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

{"title":"DiaActive protocol: A randomized controlled trial of cognitive-motor multicomponent exercise to reduce fall rate in older adults with diabetes.","authors":"Aksayan Arunanthy Mahalingasivam, Asger Ahlmann Bech, Peter Vestergaard, Martin Grønbech Jørgensen, Nicklas Højgaard-Hessellund Rasmussen","doi":"10.1111/dme.70461","DOIUrl":"https://doi.org/10.1111/dme.70461","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults with diabetes have an increased risk of falls due to neuropathy, impaired bone health and cardiovascular disease, resulting in significant morbidity and mortality. Conventional fall-prevention programmes primarily target strength and balance, while cognitive-motor integration, essential for safe mobility in complex environments, is often overlooked. Multicomponent exercise combining physical and cognitive training may therefore provide additional benefits in this population.</p><p><strong>Methods: </strong>The DiaActive trial is a single-centre, stratified, parallel-group randomized controlled trial including adults aged ≥65 years with type 1 or type 2 diabetes. After comprehensive baseline assessments, 440 participants (220 with type 1 diabetes and 220 with type 2 diabetes) with low-to-moderate fall risk are randomized 1:1 within diabetes type to a 26-week cognitive-motor multicomponent exercise intervention (RYMA) or usual care. The intervention includes two weekly supervised sessions combining rhythm-based motor training with activities-of-daily-living-focused strength and balance exercises.</p><p><strong>Results: </strong>The primary outcome is fall rate during the intervention, assessed using weekly fall calendars. Secondary outcomes include balance performance, fall-related outcomes, bone mineral density, fractures, neuropathy progression, cardiovascular risk markers, muscle strength and cognitive function. Follow-up continues to 104 weeks, with registry-based outcomes assessed at 5 years.</p><p><strong>Conclusion: </strong>The trial is approved by the North Denmark Region Ethics Committee (N-20240025). Written informed consent will be obtained. Results will be disseminated through peer-reviewed publications, conferences and stakeholder engagement.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70461"},"PeriodicalIF":3.4,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860709","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}

{"title":"PPI and researcher perspectives of islet transplantation therapy for type 1 diabetes.","authors":"Peter M Jones, Sarah Gatward, Lesley Beadle, Amanda Panizza, Clare Blaydon-Ellis, Sara Caxaria, Aidan Cruddace, Christine Deal, Ranna Patel, Alexander Silverstein, Lydia F Daniels Gatward, Tzu-Wen Hong, Rosie Sullivan, William T Blackstone Whines, Aileen J F King, Shanta J Persaud","doi":"10.1111/dme.70456","DOIUrl":"https://doi.org/10.1111/dme.70456","url":null,"abstract":"<p><strong>Aims: </strong>Islet transplantation offers the potential of a cure for type 1 diabetes (T1D), but the limited availability of human donor islets means that this therapy is currently only available to a small group of people with T1D who have intractable hypoglycaemia. The shortage of donor human islets has driven extensive research efforts to generate human islets from pluripotent stem cells (SC-islets), and current protocols are producing SC-islets which are showing promising results in early clinical trials. As part of our T1D Grand Challenge research programme, we set up a Patient and Public Involvement (PPI) Steering Group with a diverse range of members with lived experience of T1D to interact with us and provide advice. The aim of this study was to explore how perceptions of human islet transplantation differ between people with lived experience of T1D and diabetes researchers.</p><p><strong>Methods: </strong>To determine how perceptions of human islet transplantation may differ between people with lived experience of T1D and researchers, two islet transplant recipients recounted their experiences to members of the PPI group and the science researchers.</p><p><strong>Results: </strong>We subsequently asked both groups for individual, anonymised responses to the presentations, and we here present an analysis of that survey.</p><p><strong>Conclusions: </strong>Overall, this exercise highlights different approaches to islet/SC-islet transplantation between people with lived experience of T1D and basic science diabetes researchers. This emphasises the continued need for open lines of communication between the two groups so each can benefit from the other's experience.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70456"},"PeriodicalIF":3.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852294","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}

