Primary Care Diabetes最新文献

{"title":"Editorial Board and Aims & Scopes","authors":"","doi":"10.1016/S1751-9918(25)00211-6","DOIUrl":"10.1016/S1751-9918(25)00211-6","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages ii-iii"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of online health management on type 2 diabetes mellitus: A systematic review and meta-analysis","authors":"Yiwei Qiu ,&nbsp;Yao Tang ,&nbsp;Yixuan Li ,&nbsp;Li Cheng ,&nbsp;Xu Wang ,&nbsp;Baofeng Du ,&nbsp;Ruhai Bai","doi":"10.1016/j.pcd.2025.08.010","DOIUrl":"10.1016/j.pcd.2025.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Online health management has been implemented to improve glycemic control in patients with type 2 diabetes mellitus (T2DM). This study aims to evaluate the effectiveness of online health management interventions in managing T2DM through a systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in six databases—PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, and Wanfang Data—from January 1, 2010, to September 1, 2024. Eligible studies included randomized controlled trials (RCTs) involving adults (≥ 18 years) diagnosed with T2DM. Two independent reviewers screened the studies and assessed the risk of bias. Meta-analyses were performed using Review Manager 5.4 (Cochrane Collaboration). The primary outcomes included glycated hemoglobin (HbA1c), fasting blood glucose (FBG), and postprandial blood glucose (PBG).</div></div><div><h3>Results</h3><div>Out of 6283 records screened, 44 RCTs involving 27,178 T2DM patients were included (16,972 in the intervention group and 10,206 in the control group). Pooled results showed that online health management interventions significantly improved HbA1c, FBG, PBG, systolic blood pressure, diastolic blood pressure, and waist circumference. Improvements were also observed in dietary behavior, physical activity, and self-efficacy. However, no significant effects were found on body weight, body mass index, or lipid metabolism parameters, including total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. Subgroup analyses indicated that interventions delivered by physicians, those targeting individuals aged ≥ 60 years, and those using digital coaching for less than six months were more effective in glycemic control.</div></div><div><h3>Conclusion</h3><div>Online health management interventions may effectively support glycemic and blood pressure control and self-management in T2DM patients. Nevertheless, additional research with larger sample sizes and more extended follow-up periods is justified due to the substantial heterogeneity and limitations across the included studies.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 561-576"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and patterns in antidiabetic medication prescriptions: Insights from Greece’s electronic prescription database","authors":"Stefanos Karakolias ,&nbsp;George Mavridoglou ,&nbsp;Nikolaos Polyzos","doi":"10.1016/j.pcd.2025.08.004","DOIUrl":"10.1016/j.pcd.2025.08.004","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to analyze the patterns and trends of antidiabetic medication prescriptions in Greece using data from the National Electronic Prescription Database.</div></div><div><h3>Methods</h3><div>This retrospective observational study used real-world data from the Greek electronic prescription database from 2015 to 2021. The study population included all patients with a confirmed diagnosis of diabetes mellitus. Data on medication details, prescribing patterns, and costs were extracted and analyzed using descriptive statistical methods.</div></div><div><h3>Results</h3><div>The study revealed that blood glucose-lowering drugs, excluding insulins (A10B), accounted for 86.1 % of the total quantity prescribed, while insulins (A10A) contributed significantly to the total cost (28.3 %). Newer drug classes like DPP-4 inhibitors and GLP-1 analogues showed increasing trends, while some older medications declined in use. Prescribing patterns varied among medical specialties, with internal medicine and general practice physicians being the primary prescribers of these drugs.</div></div><div><h3>Conclusions</h3><div>This study highlights significant shifts in antidiabetic medication prescribing patterns in Greece, with a trend towards newer drug classes. These findings have important implications for healthcare policy, including the need to promote the cost-effective use of newer medications, manage patient transitions between drug classes, and address insulin affordability and access.