Journal of Diabetes Investigation最新文献

{"title":"Prevalence, incidence, and risk factors of diabetic retinopathy and macular edema in patients with early and late-onset type 2 diabetes mellitus","authors":"Ching-Kit Tsui,&nbsp;Andina Hu,&nbsp;Yuntong Li,&nbsp;Wenyong Huang,&nbsp;Wei Wang,&nbsp;Kaiqun Liu,&nbsp;Liqiong Xie,&nbsp;Yuting Li,&nbsp;Nathan Congdon,&nbsp;Xiaoling Liang,&nbsp;GDES Group","doi":"10.1111/jdi.70027","DOIUrl":"10.1111/jdi.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To compare the prevalence, incidence, and factors of diabetic retinopathy (DR) and macular edema (DME) in patients with early-onset (EOD) and late-onset diabetes (LOD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants with type 2 diabetes mellitus (T2DM) were recruited from a community-based study conducted in southern urban China. Participants were followed up for 2 years. The prevalence and incidence of DR and DME were compared between EOD (≤40 years) and LOD (&gt;40 years) groups, and potential factors were evaluated using multivariate logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2,703 participants, 173 (6.4%) with EOD had a higher prevalence of DR than 2,530 (93.6%) with LOD (27.8% vs 15.5%, <i>P</i> &lt; 0.001). Participants with EOD had a higher incidence of DR, although this difference was not statistically significant (EOD: 8.1% vs LOD: 3.6%, <i>P</i> = 0.12). Insulin use and higher HbA1c levels were significantly associated with DR in both EOD and LOD groups (both <i>P</i> &lt; 0.05). Additionally, longer diabetes duration, higher systolic blood pressure, and the presence of albuminuria independently associated with the presence of any DR in LOD patients (all <i>P</i> &lt; 0.05). For DME, HbA1c level was a significant association in EOD, while in LOD, age, BMI, insulin use, and albuminuria were significant factors (all <i>P</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A higher prevalence of DR was observed among patients with early-onset T2DM in urban southern China. Timely diagnosis of DR and regular eye care services are needed for early-onset T2DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 7","pages":"1254-1262"},"PeriodicalIF":3.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957963","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":"Update on slowly progressive type 1 diabetes","authors":"Yoichi Oikawa,&nbsp;Akifumi Haisa,&nbsp;Atsushi Satomura,&nbsp;Akira Shimada","doi":"10.1111/jdi.70046","DOIUrl":"10.1111/jdi.70046","url":null,"abstract":"&lt;p&gt;Type 1 diabetes is a metabolic disease in which the destruction of pancreatic β cells leads to absolute insulin deficiency and chronic hyperglycemia, mainly due to islet cell autoimmunity&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;. Different islet cell-associated autoantibodies are important in this diagnosis, including anti-glutamic acid decarboxylase antibody (GADA), anti-insulinoma-associated antigen-2 antibody (IA-2A)&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;, anti-insulin autoantibody (IAA), anti-zinc transporter 8 antibody (ZnT8A), and islet cell antibody (ICA). Type 1 diabetes can be classified into three types: acute-onset, slowly progressive, and fulminant type 1 diabetes&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt;. In recent years, many cases of type 1 diabetes associated with immune checkpoint inhibitors have been reported&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;. Historically, the presence of GADA or ICA in people with diabetes in a non-insulin-dependent state has led to a diagnosis of slowly progressive type 1 diabetes (slowly progressive insulin-dependent diabetes mellitus; SPIDDM). However, the diagnostic criteria for SPIDDM were revised in Japan in 2023, with more strict guidelines&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;. In addition, a statement regarding therapeutic interventions for suspected SPIDDM cases has been issued&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;. This article focuses on these topics in addition to the latest information on SPIDDM pathogenesis.&lt;/p&gt;&lt;p&gt;Persons with SPIDDM are non-insulin-dependent in the early stages of the disease and present a clinical picture similar to that of type 2 diabetes. However, as the disease progresses, their ability to secrete insulin gradually decreases and they finally become insulin-dependent&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;. Since the diagnostic criteria require the presence of islet-related autoantibodies such as GADA, it is inferred that autoimmune responses targeting β cells are involved in the pathological condition. We previously reported that, in approximately 22% of participants with SPIDDM, including suspected cases, mononuclear cells producing interferon-γ (T helper 1 [Th1] response) reactive to the insulin peptide consisting of amino acids 9–23 (B9-23) of the insulin B chain and its adjacent peptides (hereinafter referred to as insulin B9-23-related peptides) were detected in their peripheral blood&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt;. In addition, there was a significant negative correlation between the peripheral frequency of these mononuclear cells and the capability to secrete endogenous insulin&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt;. These findings suggest that insulin B9-23-related peptides may play an important role as autoantigens in SPIDDM development, with the insulin peptide-specific Th1 responses potentially reflecting disease activity.