Journal of Diabetes Investigation最新文献

{"title":"The prevalence of hepatitis B infection and anti-HCV antibody in patients with diabetes mellitus","authors":"Malihe Naderi,&nbsp;Seyed Masoud Hosseini,&nbsp;Vahideh Hamidi,&nbsp;Abdolvahab Moradi","doi":"10.1111/jdi.70064","DOIUrl":"10.1111/jdi.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The liver's role in glucose metabolism and hormone regulation links liver infections to diabetes mellitus. Understanding this interaction is crucial for managing diabetes in affected patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Golestan Province has the highest incidence of hepatitis B virus (HBV) infection in the country. The current research aimed to assess the prevalence of HBV infection and anti-HCV antibodies among diabetic patients in the region, providing insights to improve disease management and prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 31,803 diabetic patients, collected (2019–2023) from the NAB system at Golestan University of Medical Sciences, were used to evaluate the co-occurrence of HBV infection and anti-HCV antibodies in them. Also, this study analyzed the co-occurrence of diabetes in three/two-generation CHB (Chronic Hepatitis B) patients, and recovered patients, demographic factors, liver enzyme, and viral DNA levels. Binary logistic regression was applied to identify factors associated with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HBsAg and anti-HCV antibody positivity were found in 2.52% and 0.53% of diabetic individuals, respectively. Diabetic patients with HBV infection (<i>P</i>-value = 0.003) or anti-HCV positivity (<i>P</i>-value = 0.008) had significantly lower BMIs. HBV prevalence was higher among married individuals (78.4%, <i>P</i>-value = 0.01) and rural residents (61.7%, <i>P</i>-value = 0.3). Diabetic patients with two or three generations of HBV/diabetes had higher liver enzyme levels and HBV viral loads compared to those without diabetes (<i>P</i>-value &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In individuals with diabetes, compared to those without the disease, there was a correlation between HBV infections and altered liver function indicators, as well as HBV viral load. Additionally, familial susceptibility to HBV infection or anti-HCV antibody positivity was significant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 9","pages":"1758-1766"},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582741","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 of red blood cell distribution width/albumin ratio with renal prognosis among patients with type 2 diabetes mellitus: A retrospective cohort study","authors":"Hiroshi Kimura,&nbsp;Kenichi Tanaka,&nbsp;Hirotaka Saito,&nbsp;Sakumi Kazama,&nbsp;Michio Shimabukuro,&nbsp;Koichi Asahi,&nbsp;Tsuyoshi Watanabe,&nbsp;Junichiro James Kazama","doi":"10.1111/jdi.70118","DOIUrl":"10.1111/jdi.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The red blood cell distribution width/albumin ratio (RAR) has been reported to be a prognostic marker for adverse clinical outcomes. However, there is limited data on the relationship between RAR and renal function in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate the effect of RAR on renal prognosis in patients with T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Research Design and Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 907 patients with T2DM enrolled in the Fukushima Cohort Study, divided into two groups (high and low RAR) according to their baseline RAR. The association between RAR and renal events was assessed using Kaplan–Meier curves and multivariate Cox regression analyses. Receiver operating characteristic (ROC) curve analyses, as well as the net reclassification index (NRI) and integrated discrimination improvement (IDI), examined the differences between RAR and red blood cell distribution width (RDW) alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The high RAR group showed an increased risk of renal events in the Kaplan–Meier curve analysis. Compared with the low RAR group, the high RAR group showed an increased risk of renal events (adjusted hazard ratio [HR]: 3.40, 95% confidence interval: 1.76–6.57). RAR exhibited a significantly higher area under the curve (AUC), NRI, and IDI for renal events than RDW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We observed an association between high RAR and worse renal outcomes in patients with T2DM. RAR assessment may have potential utility as a predictive tool for renal prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1829-1835"},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582739","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":"Household income modifies the association between social capital and gestational diabetes mellitus in Japan: Results from TMM BirThree Cohort Study","authors":"Koichi Sakakibara,&nbsp;Tomoki Kawahara,&nbsp;Nobutoshi Nawa,&nbsp;Keiko Murakami,&nbsp;Hisashi Ohseto,&nbsp;Ippei Takahashi,&nbsp;Akira Narita,&nbsp;Taku Obara,&nbsp;Mami Ishikuro,&nbsp;Masatsugu Orui,&nbsp;Aoi Noda,&nbsp;Genki Shinoda,&nbsp;Satoshi Nagaie,&nbsp;Soichi Ogishima,&nbsp;Junichi Sugawara,&nbsp;Shigeo Kure,&nbsp;Kengo Kinoshita,&nbsp;Atsushi Hozawa,&nbsp;Nobuo Fuse,&nbsp;Gen Tamiya,&nbsp;Wendy L. Bennett,&nbsp;Shinichi Kuriyama,&nbsp;Takeo Fujiwara,&nbsp;Pamela J. Surkan","doi":"10.1111/jdi.70101","DOIUrl":"10.1111/jdi.