Journal of Diabetes Investigation最新文献

{"title":"Sodium zirconium cyclosilicate compared with potassium restriction for hyperkalemia management in type 2 diabetes: The SILVERSTAR trial","authors":"Masahide Hamaguchi,&nbsp;Junya Hironaka,&nbsp;Hiroshi Okada,&nbsp;Mari Yoneda,&nbsp;Ayaka Kobayashi,&nbsp;Yoshitaka Hashimoto,&nbsp;Aya Kitae,&nbsp;Noriyuki Kitagawa,&nbsp;Akio Kishi,&nbsp;Michiyo Ishii,&nbsp;Mai Asano,&nbsp;Masahiro Yamazaki,&nbsp;Toru Tanaka,&nbsp;Hanako Nakajima,&nbsp;Eiko Sato,&nbsp;Michiaki Fukui","doi":"10.1111/jdi.70388","DOIUrl":"10.1111/jdi.70388","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>To demonstrate noninferiority of continued sodium zirconium cyclosilicate therapy versus a potassium-restricted diet in achieving normokalemia at Visit 7 (Days 28–42) in individuals with type 2 diabetes and hyperkalemia, using a noninferiority margin of −10 percentage points (one-sided α = 0.025).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This multicenter, open-label, randomized trial assigned participants in the full analysis set to the sodium zirconium cyclosilicate (<i>n</i> = 37) or the diet group (<i>n</i> = 39) for the primary noninferiority analysis. Normokalemia was defined as serum potassium 3.5–&lt;5.0 mEq/L at Visit 7.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the full analysis set, normokalemia occurred in 28/36 (77.8%) and 26/38 (68.4%) patients in the sodium zirconium cyclosilicate and diet groups, respectively (risk difference +9.4 percentage points; 95% confidence interval, −11.1 to +29.8; one-sided <i>P</i> = 0.032), failing to demonstrate noninferiority. In the supportive per-protocol set, normokalemia occurred in 26/31 (83.9%) versus 17/24 (70.8%) patients, and the noninferiority criterion was met (<i>P</i> = 0.020); this analysis is exploratory. Mean serum potassium levels at Visit 7 were lower in the sodium zirconium cyclosilicate group (adjusted difference −0.23 mEq/L; 95% confidence interval, −0.42 to −0.03; <i>P</i> = 0.026). Dietary fiber intake decreased in the diet group. No changes in quality of life were observed between the two groups during the study period. The frequency of adverse events was low; however, one sudden death occurred in the sodium zirconium cyclosilicate group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The trial did not meet its primary endpoint: noninferiority of sodium zirconium cyclosilicate to the potassium-restricted diet was not demonstrated in the full analysis set.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1625-1633"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148409713","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":"Clinical characteristics of Sarcopenic obesity in Japanese people with type 2 diabetes: A post hoc analysis of the sub-cohort iDIAMOND study","authors":"Hiroyasu Mori,&nbsp;Kasei Ko,&nbsp;Satoko Notomi,&nbsp;Sumiko Yoshida,&nbsp;Tetsuyuki Yasuda,&nbsp;Yutaka Umayahara,&nbsp;Sayoko Shimizu,&nbsp;Kayoko Ryomoto,&nbsp;Kazutomi Yoshiuchi,&nbsp;Saeko Osawa,&nbsp;Tsunehiko Yamamoto,&nbsp;Akio Kuroda,&nbsp;Munehide Matsuhisa","doi":"10.1111/jdi.70383","DOIUrl":"10.1111/jdi.70383","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Sarcopenic obesity, defined by reduced muscle mass and strength with excess adiposity, is poorly characterized in Japanese individuals with type 2 diabetes (T2D). This <i>post hoc</i> analysis assessed its prevalence and associations with physical quality of life (QOL), walking ability, and falls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This <i>post hoc</i> cross-sectional analysis used sub-cohort data from the Impact of Diabetes Mellitus on Dynapenia (iDIAMOND) study, conducted across seven medical centers. The study included 930 individuals aged 40–75 years (527 with T2D and 403 without diabetes [non-D]). Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria, defined as low grip strength and/or slow gait speed with low skeletal muscle mass index. Sarcopenic obesity was diagnosed using the Japanese Working Group on Sarcopenic Obesity criteria, defined as high body mass index (BMI) or waist circumference combined with low grip strength, low skeletal muscle mass relative to BMI, and high body fat percentage. Participants meeting neither criterion were classified as robust.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among participants aged 40–75 years, sarcopenic obesity was observed in 4.9% of those with T2D and 0.5% of non-D individuals (<i>P</i> &lt; 0.001). In the T2D group, sarcopenic obesity was associated with lower physical QOL, reduced physical activity, slow gait speed, and a high incidence of falls compared with the robust group. Multivariate logistic regression identified advanced age, high BMI, and reduced physical activity as independent correlates of sarcopenic obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sarcopenic obesity is more prevalent in individuals with T2D and is associated with impaired physical QOL, reduced walking ability, and increased falls.