Journal of Diabetes Investigation最新文献

{"title":"Phenotypic characteristics of diabetic neuropathic pain and factors associated in patients with Diabetes Mellitus-type 2","authors":"Helena De Sola,&nbsp;María Dueñas,&nbsp;Inmaculada Failde,&nbsp;Jenifer Palomo-Osuna,&nbsp;Cristina Naranjo,&nbsp;Alejandro Salazar","doi":"10.1111/jdi.70089","DOIUrl":"10.1111/jdi.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>To identify subgroups of patients with diabetic neuropathic pain according to their phenotypic characteristics and factors associated with belonging to each of these groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A multicenter cross-sectional study carried out in patients with DM-type2 and diabetic neuropathy. We recorded sociodemographic and clinical data, intensity of pain, pain phenotypes, mood disorders, sleep quality, social support, and health-related quality of life. A hierarchical cluster analysis was carried out to find groups according to their phenotype. The factors associated with belonging to these groups were assessed with a multinomial logistic regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four phenotypic groups were found: G1 with longer pain duration, predominance of pain provoked by brushing or pressure, and sensation of pins/needles and tingling; G2 characterized by stabbing, pins and needles, and electric shocks; G3 with lower scores in all the NPSI items; and G4 with low-moderate scores in almost all the items, but showing some level of pins and needles and tingling. Intensity and duration of pain, and level of anxiety were the factors associated with belonging to G1, G2, and G4 with respect to G3, although the magnitude of the risk was slightly different among them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Specific treatment strategies should be developed for the different profiles found, with special attention to those with more pain and anxiety levels, including cognitive-behavioral therapies or mindfulness-based interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 8","pages":"1495-1506"},"PeriodicalIF":3.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191311","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":"Suboptimal physician adherence to evidence-based guidelines for managing cardiorenal comorbidities in diabetes care: A retrospective single-center study in Taiwan","authors":"Zong-Yu Shen,&nbsp;Horng-Yih Ou","doi":"10.1111/jdi.70090","DOIUrl":"10.1111/jdi.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In patients with diabetes and cardiorenal comorbidities, sodium–glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are critical to secondary outcome prevention. This study investigated physicians' adherence to current cardiorenal-diabetic prescription guidelines for such patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This observational, retrospective-cohort, single-center study enrolled 7,805 adults (mean age 71 years; mean HbA1c level 7.4%) with type 2 diabetes mellitus and atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), or chronic kidney disease (CKD). Patients' demographic information, comorbidities, medication history, and laboratory data were collected. Physician adherence was defined as a patient with ASCVD receiving an SGLT2i or GLP-1 RA and a patient with CKD or HF receiving an SGLT2i. The baseline characteristics of the adherence and nonadherence groups were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only 28.4% of prescriptions adhered to guidelines. Patients in the physician-adherent group had higher HbA1c levels, body mass index, and age, and more comorbidities. Logistic regression revealed that older age [odds ratio (OR) 2.29, 95% confidence interval (CI) 2.014–2.604, <i>P</i> &lt; 0.001], cerebrovascular accident history (OR 1.591, 95% CI 1.357–1.865, <i>P</i> &lt; 0.001), and dipeptidyl peptidase 4 inhibitor use (OR 2.359, 95% CI 2.062–2.700, <i>P</i> &lt; 0.001) were associated with physician nonadherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Only a suboptimal percentage of patients with diabetes and cardiorenal disease in Taiwan receive SGLT2is and GLP-1 RAs despite these medications' recognized cardiorenal benefits. Further action is required to improve physician adherence in patients with greater age, cerebrovascular accident history, and dipeptidyl peptidase 4 inhibitor use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 8","pages":"1535-1542"},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186113","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 the IL-6R rs2228145 polymorphism with diabetic nephropathy: A case-control study","authors":"Pavla Izakovicova,&nbsp;Simona Slezakova,&nbsp;Tereza Deissova,&nbsp;Hana Poskerova,&nbsp;Petra Borilova Linhartova,&nbsp;Ladislav Dusek,&nbsp;Katerina Kankova,&nbsp;Lydie Izakovicova Holla","doi":"10.1111/jdi.70073","DOIUrl":"10.1111/jdi.