Diabetic medicine : a journal of the British Diabetic Association最新文献

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Type 2 diabetes risk communication following a diagnosis of gestational diabetes mellitus: A qualitative study. 妊娠期糖尿病诊断后2型糖尿病风险沟通:一项定性研究。
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-15 DOI: 10.1111/dme.70105
Molly Caba, Alison Northern, Amar Virdee, Kamlesh Khunti, Melanie Jane Davies, Michelle Hadjiconstantinou
{"title":"Type 2 diabetes risk communication following a diagnosis of gestational diabetes mellitus: A qualitative study.","authors":"Molly Caba, Alison Northern, Amar Virdee, Kamlesh Khunti, Melanie Jane Davies, Michelle Hadjiconstantinou","doi":"10.1111/dme.70105","DOIUrl":"https://doi.org/10.1111/dme.70105","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) increases women's risk of developing type 2 diabetes (T2DM) tenfold. Understanding of T2DM risk in women with GDM is variable and can impact health behaviours. To better understand how T2DM risk is communicated by healthcare professionals, we explored women's experiences of T2DM risk communication and support following a diagnosis of GDM.</p><p><strong>Methods: </strong>A qualitative study was conducted utilising semi-structured interviews. Participants were 10 women previously diagnosed with GDM. Transcripts were analysed following reflexive thematic analysis guidelines.</p><p><strong>Results: </strong>Three themes and four sub-themes were created to describe women's experiences of, and responses to, T2DM risk communication and support following a diagnosis of GDM. Minimal T2DM risk communication during GDM and postnatally was a common experience, and as a result, women forgot about their increased risk and felt forgotten by the health service. The lack of correspondence and support further fostered a dearth of knowledge and misunderstandings regarding what T2DM is, how it affects a person's body, and the necessity of preventative actions, all of which could impact women's management of their risk. Several strategies were suggested by women to remedy the currently absent communication and support. This included group education sessions, tangible and digital support resources, providing individualised information, and continuous and harmonious T2DM risk communication from healthcare professionals and health services.</p><p><strong>Conclusions: </strong>Current deficiencies for communicating T2DM risk and providing avenues of support following a diagnosis of GDM leaves many women feeling under-supported. Improvements to current care are recommended to ameliorate this.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70105"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Residual insulin secretion in long-standing type 1 diabetes. 长期存在的1型糖尿病的残留胰岛素分泌。
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-13 DOI: 10.1111/dme.70104
Petra Augstein, Natalie Buschmann, Janik Riese, Sabine Bochnig, Peter Heinke, Michael Schlosser, Wolfgang Kerner
{"title":"Residual insulin secretion in long-standing type 1 diabetes.","authors":"Petra Augstein, Natalie Buschmann, Janik Riese, Sabine Bochnig, Peter Heinke, Michael Schlosser, Wolfgang Kerner","doi":"10.1111/dme.70104","DOIUrl":"https://doi.org/10.1111/dme.70104","url":null,"abstract":"<p><strong>Aims: </strong>Studies involving the use of sensitive C-peptide assays have revealed that a significant number of persons with long-standing type 1 diabetes have measurable serum C-peptide concentrations. We investigated meal-stimulated C-peptide levels in persons with diabetes duration of more than 30 years and whether they were associated with the presence of diabetes-associated autoantibodies.</p><p><strong>Methods: </strong>This was an observational study of 105 participants with a clinical diagnosis of type 1 diabetes and a diabetes duration ≥30 years. Participants underwent mixed-meal tolerance tests (MMTTs) with measurements of C-peptide at 0 and 90 min. The levels of autoantibodies against GAD, IA-2 and ZnT8 were measured with radio-binding assays.</p><p><strong>Results: </strong>Participants were divided into tertiles of post-meal (90 min) C-peptide values as non-responders (NR), low-responders (LR) and high-responders (HR). Compared with the NRs and HRs, the LRs had significantly lower BMI values (p < 0.001), plasma triglyceride concentrations (p = 0.010) and triglyceride/HDL-cholesterol ratios (p = 0.004). Twenty-nine and eight participants were positive for one or 2-3 antibodies, respectively. The presence of antibodies was not associated with post-meal C-peptide levels, as evidenced by the fact that the proportions of antibody-positive participants did not differ between the groups.</p><p><strong>Conclusions: </strong>We conclude that a subgroup of type 1 diabetes participants with long-standing diabetes (>30 years) has residual beta-cell function. Participants with type 1 diabetes and low stimulated C-peptide concentrations are characterized by lower BMI, triglyceride concentrations and higher insulin sensitivity.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70104"},"PeriodicalIF":0.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of dietary interventions in individuals with diabetes for preventing and healing chronic wounds; a systematic review with meta-analysis. 糖尿病患者饮食干预对慢性伤口预防和愈合的有效性荟萃分析的系统综述。