&lt;/p&gt;&lt;p&gt;Previous studies on SPIDDM demonstrated that people with diabetes in a non-insulin-dependent state with a GADA titer of ≥10 U/mL measured through a radioimmunoassay (RIA) (GADA-RIA) are at a higher risk for future progression to an insulin-depende","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 6","pages":"989-991"},"PeriodicalIF":3.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810145","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":"Pathogenic variants prevalence patients with diabetic kidney disease in Japan: A descriptive study","authors":"Toyohiro Hashiba,&nbsp;Yuka Sugawara,&nbsp;Yosuke Hirakawa,&nbsp;Dai Sato,&nbsp;Reiko Inagi,&nbsp;Masaomi Nangaku","doi":"10.1111/jdi.70041","DOIUrl":"10.1111/jdi.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>The impact of rare pathogenic variants on diabetic kidney disease (DKD) has not been investigated in detail. Previous studies have detected pathogenic variants in 22% of Caucasian patients with DKD; however, this proportion may vary depending on ethnicity and updates to the database. Therefore, we performed a whole-genome analysis of patients with DKD in type 2 diabetes mellitus in Japan, utilizing a recent database to investigate the prevalence of kidney-related pathogenic variants and describe the characteristics of these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Whole-genome sequencing was performed, and variants were analyzed following the GATK Best Practices. We extracted data on 790 genes associated with Mendelian kidney and genitourinary diseases. Pathogenic variants were defined based on the American College of Medical Genetics criteria, including both heterozygous and homozygous variants classified as pathogenic or likely pathogenic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 79 participants, heterozygous pathogenic variants were identified in 27 (34.1%), a higher prevalence than previously reported. No homozygous pathogenic variants were detected. The identified heterozygous pathogenic variants were roughly divided into 23.7% related to glomerulopathy, 36.8% related to tubulointerstitial disease, 10.5% related to cystic disease/ciliopathy, and 28.9% related to others. Diagnostic variants were found in 10 patients (12.7%) in seven genes (<i>ABCC6, ALPL, ASXL1</i>, <i>BMPR2</i>, <i>GCM2, PAX2</i>, and <i>WT1</i>), all associated with autosomal dominant congenital disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identified a considerable number of patients with DKD in Japan who carried kidney-related heterozygous pathogenic variants. These findings suggest potential ethnic differences and highlight the impact of database updates on variant detection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 7","pages":"1263-1273"},"PeriodicalIF":3.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802052","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":"Letter to the Editor in response to “Single sural nerve response: A reliable and practical method for diagnosis of diabetic peripheral neuropathy in children with type 1 diabetes”","authors":"Muhammad Ibrahim","doi":"10.1111/jdi.70044","DOIUrl":"10.1111/jdi.70044","url":null,"abstract":"<p>To the Editor,</p><p>We read with great interest the recent article by Şenol <i>et al</i>.<span>¹</span> The study presents compelling evidence supporting the efficacy of single sural nerve response assessment in diagnosing diabetic peripheral neuropathy (DPN) in pediatric patients. Given the challenges of conducting nerve conduction studies (NCS) in children, the findings highlight an approach that is not only practical but also clinically valuable.</p><p>The authors demonstrated that evaluating a single sural nerve response could achieve a sensitivity of 83.3% and a specificity of 97.2% in diagnosing DPN. This method streamlines the diagnostic process, potentially reducing patient discomfort and increasing compliance. It is noteworthy that their findings align with previous studies that have suggested the sural nerve as an early indicator of diabetic neuropathy, particularly in asymptomatic patients.<span>²</span> Moreover, the study identifies elevated HbA1c as the sole significant predictor of DPN, emphasizing the need for stringent glycemic control to mitigate neuropathic complications.<span>³</span></p><p>However, while the study offers significant clinical implications, a few aspects warrant further discussion. First, given that pediatric patients often present with subclinical neuropathy, longitudinal studies assessing the progression of nerve dysfunction over time would be valuable. Additionally, considering that previous research has indicated the involvement of other sensory nerves in early diabetic neuropathy,<span>⁴</span> a comparative analysis of different sensory nerves could further refine the diagnostic accuracy of single-nerve testing.</p><p>Another important aspect is the practical implementation of this approach in routine clinical settings. The authors suggest that point-of-care devices measuring sural nerve conduction could facilitate earlier diagnosis and intervention.<span>¹</span> Integrating such devices into primary care settings could help screen for early-stage DPN before significant neurological deficits manifest.