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1565-1574"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389532","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 prevalence of frailty and associated factors in patients with type 2 diabetes mellitus and coronary heart disease: A cross-sectional study","authors":"Junwen Ma,&nbsp;Jing Wang,&nbsp;Wei Zhu","doi":"10.1111/jdi.70369","DOIUrl":"10.1111/jdi.70369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Frailty is increasingly recognized as an important clinical issue in patients with chronic diseases. However, evidence on the prevalence of frailty and its associated factors in patients with type 2 diabetes mellitus (T2DM) complicated by coronary heart disease (CHD) remains limited. This study aimed to investigate the prevalence of frailty and identify factors associated with frailty in patients with T2DM and CHD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted among patients with T2DM and CHD recruited from the Departments of Endocrinology and Cardiology of a tertiary hospital in Shanghai, China, between September and December 2025. Frailty was assessed using the Tilburg Frailty Indicator (TFI). Data on demographic, clinical, lifestyle, and psychosocial characteristics were collected using a general information questionnaire and medical records. Univariate analyses were performed to compare differences between frail and non-frail participants, and binary logistic regression analysis was conducted to identify factors associated with frailty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 217 participants, 43.8% were frail. Significant between-group differences were observed in age, blood glucose, glycated hemoglobin, BNP, D-dimer, NLR, SIIRI, grip strength, NYHA functional class, anxiety, nutritional risk, history of PCI, number of comorbidities, and sleep duration (all <i>P</i> &lt; 0.05). Binary logistic regression analysis showed that blood glucose, BNP, anxiety, sleep duration, nutritional risk, history of PCI, and age were independently associated with frailty in patients with T2DM and CHD (all <i>P</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Frailty was common among patients with T2DM and CHD. Metabolic and cardiovascular factors, psychological and behavioral factors, and nutritional vulnerability were all associated with frailty, underscoring its multidimensional nature in this comorbid population. Early frailty screening and multidomain assessment may be important for improving the management of patients with T2DM and CHD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1548-1556"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358697","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":"Insulin-reducing effect of adding imeglimin to ongoing dipeptidyl peptidase-4 inhibitor therapy with multiple daily insulin injections (INSPIRE study)","authors":"Atsushi Itsukaichi,&nbsp;Fukumi Yoshikawa,&nbsp;Manabu Saito,&nbsp;Ayako Fuchigami,&nbsp;Yoko Iwata,&nbsp;Genki Sato,&nbsp;Hiroshi Uchino,&nbsp;Takahisa Hirose","doi":"10.1111/jdi.70390","DOIUrl":"10.1111/jdi.70390","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Simplifying multiple daily insulin injections (MDI) has attracted great interest in clinical practice. Although imeglimin shows good compatibility with dipeptidyl peptidase-4 inhibitors (DPP-4i), its effectiveness in patients treated with MDI remains unclear. This study aimed to investigate the real-world characteristics of such patients and the insulin-reducing effects of adding imeglimin to ongoing DPP-4i therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Medical records of inpatients with type 2 diabetes (T2D) treated with imeglimin (2,000 mg/day) plus DPP-4i and MDI were reviewed. Insulin dosage and self-monitoring blood glucose (SMBG) values were compared between baseline and 5 days post-imeglimin initiation. Patients were divided into bolus-discontinuation (bolus insulin discontinued) and bolus-continuation (bolus insulin continued) groups, and baseline characteristics were compared. The correlation between the reduction in bolus insulin (Δ bolus) and baseline parameters was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty patients (18 males and 12 females) were enrolled. Mean values were: age, 77.7 years; duration of T2D, 14.2 years; BMI, 21.6 kg/m², and C-peptide reactivity index, 0.78. After imeglimin initiation, total insulin dosage decreased, with bolus insulin reduced by 10.6 ± 8.0 units/day. Pre-breakfast and pre-dinner SMBG values improved. Although insulin secretory