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

{"title":"Treatment burden and health-related quality of life in young adults with type 1 diabetes.","authors":"Anka Van Gastel, Matthijs Graner-Baars, Anne M Stiggelbout, Viet-Thi Tran, Erik J Giltay, Sean F Dinneen, Jessica Mesman, Joris Swaak, Henk-Jan Aanstoot, Victor M Montori, Eelco J P De Koning, Marleen Kunneman","doi":"10.1111/dme.70376","DOIUrl":"10.1111/dme.70376","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to assess the treatment burden and health-related quality of life (HRQoL) in young adults with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>Online survey on experienced treatment burden (Treatment Burden Questionnaire, TBQ, 0-150, higher scores indicate higher burden) and HRQoL (Type 1 Diabetes and Life questionnaire for ages 18-25 and 26-45, T1DAL, 0-100, higher scores indicate better HRQoL) among Dutch young adults with T1D (aged 18-30).</p><p><strong>Results: </strong>In total, 294 young adults with T1D completed the survey. Mean TBQ score was 59.5 (SD = 24.9). Regular medical care reminding participants of their health problems scored highest. Mean T1DAL scores were 55.9 (SD = 12.9) for ages 18-25, and 62.1 (SD = 13.2) for ages 26-30. Lowest scores were in the subcategory 'Emotional experiences and daily activities' (18-25: median = 41.7, IQR = 24.9; 26-30: median = 47.8, IQR = 22.5). TBQ was strongly negatively correlated with T1DAL (r = -0.69, 95% CI [-0.74, -0.62], p < 0.001). Characteristics associated with higher treatment burden and lower HRQoL included female gender, lower time in range and dissatisfaction with diabetes management approach.</p><p><strong>Conclusion: </strong>Young adults with T1D report considerable treatment burden and moderate HRQoL, suggesting a high impact of diabetes care on their lives. Treatment burden is particularly affected by regular medical care activities, whereas diabetes affects the daily functioning and emotional experiences domains of HRQoL. Further research is needed to understand how young adults make care fit and to improve care for these patients, resulting in minimally disruptive care plans. While cautiously interpreted, this may be especially relevant for women and those with adverse clinical outcomes.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70376"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153130","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}

{"title":"Type 1 diabetes stigma: A UK survey of adults living with type 1 diabetes.","authors":"Harriet Housby, Akaal Kaur, Ian Godsland, Thomas Wylie, Nick Oliver, Katrina Scior, Vicky McKechnie","doi":"10.1111/dme.70365","DOIUrl":"10.1111/dme.70365","url":null,"abstract":"<p><strong>Aims: </strong>Type 1 diabetes stigma (T1D-stigma) refers to negative social judgement towards people living with type 1 diabetes (T1D) and is linked to poorer psychological well-being and suboptimal diabetes self management. This observational study aimed to explore sociodemographic, diabetes health and well-being factors linked to high stigma scores to inform future, targeted intervention studies.</p><p><strong>Methods: </strong>UK-based adults (aged ≥18 years) with T1D completed an online survey comprising sociodemographic and diabetes health questions, wellbeing measures for anxiety (Generalised Anxiety Disorder Scale: GAD-7), diabetes impact (Impact of Diabetes Profile: DIDP) and depression (Patient Health Questionnaire: PHQ-9) and the Type 1 Diabetes Stigma Assessment Scale (DSAS-1). Potential relationships between sociodemographic, diabetes health and well-being factors and DSAS-1 score were identified by univariate regression and the independence of significant (p < 0.05) relationships was explored in multivariable regression.</p><p><strong>Results: </strong>Of 438 participants, 96% endorsed one or more items on the DSAS-1. In multivariable regression, age (β = -0.136, p = 0.006), sex (β = 0.114, p = 0.006), BMI (β = 0.112, p = 0.023), insulin pump use (β = 0.108, p = 0.015), DIDP score (β = 0.211, p = <0.001), GAD-7 score (β = 0.192, p = 0.002) and PHQ-9 score (β = 0.195, p = 0.002) predicted DSAS-1 score. Ethnicity did not predict DSAS-1 score, nor did age at diagnosis or number of severe hypoglycaemia episodes.</p><p><strong>Conclusion: </strong>Most participants reported at least one instance of T1D-stigma. High DSAS-1 scores in the United Kingdom were predicted by younger age, being a woman, higher BMI, insulin pump use, higher diabetes impact and anxiety and depression scores. Future studies should further explore the impact of T1D-stigma within these groups to tailor appropriate interventions.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70365"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978508","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}

