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

{"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}

{"title":"Trans-ancestry meta-analysis of genome-wide association study identifies eight novel genetic loci in type 1 diabetes: A multi-population study.","authors":"Xuying Guo, Jingyang Hu, Hongsheng Tian, Chi Yan, Qinghua Liu, Tianyu Zhou, Chuanwu Liu, Yan Guo, Ning Wang, Qinduo Ren, Yuan Xu, Chang Wang, Songlin Lu, Hongmei Sun, Ye Ma, Yu Dong, Chen Zhang, Zhenwei Shang, Wenhua Lv, Yongshuai Jiang, Hongchao Lv, Mingming Zhang","doi":"10.1111/dme.70434","DOIUrl":"https://doi.org/10.1111/dme.70434","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes (T1D) is a common disease. Although genome-wide association studies (GWASs) have identified hundreds of associated single nucleotide polymorphisms (SNPs), very few T1D GWAS have simultaneously addressed both Asian and European populations.</p><p><strong>Methods: </strong>Here, we conducted a large-scale trans-ancestry meta-analysis including 680,539 European individuals (12,525 T1D cases and 668,014 controls) and 133,251 Asian individuals (1,219 T1D cases and 132,032 controls) to identify genetic associations with T1D. Subsequently, fine-mapping and Summary-data-based Mendelian randomization (SMR) analyses were performed to further refine T1D-related genetic signals.</p><p><strong>Results: </strong>We identified 27 T1D-associated loci, including 8 potentially novel loci (near CDKAL1, NRSN1, FAM65B, LRRC16A, TULP1, SLC17A3, LRIG2, C6orf1). Fine-mapping was performed and helped pinpoint 7 putative causal variants (posterior probability, PP > 0.95) with T1D. Among them, rs9366622 (PP = 0.976) and rs1165190 (PP = 0.996) are located near LRRC16A and SLC17A3, respectively. These two variants are the lead SNPs of identified novel loci. SMR analysis identified a putative risk gene (U91328.19) at the novel locus SLC17A3-rs1165190, whose expression level is causally associated with T1D.</p><p><strong>Conclusions: </strong>These findings suggest that, for T1D, increasing ancestral diversity in genetic studies helps identify core genes and provides new insights into pathogenesis.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70434"},"PeriodicalIF":3.4,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765768","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":"Conventional adherence assessment methods are low-sensitivity diagnostic tests in people with type 2 diabetes: The TARGET study.","authors":"Hanad Osman, Sian Jenkins, Prashanth Patel, Kamlesh Khunti, Samuel Seidu, Pankaj Gupta","doi":"10.1111/dme.70429","DOIUrl":"https://doi.org/10.1111/dme.70429","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the performance of conventional adherence assessment methods against objective chemical adherence testing (CAT) in people with type 2 diabetes.</p><p><strong>Methods: </strong>In this prospective cohort study, 90 participants with type 2 diabetes attending primary care were assessed using CAT (n = 49), medication possession ratio (MPR; n = 60) and Hill-Bone Medication Adherence Scale (HBMAS; n = 58). Associations with HbA_1c and blood pressure (BP) were assessed, and within-person diagnostic performance was evaluated in 21 participants with all three measures.</p><p><strong>Results: </strong>Only CAT-defined non-adherence was associated with significantly higher HbA_1c, while CAT and MPR showed a significant association with diastolic BP. Within-person analysis suggested poor sensitivity for both MPR (16.7%; 95% CI 4.7-44.8) and HBMAS (66.7%; 95% CI 39.1-86.2), although HBMAS demonstrated very low specificity (11.1%; 95% CI 2.0-43.5) compared with CAT.</p><p><strong>Conclusions: </strong>Conventional adherence methods are low-sensitivity diagnostic tests, and CAT offers improved diagnosis of non-adherence in people with type 2 diabetes.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70429"},"PeriodicalIF":3.4,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762391","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":"Ecological momentary assessment in adolescents with type 1 diabetes mellitus: A scoping review.","authors":"Menglei Chen, Shiyu Wei, Jinru Sun, Chunmei Zhang","doi":"10.1111/dme.70433","DOIUrl":"https://doi.org/10.1111/dme.70433","url":null,"abstract":"<p><strong>Aims: </strong>To conduct a scoping review of the application of ecological momentary assessment (EMA) in adolescents with type 1 diabetes (T1DM), providing references for future research and practice in this field.</p><p><strong>Methods: </strong>This review followed the JBI scoping review methodology framework and systematically searched 10 databases, including CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Cochrane Library, EMbase, PsycINFO and CINAHL, from the establishment of the databases to 29 September 2025. The included literature was summarised and analysed.