Journal of Diabetes Investigation最新文献

{"title":"Relationship between maternal body composition changes and heavy for date infants in pregnant women with diabetes","authors":"Eriko Eto,&nbsp;Masakazu Kato,&nbsp;Satoe Kirino,&nbsp;Chiaki Kuriyama,&nbsp;Syujiro Sakata,&nbsp;Hikari Nakato,&nbsp;Sakurako Mishima,&nbsp;Akiko Ohira,&nbsp;Hisashi Masuyama","doi":"10.1111/jdi.70131","DOIUrl":"10.1111/jdi.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Maternal hyperglycemia is associated with heavy for date (HFD) infants. Considering the association between body composition and hyperglycemia, we investigated the changes in maternal body composition and their relationship with HFD infants in pregnant women with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Body composition was measured during pregnancy using a bioelectrical impedance analysis system. This retrospective study included 151 pregnant women; 27 women had type 1 diabetes mellitus (DM), 21 had type 2 DM, 101 were diagnosed with gestational DM, and 2 had overt DM. The number of HFD infants was 40.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the non-type 1 DM group, change in fat mass (ΔFM) (<i>P</i> &lt; 0.01) and pre-pregnancy BMI (<i>P</i> &lt; 0.05) were risk factors for HFD. In the insulin group, ΔFM, pre-pregnancy BMI, and age (all <i>P</i> &lt; 0.05) were risk factors for HFD. The area under the curve was 0.813 for the predictive model combined with ΔFM and pre-pregnancy BMI in the non-type 1 DM group and 0.818 for the model combined with ΔFM, pre-pregnancy BMI, and age in the insulin group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of body composition parameters and clinical data may predict HFD in pregnant women with diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1910-1918"},"PeriodicalIF":3.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726249","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 multicenter, prospective, real-world study of oral semaglutide in adults with type 2 diabetes in Japanese clinical practice (PIONEER REAL Japan): Subgroup analyses","authors":"Daisuke Yabe,&nbsp;Yoshiyuki Hamamoto,&nbsp;Daiji Kawanami,&nbsp;Rimei Nishimura,&nbsp;Yasuo Terauchi,&nbsp;Hanan Amadid,&nbsp;Uffe Christian Braae,&nbsp;Atheline Major-Pedersen,&nbsp;Ryo Suzuki","doi":"10.1111/jdi.70099","DOIUrl":"10.1111/jdi.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>HbA_1c and body weight were assessed across selected subgroups of adults with type 2 diabetes receiving oral semaglutide in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this non-interventional study, changes in HbA_1c and body weight to end of study (EoS) and safety were assessed by subgroup: baseline age, body mass index (BMI), type 2 diabetes duration, participants switching from dipeptidyl peptidase-4 inhibitors, and semaglutide dose at EoS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All subgroups experienced reductions in HbA_1c and body weight. Younger participants had greater reductions in HbA_1c than older participants (−0.9, −0.7, −0.7, and −0.5 percentage points for participants aged &lt;55, ≥55–&lt;65, ≥65–&lt;75, and ≥75 years, respectively [<i>P</i> = 0.0467]). Shorter type 2 diabetes duration and lower EoS semaglutide dose were associated with greater HbA_1c reductions (−0.8, −0.7, and −0.6 percentage points with ≤5, &gt;5–≤10, and &gt;10 years' duration, respectively [<i>P</i> &lt; 0.0001]; −1.2, −0.7, and −0.4 percentage points with 3, 7, and 14 mg, respectively [<i>P</i> &lt; 0.0001]). Changes in HbA_1c were not significantly different across other subgroups. Lower EoS semaglutide dose was associated with greater body weight reductions (−3.8, −2.9, and −2.8 kg with 3, 7, and 14 mg, respectively [<i>P</i> &lt; 0.0001]); body weight reductions were not significantly different across other subgroups. Adverse events were similar between subgroups, except that older subgroups experienced more events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HbA_1c and body weight decreased across all subgroups, providing insights into oral semaglutide use in clinical practice for individuals with different characteristics in the real-world setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1794-1807"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715039","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 ‘A prediction model for diabetes complications using the Kokuho Database and its application to public health services in Japan’","authors":"Yanna Le,&nbsp;Feiqi Xu,&nbsp;Qingyun Xu","doi":"10.1111/jdi.70128","DOIUrl":"10.1111/jdi.70128","url":null,"abstract":"<p>Dear Editor,</p><p>We read with great interest the article ‘A prediction model for diabetes complications using the Kokuho Database and its application to public health services in Japan’<span>¹</span>. This study represents a valuable endeavor in developing a diabetes complication prediction model leveraging large-scale data, with substantial implications for public health practice in Japan. However, two methodological considerations warrant further clarification to enhance the scientific rigor and clinical translatability of the findings.