{"title":"HbA1c improvement in pregnant women with type 1 diabetes using the CamAPS FX automated insulin delivery (AID) system: Clinical and economic outcomes.","authors":"Maria-Eleni Syleouni, Tara T M Lee, Federica Carrieri, Eleanor M Scott, Aesha Khan Mirón, Helen R Murphy","doi":"10.1111/dme.70394","DOIUrl":"10.1111/dme.70394","url":null,"abstract":"<p><strong>Aims: </strong>The Automated Insulin Delivery among Pregnant women with Type 1 diabetes (AiDAPT) trial demonstrated that using the CamAPS FX automated insulin delivery (AID) was associated with improved glycaemic outcomes. This study aimed to assess the clinical and economic impact of improving third-trimester HbA1c.</p><p><strong>Methods: </strong>Using the AiDAPT data, a health economics model was built to estimate clinical outcomes and healthcare resource utilisation associated with third-trimester HbA1c categories (<42 mmol/mol, 42-53 mmol/mol, ≥53 mmol/mol). AiDAPT HbA1c distribution and associated clinical outcomes (obstetric: pre-eclampsia, delivery method; neonatal: length of stay in normal/critical/intensive care) were used to estimate perinatal complications. UK-specific healthcare costs were extracted from the NHS National Schedule and other published sources. Total costs to the UK healthcare system were estimated using an incremental 3.3 mmol/mol (0.3%) HbA1c reduction observed with CamAPS FX AID over Standard Care in AIDAPT.</p><p><strong>Results: </strong>In the model, HbA1c improvement with CamAPS FX AID was associated with projected reductions in pre-eclampsia risk (-13%), high dependency neonatal care days (-16%), neonatal intensive care unit days (-12%) and clinic visits. The model projected cost reduction for the NHS healthcare system of £6,696,636 under conservative modelling assumptions, being cost saving at 96.8% of the simulations. The projected incremental cost difference per woman treated with CamAPS FX AID was -£1016, mainly derived from a modelled shift in the distribution of neonatal care, with reduced length of stay in high dependency neonatal intensive care.</p><p><strong>Conclusion: </strong>CamAPS FX AID improves third-trimester HbA1c with projected cost reductions for the UK healthcare system.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70394"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298599","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}

{"title":"Fear of hypoglycaemia and parent sleep disturbance in families of young children with type 1 diabetes.","authors":"Susana R Patton, Alexandra D Monzon, Jacob Redel, Holly O'Donnell, Kimberly A Driscoll","doi":"10.1111/dme.70441","DOIUrl":"10.1111/dme.70441","url":null,"abstract":"<p><strong>Background: </strong>Parents of young children with type 1 diabetes (T1D) commonly report fear of hypoglycaemia (FH), which may prompt night-time vigilance and disrupt sleep. We examined whether FH relates to parent-reported sleep disturbance using baseline (pretreatment) data from a multisite randomized clinical trial. We also evaluated whether these associations remain after accounting for other parent concerns and child demographic and device covariates.</p><p><strong>Methods: </strong>Parents of children ages 2-7 years (N = 180) completed questionnaires assessing FH (HFS-PYC), sleep disturbance (PROMIS-S), diabetes distress (PAID-PR), anxiety (PROMIS-A) and depressive symptoms (CESD-R). We collected demographic and clinical data and obtained 14-day continuous glucose monitoring (CGM) downloads from young children when available. We used Pearson correlations, partial correlations and multiple regression models to test FH-sleep associations.</p><p><strong>Results: </strong>Parents reported slightly elevated sleep disturbance (M = 57.9 ± 8.1). Higher FH total, worry and hypoglycaemia avoidance behaviour scores showed positive associations with sleep disturbance in unadjusted models (all p < 0.05). After adjusting for anxiety, diabetes distress and elevated depressive symptoms, FH total and worry scores continued to predict sleep disturbance, whereas hypoglycaemia avoidance behaviours did not. In regression analyses, FH total, diabetes distress and elevated depressive symptoms each uniquely predicted sleep disturbance; anxiety and child clinical/device characteristics did not. In the CGM subset, parent sleep disturbance did not relate to children's glycaemic metrics.</p><p><strong>Conclusions: </strong>FH, particularly worry-driven FH, independently contributes to parent sleep disturbance in families of very young children with T1D. Screening for FH and offering interventions targeting FH worry may help improve parent sleep.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70441"},"PeriodicalIF":3.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633571","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}

