Journal of Diabetes Investigation最新文献

{"title":"Response to Commentary on ‘Diminished levels of insulin-like growth factor-1 may be a risk factor for peripheral neuropathy in type 2 diabetes patients’","authors":"Jingyi Zhong,&nbsp;Xiaopu Lin,&nbsp;Xiaobin Zheng,&nbsp;Yanting Zhou,&nbsp;Haishan Huang,&nbsp;Lingling Xu","doi":"10.1111/jdi.70017","DOIUrl":"10.1111/jdi.70017","url":null,"abstract":"<p>We truly value the readers' meticulousness and conscientiousness. Future studies will incorporate these instructive recommendations to further investigate diabetic neuropathy.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"762"},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply to Letter to Editor in response to the article “Rising mortality rates linked to type-2 diabetes and obesity in the United States: An observational analysis from 1999 to 2022”","authors":"Mushood Ahmed,&nbsp;Aimen Shafiq,&nbsp;Raheel Ahmed","doi":"10.1111/jdi.70013","DOIUrl":"10.1111/jdi.70013","url":null,"abstract":"<p>We read the letter by Khan<span>¹</span> regarding our study<span>²</span> with great interest. We appreciate the comments regarding the interpretation of age-adjusted mortality rates (AAMR) and annual percentage changes (APCs) in our study.</p><p>The APC analysis identifies statistically significant trend changes in mortality rates based on segmented regression modeling conducted with Joinpoint software in our study<span>³</span>. Joinpoint is made by the National Cancer Institute specifically for trend analysis of epidemiological data. It objectively detects inflection points in the data. In our case, the model determined that a significant change in AAMR trajectory began in 2017, even though the steepest visual increase in AAMR appears after 2019. This difference arises as APC considers both the magnitude and statistical significance of rate changes over time, which may not always align precisely with visual trends, especially when year-to-year fluctuations occur. This is reported in figure S1B and table S2 of our study<span>²</span>.</p><p>Moreover, to help readers who might not be familiar with the interpretation of AAMRs in the context of APCs, we created a bar graph as indicated in figure 2 depicting a 3.5-fold increase in AAMR after 2019<span>²</span>. This highlights the impact of the COVID-19 pandemic on mortality in patients with type 2 diabetes and obesity.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"763"},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Diminished levels of insulin-like growth factor-1 may be a risk factor for peripheral neuropathy in type 2 diabetes patients”","authors":"Mostafa Javanian,&nbsp;Mohammad Barary,&nbsp;Fatemeh Rasulpur,&nbsp;Ali Alizadeh Khatir,&nbsp;Soheil Ebrahimpour","doi":"10.1111/jdi.70009","DOIUrl":"10.1111/jdi.70009","url":null,"abstract":"<p>Dear Editor,</p><p>We read with interest the article “Diminished levels of insulin-like growth factor-1 may be a risk factor for peripheral neuropathy in patients with type 2 diabetes,” published in your esteemed journal. The study found that the diminished levels of insulin-like growth factor-1 may be a risk factor for peripheral neuropathy in patients with type 2 diabetes<span>¹</span>. The aims of this study were to determine the risk factors related to diabetic peripheral neuropathy (DPN) and to investigate the association of insulin-like growth factor-1 (IGF-1) with DPN in patients with type 2 diabetes. Barbarella <i>et al</i>. (2016) observed a significant decrease in IGF-1 levels in patients with DPN, pinpointing the idea that IGF-1 is a protective factor against injury that impacts the effect of the large fiber nerve in type 2 DM. We commend the authors for their contribution to this important area of research. However, the study has some potential limitations, which, if addressed, could improve the applicability and relevance of the work.</p><p>First, these findings could be significantly enhanced by the addition of relevant laboratory parameters. Without such data, the results would generally be less valid. Adding biomarkers like erythrocyte sedimentation rate (ESR), albumin, platelet count, interleukin-1 (IL-1) receptor antagonist (IL-1RA), IL-6, IL-18, vitamin B12, vitamin D3, serum zinc and potassium levels, the platelet-to-lymphocyte ratio (PLR), and the neutrophil-to-lymphocyte ratio (NLR) can you can find more information about the probability of poor results<span>^{2, 3}</span>. Second, the analysis is further limited by a failure to adjust for critical comorbid conditions such as both psychological disorders and diabetic retinopathy, both of which will have a marked impact on overall patient outcomes.