capacity tended to be lower in the bolus-continuation group, Δ insulin and Δ bolus did not differ between groups. Δ bolus showed no correlation with baseline BMI, duration of T2D, or insulin secretory capacity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adding imeglimin to DPP-4i significantly reduced insulin dosage, even in patients with low insulin secretory capacity. This combination may represent a useful therapeutic option for Japanese patients with T2D treated with MDI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1467-1473"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434569","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":"Intensified multifactorial intervention leads to long-term benefit on kidney outcomes in advanced diabetic kidney disease: A 10-year follow-up of the DNETT-Japan trial","authors":"Kenichi Shikata,&nbsp;Satoshi Miyamoto,&nbsp;Masakazu Haneda,&nbsp;Hiroki Hosoi,&nbsp;Kota Sakamoto,&nbsp;Yoshiki Suzuki,&nbsp;Daisuke Suzuki,&nbsp;Hitoshi Ishida,&nbsp;Hiroaki Akai,&nbsp;Yasuhiko Tomino,&nbsp;Takashi Uzu,&nbsp;Motonobu Nishimura,&nbsp;Hiromi Kuramoto,&nbsp;Michihiro Yoshida,&nbsp;Daisuke Ogawa,&nbsp;Toshiharu Ninomiya,&nbsp;Hirofumi Makino,&nbsp;the Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT-Japan) collaborative group","doi":"10.1111/jdi.70392","DOIUrl":"10.1111/jdi.70392","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite recent therapeutic advances in slowing kidney disease progression, the long-term efficacy of intensive multifactorial treatment in advanced-stage diabetic kidney disease remains unclear. We assessed long-term kidney outcomes through the 5-year Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT-Japan) and an additional 5-year post-trial observational follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 164 patients with advanced-stage diabetic kidney disease (urinary albumin-to-creatinine ratio ≥ 300 mg/g and serum creatinine 1.2–2.5 mg/dL in men and 1.0–2.5 mg/dL in women) were randomly assigned to intensive multifactorial treatment—targeting glycemic, blood pressure, and lipid control with lifestyle modification—or conventional treatment for 5 years. After the intervention, an additional 5-year observational follow-up was conducted. The primary outcome was the composite of a doubling of serum creatinine, end-stage kidney disease, or all-cause death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-four patients who were free of the primary outcome during the intervention entered the follow-up study. The risk of the primary outcome was lower in the intensive multifactorial treatment group versus the conventional treatment group (hazard ratio, 0.62; 95% confidence interval, 0.41–0.93; <i>P</i> = 0.021). Increases in systolic blood pressure (per 10 mmHg) and serum low-density lipoprotein cholesterol (per 10 mg/dL) during the intervention were associated with a higher risk of the primary outcome (hazard ratio, 1.43 [1.15–1.78] and 1.23 [1.12–1.35], respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The benefit of 5-year intensive multifactorial treatment on kidney outcomes was demonstrated during an additional 5-year follow-up period, highlighting the importance of sustained comprehensive risk-factor management in advanced-stage diabetic kidney disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1514-1523"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443553","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":"Associations of skeletal muscle mass and strength with arterial stiffness in type 2 diabetes","authors":"Naoki Koike,&nbsp;Yoko Irie,&nbsp;Yuji Doi,&nbsp;Ryosuke Kemmotsu,&nbsp;Moe Kusushita,&nbsp;Yasuna Sakai,&nbsp;Tomonori Okita,&nbsp;Hiroyuki Sho,&nbsp;Ryoko Inui,&nbsp;Yukiko Tabuchi,&nbsp;Tetsuyuki Yasuda","doi":"10.1111/jdi.70376","DOIUrl":"10.1111/jdi.70376","url":null,"abstract":"<p>Sarcopenia is prevalent in people with type 2 diabetes mellitus (T2DM) and may contribute to increased cardiovascular risk. However, the associations of skeletal muscle mass and strength with arterial stiffness in T2DM remain unclear. This retrospective cross-sectional study included 281 hospitalized people with T2DM. Arterial stiffness was assessed by brachial–ankle pulse wave velocity (baPWV), and skeletal muscle mass index (SMI) and handgrip strength (HS) were evaluated. Associations with baPWV were examined using correlation and multivariable linear regression analyses. baPWV was inversely associated with both SMI and HS. In multivariable analyses, lower SMI (β = −0.247, <i>P</i> = 0.009) and lower HS (β = −0.212, <i>P</i> = 0.002) were significantly associated with higher arterial stiffness after adjustment for established cardiovascular risk factors. Both skeletal muscle mass and strength were associated with arterial stiffness in individuals with T2DM. Assessment of both parameters may provide complementary information regarding vascular risk.