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-09 DOI: 10.1111/dme.70100
Hailey R Donnelly, Clare E Collins, Erin D Clarke, Prudence I Morrissey, Natalie Gilbertson-Viljevac, Lucy Leigh, Peta E Tehan
{"title":"Effectiveness of dietary interventions in individuals with diabetes for preventing and healing chronic wounds; a systematic review with meta-analysis.","authors":"Hailey R Donnelly, Clare E Collins, Erin D Clarke, Prudence I Morrissey, Natalie Gilbertson-Viljevac, Lucy Leigh, Peta E Tehan","doi":"10.1111/dme.70100","DOIUrl":"https://doi.org/10.1111/dme.70100","url":null,"abstract":"<p><strong>Background: </strong>Optimising the nutritional status of individuals with diabetes is essential to optimise glycaemic control, as well as to prevent and promote wound healing. A variety of nutrition interventions are available. This systematic review and meta-analysis aimed to describe and synthesise the effectiveness of nutrition interventions for the prevention and management of chronic wounds in people with diabetes.</p><p><strong>Methods: </strong>Five databases and four clinical trial registries were searched for nutrition intervention studies. Included studies involved a nutrition intervention, such as personalised medical nutrition therapy, education and/or nutrient supplementation for those with diabetes and a chronic wound. Meta-analysis was completed utilising mean wound size at follow-up and non-adjusted data where available. Quality was appraised using RoB 2 and ROBINS, and certainty of evidence was assessed using GRADE.</p><p><strong>Results: </strong>Twenty-three studies were included; all included studies were in diabetes-related foot ulcer populations. Meta-analyses demonstrated nutrient supplements, including single and multi-nutrient supplements, significantly reduced wound depth (MWD -0.200 [95% CI -0.364, -0.035], p = 0.0172), width (WMD -0.466 [95% CI -0.724, -0.208], p = 0.0004) and length (-0.443 [95% CI -0.841, -0.045], p = 0.0292), the quality of included studies was low and the certainty of evidence was very low. While substantial heterogeneity was detected (I<sup>2</sup> = 56%-68%), a random-effects meta-analysis was conducted to account for between-study variability, providing an overall estimate while acknowledging differences in study characteristics. Two studies evaluating the effect of nutrition education demonstrated significant wound size reduction (n = 1) and proportion of people healed (n = 1).</p><p><strong>Conclusion: </strong>There is low-quality evidence that nutrient supplementation improves wound healing. Nutrition education may have a role in enhancing wound size reduction. Further studies are needed using robust methodologies to comprehensively determine the effectiveness of nutrition interventions for wound healing.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70100"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concordance of molecular microbiology and conventional culture techniques for infected diabetic foot ulcer management. 分子微生物学与常规培养技术在糖尿病足溃疡治疗中的一致性。
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-09 DOI: 10.1111/dme.70089
Angela Oates, Sarah T Brown, Colin C Everett, Fran Game, Jane E Nixon, Tim Sloan, Michelle M Lister, Michael Backhouse, Benjamin A Lipsky, David Russell, Howard Collier, Joanna Dennett, Rachael Gilberts, E Andrea Nelson
{"title":"Concordance of molecular microbiology and conventional culture techniques for infected diabetic foot ulcer management.","authors":"Angela Oates, Sarah T Brown, Colin C Everett, Fran Game, Jane E Nixon, Tim Sloan, Michelle M Lister, Michael Backhouse, Benjamin A Lipsky, David Russell, Howard Collier, Joanna Dennett, Rachael Gilberts, E Andrea Nelson","doi":"10.1111/dme.70089","DOIUrl":"https://doi.org/10.1111/dme.70089","url":null,"abstract":"<p><strong>Aim: </strong>The management of infected diabetic foot ulcers (DFUs) requires balancing the need for timely interventions against the desire for targeted antibiotic therapy, which relies on laboratory results. This study aimed to evaluate concordance between molecular and conventional culture and sensitivity (C&S) methods in identifying bacteria from infected DFUs.