</p><p><strong>Results: </strong>Sixteen studies were included. EMA was used to investigate self-management, glycaemic control, psychosocial factors and cognitive function in adolescents with T1DM. Key findings revealed dynamic, real-time associations: self-management behaviours showed time- and context-dependent effects on glycaemic control (e.g. higher risk of omissions in mornings or social situations); affect and glucose levels exhibited bidirectional interactions, with negative affect impairing and positive affect improving glycaemic stability; social environment (peer and family support) and cognitive function (e.g. executive function) significantly moderated management outcomes. Most identified associations were within-person and contemporaneous; few studies examined between-person differences or time-lagged predictive effects. EMA demonstrated acceptable feasibility across diverse protocols. However, considerable methodological heterogeneity existed across studies, and most evidence was limited to Western populations.</p><p><strong>Conclusion: </strong>EMA is a feasible method for managing type 1 diabetes in adolescents and is capable of capturing real-time, dynamic associations among behaviour, affect, social context and glycaemic control. Future research should prioritise methodological standardisation, develop culturally adapted assessment tools and explore real-time intervention strategies to enable precise and personalised diabetes management. From a clinical perspective, EMA can guide individualised care by identifying high-risk time windows (e.g. mornings), social contexts (e.g. peer dining) and emotional triggers (e.g. negative affect), supporting targeted patient education, just-in-time behavioural reminders and collaborative mental health interventions.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70433"},"PeriodicalIF":3.4,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690725","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":"Commentary: Central themes and insights from the Diabetes and Disordered Eating Conference 2025.","authors":"Pil Lindgreen, Loa Clausen, Line Wisting, Khalida Ismail, Marietta Stadler, Bryan Cleal","doi":"10.1111/dme.70431","DOIUrl":"https://doi.org/10.1111/dme.70431","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70431"},"PeriodicalIF":3.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687552","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":"Compare diabetes care patterns by primary care accessibility during the COVID-19 pandemic.","authors":"Wei-Chen Lee, Laura R Porterfield, Elizabeth M Vaughan, Mukaila Raji","doi":"10.1111/dme.70442","DOIUrl":"10.1111/dme.70442","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic disrupted primary care delivery and may have exacerbated disparities in chronic disease management, particularly for diabetes mellitus. This study sought to investigate how living in areas with low access to primary care providers (PCP) affected the delivery of diabetes care during the pandemic.</p><p><strong>Methods: </strong>This is a retrospective longitudinal study using the Panel 24 of the Medical Expenditure Panel Survey data merged with the 2019 County Health Rankings data to classify areas by PCP availability (low vs. high). Dependent variables included measures of care processes (e.g., number of HbA1c tests), quality (e.g., diet modification) and outcomes (e.g., eye complications). Multivariable models were adjusted for demographics, insurance status and COVID-19 diagnosis.</p><p><strong>Findings: </strong>HbA1c testing, foot examinations and retinal examinations decreased during the pandemic for both groups, with much more pronounced declines in low PCP density areas. The largest change occurred in the frequency of attending group classes, dropping nearly 80% in low PCP areas. Individuals in low PCP areas were more likely to initiate oral diabetes medications (as opposed to insulin) compared with those in high PCP areas (0.84% vs. 0.28%, p = 0.015). Older age was associated with new diabetes (HR = 1.05) and new kidney disease (HR = 1.04), but less likely to start diet modification (HR = 0.99). Being female (HR = 0.69) and non-Hispanic whites (HR = 0.60) were associated with a lower likelihood of diabetes incidents.</p><p><strong>Conclusions: </strong>These findings highlight the importance of preparing public health responses for future events that limit access to routine care, particularly for individuals with or at risk of diabetes. Strengthening both in-person and virtual primary care services is critical to reducing gaps in chronic disease management and to supporting ongoing PCP follow-up.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70442"},"PeriodicalIF":3.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148672013","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}