{"title":"Physical activity during pregnancy in women with type 1 or type 2 diabetes: A scoping review.","authors":"Holly Mei Jones, Lolwa Alyafei, Laura Macro, Gina Gardener, Emma Cockcroft, Rob Andrews, Richard M Pulsford","doi":"10.1111/dme.70452","DOIUrl":"https://doi.org/10.1111/dme.70452","url":null,"abstract":"<p><strong>Aim: </strong>Physical activity (PA) is recommended during pregnancy for its health benefits. While general PA guidance exists for uncomplicated pregnancies, evidence specific to women with pre-existing type 1 diabetes or type 2 diabetes (T1D; T2D) is limited. This scoping review synthesised available evidence regarding PA during pregnancy among women with pre-existing diabetes to identify evidence gaps and inform future research.</p><p><strong>Methods: </strong>Systematic searches of MEDLINE, Embase, Web of Science, Scopus, CINAHL, and SportDiscus were conducted. Studies were eligible if they reported PA participation, evaluated PA interventions, or explored PA-related experiences in pregnant women with T1D or T2D. Two reviewers independently screened titles, abstracts, and full texts. Data were extracted and synthesised narratively according to study design, PA measurement methods, and reported associations with diabetes or pregnancy outcomes.</p><p><strong>Results: </strong>Twenty-three studies were included. Overall, the literature reports that PA levels among women with pre-existing diabetes are typically below recommended levels and decline across pregnancy. Qualitative studies identified barriers to PA, including physical discomfort, fear of glycaemic instability, and inadequate social support. Methodological limitations were common, including reliance on self-reported PA, frequent aggregation of different diabetes types, a lack of longitudinal study designs, and scarce integration of objective PA measurement with glucose monitoring. Additionally, qualitative studies rarely focused on PA behaviours and experiences, and no studies explored the experiences of healthcare professionals supporting these women.</p><p><strong>Conclusion: </strong>Evidence on PA during pregnancy in women with pre-existing diabetes remains sparse and methodologically limited. Future research should prioritise longitudinal designs, objective PA measures alongside contemporaneous glucose monitoring, and incorporate qualitative research focused on barriers and facilitators to PA.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70452"},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852335","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}

{"title":"Comment on 'Improved prediction of symptomatic type 1 diabetes using a luciferase-based assay to measure (pro) insulin autoantibodies'.","authors":"Supriya S Desai, Maajid Mohi Ud Din Malik","doi":"10.1111/dme.70462","DOIUrl":"https://doi.org/10.1111/dme.70462","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70462"},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841965","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}

{"title":"In response to comment on improved prediction of symptomatic type 1 diabetes using a luciferase-based assay to measure (pro) insulin autoantibodies.","authors":"Rebecca C Wyatt, Cristina Brigatti, Sian L Grace, Claire L Williams, Ilaria Marzinotto, Ben T Gillard, Elena Bazzigaluppi, Deborah Shoemark, Michela A-M Chandler, Peter Achenbach, Lorenzo Piemonti, Kathleen M Gillespie, Vito Lampasona, Alistair J K Williams, Josh Tyler, Anna E Long","doi":"10.1111/dme.70471","DOIUrl":"https://doi.org/10.1111/dme.70471","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70471"},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842039","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}

{"title":"The impact of frailty on glycaemic control in older adults with type 1 diabetes: An observational study.","authors":"A Bullock","doi":"10.1111/dme.70460","DOIUrl":"https://doi.org/10.1111/dme.70460","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70460"},"PeriodicalIF":3.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835998","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}

{"title":"Evaluating EndoC βH5 pseudoislets as a model for human islet transplantation.","authors":"Lydia F Daniels Gatward, William T Blackstone Whines, Tzu-Wen Hong, Rosie Sullivan, Jessica Starikova, Adya Lonsane, Ryea Arora, Victoria Salem, Min Zhao, Peter M Jones, Aileen F J King, Shanta J Persaud","doi":"10.1111/dme.70454","DOIUrl":"https://doi.org/10.1111/dme.70454","url":null,"abstract":"<p><strong>Aims: </strong>The EndoC βH5 cell line represents a promising human β-cell model for preclinical diabetes research. Indeed, EndoC βH5 cells aggregate into islet-like organoids, secrete insulin in a glucose-dependent manner, and express a variety of β-cell functional markers. However, EndoC βH5 cell survival and functionality in vivo have not yet been investigated. Here, we have transplanted EndoC βH5 pseudoislets under the kidney capsule in SCID mice and analysed their capacity to regulate whole body blood glucose concentrations.</p><p><strong>Methods: </strong>EndoC βH5 pseudoislets were formed in agar microwells. Oxygen consumption rate and glucose-stimulated insulin secretion were quantified in vitro. After 31 days, groups of 1000 EndoC βH5 pseudoislets were transplanted under the kidney capsule in SCID mice. To selectively ablate endogenous β-cells, streptozotocin was administered 1 month after transplantation, and EndoC βH5 graft function was analysed through quantification of blood glucose and human plasma insulin.</p><p><strong>Results: </strong>EndoC βH5 pseudoislets exhibited glucose-induced insulin secretion at 15 days, which was maintained at 31 days of culture. Human insulin was detectable in mouse plasma at 1 week post-transplantation. Despite this, streptozotocin administration led to overt diabetes in transplant recipients.</p><p><strong>Conclusion: </strong>EndoC βH5 pseudoislets secrete insulin in a glucose-responsive manner in vitro, remain viable in vivo, and secrete insulin. Despite this, transplantation of 1000 pseudoislets is not sufficient to maintain glycaemia when endogenous β-cells are destroyed. Nonetheless, EndoC βH5 pseudoislets represent a useful tool for preclinical islet transplantation studies where graft control of systemic glycaemia is not a requirement.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70454"},"PeriodicalIF":3.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815436","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}