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The pathogenesis of diabetes mellitus (DM) and its complications has been previously linked to elevated levels of interleukin-6 (IL-6); IL-6 triggers intracellular pathways through interaction with the IL-6 receptor (IL-6R). This study aimed to determine the association of single nucleotide polymorphisms (SNPs) <i>IL-6</i> −597G/A (rs1800797), −572G/C (rs1800796), −174G/C (rs1800795), its receptor (<i>IL-6R</i>) Asp358Ala (+48892A/C, rs2228145) and DM or its complications in the Czech population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In total, 669 subjects participated in this case-control study, including 167 controls, 119 patients with type 1 DM (T1DM), and 383 patients with type 2 DM (T2DM). The subjects were monitored for glycemia, glycated hemoglobin, lipid profile, glomerular filtration rate (GFR), and common complications, such as diabetic nephropathy (DN), retinopathy (DR), (poly)neuropathy (DPN), and periodontitis (P).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Frequencies of the <i>IL-6</i> and <i>IL-6R</i> alleles or genotypes, and <i>IL-6</i> haplotypes were similar between the controls and the patients with T1DM or T2DM (<i>P</i> &gt; 0.05). However, lower values of GFR were observed in diabetic patients with <i>IL-6</i> −174CC homozygotes compared to other (CG and GG) genotypes (<i>P</i> ≤ 0.05). In addition, the <i>IL-6R</i> Asp358Ala variant was associated with DN (<i>P</i> = 0.031, OR = 1.74, 95% CI: 1.05–2.89). After subclassification according to the type of DM, the significant association of the <i>IL-6R</i> polymorphism with DN was only found in T1DM (<i>P</i> = 0.013, OR = 2.90, 95% CI: 1.25–6.71).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study implies a significant relationship between the <i>IL-6R</i> Asp358Ala polymorphism and DN in Czech T1DM patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 8","pages":"1463-1472"},"PeriodicalIF":3.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172138","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 cholesterol-HDL-glucose (CHG) index and traditional adiposity markers in predicting diabetic retinopathy and nephropathy","authors":"Merve Çatak,&nbsp;Şerife Gülhan Konuk,&nbsp;Sema Hepsen","doi":"10.1111/jdi.70086","DOIUrl":"10.1111/jdi.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the relationship between four metabolic indices—visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, and cholesterol-HDL-glucose (CHG) index—and the presence of diabetic nephropathy (DN) and diabetic retinopathy (DR) in patients with long-standing type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This prospective cross-sectional study included 175 T2DM patients with disease duration &gt;10 years who attended an endocrinology outpatient clinic between July 2021 and January 2022. DR was assessed via fundus photography, and DN was defined using the urinary albumin-to-creatinine ratio and eGFR. VAI, LAP, TyG, and CHG indices were calculated using anthropometric and biochemical parameters. Logistic regression was used to identify independent predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age was 60 ± 10.1 years; 63.4% were female. DR and DN were observed in 50.3% and 38.9% of patients, respectively. VAI, LAP, and TyG were significantly higher in patients with DN but not with DR. CHG was elevated in both DN and DR (<i>P</i> &lt; 0.05), and was the only independent predictor of DN (<i>P</i> = 0.005). Notably, CHG was significantly higher in proliferative vs non-proliferative DR (<i>P</i> = 0.009), unlike the other indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While VAI, LAP, and TyG were associated only with nephropathy, CHG was linked to both DN and DR. Its integration of glycemic and lipid parameters may offer greater sensitivity for microvascular risk stratification in T2DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 8","pages":"1487-1494"},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155428","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 case of SHORT syndrome with a novel genetic mutation diagnosed 19 years after the onset of diabetes","authors":"Kumiko Tajima,&nbsp;Yushi Hirota,&nbsp;Tomofumi Takayoshi,&nbsp;Wataru Ogawa","doi":"10.1111/jdi.70088","DOIUrl":"10.1111/jdi.70088","url":null,"abstract":"<p>A 