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1533-1537"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343463","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":"Waist-to-height ratio and renal dysfunction as independent correlates of low handgrip strength in patients with type 2 diabetes","authors":"Shing-Hua Chen,&nbsp;Chen-Kai Chou,&nbsp;Shao-Wen Weng,&nbsp;Jung-Fu Chen,&nbsp;Feng-Chih Shen","doi":"10.1111/jdi.70379","DOIUrl":"10.1111/jdi.70379","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Handgrip strength (HGS) is a key indicator of functional decline. We investigated whether central adiposity (waist-to-height ratio, WHtR) and renal dysfunction independently or additively correlate with low HGS across body mass index (BMI) categories in Asian patients with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study included 1,468 patients. Low HGS was defined by the Asian Working Group for Sarcopenia 2019 criteria. Multivariable logistic regression evaluated independent and combined correlates. Subgroup analyses examined the interactions between WHtR, BMI, and chronic kidney disease (CKD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Older age, higher albuminuria, CKD (adjusted odds ratio [aOR] = 1.98), and WHtR &gt;0.5 (aOR = 1.82) were independently associated with low HGS, whereas BMI &gt; 24 kg/m² was protective (aOR = 0.44). Significant effect modification existed between BMI and WHtR (<i>P</i> for interaction = 0.026): central obesity neutralized the protective effect of higher BMI (aOR shifted from 0.13 to 0.81). Furthermore, while WHtR &gt;0.5 and CKD showed no multiplicative interaction, their co-occurrence exerted a clear additive clinical burden, yielding the highest risk for low HGS (aOR = 1.74, <i>P</i> = 0.025) compared to patients without either condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Central obesity and renal dysfunction (impaired eGFR and albuminuria) are distinct, additive correlates of low HGS. WHtR effectively unmasks functional vulnerability, especially in normal-weight individuals. Integrating WHtR and comprehensive renal parameters provides a robust, low-cost screening strategy for sarcopenia risk in diabetes care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1538-1547"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148349914","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":"Protein consumption during pregnancy and risk of gestational diabetes mellitus: Insights from a multi-center case–control study","authors":"Marzieh Zare,&nbsp;Elnaz Daneshzad,&nbsp;Hatav Tehrani,&nbsp;Razieh Tabaeifard,&nbsp;Maryam Mahmoudi,&nbsp;Leila Azadbakht","doi":"10.1111/jdi.70367","DOIUrl":"10.1111/jdi.70367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) poses major health risks for mothers and infants. Evidence on the association between dietary protein intake and GDM risk remains inconsistent. This study investigated dietary protein quantity and quality in relation to GDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A hospital-based case–control study was conducted in Isfahan, Iran, involving 200 cases and 263 controls. Dietary intake was assessed using three 24-h dietary records, and protein intake was categorized into plant- and animal-based sources. Multivariate logistic regression models were applied to evaluate associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher plant protein intake was associated with a significantly lower risk of GDM (OR = 0.34; 95% CI: 0.20–0.59). Similarly, higher seafood (OR = 0.40; 95% CI: 0.24–0.68) and egg intake (OR = 0.59; 95% CI: 0.35–0.98) were inversely associated with GDM risk. In contrast, total protein, animal protein, poultry, dairy protein, aromatic amino acids, and branched-chain amino acids showed no significant or meaningful trend with GDM risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study did not identify significant associations between total or animal protein intake during pregnancy and GDM risk. However, higher consumption of plant protein, seafood, and eggs was associated with lower odds of GDM in multivariable-adjusted models that accounted for BMI, total energy intake, socioeconomic status, and other relevant confounders. Given the observational case–control design, these findings cannot establish causality, and the possibility of residual confounding remains. Nevertheless, the results suggest that protein-intake quality may play a role in GDM risk, warranting confirmation in prospective cohorts and randomized trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1575-1582"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300322","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":"Liraglutide