</p><p>First, the selection of a 6-year historical stratification window for ischemic heart disease and cerebrovascular disease requires mechanistic and empirical justification. Epidemiological evidence consistently indicates that diabetic macrovascular complications exhibit stronger associations with short-term metabolic control parameters (1–3 years) such as glycemic variability and blood pressure trajectories, rather than distant historical data<span>^{2, 3}</span>. A 6-year window may introduce collinearity by over-including less relevant historical records, potentially attenuating the weight of dynamic, time-sensitive risk factors. In addition, long-term indicators may not directly reflect the current risk status of the patient. The overall risk factor status of the patient during this period may change due to various factors (such as improved lifestyle, changes in medication, and the occurrence of other comorbidities). We urge the authors to clarify whether systematic comparisons of alternative time frames (1, 3, and 6 years) were performed to validate the optimal stratification criteria for predictive accuracy.</p><p>Second, the comparative prognostic value of early lifestyle determinants vs late biochemical markers in the model merits discussion. Lifestyle factors (sedentary behavior, dietary patterns, and smoking) typically precede biochemical abnormalities by 5–10 years, offering a critical window for primordial prevention. From a translational perspective, these modifiable behaviors represent more actionable targets for public health interventions compared to established metabolic derangements. Did the authors perform subgroup analyses to quantify the relative predictive power of these variables, particularly regarding their incremental value in early risk stratification?</p><p>Addressing these points would significantly strengthen the study's methodological robustness and public health relevance. We commend the authors for their contribution to this important field and anticipate their clarifications.</p><p>The authors declare 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/trial: N/A.</p><p>Animal studies: N/A.</p><p>None.</p><p>Yanna Le and Qingyun Xu: methodology, writing—review and editing. Feiqi Xu: methodology, writing.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688483","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":"Association among circulating erythropoietin-producing hepatoma A2, progranulin, and kidney function in individuals with diabetes","authors":"Maki Murakoshi,&nbsp;Nozomu Kamei,&nbsp;Kenichiro Abe,&nbsp;Takumi Iwasawa,&nbsp;Kazunori Kato,&nbsp;Marenao Tanaka,&nbsp;Tatsuya Sato,&nbsp;Masato Furuhashi,&nbsp;Mitsunobu Kubota,&nbsp;Michiyoshi Sanuki,&nbsp;Yusuke Suzuki,&nbsp;Tomohito Gohda","doi":"10.1111/jdi.70116","DOIUrl":"10.1111/jdi.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Erythropoietin-producing hepatoma A2 (EphA2), a receptor for progranulin (PGRN), which is a growth factor associated with metabolic disorders, is implicated in inflammation and atherosclerotic diseases. Since both EphA2 and PGRN play roles in diabetic kidney disease (DKD) and cardiovascular disease (CVD), this study examined their association with renal function and CVD markers in individuals with diabetes. In addition, the diagnostic value of EphA2 and PGRN in predicting renal impairment was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Circulating EphA2 and PGRN levels were measured using enzyme-linked immunosorbent assay in 735 participants with diabetes. Clinical data, including biometric parameters, physiological measurements, and comorbidities, were collected for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both EphA2 and PGRN levels positively correlated with older age, elevated blood pressure, higher urinary albumin-to-creatinine ratio (UACR), and brain natriuretic peptide (BNP) levels but negatively correlated with estimated glomerular filtration rate (eGFR). Multivariate logistic regression analysis revealed that EphA2 was an independent predictor of eGFR &lt;60 mL/min/1.73 m², even after adjusting for UACR and CVD risk factors and glycated hemoglobin. Although PGRN was also independently associated with eGFR &lt;60 mL/min/1.73 m², its association was weaker than that of EphA2. Conversely, when UACR ≥30 mg/g was used as the dependent variable, PGRN emerged as a stronger independent determinant than EphA2, even after adjusting for eGFR and CVD risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EphA2 and PGRN levels are significantly associated with renal function in individuals with diabetes. These findings suggest that EphA2 and PGRN could serve as novel biomarkers for kidney impairment, independent of established CVD markers in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1836-1843"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697219","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":"Study of insulin infusion in diabetic rats with an ultra-low-cost insulin pump for managing blood glucose levels","authors":"Jhon E. Goez-Mora MSc,&nbsp;Natalia Arbelaez-Córdoba MSc,&nbsp;Norman Balcazar-Morales PhD,&nbsp;Pablo S. Rivadeneira PhD","doi":"10.1111/jdi.70072","DOIUrl":"10.1111/jdi.