</p><p>In conclusion, the study by Şenol <i>et al</i>. represents a significant advancement in the early detection of DPN in pediatric type 1 diabetes patients. Future studies should explore broader applications of this method across diverse populations and evaluate its cost-effectiveness in routine clinical practice. We commend the authors for their contribution and look forward to further research in this critical area.</p><p>The author declares no conflict of interest.</p><p>Approval of the research protocol: N/A.</p><p>Informed consent: N/A.</p><p>Registry and the registration no. of the study: N/A.</p><p>Animal studies: No animal studies or trial was involved.</p><p>No funding was received for this work.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 6","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802049","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":"Case of type 1 diabetes mellitus with decreased hemoglobin glycation index after switching insulin pump","authors":"Momoka Hasegawa,&nbsp;Akihiro Katayama,&nbsp;Eisaku Morimoto,&nbsp;Mayu Watanabe,&nbsp;Yuichi Matsushita,&nbsp;Masaya Takeda,&nbsp;Kazuyuki Hida","doi":"10.1111/jdi.70040","DOIUrl":"10.1111/jdi.70040","url":null,"abstract":"<p>This case report described a 78-year-old woman with type 1 diabetes who experienced a significant decrease in the hemoglobin glycation index (HGI) after switching her insulin pump from MiniMed™770G to 780G. Despite minimal changes in glycemic control, including a slight decrease in the average sensor glucose and % coefficient of variation (%CV) from continuous glucose monitoring metrics, her glycated hemoglobin level decreased from 8.2% to 7.3%, and HGI decreased from approximately 1.3–0.5. Previous reports have shown that HGI indicates differences in the glycation rate of hemoglobin between individuals. Moreover, a high HGI is a risk factor for diabetic complications. However, there are no reports on changes in HGI within an individual. Therefore, the significance of intraindividual HGI changes, as in this case, should be investigated.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 7","pages":"1346-1349"},"PeriodicalIF":3.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810142","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":"LGR signaling and metabolic regulation: A new frontier in addressing insulin resistance and diabetes treatment","authors":"Tomohisa Aoyama,&nbsp;Toshimasa Yamauchi","doi":"10.1111/jdi.70042","DOIUrl":"10.1111/jdi.70042","url":null,"abstract":"<p>LGR signaling plays a crucial role in metabolic regulation by coordinating muscle-neuron-adipose tissue crosstalk. In response to a high-sugar diet, muscle-derived BMP signaling activates neuronal Bursicon, which stimulates insulin secretion and enhances adipose insulin sensitivity. This evolutionarily conserved pathway underscores LGR4 as a promising therapeutic target for insulin resistance and diabetes.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 6","pages":"984-985"},"PeriodicalIF":3.1,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787420","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 causal relationship between gestational diabetes mellitus and postpartum depression: A Mendelian randomization study","authors":"Yao Ni,&nbsp;Youqian Zhang,&nbsp;Min Jiang","doi":"10.1111/jdi.70038","DOIUrl":"10.1111/jdi.70038","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>There is no evidence of a causal relationship between GDM and PPD in European populations. Future research should explore this association in diverse ancestries and investigate the link between GDM and antenatal depression.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 6","pages":"1138-1140"},"PeriodicalIF":3.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778602","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":"Concomitant use of metformin and proton pump inhibitors increases vitamin B12 deficiency risk in type 2 diabetes","authors":"Choungwon Jung,&nbsp;Soyoung Park,&nbsp;Hyunah Kim","doi":"10.1111/jdi.70037","DOIUrl":"10.1111/jdi.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Vitamin B12 deficiency is one of the adverse drug reactions of metformin and proton pump inhibitors (PPIs). As symptoms of gastroesophageal reflux disease are frequently reported in patients with diabetes, the concomitant use of metformin and PPI is expected. Therefore, this study aimed to investigate the effects of concurrent PPI use on the risk of vitamin B12 deficiency in patients with type 2 diabetes (T2DM) using metformin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective cohort study was conducted using a sample cohort database provided by the National Health Insurance Service. Among adult patients newly diagnosed with T2DM, new users of metformin who used metformin ≥4 months were included. The subjects were divided into two cohorts: metformin monotherapy and metformin + PPI. Vitamin B12 deficiency was defined by a diagnostic code or a prescription of medications for vitamin B12 supplementation. A Cox proportional hazards model was used to estimate the adjusted hazard ratio (aHR) with a 95% confidence interval (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 11,200 subjects were included in the 1:1 propensity score-matched cohort. The risk of vitamin B12 deficiency was significantly higher in the metformin + PPI cohort compared with the metformin monotherapy cohort (aHR, 1.18; 95% CI, 1.02–1.35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A significant association between the concurrent use of metformin and PPI and an increased risk of vitamin B12 deficiency was found, highlighting the need to carefully monitor the symptoms associated with vitamin B12 deficiency and regularly assess vitamin B12 levels when considering the concomitant use of PPI and metformin.