33-year-old man presented with short stature, thin build, hearing impairment, Rieger anomaly, and a history of inguinal hernia. He also exhibited characteristic facies, including a triangular face with a small chin, deeply set eyes, and low-set ears. He was born with intrauterine growth restriction and developed diabetes during adolescence, requiring high-dose insulin therapy. For 19 years, an accurate diagnosis was not made. We performed direct sequencing of the insulin receptor gene and exons 11–16 of the <i>PIK3R1</i> gene, identifying a c.1957A&gt;T mutation (p.Lys653*) in the <i>PIK3R1</i> gene, which confirmed a diagnosis of SHORT syndrome. Suspecting SHORT syndrome in individuals who exhibit some of its typical symptoms may facilitate an accurate diagnosis and enable effective management of this condition.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 8","pages":"1561-1565"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148784","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":"PIK3R1 mutations in individuals with insulin resistance or growth retardation: Case series and in silico functional analysis","authors":"Tomofumi Takayoshi,&nbsp;Yushi Hirota,&nbsp;Aki Sugano,&nbsp;Kenji Sugawara,&nbsp;Takehito Takeuchi,&nbsp;Mika Ohta,&nbsp;Kai Yoshimura,&nbsp;Seiji Nishikage,&nbsp;Akane Yamamoto,&nbsp;Yu Mimura,&nbsp;Shinji Higuchi,&nbsp;Jun Mori,&nbsp;Rie Kawakita,&nbsp;Tohru Yorifuji,&nbsp;Yutaka Takaoka,&nbsp;Wataru Ogawa","doi":"10.1111/jdi.70062","DOIUrl":"10.1111/jdi.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Phosphatidylinositol 3-kinase (PI3K) plays a key role in insulin signaling, and mutations in <i>PIK3R1</i>, which encodes a regulatory subunit (p85α) of this enzyme, are responsible for SHORT syndrome, which is associated with insulin-resistant diabetes. We here describe four Japanese individuals from three families with SHORT syndrome who harbor either a common or a previously unknown mutation in <i>PIK3R1</i> as well as provide an <i>in silico</i> functional analysis of the mutant proteins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Gene sequencing was performed to identify <i>PIK3R1</i> mutations. 3D structural analysis of wild-type and mutant p85α proteins was performed by homology modeling, and structural optimization and molecular dynamics simulations confirmed stable trajectories. Docking simulations of p85α with a phosphopeptide were also conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified two families with a common mutation (c.1945C&gt;T, p.R649W) and one family with a previously unidentified mutation (c.1957A&gt;T, p.K653*) of <i>PIK3R1</i>. <i>In silico</i> modeling revealed that both mutations impaired binding of p85α to phosphopeptide, with K653* resulting in the loss of amino acids that contribute to such binding. Docking simulations showed a significant loss of docking energy for the R649W mutant compared with the wild-type protein (<i>P</i> = 0.00329).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The four cases of SHORT syndrome were associated with early-onset diabetes and intrauterine growth retardation, with the identified mutations likely disrupting the binding of p85α to phosphopeptide and thereby impairing insulin signaling. One case uniquely manifested diabetes without insulin resistance, emphasizing the need for further study of the clinical variability of SHORT syndrome, especially with regard to its associated diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 8","pages":"1526-1534"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148793","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":"Diabetes advocacy in the Asia–Pacific region","authors":"Noriko Kodani,&nbsp;Asuka Kato,&nbsp;Moon-Kyu Lee,&nbsp;Ronald Ching Wan Ma,&nbsp;Anita Sabidi,&nbsp;Renza Scibilia,&nbsp;Zhiguang Zhou,&nbsp;Alicia Jenkins","doi":"10.1111/jdi.70084","DOIUrl":"10.1111/jdi.70084","url":null,"abstract":"<p>Living with diabetes is challenging. From diagnosis, one has to deal with lifelong management of glycemia and other factors. Misunderstandings about diabetes persist. People with diabetes (PWD) are sometimes misperceived as having brought diabetes upon themself, being incapable of self-management, maintaining a healthy lifestyle, or appropriate dietary habits, among other negative attributes. As a result, PWD can face difficulties at school, at home, in the workplace, and in the community. PWD also face financial burden with medical costs, health insurance, and loans. There has been growing awareness of diabetes-related stigma, highlighting the prevalence and