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 651-657"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular disease burden and macrovascular outcomes in type 2 diabetes: Risk calculator in Taiwan","authors":"Chih-Yuan Wang ,&nbsp;Jung-Fu Chen ,&nbsp;Shih-Te Tu ,&nbsp;Chun-Chuan Lee ,&nbsp;Horng-Yih Ou","doi":"10.1016/j.pcd.2025.09.004","DOIUrl":"10.1016/j.pcd.2025.09.004","url":null,"abstract":"<div><div>The growing prevalence of type 2 diabetes mellitus (T2DM) poses a significant challenge to healthcare systems globally. Microvascular diseases, including diabetic kidney disease, retinopathy, and neuropathy, are frequent complications of T2DM and may signal an increased risk of macrovascular diseases, such as stroke and myocardial infarction. This study, based on prior findings from a nationwide cohort in Taiwan demonstrated that individuals with two or more macrovascular complications had elevated risks of cardiovascular events and mortality over a median follow-up of 3.3 years. Building on this, the current study develops a practical risk calculator for predicting 3-year cardiovascular risk. Shared pathogenic mechanisms, such as vascular injury, endothelial dysfunction, and autonomic neuropathy, may suggest these associations. In response, we developed a Risk Engine Calculator that incorporates the number of microvascular diseases, elevated HbA1c, systolic blood pressure, LDL cholesterol, and insulin use to estimate 3-year cardiovascular risk in patients with T2DM without established macrovascular complications. Patients are stratified into low, moderate, or high risk categories to guide clinical decision-making. While the calculator is practical and evidence-based, limitations include its additive design, potential simplification of risk relationships, and relatively short follow-up period. Overall, this study underscores the importance of integrating microvascular diseases burden into cardiovascular risk assessment and provides a user-friendly tool to support precision medicine in diabetes management.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 678-680"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of resistance training among individuals living with diabetes, prediabetes, and without diabetes: 2017–2023 BRFSS","authors":"Anthony Figueroa ,&nbsp;Ariella Palmieri ,&nbsp;Lu Shi ,&nbsp;Willie Leung","doi":"10.1016/j.pcd.2025.09.001","DOIUrl":"10.1016/j.pcd.2025.09.001","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to compare the weekly resistance training (RT) frequency between people with diabetes, prediabetes, and without diabetes.</div></div><div><h3>Methods</h3><div>A total of 536,703 participants from 2017 to 2023 Behavioral Risk Factors Surveillance System were included in the analysis. Unadjusted and adjusted Poisson regression was performed to compare weekly resistance training frequency among participants with different diabetes statuses (without diabetes, prediabetes, and with diabetes).</div></div><div><h3>Results</h3><div>89.28 % (95 % CI [89.11, 89.45]) of participants did not have diabetes, 1.67 % (95 % CI [1.59, 1.73]) had prediabetes, and 9.10 % (95 % CI [8.91, 9.22]) had diabetes. Across the sample, the averages weekly RT frequency among the sample was 1.73 times (95 % CI [1.71, 1.74]). Participants without diabetes had the highest weekly RT frequency of 1.79 (95 % CI [1.71, 1.74]) times. Participants with prediabetes had the weekly RT frequency of 1.38 (95 % CI [1.26, 1.50]) times and participants with diabetes had the lowest average frequency between the three groups with 1.19 (95 % CI [1.15, 1.23]) times per week. The unadjusted and adjusted linear regression found that people with diabetes had less weekly RT frequency than participants without diabetes (β=-.60, p &lt; .01; αβ=-.23, p &lt; .01). Participants with prediabetes also had lower weekly RT frequency in the unadjusted regression compared to participants without diabetes (β=-.41, p &lt; .01).