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 6","pages":"1020-1027"},"PeriodicalIF":3.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778594","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":"Investigating the non-linear association between sleep duration and type 2 diabetes: conventional and Mendelian randomization analyses from the UK Biobank","authors":"Hiroyuki Kuroda,&nbsp;Shiu Lun Au Yeung,&nbsp;Ryosuke Fujii,&nbsp;Masao Iwagami,&nbsp;Atsushi Goto","doi":"10.1111/jdi.70039","DOIUrl":"10.1111/jdi.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Previous observational studies have suggested an increased risk of type 2 diabetes associated with both short and long sleep duration. However, there remains uncertainty, particularly regarding the adverse effects of long sleep duration. We investigated the association between self-reported questionnaire-based and objectively measured accelerometer-derived sleep duration and the risk of type 2 diabetes using data from the UK Biobank.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>First, we performed conventional Cox regression analysis with restricted cubic splines to illustrate the potentially non-linear association between sleep duration and the risk of type 2 diabetes. Second, we performed non-linear Mendelian randomization (MR) analysis using the doubly-ranked method with 85 and 20 genetic variants associated with questionnaire-based and accelerometer-based sleep duration, respectively. Third, we performed two-sample MR analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results of conventional analysis of accelerometer-derived sleep duration did not suggest a strong association between longer sleep duration and type 2 diabetes risk (hazard ratio [HR] of ≥10 h compared with 7–8 h, 1.08; 95% confidence interval [CI], 0.92–1.27). The results of non-linear MR showed no strong evidence for an increased risk of type 2 diabetes associated with questionnaire-based longer sleep duration (HR of 9 h compared with 7 h, 0.77; 95% CI, 0.52–1.15). This finding was consistent with non-linear MR of accelerometer-derived sleep duration (HR of 9 h compared with 7 h, 0.78; 95% CI, 0.29–2.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that longer sleep duration does not play a major role in the development of type 2 diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 6","pages":"1126-1137"},"PeriodicalIF":3.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778595","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":"A prediction model for diabetes complications using the Kokuho Database and its application to public health services in Japan","authors":"Shumpei Chiba,&nbsp;Takaaki Itoga,&nbsp;Kazuo Asada,&nbsp;Daisuke Yabe","doi":"10.1111/jdi.70035","DOIUrl":"10.1111/jdi.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>This study aimed to improve efficiency of participant selection in Japan's Specific Health Guidance (SHG) program by developing a model to predict 3-year risk of diabetes complications. The targeted complications included macrovascular diseases (ischemic heart disease and cerebrovascular disease), microvascular diseases (diabetic nephropathy, diabetic neuropathy, diabetic retinopathy), and chronic kidney disease (CKD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We utilized the Kokuho Database to analyze individuals in Saga Prefecture who underwent Specific Health Checkups from 2016 to 2019 without diabetes complications at baseline. To evaluate risk of the complications across all examinees, we excluded medicated individuals ineligible for SHG, while including those without diabetes in the prediction cohort. The outcomes of diabetes complications were derived from claims data. Explanatory variables included health checkup results, questionnaire responses, medical diagnoses, and prescription records. The predictive model was constructed using logistic regression, and its performance was evaluated using the Area Under the Curve (AUC) from fivefold cross-validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Through model optimization techniques, including stratification, the incorporation of quadratic terms, and variable selection, the AUC exceeded 0.7 for all conditions. Notably, the AUC for microvascular complications and CKD surpassed 0.8, indicating high predictive accuracy. The model identified a higher risk among individuals who met the health guidance criteria established by the Ministry of Health, Labour and Welfare, demonstrating alignment with existing standards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This predictive model has potential to enhance the targeting process for health guidance in Japan, enabling more timely medical intervention. Its implementation could significantly contribute to the prevention of severe diabetes complications through earlier detection and treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 6","pages":"1091-1099"},"PeriodicalIF":3.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762499","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}