</p><p><strong>Methods: </strong>This study was conducted alongside CODIFI2, a Phase III randomised controlled trial comparing tissue sampling with wound swabbing. It assessed C&S and metagenomic 16S rRNA gene sequencing (M16S) in DFUs with suspected mild or moderate infections using both tissue and swab samples.</p><p><strong>Results: </strong>In 145 participants, C&S identified 248 microorganisms across 25 genera including eight anaerobic genera. M16S identified a greater number and diversity of microorganisms, detecting 455 across 40 genera, including 173 anaerobes from 15 distinct genera. No bacterial growth was reported in 25.5% (95% CI: 18.0%-32.3%) of C&S samples, whereas M16S identified at least one organism in all samples. While the observed agreement between methods was high (75%), Cohen's Kappa revealed low concordance overall, except for Pseudomonas spp. and Streptococcus spp. (Kappa ≥ 0.5).</p><p><strong>Conclusions: </strong>M16S detected a broader microbial spectrum, including fastidious anaerobes, but its low concordance with C&S and lack of antibiotic sensitivity data, challenge its suitability as a replacement for C&S in mild or moderate DFU infections. It may offer advantages in infections where increased sensitivity is beneficial, particularly where extended culture approaches are recommended to detect fastidious or low-abundance organisms. For mild to moderate DFU infections, our findings support continued reliance on conventional C&S testing.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70089"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Partial starch substitution with resistant starch lowers postprandial glucose and glycaemic variability in people with type 2 diabetes. 用抗性淀粉代替部分淀粉可降低2型糖尿病患者餐后血糖和血糖变异性。
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-09 DOI: 10.1111/dme.70079
Sineaid M Collins, M Bernadette Egan, Martin B Whyte, M Denise Robertson
{"title":"Partial starch substitution with resistant starch lowers postprandial glucose and glycaemic variability in people with type 2 diabetes.","authors":"Sineaid M Collins, M Bernadette Egan, Martin B Whyte, M Denise Robertson","doi":"10.1111/dme.70079","DOIUrl":"https://doi.org/10.1111/dme.70079","url":null,"abstract":"<p><strong>Aims: </strong>Approximately 40% of the caloric intake of the UK diet consists of starch. Most of which is readily digestible, thereby raising blood glucose. However, resistant starch (RS) evades metabolism in the small intestine, and in healthy adults, partial substitution of the diet with RS lowers postprandial glycaemia. The effect of RS in adults with type 2 diabetes is unknown.</p><p><strong>Methods: </strong>We investigated the effect of substituting ~15% of dietary starch with RS on glycaemic measures in adults with type 2 diabetes in a controlled but free-living setting. This was a single-blinded, crossover design, comparing 4-day RS and control diets. Proportions of resistant and digestible starch in identical food products were the only difference. IPro™2 continuous glucose monitors captured glycaemic excursions and glycaemic variability.</p><p><strong>Results: </strong>Twenty adults with type 2 diabetes, HbA<sub>1c</sub> (52 ± 2 mmol/mol; 6.9 ± 0.3%), age 58 ± 11 years, were enrolled, with 95% completing arms. Mean amplitude of glycaemic excursion (MAGE) was lower over lunch with RS (0.94 mmol/L; p = 0.004), as was SD glucose (0.31 mmol/L; p = 0.027), and peak glucose (0.94 mmol/L; p = 0.028). RS prolonged the time it took glucose to peak by 18 min at lunch (p = 0.046) and 28 min at dinner (p = 0.002). Time in range (TIR; glucose 3.9-10.0 mmol/L) was 7.8% greater with RS (p = 0.021).</p><p><strong>Conclusion: </strong>Substituting a proportion of starch with RS lowers blood glucose without changing the sensory attributes of foods significantly. There is potential to develop a functional diet for adults with type 2 diabetes to aid glycaemic control.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70079"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Socioeconomic deprivation results in high rates of diabetic ketoacidosis at type 1 diabetes diagnosis in England: A multicentre observational study. 社会经济剥夺导致英国1型糖尿病患者酮症酸中毒高发:一项多中心观察性研究。
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-08 DOI: 10.1111/dme.70102
Chamila Balagamage, Chariklia Pieridou, Afiya Andrews, Prem Sundaram, Tabitha Randell, Fiona Campbell, James Young, Ruben H Willemsen, Astha Soni, Meghan McGrath, M Loredana Marcovecchio, Nisha Pargass, Dhaara Iyer, Renuka P Dias