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study assesses the accuracy of an ultra-low-cost insulin pump for regulating blood glucose, an essential component of the artificial pancreas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective is to assess the accuracy of blood glucose regulation using an ultra-low-cost insulin pump compared with insulin injections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was conducted using 14 male Wistar rats aged 14 weeks, which were induced with diabetes through a streptozotocin procedure. The control group (seven subjects) was treated with subcutaneous insulin injections, and the study group (seven subjects) was treated with the experimental insulin pump.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our findings reveal that the ultra-low-cost insulin pump performs comparably to insulin injections for glycemia regulation using standard clinical insulin treatment. The blood glucose records obtained by CGM indicate that trends in both methods correspond, with a glycemia median absolute relative difference of 6.1748 mg/dL and an interquartile range of 14.57 mg/dL. The response time to reach glucose levels between 70 and 180 mg/dL was around 55 min, testing different amounts of insulin units ranging from 0.09 to 2.06 U. Also, four obstruction cases were detected by the system in an average time of 3 s, showing compliance with the EN60601-2-24 standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The <i>in vivo</i> experiments with diabetic rats and ultra-low-cost insulin pumps demonstrate that these prototypes can be used for glucose regulation in clinical trials while complying with the conditions of the EN60601-2-24 standard. Future work should focus on conducting insulin pump tests in a closed loop and a cybersecurity study to prevent any possible external attack.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1782-1793"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688484","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":"Bidirectional causal links between diabetes mellitus and autoimmune liver diseases: Insights from Mendelian randomization","authors":"Haixia Kuang,&nbsp;Jian Wu,&nbsp;Tao Huang,&nbsp;Kai Yan,&nbsp;Xiaoyun Hu,&nbsp;Ying Wu,&nbsp;Yudi Wang,&nbsp;Zhihong Wu,&nbsp;Xiao Chen,&nbsp;Gaole Yuan","doi":"10.1111/jdi.70114","DOIUrl":"10.1111/jdi.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetes, a growing global public health issue, is often associated with autoimmune liver diseases (AILD), such as autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC), in both type 1 diabetes (T1DM) and type 2 diabetes (T2DM). However, the causal relationship between these conditions remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used two-sample bidirectional Mendelian randomization (MR) to explore causal links between AILD and diabetes. Genetic variants identified from genome-wide association studies were used as instruments. Sensitivity and multivariable analyses adjusted for potential confounders were performed to assess the robustness of findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Genetically predicted PBC (OR 1.41, 95% CI 1.19–1.67) and PSC (OR 1.39, 95% CI 1.14–1.68) were associated with an increased risk of T1DM. PBC (OR 1.03, 95% CI 1.01–1.05) was also linked to a higher risk of T2DM. In reverse MR analysis, genetically predicted T1DM was associated with an increased risk of PBC (OR 1.28, 95% CI 1.09–1.50), PSC (OR 1.27, 95% CI 1.14–1.41), and AIH (OR 1.13, 95% CI 1.06–1.19). Multivariable MR confirmed the causal effect of PBC and PSC on T1DM, but the link between PBC and T2DM weakened after adjusting for BMI and inflammatory bowel disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identifies bidirectional causal relationships between PBC/PSC and T1DM, suggesting shared pathogenesis, and T1DM also raises the risk for AIH. Although the link between PBC and T2DM weakened after adjusting for confounders, it highlights the complexity of genetic and environmental interactions, underscoring the importance of diabetes screening in AILD patients and guiding potential targeted therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1929-1940"},"PeriodicalIF":3.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673537","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":"Retrospective analysis of influences of sacubitril/valsartan in patients with diabetes with poorly controlled blood pressure in Japan","authors":"Shun Ito,&nbsp;Kazuo Kobayashi,&nbsp;Mari Sotozawa,&nbsp;Kyoji Chiba,&nbsp;Keiichi Chin,&nbsp;Hideo Shimura,&nbsp;Toshinao Tsuge,&nbsp;Hiroyuki Sakai,&nbsp;Takayuki Furuki,&nbsp;Atsushi Matsuzaki,&nbsp;Shinichi Nakajima,&nbsp;Nobukazu Takada,&nbsp;Hareaki Yamamoto,&nbsp;Hiroshi Takeda,&nbsp;Hiromichi Wakui,&nbsp;Takamasa Iwasawa,&nbsp;Togo Aoyama,&nbsp;Kouichi Tamura,&nbsp;Masao Toyoda,&nbsp;Akira Kanamori","doi":"10.1111/jdi.70126","DOIUrl":"10.1111/jdi.