consequences of biased, one-sided, and inaccurate information. Stigma can negatively affect the self-esteem, self-confidence, and self-care of PWD, and adversely affect their clinical outcomes. Therefore, advocacy to reduce the burden is essential. The situation varies within and between countries. There are still countries with limited access to insulin, more powerful glucose-lowering, cardio- and reno-protective drugs for type 2 diabetes, glucose monitoring strips, let alone technologies including continuous glucose monitoring (CGM) and insulin pumps. As members of the Asia–Pacific region, we strive to improve the quality of life for PWD within our countries and to enhance the global advocacy movement to achieve sustainable health equity worldwide. Herein, we share information from some Asia–Pacific countries: Australia, China, Korea, Indonesia, and Japan, including some aspects of the advocacy movement in each country. Through mutual understanding and collaboration, we aim to strengthen advocacy efforts across the Asia–Pacific region and contribute to global initiatives that enhance health outcomes for PWD.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 7","pages":"1191-1201"},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148788","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 need for a comprehensive diabetes data system in Ireland","authors":"Naomi Holman,&nbsp;Claire M. Buckley,&nbsp;Lisa Devine,&nbsp;Kate Gajewska,&nbsp;Sean F. Dinneen,&nbsp;the Chronic Disease Data System Consortium","doi":"10.1111/jdi.70080","DOIUrl":"10.1111/jdi.70080","url":null,"abstract":"<p>The primary purpose of healthcare systems is to prevent and treat disease. The mainstay of this is direct patient clinical care, but the system needs to be supported by reliable and timely data to function in an evidence-based and responsive way<span>¹</span>. Many health systems around the globe have a rich tradition of using data to inform and improve care processes<span>^2-4</span>. In Ireland, there is currently no single source of data that can reliably report the number of people living with diabetes and no collation of records that provides an overview of the care received and outcomes experienced by people living with diabetes. A dual payer (public/private) system has led to diverse models of care, with a substantial proportion of diabetes care being provided privately by general practitioners. Historically, the lack of a unique identifier makes linkage of (clinical and administrative) data systems challenging. Many questions remain unanswered, and the scope to improve services and health-services planning is hindered without mechanisms to monitor change. Issues of equity and equality remain hidden, and the perspectives of people within the health service on the characteristics and outcomes of people living with diabetes cannot be substantiated by data.</p><p>Without a comprehensive data system, there is no scope to verify (or disprove) perceptions and changes to services that may be made with limited data to support their evaluation; plans are not evidence-based, and data to prioritize and shape policymaking are lacking.</p><p>Currently, aspects of diabetes care are captured in several national administrative datasets, including records of prescriptions dispensed by community pharmacies, publicly funded hospital admissions, Chronic Disease Management (CDM) programme returns by General Practitioners, Diabetic RetinaScreen, and civil death registrations. The combination of public and private care provision in the Irish health service (Figure 1) means that coverage of the datasets is not always universal. Data analysis is limited by a lack of governance, infrastructure, and public engagement that facilitates continuous networked dataset linkage. A national individual health identifier (IHI) has been created, but full implementation requires further legislation. Additionally, some crucial data on the care and outcomes of people with diabetes, such as laboratory tests, anthropometric measures, and lifestyle risk factors, are held in local or sub-national systems, which vary in their compatibility. The need for a diabetes data system has been consistently identified and has the support of the Department of Health, the Health Service Executive (HSE), Diabetes Ireland (national patient organization) and academic organizations. With early funding allocated and posts being filled in 2025, processes are being established to provide clinical leadership, programme management, data management, analysis, and reporting functions.","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 8","pages":"1367-1370"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207285","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 use and monitoring of adverse effects of sodium-glucose cotransporter-2 inhibitors in persons with type 1 diabetes mellitus","authors":"Chinatsu Sakai,&nbsp;Shinichi Tamaru,&nbsp;Keiji Sugai,&nbsp;Hironori Takeuchi,&nbsp;Ryo Suzuki","doi":"10.1111/jdi.70085","DOIUrl":"10.1111/jdi.