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>While social capital can prevent diabetes, these benefits can be heterogeneous with respect to socioeconomic status. We investigated the association between social capital and gestational diabetes mellitus (GDM) while examining effect modification by household income.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a secondary data analysis using the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study carried out between July 2013 and March 2017. Social capital (mutual aid, social trust, informal social control, collective action) and covariates were self-reported, while GDM diagnosis and other medical and physiological information were obtained from medical records. To assess the association between social capital and GDM, we conducted logistic regression models. We further tested for interactions between social capital and household income as well as stratified the models by income.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 20,339 study participants, 700 (3.4%) were diagnosed with GDM. Multivariable logistic regression models found that social trust and collective action were associated with lower GDM prevalence, even after adjustment of covariates. When stratifying household income, however, social capital was significantly associated with the reduced risks of GDM only among participants with higher household income (OR: 0.90, 95% CI: 0.85–0.97). No significant association was observed among those with lower household income.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The health benefit of social capital on GDM prevalence was heterogeneous, and the protective effect of social capital on GDM was found only among women with higher household income. The differential impact of social capital on GDM highlights the need for targeted interventions addressing structural health inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 10","pages":"1900-1909"},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590028","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 “Glycemic control is worse in rural compared to urban type 2 diabetes in Bangladesh, irrespective of food security status”","authors":"Jie Chen,&nbsp;Yindan Song","doi":"10.1111/jdi.70119","DOIUrl":"10.1111/jdi.70119","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;We read the recent article titled “Glycemic control is worse in rural compared to urban type 2 diabetes in Bangladesh, irrespective of food security” status&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; with great interest. This study represents the first systematic exploration in Bangladesh (a lower-middle-income country, LMIC) of the associations between food insecurity (FIS), place of residence (rural/urban disparity), and glycemic control in type 2 diabetes, filling a significant data gap for developing countries in this field. Given the distinct challenges in healthcare resource allocation, social structure, and food security in LMICs compared to the high-income countries where previous similar research has largely focused, this study provides crucial evidence for global diabetes health equity. However, key methodological limitations necessitate clarification to ensure robust interpretation of the findings.&lt;/p&gt;&lt;p&gt;We have significant methodological concerns regarding the interpretation of the key finding—the independent effect of rural residence. The authors adjusted only for age, sex, and BMI in their regression models. Yet, table 1 clearly demonstrates systemic socioeconomic disadvantages in the rural group: only 3.9% had higher education vs 24.0% in the urban group (&lt;i&gt;P&lt;/i&gt; &lt; 0.001); median annual household income was $2,336 in rural areas vs $5,607 in urban areas (&lt;i&gt;P&lt;/i&gt; &lt; 0.001); and only 7.9% of the rural group were professionals compared to 28.3% in the urban group (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). Compounding this, as mentioned in the Introduction, rural residents needed to travel long distances to urban specialty clinics for care. These factors—education, income, occupation, and healthcare access—directly impact diabetes management capabilities, such as medication affordability, health literacy, and frequency of follow-up visits. Consequently, had variables like education, income, and occupation been included in the model, the reported effect size attributed to residence alone (&lt;i&gt;β&lt;/i&gt; = 1.4, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) might have been substantially attenuated or even disappeared. While the authors claim rural residence is an independent factor, the failure to control for these critical confounders casts doubt on the credibility of this conclusion, and we strongly recommend re-running the regression models incorporating these socioeconomic variables to verify if the residence effect remains significant.