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Achieving optimal blood pressure control remains challenging, particularly for patients with diabetes. This post-hoc study compared the efficacy and safety of switching to sacubitril/valsartan vs adding thiazide diuretics in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included patients with diabetes and inadequate blood pressure control in the office or home settings despite combination therapy with renin-angiotensin system inhibitors and calcium channel blockers. Patients were categorized into those receiving an additional thiazide diuretic (THZ group, <i>n</i> = 136) and those switching to sacubitril/valsartan (SacVal group, <i>n</i> = 199). The treatment effects over 12 months were analyzed using propensity score analysis with inverse probability weighting. Treatment discontinuation rates were assessed using the Cox proportional hazards model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the propensity score analysis model, target pressure achievement rates were similar between the two groups. However, compared to the THZ group, the SacVal group exhibited significantly lower uric acid levels (<i>P</i> &lt; 0.001), improved glycated hemoglobin A_1c (<i>P</i> = 0.02), and a smaller estimated glomerular filtration rate decline (<i>P</i> = 0.02). Treatment discontinuation due to adverse events was significantly higher in the THZ group (13% vs 1%), with a hazard ratio of 11.53 (95% confidence interval: 2.66–49.93, <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of sacubitril/valsartan with calcium channel blockers provided a similar reduction in blood pressure compared with thiazide with renin-angiotensin system inhibitors and calcium channel blockers, and reported more favorable changes in uric acid levels, glycated hemoglobin A_1c, and estimated glomerular filtration rate, along with a significantly better treatment tolerability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1859-1869"},"PeriodicalIF":3.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657908","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 the “Comment on ‘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.70125","DOIUrl":"10.1111/jdi.70125","url":null,"abstract":"&lt;p&gt;Dear editor,&lt;/p&gt;&lt;p&gt;We appreciate the thoughtful comments from Liao &lt;i&gt;et al&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; regarding our study&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; and are pleased to address the points they raised and to provide clarification on our methodology and interpretation.&lt;/p&gt;&lt;p&gt;First, Liao &lt;i&gt;et al&lt;/i&gt;. pointed out the physiological plausibility of the ≥2 weeks use of concurrent metformin and proton pump inhibitor (PPI) use on vitamin B12 deficiency. We would like to clarify that the 2-week threshold was only used to define overlapping PPI use based on previous literature, in order to capture a broad range of concurrent exposure durations&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;. In fact, in our as-treated analysis, where PPI discontinuation was included as a censoring event, the total person-years for the metformin + PPI group (&lt;i&gt;n&lt;/i&gt; = 5,600) was 1589, corresponding to an average follow-up duration of approximately 3.4 months (around 13.6 weeks) per person. This shows that the actual duration of concurrent drug exposure was longer than 2 weeks in most of the patients in our cohort.&lt;/p&gt;&lt;p&gt;Second, although the absolute risk increase observed in our study appears modest as Liao &lt;i&gt;et al&lt;/i&gt;. mentioned, the potential public health implications are more substantial when viewed at the population level. In our cohort, 11,761 of 117,727 (approximately 10%) of patients with type 2 diabetes mellitus (T2DM) were exposed to concurrent metformin and PPI (metformin + PPI). Extrapolating this proportion to the total T2DM population in Korea suggests that nearly 530,000 patients may have received metformin + PPI, which would result in an estimated 584 additional cases of vitamin B12 deficiency per year. This projection is not merely speculative, as our findings are based on the National Health Insurance Service—National Sample Cohort (NHIS-NSC), a stratified 2% sample of the entire Korean population.&lt;/p&gt;&lt;p&gt;Third, while the subgroup analyses demonstrated trends consistent with the overall pooled results across age- and sex-based strata, these subgroup analyses were exploratory in nature and not powered to detect statistical interactions. We acknowledge the absence of formal interaction testing as a limitation; however, further analyses were not feasible due to data access restrictions following the approved analysis period.