</div></div><div><h3>Conclusion</h3><div>People with prediabetes and diabetes might face personal and environmental barriers in engaging in RT, leading to lower weekly RT frequency compared to those without diabetes. There is a need to overcome barriers and continue promote RT among people with and without diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 684-689"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Ramadan education decreases hypoglycemic events in fasting group","authors":"Muhammad Mohid Haroon","doi":"10.1016/j.pcd.2025.08.003","DOIUrl":"10.1016/j.pcd.2025.08.003","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 690-691"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the IDF-DAR risk tool for fasting in Ramadan for adults with diabetes mellitus in primary care: A nationwide multicentre study in Malaysia","authors":"Jazlan Jamaluddin ,&nbsp;Nik Aminah Nik Abdul Kadir ,&nbsp;Lin Xiang Goh ,&nbsp;Dayang Haniffa Abang Hashim ,&nbsp;Nur Athirah Rosli ,&nbsp;Nurfauzani Ibrahim ,&nbsp;Sharifah Syadiyah Syed Saffi ,&nbsp;Siti Nur Hidayah Abd Rahim","doi":"10.1016/j.pcd.2025.08.002","DOIUrl":"10.1016/j.pcd.2025.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Fasting during Ramadan is a religious obligation for Muslims but poses health risks for individuals with diabetes mellitus. The International Diabetes Federation–Diabetes and Ramadan Alliance (IDF-DAR) introduced a risk stratification tool in 2021 to guide clinicians, though its utility in primary care settings remains limited.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted on adults with diabetes attending government health clinics in Malaysia from April 15 to June 15, 2024. Medical records of those who attempted fasting during Ramadan were reviewed. The primary outcome was a composite of hypoglycaemia, hyperglycaemia, diabetes-related hospitalization, or dehydration leading to breaking the fast. Discriminative performance of the IDF-DAR tool was evaluated using area under the receiver operating characteristic curve (AUC). Calibration was assessed via the Hosmer-Lemeshow test.</div></div><div><h3>Results</h3><div>A total of 310 patients were included (99 % with type 2 diabetes). The mean age was 61 years and the median diabetes duration was 7 years. Adverse fasting outcomes were observed in 18.4 % of patients, with hypoglycaemia being the most common (13.5 %). The IDF-DAR risk stratification tool demonstrated good discriminative ability, achieving an area under the ROC curve (AUC) of 0.78 (95 % CI: 0.72–0.84). At the recommended cut-off for distinguishing low-moderate from high-risk categories, the tool achieved a sensitivity of 92.9 % and a specificity of 40.9 %. The Hosmer-Lemeshow goodness-of-fit test indicated poor agreement between observed and predicted adverse outcomes, with a statistically significant result (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The IDF-DAR risk stratification tool identifies high-risk patients fasting during Ramadan in primary care. However, its poor calibration and specificity as highlights the need for refinement of the model to improve its predictive accuracy. Enhancing the tool's calibration could allow for better individual risk estimation and more precise clinical decision-making in diverse primary care settings.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 608-612"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to gout treatment guidelines in patients with diabetes: A Danish prospective cohort study with 4 years of follow-up","authors":"Claus Rasmussen ,&nbsp;Jesper Walther Larsen ,&nbsp;Peter Clement Waldhauer Holm ,&nbsp;Søren Terpager Jepsen ,&nbsp;Gunnar Lauge Nielsen","doi":"10.1016/j.pcd.2025.08.006","DOIUrl":"10.1016/j.pcd.2025.08.006","url":null,"abstract":"<div><h3>Aims</h3><div>Diabetes affects about 6 % of the global population, with 20 % developing foot ulcers. Gout impacts approximately 3 %, but fewer than 40 % receive adequate urate-lowering therapy to prevent or dissolve tophi in the feet. This study assessed adherence to recommended gout treatment in patients with diabetes.</div></div><div><h3>Methods</h3><div>From a prospective cohort of gout patients, confirmed by microscopy-identified urate crystals, we identified those with concomitant diabetes. Patients were treated in various real-life healthcare settings. The primary outcome was achieving target serum urate levels four years post-diagnosis: &lt; 0.36 mmol/L for general gout management and &lt; 0.30 mmol/L for tophi patients.</div><div>Results: Of 286 gout patients, 85 (30 %) had diabetes. The median age was 71 years, and 76 % were male, with common comorbidities. Urate levels sufficient to prevent new tophi were maintained by 58 %. However, 45 % had tophi at diagnosis, and only 46 % of these achieved levels low enough to dissolve tophi.