{"title":"Addressing the landscape of diabetes care within community nursing: Learning from a Sussex-based service evaluation.","authors":"Jonathan Golding, Penelope Hamilton-Evans, Victoria Marlow, David Lipscomb","doi":"10.1111/dme.70467","DOIUrl":"https://doi.org/10.1111/dme.70467","url":null,"abstract":"<p><strong>Aims: </strong>Well-established provision in the United Kingdom offers insulin administration for those who are unable to self-manage. An ageing population is increasing pressure on community nursing teams, with many reporting unsustainable workloads. This service evaluation sought to review the community nursing workload of one community trust.</p><p><strong>Methods: </strong>The electronic records of all those receiving community nursing care for insulin administration were reviewed. Data extracted included age, ethnicity, frailty score (Clinical Frailty Scale), presence of dementia, whether the person is a care home resident, insulin regimen, number of daily nurse visits, HbA1c, and where available, continuous glucose monitoring (CGM) data. CGM data were compared by insulin regimen and diabetes type.</p><p><strong>Results: </strong>Searches identified 499 cases; 410 were eligible for analysis. Participants with type 1 diabetes were younger and less frail than those with type 2 diabetes, with more nursing visits per day. Median hypoglycaemia was low (0.0 in both groups), but median time-above-range was high regardless of diabetes type (60 in type 1 diabetes, 62 in type 2 diabetes) and insulin regimen.</p><p><strong>Conclusion: </strong>This service evaluation uncovered evidence of high workload for community nursing teams. Commissioners should recognise this and the potential for future increases in workload with an ageing population. Glucose control was sub-optimal but hypoglycaemia rates were low. Consideration should be given to ways to improve care. Options include involving carers in insulin administration, using longer acting insulins, and greater use of diabetes technology. Research into these strategies will help future proof this service and prevent widening of health inequalities.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70467"},"PeriodicalIF":3.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809728","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}

{"title":"Potential future directions for research into hypoglycaemia awareness and mental health: The role of substance use, sedative exposure and sleep.","authors":"Aisling McCarthy, Patrick Divilly","doi":"10.1111/dme.70447","DOIUrl":"https://doi.org/10.1111/dme.70447","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70447"},"PeriodicalIF":3.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805141","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}

{"title":"The effect of telemonitoring on quality of life in people with insulin-treated type 2 diabetes: A secondary analysis of a randomised controlled trial.","authors":"Rúni Knoph, Jannie Toft Damsgaard Nørlev, Thomas Kronborg, Peter Vestergaard, Morten Hasselstrøm Jensen, Stine Hangaard","doi":"10.1111/dme.70448","DOIUrl":"https://doi.org/10.1111/dme.70448","url":null,"abstract":"<p><strong>Aims: </strong>Telemonitoring in type 2 diabetes (T2D) care has demonstrated positive trends in terms of glycaemic control. However, evidence regarding its impact on patient-reported outcomes, such as general and diabetes-specific quality of life (QoL), remains inconclusive. In particular, the effect of telemonitoring in people with insulin-treated T2D is underexplored. This study aimed to evaluate the effect of telemonitoring on general and diabetes-specific QoL compared with usual care in people with insulin-treated T2D.</p><p><strong>Methods: </strong>Participants were randomised (1:1) to telemonitoring or usual care for 3 months. The primary outcomes were changes in the Short Form-12 Health Survey (SF-12) and the DAWN2 Impact of Diabetes Profile (DIDP). Telemonitoring included a continuous glucose monitor (CGM), a connected insulin pen, and an activity tracker. Data were monitored by hospital staff, who also provided regular telephone support. Usual care comprised a blinded connected insulin pen and a blinded CGM during the first and final 20 days, but their data were not monitored. ANCOVA compared groups for normally distributed data, with baseline scores as covariates. The Mann-Whitney U test was applied for non-normally distributed outcomes.</p><p><strong>Results: </strong>A total of 331 participants were included (telemonitoring: n = 166; usual care: n = 165). No significant between-group differences were found in SF-12 scores for neither the physical (p = 0.102) nor mental component summary score (p = 0.566). The telemonitoring group showed a statistically significant improvement in DIDP compared with usual care (p = 0.015).</p><p><strong>Conclusions: </strong>Telemonitoring had no effect on general QoL but led to a statistically significant improvement in diabetes-specific QoL.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70448"},"PeriodicalIF":3.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805188","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}