{"title":"Socioeconomic deprivation results in high rates of diabetic ketoacidosis at type 1 diabetes diagnosis in England: A multicentre observational study.","authors":"Chamila Balagamage, Chariklia Pieridou, Afiya Andrews, Prem Sundaram, Tabitha Randell, Fiona Campbell, James Young, Ruben H Willemsen, Astha Soni, Meghan McGrath, M Loredana Marcovecchio, Nisha Pargass, Dhaara Iyer, Renuka P Dias","doi":"10.1111/dme.70102","DOIUrl":"https://doi.org/10.1111/dme.70102","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70102"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arterial stiffness and atherosclerosis and incident cardiovascular events and all-cause mortality in individuals with manifest cardiovascular disease with and without type 2 diabetes. 伴有和不伴有2型糖尿病的明显心血管疾病患者的动脉硬化和动脉粥样硬化、心血管事件和全因死亡率
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-04 DOI: 10.1111/dme.70067
Jan F de Leijer, Frank L J Visseren, Birgitta K Velthuis, Ynte M Ruigrok, Jaco J M Zwanenburg, Manon G van der Meer, Martin Teraa, Pim A de Jong, Thomas T van Sloten
{"title":"Arterial stiffness and atherosclerosis and incident cardiovascular events and all-cause mortality in individuals with manifest cardiovascular disease with and without type 2 diabetes.","authors":"Jan F de Leijer, Frank L J Visseren, Birgitta K Velthuis, Ynte M Ruigrok, Jaco J M Zwanenburg, Manon G van der Meer, Martin Teraa, Pim A de Jong, Thomas T van Sloten","doi":"10.1111/dme.70067","DOIUrl":"https://doi.org/10.1111/dme.70067","url":null,"abstract":"<p><strong>Background: </strong>It is unclear if arterial stiffness and atherosclerosis are differentially related to cardiovascular events and mortality in individuals with manifest cardiovascular disease with and without type 2 diabetes (T2DM) and to what extent they mediate the relation between T2DM and these outcomes.</p><p><strong>Methods: </strong>Prospective data were used from the UCC-SMART cohort, including individuals with manifest cardiovascular disease (n = 9465). Arterial stiffness (brachial pulse pressure and carotid artery distensibility coefficient (DC)) and atherosclerosis (presence of carotid plaque and ankle-brachial index <0.9) were determined. Cardiovascular events included non-fatal stroke, non-fatal myocardial infarction and cardiovascular death. Cox regression and structural equation models were used with adjustment for confounders.</p><p><strong>Results: </strong>Over a median follow-up of 10.3 years, 2087 cardiovascular events and 2808 deaths occurred. Higher brachial pulse pressure was related to cardiovascular events and mortality in individuals with T2DM and without T2DM (HRs ≥ 1.09; 95% confidence intervals (CIs) between 1.03 and 1.30). Lower carotid artery DC was related to mortality in individuals with T2DM and without T2DM (hazard ratios (HRs) ≥ 1.20; 95% CI between 1.00 and 1.48), but only related to cardiovascular events in individuals without T2DM (HR 1.34; 95% CI between 1.20 and 1.49). Carotid and lower extremity atherosclerosis were both related to cardiovascular events and mortality in individuals with T2DM and without T2DM (HRs ≥ 1.52; 95% CI between 1.27 and 2.21). Up to 8.1% and 16.3% of the relation between T2DM and outcomes was mediated through arterial stiffness and atherosclerosis, respectively.</p><p><strong>Conclusion: </strong>Arterial stiffness and atherosclerosis are independently, but not differentially, related to cardiovascular events and mortality in individuals with manifest cardiovascular disease with and without T2DM. Atherosclerosis explained a larger proportion of the relation between T2DM and outcomes.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70067"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Experiences of women with type 2 diabetes during the pre-pregnancy, pregnancy and postpartum periods: A systematic review of qualitative studies. 2型糖尿病女性在孕前、孕期和产后的经历:定性研究的系统回顾
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-03 DOI: 10.1111/dme.70094
Lily Hopkins, Noreen O'Leary, Aileen Burton, Eleanor Dyer, Angela C Flynn, Sowmiya Gunabalasingam, Nicola Heslehurst, Artemis Kyrka, Rivka Lebrett, Claire L Meek, Danielle A J M Schoenaker, Sara L White, Rita Forde
{"title":"Experiences of women with type 2 diabetes during the pre-pregnancy, pregnancy and postpartum periods: A systematic review of qualitative studies.","authors":"Lily Hopkins, Noreen O'Leary, Aileen Burton, Eleanor Dyer, Angela C Flynn, Sowmiya Gunabalasingam, Nicola Heslehurst, Artemis Kyrka, Rivka Lebrett, Claire L Meek, Danielle A J M Schoenaker, Sara L White, Rita Forde","doi":"10.1111/dme.70094","DOIUrl":"https://doi.org/10.1111/dme.70094","url":null,"abstract":"<p><strong>Aim: </strong>To explore the experiences of women with type 2 diabetes prior to, during and after pregnancy.</p><p><strong>Methods: </strong>Six databases were systematically searched in September 2023. Qualitative studies involving women of childbearing age living with type 2 diabetes in the pre-pregnancy, pregnancy and postpartum periods were included. A thematic synthesis was conducted to inductively generate themes related to the experiences of women with type 2 diabetes. Descriptive themes were mapped to the Socio-Ecological Model to generate analytical themes relating to the personal, interpersonal and organisational level impacts that underlie women's experiences. Study quality was assessed using the CASP checklist for qualitative studies.