combined with dapagliflozin treatment improves myocardial disease and endothelial dysfunction in T2DM mice","authors":"An-Jun Tan,&nbsp;Tian-Rong Li,&nbsp;Jing-Jing Yang,&nbsp;Xiao-Lu Li,&nbsp;Wen-Qin Li,&nbsp;Jin-Wen Yu","doi":"10.1111/jdi.70363","DOIUrl":"10.1111/jdi.70363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetic cardiomyopathy (DCM) and endothelial dysfunction are major drivers of cardiovascular morbidity in type 2 diabetes (T2DM). The present study investigates whether combined therapy with liraglutide (LIRA) and dapagliflozin (DAPA) provides synergistic cardioprotection and vascular improvement in a murine model of T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A murine model of T2DM was established by high-fat diet feeding followed by low-dose streptozotocin injection. Diabetic mice were treated for 4 weeks with LIRA, DAPA, or their combination. Echocardiographic analysis was performed to assess cardiac systolic function and structural parameters. Systemic metabolic parameters, cardiac injury biomarkers, histopathology, oxidative stress markers, and inflammation were assessed. Key signaling pathways were evaluated by Western blot and qPCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with monotherapies, combined LIRA and DAPA treatment produced superior metabolic improvements, including attenuated weight loss and enhanced glucose tolerance. The combination also more effectively reduced markers of myocardial injury (CK-MB, LDH), diminished cardiac fibrosis, and preserved aortic architecture while inhibiting endothelial apoptosis. Mechanistically, co-administration synergistically activated both the antioxidative NRF2/HO-1 pathway and the vasoprotective AMPK/PKA-eNOS axis, leading to a more comprehensive suppression of oxidative stress, inflammation, and apoptosis in cardiac and vascular tissues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combined use of LIRA and DAPA exerts synergistic cardioprotective and vasoprotective effects in a preclinical model of T2DM-induced DCM. This synergistic effect may be mediated by the coordinated activation of the NRF2/HO-1 and AMPK/PKA-eNOS signaling pathways, leading to the attenuation of the key pathological drivers of diabetic cardiovascular injury. These findings provide a mechanistic rationale for the clinical exploration of GLP-1RA and SGLT2i combination therapy in DCM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1474-1488"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148373954","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":"Early diagnosis of gestational diabetes mellitus evidence from Asia countries: A meta-analysis and systematic review","authors":"Ke Thi Lan Anh,&nbsp;Nguyen Ngoc Anh,&nbsp;Pham Minh Nguyet,&nbsp;Dang Phuong Linh,&nbsp;Tran Thi Hai Yen,&nbsp;Vo Duy Quan","doi":"10.1111/jdi.70381","DOIUrl":"10.1111/jdi.70381","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy associated with substantial maternal and neonatal morbidity. Asian populations demonstrate increased susceptibility to glucose intolerance and may develop gestational diabetes earlier in pregnancy. However, the prevalence and outcomes of early-diagnosed gestational diabetes mellitus (E-GDM) in Asian populations remain incompletely understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed, ScienceDirect, and Web of Science were searched from database inception to February 2026 to identify studies evaluating gestational diabetes diagnosed before 24 weeks of gestation in Asian populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2329 records were identified, and 17 studies were included, with 16 eligible studies for meta-analysis. E-GDM prevalence ranged from 0.75% to 22.81%, accounting for 9.43%–78.78% of total GDM cases. Compared with conventional GDM, E-GDM was associated with increased risks of C-section or instrumental delivery (OR = 1.13, 95% CI 1.01–1.26), preterm birth (OR = 1.38, 95% CI 1.07–1.78), and insulin therapy requirement (OR = 1.60, 95% CI 1.09–2.36). Most neonatal outcomes were similar between groups. Women with E-GDM showed greater metabolic vulnerability and possible postpartum metabolic dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>E-GDM in Asian populations identifies women with greater metabolic vulnerability and increased obstetric risk. E-GDM was associated with higher insulin requirements, increased risks of preterm birth and operative delivery, and possible long-term metabolic dysfunction. Harmonized diagnostic criteria and region-specific screening strategies are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"17 9","pages":"1591-1603"},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381347","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}