</p><p>Moreover, the lack of detail in the demographic variables, including smoking habit (heavy smoker, current smoker, former smoker), alcohol use (mild, moderate, or severe), education level, socioeconomic status, nutritional intake, and toxins, does render this study non-definitive at least. The inclusion of these variables in future studies is crucial for a more comprehensive understanding of the disease. Other necessary limits are opacity in the assessments of bone malformations, physical activity levels, hyperinsulinemia, and insulin resistance<span>⁴</span>.</p><p>Overall, the present study has highlighted the correlation between IGF-1 and the prevalence of DPN in patients with T2D. While the points raised earlier could be addressed in future studies, their resolution could lead to significant advancements in patient care. We hope that the adoption of our recommendations will ultimately result in improved patient outcomes.</p><p>The authors declare no conflict of interest.</p><p>No ethical approval was required as this letter-to-the-editor article has no original research data.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"760-761"},"PeriodicalIF":3.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetic properties of once-weekly insulin icodec in Chinese individuals with type 2 diabetes","authors":"Yijun Li,&nbsp;Ariel Fu,&nbsp;Shan Jiang,&nbsp;Ann-Katrine Kjærsgaard Jøns,&nbsp;Beibei Liang,&nbsp;Qi Ni,&nbsp;Rasmus Ribel-Madsen,&nbsp;Lisbet Westergaard","doi":"10.1111/jdi.70005","DOIUrl":"10.1111/jdi.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Insulin icodec is a novel once-weekly basal insulin developed for the treatment of diabetes. The aim of this study was to investigate the pharmacokinetics of icodec in Chinese individuals with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In an open-label, single-group study, 24 Chinese individuals with type 2 diabetes (18–64 years, glycated hemoglobin ≤9.0%, body mass index 18.0–38.0 kg/m²) were treated with once-weekly icodec for 6 weeks. The icodec dose was constant and individualized, aimed at achieving self-measured plasma glucose of 4.4–7.0 mmol/L before breakfast. Blood samples were drawn from the first icodec dose until 35 days after last dose and were analyzed for total serum icodec concentration (i.e., the sum of albumin-bound and unbound icodec).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Icodec trough concentrations measured following initiation of once-weekly icodec dosing suggested that clinical steady state for icodec was achieved after approximately 3–4 weeks of dosing. When at steady state, icodec exposure covered the full 1-week dosing interval. The geometric mean half-life was 159 h. The slopes of total icodec exposure (AUC_τ,SS) and maximum icodec concentration (<i>C</i>_max,SS) vs icodec dose did not differ significantly from 1, supporting dose-proportionality for both AUC_τ,SS (<i>P</i> = 0.40) and <i>C</i>_max,SS (<i>P</i> = 0.43). Icodec was safe and well tolerated, and no new safety issues were identified in relation to icodec in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The pharmacokinetic properties of icodec assessed at steady state in this study demonstrated well-distributed exposure across the 1-week dosing interval and a half-life that supports once-weekly administration in Chinese individuals with type 2 diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"639-645"},"PeriodicalIF":3.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is new in metabolic dysfunction-associated steatotic liver disease?","authors":"Kathryn CB Tan","doi":"10.1111/jdi.70003","DOIUrl":"10.1111/jdi.70003","url":null,"abstract":"<p>The change in nomenclature from nonalcoholic fatty liver disease to metabolic dysfunction associated-steatotic liver disease has emphasized the importance of metabolic abnormalities in this liver disorder. New pharmacological therapy has recently become available and resmetirom, a thyroid hormone receptor agonist, has received approval for the treatment of non-cirrhotic metabolic dysfunction-associated steatohepatitis and significant liver fibrosis.