</p><p><strong>Results: </strong>Eleven papers from seven countries met the inclusion criteria. Four themes containing six subthemes were generated. At a personal level, women prioritised their desire to plan a family over 'family planning'; however, once pregnant they were fearful for the future health of their children. At the interpersonal level, women reported that their self-efficacy was influenced by family and socio-cultural factors which often lacked diabetes-specific information. At the organisational level, women described a fragmented healthcare system and felt that healthcare professionals' unfamiliarity with the reproductive health needs of women with type 2 diabetes resulted in ineffective integration into their diabetes care.</p><p><strong>Conclusion: </strong>The provision of appropriate care to women with type 2 diabetes prior to and during pregnancy is inadequate, leaving them vulnerable to increased health risks and emotional distress. Innovative ways are needed to embed reproductive healthcare into mainstream diabetes management for women with type 2 diabetes prior to and post-pregnancy.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70094"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-effectiveness of fenofibrate versus standard care for reducing the progression of diabetic retinopathy: An economic evaluation based on data from the LENS trial. 非诺贝特与标准治疗减少糖尿病视网膜病变进展的成本效益:基于LENS试验数据的经济评估。
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-03 DOI: 10.1111/dme.70098
Graham Scotland, Mekazin Tsehaye, Caroline Styles, Jennifer Logue, Emily Sammons, Mohammed Zayed, Jonathan Emberson, Rachel Wade, Karl Wallendszus, Will Stevens, Rosanna Cretney, Simon Harding, Graham Leese, Gemma Currie, Jane Armitage, David Preiss
{"title":"Cost-effectiveness of fenofibrate versus standard care for reducing the progression of diabetic retinopathy: An economic evaluation based on data from the LENS trial.","authors":"Graham Scotland, Mekazin Tsehaye, Caroline Styles, Jennifer Logue, Emily Sammons, Mohammed Zayed, Jonathan Emberson, Rachel Wade, Karl Wallendszus, Will Stevens, Rosanna Cretney, Simon Harding, Graham Leese, Gemma Currie, Jane Armitage, David Preiss","doi":"10.1111/dme.70098","DOIUrl":"10.1111/dme.70098","url":null,"abstract":"<p><strong>Aims: </strong>The LENS trial demonstrated that fenofibrate slowed the progression of diabetic retinopathy compared to placebo in participants with early diabetic eye disease. We assessed its cost-effectiveness for reducing the progression of diabetic retinopathy versus standard care from a UK National Health Service perspective.</p><p><strong>Methods: </strong>Resource use and outcome data were collected over follow-up for participants enrolled in LENS. Mean costs were compared at 2 years and per 6-month follow-up (median 4.0 years). Within the trial, cost-effectiveness was assessed in terms of the incremental cost per case of referable disease averted. A microsimulation model, with inputs derived primarily from LENS trial data, was used to assess the incremental cost per quality-adjusted life year (QALY).</p><p><strong>Results: </strong>Fenofibrate resulted in a mean (95% confidence interval) reduction in health service costs of -£254 (-1062 to 624) at 2 years and -£101 (-243 to 42) per 6-month follow-up. This was accompanied by a 4.4% (1.3% to 8.0%) absolute reduction in any referable diabetic retinopathy or treatment thereof at 2 years, and a 27% (9%-42%) relative reduction over follow-up. Modelled over 10 years, fenofibrate use cost an additional £6 per patient for an expected QALY gain of 0.02, costing £406 per QALY versus standard care under base case assumptions. The probability of cost-effectiveness varied from 70% to 79% at a threshold of £20,000 per QALY, depending on the price discount applied to anti-VEGF drugs.</p><p><strong>Conclusions: </strong>Fenofibrate is likely to offer a cost-effective treatment for slowing the progression of diabetic retinopathy in people with early to moderate diabetic retinopathy or maculopathy.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70098"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dorothy Hodgkin lecture 2024: Insulin regulation of mitochondrial biogenesis and function-Impact of dysregulation of mitochondrial function in diabetes and its complications. 多萝西霍奇金讲座2024:胰岛素对线粒体生物发生和功能的调节-线粒体功能失调对糖尿病及其并发症的影响。
Diabetic medicine : a journal of the British Diabetic Association Pub Date : 2025-07-01 DOI: 10.1111/dme.70086
K Sreekumaran Nair
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