</div></div><div><h3>Conclusions</h3><div>Gout in patients with diabetes is often inadequately managed, potentially leading to persistent tophi, which may ulcerate and contribute to foot ulcers. These findings likely reflect typical treatment settings. Affordable and effective gout treatment could prevent tophi formation and improve outcomes. Consideration of gout screening in diabetes management guidelines is recommended.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 613-617"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A structured education program for improving cardiovascular risk and glycaemic control in type 2 diabetes mellitus (the SUGAR study)","authors":"Mark P. Ranasinghe ,&nbsp;Marly Ranasinghe ,&nbsp;Mayurathan Balachandran ,&nbsp;Vinay Goel ,&nbsp;Sulochi Subasinghe ,&nbsp;Shane Nanayakkara","doi":"10.1016/j.pcd.2025.09.008","DOIUrl":"10.1016/j.pcd.2025.09.008","url":null,"abstract":"<div><h3>Aims</h3><div>Structured community-based diabetes education programs may improve cardiometabolic outcomes, yet objective evidence remains limited. We evaluated the efficacy of a multidisciplinary education program in improving glycaemic control and cardiovascular risk factors in adults with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>Adults with T2DM participated in a four-week program comprising weekly two-hour sessions on diabetes and cardiovascular disease, nutrition, exercise, and mental health. HbA1c, body mass index (BMI), weight, blood pressure, and lipid profile were assessed at baseline and at 3, 6, and 12 months. Outcomes were analysed using pooled linear mixed-effects models with multiple imputation, with sensitivity analyses excluding participants requiring pharmacotherapy escalation.</div></div><div><h3>Results</h3><div>Fifty participants (median age 49 years; 38 % female) completed the program. HbA1c improved significantly and was sustained at 12 months (−1.57 % (95 %CI(-1.96, −1.17), p &lt; 0.001). LDL cholesterol (-0.51 mmol/L (95 %CI(-0.71,-0.30), <em>p</em> &lt; 0.001), triglycerides (-0.86 mmol/L (95 %CI(-1.34,-0.39), p = 0.001), and BMI (−1.45 kg/m², 95 %CI(-1.99,-0.91), p &lt; 0.001) also improved at 12 months. These findings were supported by sensitivity analysis for HbA1c, but attenuated for other cardiometabolic parameters at 12 months.</div></div><div><h3>Conclusions</h3><div>A structured, multidisciplinary community-based education program was associated with significant improvements in glycaemic control and key parameters of cardiometabolic risk. As a cost-efficient model, it offers a scalable strategy for T2DM management in primary care, warranting further evaluation of interactions with pharmacotherapy.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 592-601"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying high glucose variability using non-glycemic factors in low continuous glucose monitoring use settings","authors":"Suresh Rama Chandran ,&nbsp;Ming Ming Teh ,&nbsp;Hong Chang Tan ,&nbsp;May Zin Oo ,&nbsp;Alcey Ang Li Chang ,&nbsp;Daphne Gardner","doi":"10.1016/j.pcd.2025.08.008","DOIUrl":"10.1016/j.pcd.2025.08.008","url":null,"abstract":"<div><h3>Aims</h3><div>Identifying non-glycemic factors associated with high Glucose variability (GV).</div></div><div><h3>Methods</h3><div>A cross-sectional observational study recruited people with type 2 diabetes, who wore a Freestyle Libre Pro CGM. Independent variables: Age, sex, BMI, diabetes medication, diabetes duration, HbA1c and estimated glomerular filtration rate (eGFR). CGM-derived variables calculated included Time-in-Range (TIR, 70–180 mg/dl), below-range 1 (TBR1, &lt;70 mg/dl), -below-range 2 (TBR2, &lt;54 mg/dl) and -above-range (TAR, &gt;180 mg/dl), coefficient of variation (%CV). A logistic regression model examined independent variables associated with high GV (CV ≥36 %). All analysis was done on R version 4.3.1</div></div><div><h3>Results</h3><div>T2D cohort (n = 403), 46 % women, had median age of 61 y, BMI of 26.5 kg/m², diabetes duration 14 y, HbA1c 7.8 %(62 mmol/mol) and creatinine of 75 µmol/L. Using sulphonylurea, premixed or basal-bolus insulin had an odds ratio (OR) of 4.7 – 5.2 for CV ≥ 36 %. Longer diabetes duration [OR 1.2], and lower eGFR [OR 1.2] were associated with higher odds and older age [OR 0.8]and higher BMI [0.8] were associated with lower odds of CV≥ 36 %. Sex and HbA1c had no association with high GV.</div></div><div><h3>Conclusion</h3><div>Nonglycemic-factors like medication type, diabetes duration and eGFR can aid in identification of high GV even in low-CGM use settings.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 624-628"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}