\u0000 <figure>\u0000 <div><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"581-583"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143072963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights from the fructose-derived product glucoselysine: Revisiting the polyol pathway in diabetic complications","authors":"Hiroko Yamaguchi,&nbsp;Ryoji Nagai","doi":"10.1111/jdi.70000","DOIUrl":"10.1111/jdi.70000","url":null,"abstract":"<div>\u0000 \u0000 <p>Advanced glycation end-products (AGEs) have been extensively studied because of their close association with the onset and progression of diabetic complications. However, owing to their formation through diverse metabolic pathways, AGEs often reflect a wide range of pathological conditions rather than being specific to diabetic complications. Consequently, identifying an AGE that directly correlates only with diabetic complications remains a challenge. Chronic hyperglycemia not only saturates the glycolytic pathway but also upregulates the polyol pathway, leading to the excessive production of fructose, a highly reactive reducing sugar. Although it has long been understood that fructose-derived AGEs contribute to diabetic complications, their chemical structures remain unidentified. Recent breakthroughs have revealed that glucoselysine (GL) is a primary fructose-specific AGE. Unlike other AGEs, GL is exclusively formed from fructose and not from other reducing sugars, such as glucose or galactose. This specificity provides GL with a distinct advantage in that its production pathway can be traced, making it a reliable indicator of polyol pathway activity. Furthermore, emerging evidence suggests that GL levels correlate with the progression of diabetic complications, including both micro- and macrovascular complications, making it a promising biomarker. GL's potential extends beyond diagnostics, as it may serve as a therapeutic target for managing complications associated with prolonged hyperglycemia and enhanced of polyol pathway. This review focuses on the enhanced polyol pathway and the formation of GL and discusses its biochemical characteristics, clinical significance, and potential as a novel diagnostic marker and therapeutic target in diabetic care.</p>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"569-577"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143072960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent updates to understand the heterogeneity of type 2 diabetes mellitus","authors":"Jianping Weng","doi":"10.1111/jdi.70001","DOIUrl":"10.1111/jdi.70001","url":null,"abstract":"<p>This is an inivitation article for ‘JDI updates’ series, focusing on the heterogeneity of type 2 diabetes.\u0000 <figure>\u0000 <div><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"578-580"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143072962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of exercise on GDF-15 levels in individuals with prediabetes: A randomized controlled trial","authors":"Elif Yıldırım Ayaz,&nbsp;Banu Mesci,&nbsp;Özden Ezgi Üner,&nbsp;Fatoş Nimet Kaya,&nbsp;Berna Dincer,&nbsp;Ferruh Kemal İşman,&nbsp;Aytekin Oğuz","doi":"10.1111/jdi.14404","DOIUrl":"10.1111/jdi.14404","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Growth differentiation factor-15 (GDF-15) is an inflammatory cytokine that increases in prediabetes and is known for its anorexigenic effects. This study aims to evaluate the effects of a 12-week exercise program on GDF-15 in individuals with prediabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this multicenter, parallel-group, randomized-controlled trial, 64 patients aged 18–60 diagnosed with prediabetes were randomized in a 1:1 ratio into the exercise group (E) and the control group (C). Additionally, 32 patients who were planned to start metformin were included in the metformin group (M). Participants in the exercise group engaged in aerobic exercise at 50–70% of their maximum heart rate for 60 min, 3 days a week. Serum GDF-15 levels were evaluated at the beginning and the end of the 12th week.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the 91 participants who completed the study was 46.13 ± 8.52 years, and 23.1% were male. Basal GDF-15 levels were similar among the groups (E = 668.6 ± 415.1, C = 651.8 ± 352.5, M = 603.6 ± 387.2, <i>P</i> = 0.47). At the 12th week, GDF-15 levels were lower in the E compared to the C, while higher in the M compared to the C (E = 383.1 ± 215.6, C = 556.4 ± 285.6, M = 810.8 ± 498.0, <i>P</i> &lt; 0.001). In inter-group comparisons, no significant change was observed in the C between the 0th and 12th weeks, while GDF-15 decreased in the E (<i>P</i> &lt; 0.001) and increased in the M (<i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It was determined that in individuals with prediabetes, GDF-15, which serves both as a biomarker of metabolic disorder and has a negative regulatory effect on appetite, decreased with 12 weeks of aerobic exercise and increased with metformin administration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"656-669"},"PeriodicalIF":3.