&lt;/p&gt;&lt;p&gt;Lastly, we agree that vitamin B12 screening should be tailored based on individual patient risk factors. Our findings support the interpretation of concomitant metformin and PPI use as one such risk factor to consider, but not as justification for universal testing. Given the known association between vitamin B12 deficiency and the risk of diabetic neuropathy, the American Diabetes Association (ADA) recommends regular vitamin B12 monitoring in patients presenting with symptoms such as anemia or neuropathy, or in those with additional risk factors, including &gt;4 years of metformin use, malabsorption syndromes, or low dietary intake&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1969-1970"},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648091","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":"Relationship between medication use and non-attendance (missed appointment) from primary care visits among people with type 2 diabetes: The Japan Diabetes Outcome Intervention Trial-2 Large-Scale Trial 006 (J-DOIT2-LT006)","authors":"Yusuke Hikima,&nbsp;Ryotaro Bouchi,&nbsp;Yasuaki Hayashino,&nbsp;Atsushi Goto,&nbsp;Hikari Suzuki,&nbsp;Katsuya Yamazaki,&nbsp;Kazuo Izumi,&nbsp;Masaomi Nangaku,&nbsp;Mitsuhiko Noda,&nbsp;J-DOIT2 Study Group","doi":"10.1111/jdi.70121","DOIUrl":"10.1111/jdi.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>To clarify the relationship between medication use and primary care visit non-attendance (missed appointment) among people with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Data of 2,200 patients registered in the Japan Diabetes Outcome Intervention Trial-2 Large-Scale trial were reviewed. The intervention group received multifaceted interventions encouraging regular visits. The hazard ratios (HR) and 95% confidence intervals (CI) of oral medications relative to not taking any oral medications were estimated using the Cox proportional hazards model, adjusted for district medical association ID, intervention, insulin usage, age, sex, and HbA1c. We also investigated whether the HRs differed based on the oral medication type. Furthermore, we divided the intervention and control groups into four groups based on medication use (taking/not taking oral medications and insulin therapy) and performed survival analysis for each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The HRs (95% CI) for oral medication use relative to not taking oral medications and for insulin use relative to not receiving insulin therapy were 0.178 (0.104–0.305) and 0.725 (0.378–1.352), respectively. Regardless of the type of oral medication, non-attendance was lower in the groups taking oral medications. The HRs (95% CI) in the groups taking only oral hypoglycemic agents, only other drugs, and both relative to no oral medication were 0.229 (0.126–0.417), 0.235 (0.112–0.494), and 0.148 (0.084–0.260), respectively. Only in the control group, non-attendance was more frequent with no medications than with oral medications, regardless of insulin (<i>P</i> &lt; 0.01, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that taking oral medications might be important to prevent non-attendance among people with type 2 diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1960-1968"},"PeriodicalIF":3.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615597","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 nomogram incorporating clinical and laboratory indicators for predicting metabolic dysfunction-associated fatty liver disease in newly diagnosed type 2 diabetes patients","authors":"Tingting Li,&nbsp;Yao Wang,&nbsp;Shengnan Zhao,&nbsp;Yuliang Cui,&nbsp;Zhenzhen Qu","doi":"10.1111/jdi.70112","DOIUrl":"10.1111/jdi.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To develop and validate a nomogram model based on clinical and laboratory parameters to predict the risk of metabolic dysfunction-associated fatty liver disease (MAFLD) in the early stage of type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We performed this study among 883 inpatients with new-onset type 2 diabetes, and the data were divided randomly into training and validation groups. The logistic regression method was used to identify the independent risk factors of MAFLD, and a nomogram was established according to the logistic regression analysis and these selected parameters. The discrimination, calibration, and clinical utility of the nomogram were measured by receiver operating characteristic curve analysis, calibration curves, and decision-curve analysis, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight variables were identified and included in the nomogram (body mass index, alanine aminotransferase, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting plasma glucose, urea nitrogen and serum uric acid). The value of the area under the receiver operating characteristic (ROC) curve was 0.898 for the training group and 0.92 for the validation group. The calibration plots indicated that this model had good accuracy, and the decision-curve analysis revealed high-clinical practicability of the nomogram.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study established a convenient and practical nomogram model, which can be used as an easy-to-use tool to evaluate the risk of MAFLD among patients with newly diagnosed T2DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1919-1928"},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606951","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}