&lt;/p&gt;&lt;p&gt;Moreover, significant sample selection bias is a concern. The study exclusively recruited patients from specialty diabetes clinics (BADAS clinics), yet the Introduction notes that primary healthcare resources are severely lacking in rural Bangladesh. This recruitment strategy likely introduces a critical bias: rural patients able to attend urban specialty clinics probably represent a subgroup with relatively better economic and/or educational status, as they can bear the associated travel costs and time commitments. This suggests the s","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 9","pages":"1772-1773"},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582740","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":"Identification and verification of feature biomarkers associated with CD14+ monocytes in type 1 diabetes","authors":"Jin Huang,&nbsp;Yu Ding,&nbsp;Tong Yu,&nbsp;Shanshan Chen,&nbsp;Jinrong He,&nbsp;Lifeng Shi,&nbsp;Xiuling Wang","doi":"10.1111/jdi.70117","DOIUrl":"10.1111/jdi.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Monocytes contribute to the immune dysregulation of pancreatic islets in Type 1 diabetes mellitus (T1D). This study aims to identify the feature genes of CD14⁺ monocytes in T1D, which might offer a new perspective on immune dysregulation and potential therapeutic targets in T1D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Two CD14⁺ monocyte-related datasets were integrated for DEGs and WGCNA analysis. LASSO and SVM-RFE machine learning algorithms were applied for further screening of feature genes. Subsequent nomogram model and single-gene GSEA analysis were performed. The experiments in vitro and in vivo were conducted for the verification and functional investigation of the feature gene.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven up-regulated and five down-regulated DEGs in T1D samples were identified in the integrated dataset. WGCNA analysis obtained 13 gene co-expression modules in which the yellow module had a significantly positive correlation with the T1D phenotype, and the magenta module had a negative correlation. Thirteen intersecting genes between DEGs and WGCNA gene modules were subjected to LASSO and SVM-RFE machine learning, and the feature gene ID1 was eventually screened out and verified. In terms of the T1D diagnostic model, the calibration curve and ROC curve displayed high predictive accuracy and effectiveness. Single-gene GSEA analysis revealed that high ID1 was associated with the IL1/IL1R/JNK signaling pathway gene set. The increased ID1 was verified in high glucose-treated THP-1 cells and T1D subjects, and the deficiency of ID1 impaired the expression of the inflammatory cytokine IL6.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We had identified ID1 as the feature gene of CD14⁺ monocytes, which exhibited the ability for diagnosis and prediction of T1D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 9","pages":"1631-1644"},"PeriodicalIF":3.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566861","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 value of high-frequency ultrasound and serum miR-92a-3p in diabetic peripheral neuropathy","authors":"Chunmei Qiao,&nbsp;Zhenjiao Liu,&nbsp;Boran Wang,&nbsp;Xin Wang,&nbsp;Zifu Zhao,&nbsp;Hui Wang,&nbsp;Xiaolei Wang","doi":"10.1111/jdi.70110","DOIUrl":"10.1111/jdi.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Cross-sectional area (CSA) by high-frequency ultrasound (HF-US) detects morphologic changes in neuropathy. microRNA (miR)-92a-3p is linked to diabetes and nerve damage. Our study evaluated the diagnostic use of CSAs along with miR-92a-3p in diabetic peripheral neuropathy (DPN) and its relationship to the condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 172 patients were enrolled, comprising 89 with DPN and 83 T2DM cases without DPN. Real-time quantitative polymerase chain reaction (RT-qPCR) was utilized to quantify serum miR-92a-3p levels. HF-US detected CSA in the median, ulnar, and tibial nerves. Logistic regression analyzed potential risk factors for DPN occurrence and severity. Receiver operating characteristic curves assessed the diagnostic significance of miR-92a-3p and CSAs for DPN. Pearson coefficients evaluated the correlation between the Toronto Clinical Scoring System (TCSS) score and miR-92a-3p or CSAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DPN patients had significantly