimates so that they sum to 100% of people living with diabetes in each stratum. Using GBD 2023 estimates of the number of people with diabetes, we calculated the diabetes cascade of care: proportion of people diagnosed among those with diabetes, proportion of people receiving treatment among those with diagnosed diabetes, and proportion of people with optimal glycaemic concentrations among those receiving treatment for diabetes across all strata.</p><p><strong>Findings: </strong>In 2023, an estimated 55·8% (95% UI 49·3-62·3) of people with diabetes aged 15 years and older were diagnosed with diabetes globally. The proportion of people with diagnosed diabetes who were on treatment was 91·4% (88·0-94·2), and the proportion of people on diabetes treatment with optimal glycaemic concentrations was 41·6% (35·7-48·5). Among all people with diabetes, the proportion with optimal glycaemic concentrations on treatment was 21·2% (17·4-25·6) in 2023 globally. Substantial regional differences were observed, with the highest rates of diagnosis in high-income North America, the highest rates of treatment among those with diagnosed diabetes in high-income Asia Pacific, and the highest rates of optimal glycaemic concentrations among those receiving treatment for diabetes in southern Latin America. Between 2000 and 2023, globally, the proportion of people diagnosed with diabetes increased by 8·3 (6·6-10·0) percentage points, and the proportion of people receiving treatment among those diagnosed increased by 7·2 (5·7-8·8) percentage points. The proportion of people receiving treatment who had optimal glycaemic concentrations increased by 1·3 (0·8-1·8)","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"924-934"},"PeriodicalIF":41.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Diabetes Endocrinol 2022; 10: 623–33","authors":"","doi":"10.1016/s2213-8587(25)00325-0","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00325-0","url":null,"abstract":"<em>Inagaki N, Takeuchi M, Oura T, et al. Efficacy and safety of tirzepatide monotherapy compared with dulaglutide in Japanese patients with type 2 diabetes (SURPASS J-mono): a double-blind, multicentre, randomised, phase 3 trial.</em> Lancet Diabetes Endocrinol <em>2022;</em> 10: <em>623–33</em>—Appendix 2 of this Article has been corrected as of Oct 15, 2025.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"67 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145295654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing educational needs in older adults with type 1 diabetes","authors":"Giuseppe Maltese, Partha Kar, Geraldine Gallen, Debbie Hicks, Alan J Sinclair","doi":"10.1016/s2213-8587(25)00259-1","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00259-1","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"13 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145289220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing adults with screen-detected islet autoantibody positivity: a pragmatic framework","authors":"Nicholas Thomas, Danijela Tatovic, Angus Jones, Parth Narendran","doi":"10.1016/s2213-8587(25)00260-8","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00260-8","url":null,"abstract":"New disease-modifying therapies, such as teplizumab, offer opportunities to delay the clinical onset of type 1 diabetes but require islet autoantibody screening to identify individuals at increased risk of progression to diabetes. As type 1 diabetes screening programmes expand, clinicians will increasingly encounter a new group of people: adults who test positive for islet autoantibodies but have not yet been diagnosed with diabetes. Although international guidelines outline management for both children and adults, considerable uncertainties remain, particularly for adults. In adults with islet autoantibody positivity, the lower risk of progression to type 1 diabetes compared with children, combined with the high background prevalence of mild non-autoimmune dysglycaemia, presents substantial challenges for clinical management. This Personal View aims to add clarity to international consensus guidelines, proposing a pragmatic framework for managing adults with islet autoantibody positivity. Although fitting within a UK National Health Service setting, we feel this framework is also relevant to other health systems.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"9 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145289379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of empagliflozin on conventional and exploratory acute and chronic kidney outcomes: an individual participant-level meta-analysis","authors":"William G Herrington, Zhaojing J Che, Rebecca Sardell, Alistair J Roddick, Parminder K Judge, Christoph Wanner, Sibylle J Hauske, Stefan Anker, Javed Butler, Gerasimos Filippatos, Milton Packer, Faiez Zannad, Dominik Steubl, Martina Brueckmann, Jennifer B Green, Jonathan R Emberson, Martin J Landray, Colin Baigent, Richard Haynes, Natalie Staplin","doi":"10.1016/s2213-8587(25)00222-0","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00222-0","url":null,"abstract":"<h3>Background</h3>Uncertainty remains about effects of sodium–glucose co-transporter-2 (SGLT2) inhibition on kidney outcomes in individuals with slowly progressive chronic kidney disease (eg, low albuminuria) and those at risk of large acute estimated glomerular filtration rate (eGFR) dips on initiation of such treatment. We aimed to explore the effects of empagliflozin on a range of kidney outcomes in these population subtypes.<h3>Methods</h3>In this meta-analysis, we used individual-level data from 23 340 participants in four large placebo-controlled trials (EMPA-REG OUTCOME, EMPEROR-Reduced, EMPEROR-Preserved, and EMPA-KIDNEY) to assess the effects of empagliflozin on conventional and exploratory acute and chronic kidney outcomes. We then assessed whether effects varied by predicted size of the acute eGFR dip on treatment initiation or among other key population subtypes using tests for heterogeneity and trend. The individual-level data were requested from Boehringer Ingelheim (Ingelheim, Germany).<h3>Findings</h3>Compared with placebo, allocation to empagliflozin reduced the risk of a marker of acute kidney injury (a ≥50% increase in serum creatinine in consecutive follow-up samples) by 20% (hazard ratio 0·80 [95% CI 0·72–0·88]; 1573 outcomes), acute kidney injury adverse events by 27% (0·73 [0·63–0·85]; 694 outcomes), a categorical chronic kidney disease progression outcome by 30% (0·70 [0·63–0·78]; 1403 outcomes), and kidney failure by 34% (0·66 [0·55–0·79]; 490 outcomes). Empagliflozin slowed a chronic annual rate of eGFR decline by 64% (95% CI 59–69) and off-treatment dip-free slope—a post-hoc outcome using randomisation and off-treatment eGFR values available in a subset of 10 630 participants—by 64% (54–73). These kidney benefits were similar in subgroups divided by predicted size of acute eGFR dip, and were present irrespective of diabetes or heart failure status, level of kidney function, or albuminuria.<h3>Interpretation</h3>SGLT2 inhibition reduces risk of acute and chronic kidney outcomes irrespective of the size of the acute dip in eGFR. Kidney benefits are evident irrespective of diabetes status, heart failure status, primary cause of kidney disease, and markers of severity of these diseases.<h3>Funding</h3>None.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"52 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empagliflozin in chronic kidney disease: evidence for early, inclusive, and confident use","authors":"Carmine Zoccali, Francesca Mallamaci","doi":"10.1016/s2213-8587(25)00224-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00224-4","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"104 5 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has the WHO Model Essential Medicines List lost its way?","authors":"David Beran, Amanda Adler, Carol Abidha, Naomi Levitt, Nikhil Tandon, Janeth Tenorio Mucha, John S Yudkin, Stephen Colagiuri","doi":"10.1016/s2213-8587(25)00292-x","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00292-x","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"5 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolutionary basis for type 2 diabetes prevalence in the Arabian Peninsula","authors":"Hamad Ali, Barrak Alahmad, Mohamed Abu-Farha, Jehad Abubaker, Fahd Al-Mulla","doi":"10.1016/s2213-8587(25)00294-3","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00294-3","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"54 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145216142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral CB1 receptor blockade for treatment of obesity","authors":"Kishore M Gadde, Jonanne Talebloo, Daniele Piomelli","doi":"10.1016/s2213-8587(25)00255-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00255-4","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"53 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}