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to evaluate the factors contributing to insulin dosage adjustment and the risk of sodium-glucose cotransporter-2 inhibitor (SGLT2i) discontinuation in persons with type 1 diabetes mellitus (T1DM) starting SGLT2i therapy in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective study used the electronic medical record-based survey data of 49 patients attending our hospital between December 2018 and October 2021 to investigate the clinical use and adverse effects of SGLT2i in persons with T1DM starting SGLT2i.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Upon SGLT2i initiation, there were five patients in the favorable glycemic control group (HbA1c &lt; 7.5%) and 44 patients in the poor glycemic control group (HbA1c ≥ 7.5%); few patients in the favorable glycemic control group reduced total daily insulin dose according to the recommendation, while 75% of patients in the group with poor glycemic control followed the guideline. Moreover, 60% of patients had hypoglycemia before the introduction of SGLT2i; additionally, among patients with no hypoglycemia before introduction, 50% had hypoglycemia after introduction. The group with hypoglycemia after induction tended to have longer diabetes duration and lighter body weight compared to the group without hypoglycemia. Multiple regression analysis revealed that diuretic use was an independent risk factor for discontinuation of SGLT2i (partial regression coefficient = 0.819, <i>P</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>When initiating SGLT2i in T1DM patients, it is important to evaluate glycemic control and adjust insulin dosage based on weight and diabetes duration to reduce hypoglycemia frequency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 8","pages":"1420-1429"},"PeriodicalIF":3.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140871","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":"Young-onset type 2 diabetes—Epidemiology, pathophysiology, and management","authors":"Andrea O.Y. Luk,&nbsp;Hongjiang Wu,&nbsp;Yingnan Fan,&nbsp;Baoqi Fan,&nbsp;Chun Kwan O,&nbsp;Juliana C.N. Chan","doi":"10.1111/jdi.70081","DOIUrl":"10.1111/jdi.70081","url":null,"abstract":"<p>The prevalence and incidence of young-onset type 2 diabetes is increasing globally, especially in low- and middle-income countries, and predominantly affects non-White ethnic and racial populations. Young-onset type 2 is heterogeneous in terms of the genetic and environmental contributions to its underlying pathophysiology, which poses challenges for glycemic management. Young at-risk individuals remain underrepresented in clinical trials, including diabetes prevention studies, and there is still an insufficient evidence base to inform practice for this age group. Improvements in diabetes care delivery have not reached young people who will progress to have disabling complications at an age when they are most productive. This review summarizes recent studies on the epidemiology of young-onset type 2 diabetes and its complications. We discuss the genetic and environmental risk factors that act in concert to promote glycemic dysregulation and early onset of type 2 diabetes. We provide perspectives on diabetes prevention and management, and propose strategies to address the unique medical and psychosocial issues associated with young-onset type 2 diabetes. The Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes Randomized Controlled Trial (PRISM-RCT) is the first large-scale clinical trial designed to evaluate the effect of a structured care model that integrates biogenetic markers with communication and information technology on attaining strict metabolic targets and improving clinical outcomes in individuals with young-onset type 2 diabetes. The results of this study will inform the scientific community about the impact of multifactorial intervention and precision care in young patients, for whom the legacy effect is particularly significant.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 7","pages":"1157-1172"},"PeriodicalIF":3.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136071","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}