higher serum miR-92a-3p levels and CSAs of the median, tibial, and ulnar nerves than T2DM patients. Moreover, miR-92a-3p and CSAs were risk factors for DPN. When combined, they yielded an AUC of 0.891, with 80.90% sensitivity and 91.57% specificity, accurately identifying DPN patients. Furthermore, miR-92a-3p and CSAs correlated with TCSS score and were higher in moderate-to-severe patients with DPN than in mild patients with DPN. Finally, miR-92a-3p combined with CSAs predicted moderate-to-severe DPN with 91.67% sensitivity and 85.37% specificity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum miR-92a-3p and CSAs of median, ulnar, and tibial nerves are elevated in DPN patients. Their combination has high diagnostic significance in identifying DPN in T2DM patients and assessing its severity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 9","pages":"1692-1703"},"PeriodicalIF":3.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558627","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":"Hyperglycemia as an atypical finding of malignant hyperthermia: A case report and literature review","authors":"Huai-Jhih Sun,&nbsp;Yuan-Yi Chia,&nbsp;Yung-Yun Huang,&nbsp;Jun-Chen Sun,&nbsp;Chun-Hsien Wen","doi":"10.1111/jdi.70120","DOIUrl":"10.1111/jdi.70120","url":null,"abstract":"<p>Malignant hyperthermia (MH) is a rare but life-threatening disorder induced by volatile anesthetics or depolarizing muscle relaxants. Studies have reported the increased prevalence of hyperglycemia among patients susceptible to MH. Herein, we present the case of a 13-month-old toddler who had successfully undergone dextro-transposition of the great arteries and required main and bilateral pulmonary artery augmentation because of residual pulmonary atresia. The patient exhibited atypical manifestations of MH including hyperglycemia with an inadequate insulin response during the perioperative period. The hyperglycemia resolved following administration of dantrolene, the antidote for MH. Research has associated intracellular calcium leaks with reduced glucose storage in human muscle. Metabolic alterations in patients susceptible to MH may predispose them to hyperglycemia during acute MH episodes.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 9","pages":"1767-1770"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551522","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":"Classification of Japanese type 1 diabetes based on clinical phenotypes and its association with diabetic complications: Across-sectional study","authors":"Takafumi Masuda,&nbsp;Naoto Katakami,&nbsp;Naohiro Taya,&nbsp;Kazuyuki Miyashita,&nbsp;Mitsuyoshi Takahara,&nbsp;Ken Kato,&nbsp;Iichiro Shimomura","doi":"10.1111/jdi.70108","DOIUrl":"10.1111/jdi.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite the increasing number of studies using machine learning to develop individualized treatment strategies, only a few have been conducted in patients with type 1 diabetes. This study aimed to identify the characteristics of Japanese patients with type 1 diabetes, classified into subgroups using data-driven cluster analysis based on pancreatic beta-cell function, obesity, and glycemic control, and clarify the association between these subgroups and diabetic complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, a cluster analysis using three variables (C-peptide, body mass index, and glycated hemoglobin) in 206 Japanese patients with type 1 diabetes was performed. Multivariate logistic regression analysis was performed to compare the risk of diabetic complications by subgroup.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cluster analysis identified four subgroups. Group 2 (<i>n</i> = 58), characterized by high body mass index levels, had a higher risk of hepatic steatosis than the control group (Group 1, <i>n</i> = 90). Meanwhile, Group 3 (<i>n</i> = 44), characterized by high glycated hemoglobin levels, had higher risks of retinopathy, polyneuropathy, elevated brachial–ankle pulse wave velocity, and hepatic steatosis than Group 1 and Group 4 (<i>n</i> = 14), characterized by residual endogenous insulin, had a higher risk of chronic kidney disease than Group 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The risks of diabetic complications differed between subgroups of Japanese patients with type 1 diabetes. Tailored treatment approaches based on subgroup characteristics are a potential treatment option for reducing the risks of diabetic complications in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 9","pages":"1653-1662"},"PeriodicalIF":3.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537593","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":"Effect of SGLT-2 inhibitors on COPD exacerbations in individuals with type 2 diabetes: A meta-analysis and Bayesian sensitivity analysis","authors":"Muhammed Shabil,&nbsp;Jayaraj Patil,&nbsp;Prakasini Satapathy,&nbsp;Abhay M Gaidhane,&nbsp;Kattela Chennakesavulu,&nbsp;Nasir Vadia,&nbsp;Soumya V Menon,&nbsp;Rajashree Panigrahi,&nbsp;Ganesh Bushi,&nbsp;Mahendra Singh,&nbsp;Sanjit Sah,&nbsp;Awakash Turkar,&nbsp;Khang Wen Goh,&nbsp;S. Govinda Rao,&nbsp;Edward Mawejje","doi":"10.1111/jdi.70111","DOIUrl":"10.1111/jdi.