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics and risk factors for heart failure in Japanese patients with type 2 diabetes: A retrospective analysis of the J-DREAMS database","authors":"Mitsuru Ohsugi,&nbsp;Daisuke Nitta,&nbsp;Yusuke Naito,&nbsp;Kohjiro Ueki","doi":"10.1111/jdi.14378","DOIUrl":"10.1111/jdi.14378","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To determine the epidemiological characteristics and risk factors for heart failure (HF) among Japanese patients with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort analysis, using J-DREAMS database, was conducted from December 2015 to January 2020 with type 2 diabetes. The primary objectives were to describe patient characteristics stratified by HF history at baseline and new HF events during follow-up. The secondary objectives were to clarify the association between HF history or new HF events and clinical characteristics. The association between renal disease stage and HF was also studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 18,250 adult patients with type 2 diabetes, 3,613 (19.8%) patients had HF history and the mean age was 68.46 years, predominantly male (66.4%) with 13.32 years of mean duration of type 2 diabetes. Patients with HF history had a higher proportion of patients with nephropathy (51.2%) and coronary heart disease (55.6%) than those without HF history. Coronary heart disease (CHD) and deteriorating renal function were strongly associated with both HF history (CHD adjusted odds ratio [OR]: 7.41, 95% confidence interval [CI]: 6.05–9.08; eGFR G5 stage adjusted OR: 6.56, 95% CI: 2.97–14.49) and new HF events (CHD adjusted OR: 1.63, 95% CI: 1.17–2.29; eGFR G4 stage adjusted OR: 3.42, 95% CI: 1.81–6.47).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Comorbidities, especially CHD and deteriorating renal function, were strongly associated with HF history and new HF events among Japanese patients with type 2 diabetes. The study results suggested the importance of early intervention to treat comorbidities and maintain renal function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 3","pages":"414-425"},"PeriodicalIF":3.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of maternal overweight/obesity and high fasting plasma glucose on adverse perinatal outcomes in early gestational diabetes mellitus","authors":"Noriyuki Iwama,&nbsp;Maki Yokoyama,&nbsp;Hiroshi Yamashita,&nbsp;Kei Miyakoshi,&nbsp;Ichiro Yasuhi,&nbsp;Maki Kawasaki,&nbsp;Naoko Arata,&nbsp;Shiori Sato,&nbsp;Yuko Iimura,&nbsp;Waguri Masako,&nbsp;Haruna Kawaguchi,&nbsp;Naoki Masaoka,&nbsp;Yoshiyuki Nakajima,&nbsp;Yuji Hiramatsu,&nbsp;Takashi Sugiyama,&nbsp;DREAMBee Study Gestational Diabetes Mellitus Group","doi":"10.1111/jdi.14411","DOIUrl":"10.1111/jdi.14411","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To elucidate risk factors associated with adverse perinatal outcomes in early-gestational diabetes mellitus (GDM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A dataset of 385 early-GDM cases from a prospective cohort was analyzed. Early-GDM was diagnosed if one or more of the following criteria were met: fasting plasma glucose (PG) levels of 92–125 mg/dL, 1-h PG levels ≥180 mg/dL, and 2-h PG levels ≥153 mg/dL during a 75-g oral glucose tolerance test before 20 weeks of gestation. Multivariate analysis was used to examine associations between candidate risk factors and a composite outcome of maternal and neonatal adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pre-pregnancy overweight/obesity (pre-pregnancy body mass index [BMI] ≥25.0 kg/m²) was significantly associated with a higher risk of the composite outcome compared with normal weight (pre-pregnancy BMI of 18.5–24.9 kg/m²), an adjusted risk ratio (aRR) of 1.44 (95% confidence interval [CI]: 1.08–1.93), and an adjusted risk difference (aRD) of 13.6% (95% CI: 2.6–24.6%). Compared with fasting PG levels below 92 mg/dL, levels between 95 and 125 mg/dL were associated with a significantly higher risk of the composite outcome, with an aRR and aRD of 1.42 (95% CI: 1.01–1.99) and 12.9% (95% CI: 0.3–25.5%), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early-GDM, combined with pre-pregnancy overweight/obesity and/or fasting PG levels of 95–125 mg/dL, is associated with a higher risk of adverse perinatal outcomes and should be prioritized for intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 4","pages":"744-754"},"PeriodicalIF":3.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}