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic obstructive pulmonary disease (COPD) and Type 2 diabetes mellitus (T2DM) frequently coexist, amplifying morbidity, mortality, and healthcare costs. COPD exacerbations are more frequent and severe in T2DM patients, necessitating therapies addressing both conditions. This systematic review and meta-analysis evaluates the impact of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) on COPD exacerbations in T2DM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines, we searched PubMed, Embase, and Web of Science until March 2025 for studies assessing SGLT-2i effects on COPD exacerbations in T2DM. Eligible studies included adults with T2DM-COPD overlap, reporting exacerbation outcomes. A random-effects meta-analysis and Bayesian hierarchical models were employed, with sensitivity and subgroup analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven studies (449,530 participants) were included. SGLT-2i use reduced COPD exacerbation risk by 39% (pooled HR: 0.609, 95% CI: 0.431–0.858), with Bayesian analysis supporting a 31% reduction (HR: 0.64, 95% CrI: 0.40–0.88). Subgroup analyses showed superior efficacy vs DPP-4 inhibitors (HR: 0.618, 95% CI: 0.462–0.827) and sulfonylureas (HR: 0.620, 95% CI: 0.526–0.731), and modest benefit over GLP-1RAs (HR: 0.940, 95% CI: 0.890–0.992). Severe exacerbation reduction was non-significant (HR: 0.676, 95% CI: 0.340–1.344). Heterogeneity was high (<i>I</i>² ≥ 97.9%), but sensitivity analyses confirmed robustness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SGLT-2 inhibitors significantly reduce COPD exacerbations in T2DM patients, offering dual cardiometabolic and respiratory benefits. Their superiority over other antidiabetic agents supports prioritization in high-risk T2DM-COPD populations. Further trials are needed to validate effects on severe exacerbations and elucidate mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 9","pages":"1670-1682"},"PeriodicalIF":3.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537594","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":"Management of pregnancy with metformin: Case reports for genetic insulin resistance syndrome and a literature review for gestational and type 2 diabetes","authors":"Kai Yoshimura,&nbsp;Yushi Hirota,&nbsp;Tetsushi Hamaguchi,&nbsp;Takehito Takeuchi,&nbsp;Tomofumi Takayoshi,&nbsp;Shuichiro Saito,&nbsp;Mariko Ueda,&nbsp;Seiji Nishikage,&nbsp;Akane Yamamoto,&nbsp;Naoko Hashimoto,&nbsp;Wataru Ogawa","doi":"10.1111/jdi.70105","DOIUrl":"10.1111/jdi.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Genetic insulin resistance syndrome is characterized by severe insulin resistance due to functional abnormalities of the insulin receptor or downstream signaling molecules. Treatment typically includes insulin formulations and oral hypoglycemic agents such as metformin and sodium-glucose cotransporter 2 (SGLT2) inhibitors. However, achieving adequate glycemic control remains challenging. Moreover, given its rarity, reports on perinatal glycemic management in affected pregnancies remain scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We describe prenatal care for two cases of genetic insulin resistance syndrome: a case of type A insulin resistance syndrome attributed to a heterozygous variant (Asn462Ser) of <i>INSR</i> (case 1) and a case of genetic insulin resistance syndrome due to a heterozygous variant (Arg649Trp) of <i>PIK3R1</i> (case 2). We also review the literature for metformin treatment of gestational diabetes mellitus (GDM) or type 2 diabetes during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In case 1, perinatal glycemic management during three pregnancies was achieved with metformin alone, resulting in deliveries without any adverse events for both mother and infants. In case 2, administration of metformin during pregnancy initially reduced daily insulin requirements from 230 to 50 U/day, with a predelivery insulin dose of 112 U/day. At 34 weeks of gestation, a cesarean section was performed because of intractable uterine contractions. The child was diagnosed as small for gestational age and harbored the same genetic variant as the mother.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present cases suggest that metformin administration during pregnancy can be beneficial in cases of genetic insulin resistance syndrome, similar to its use in pregnancies associated with T2D or GDM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 9","pages":"1663-1669"},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525725","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}