{"title":"Potential future directions for research into hypoglycaemia awareness and mental health: The role of substance use, sedative exposure and sleep.","authors":"Chun-Ting Ma, Lien-Chung Wei","doi":"10.1111/dme.70446","DOIUrl":"https://doi.org/10.1111/dme.70446","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70446"},"PeriodicalIF":3.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650279","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":"Immune checkpoint inhibitor-induced diabetes mellitus: A case series from a large tertiary centre in the UK.","authors":"Kleoniki I Athanasiadou, Panagiotis Pavlou, Asad Qureshi, Anna Brackenridge, Yuk-Fun Liu","doi":"10.1111/dme.70439","DOIUrl":"https://doi.org/10.1111/dme.70439","url":null,"abstract":"<p><strong>Aims: </strong>Immune checkpoint inhibitors (ICI) have transformed oncology treatment. This study presents a case series of adults diagnosed with ICI-induced diabetes mellitus (ICI-DM) and evaluates the challenges involved in the diagnosis and management of this rare immunotherapy side-effect.</p><p><strong>Methods: </strong>A single-centre case series from the UK involved individuals who developed new onset insulin dependent diabetes after ICI treatment between 2017 and 2026. Data were extracted from the electronic medical records (EPIC® Systems Corporation).</p><p><strong>Results: </strong>Thirteen individuals (61.5% male, median age: 61 years [IQR 45-71]) diagnosed with ICI-DM were included. The majority were from a White ethnic background (84.6%). Time from ICI start to ICI-DM presentation had a median of 4 months (IQR 2-18). Most (n = 9, 69.2%) presented with diabetic ketoacidosis (DKA), with two requiring intensive care. Importantly three cases of DKA were potentially avoidable with earlier insulin initiation. Diabetes autoantibodies were positive in 54.5% (5 with GAD65 and 1 with IA-2 antibodies) with median C-peptide levels at diagnosis 161 pmol/L (IQR 10-232). The mean HbA1c before ICI start was 40 <math><mrow><mo>±</mo></mrow> </math> 7 mmol/mol (5.8 ± 2.8%) climbing to 80 ± 15 mmol/mol (9.5 ± 3.5%) at diagnosis, within a median interval of 3 months (IQR 2-4).</p><p><strong>Conclusions: </strong>It is essential to increase healthcare professional awareness of immunotherapy side-effects to achieve early recognition and prompt management. Increased use of capillary glucose testing and immunotherapy alert card can improve outcomes. Future studies can investigate the relationship between potential risk factors and predisposition to ICI-DM development.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70439"},"PeriodicalIF":3.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612224","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":"Glycaemia risk index and continuous glucose monitoring metrics across menstrual cycle phases in women with type 1 diabetes using automated insulin delivery.","authors":"Grazia Piras, Marta Bassi, Angelo Milioto, Maria Grazia Calevo, Giordano Spacco, Francesco Cocchiara, Nicola Minuto, Davide Maggi","doi":"10.1111/dme.70436","DOIUrl":"https://doi.org/10.1111/dme.70436","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70436"},"PeriodicalIF":3.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564322","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":"Determinants of health-related quality of life in adults with type 1 diabetes: The predominant role of sleep among lifestyle parameters.","authors":"Melina Karipidou, Stavros Liatis, Athanasia Kyrkili, Alexandra Skoufi, Vaia Lambadiari, Stelios Tigas, Evangelos Liberopoulos, Vasiliki Bountziouka, Meropi D Kontogianni","doi":"10.1111/dme.70432","DOIUrl":"https://doi.org/10.1111/dme.70432","url":null,"abstract":"<p><strong>Aim: </strong>To examine the effect of lifestyle parameters on health-related quality of life (HrQoL) in people with type 1 diabetes (PwT1D); specifically, whether aggregated lifestyle indices or individual components better explain variations in HrQoL.</p><p><strong>Methods: </strong>Dietary intake, physical activity, sleep habits and HrQoL were evaluated using validated questionnaires. Diet quality was assessed with the MedDiet and PURE Diet Scores. Two composite healthy lifestyle indices (MLI: Mediterranean Lifestyle Index, PLI: PURE Lifestyle Index) were constructed based on diet, physical activity, smoking and sleep. Participants were classified according to overall quality of life (OQoL) as worse, average or better.</p><p><strong>Results: </strong>A total of 236 PwT1D participated [median age 38.0 (25.0, 48.8) years; 42.4% men; median T1D duration 19.0 (10.0, 29.0) years; HbA1c 7.4% (6.8, 8.2)], with 24.2%, 52.1%, and 23.7% reporting worse, average and better OQoL, respectively. After adjustments for sociodemographic and clinical factors, higher MLI and PLI scores were associated with greater odds of better OQoL (MLI: OR = 1.41, 95% CI: 1.15-1.72; PLI: OR = 1.40, 95% CI: 1.15-1.70). These associations became non-significant when the sleep component was excluded. In individual analyses, poor sleep quality was the only lifestyle parameter associated with OQoL (OR = 0.55, 95% CI: 0.45-0.68), physical (OR = 0.89, 95% CI: 0.82-0.98) and mental (OR = 0.73, 95% CI: 0.65-0.82) components.</p><p><strong>Conclusion: </strong>Lifestyle indices (MLI, PLI) were associated with better compared to worse HrQoL in PwT1D; however, this was entirely driven by sleep quality, with poor sleep linked to lower physical, mental and overall HrQoL.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70432"},"PeriodicalIF":3.4,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521782","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":"Peripheral nerve conduction in youth with type 1 diabetes: A longitudinal analysis of clinical and glycemic predictors.","authors":"Bruno Bombaci, Giuseppina Salzano, Sara Aramnejad, Fabio Macrì, Luisa Faranna, Angela Alibrandi, Vincenzo Rizzo, Francesco Luppino, Fortunato Lombardo, Stefano Passanisi","doi":"10.1111/dme.70423","DOIUrl":"https://doi.org/10.1111/dme.70423","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to describe nerve conduction study (NCS) findings in a pediatric type 1 diabetes cohort and to identify clinical and continuous glucose monitoring (CGM) predictors.</p><p><strong>Methods: </strong>In this longitudinal study, 207 children and adolescents with type 1 diabetes (mean age 14.0 ± 3.5 years; diabetes duration 6.5 ± 3.5 years) underwent standardised lower-limb NCS assessing peroneal motor conduction velocity (MCV) and compound muscle action potential (CMAP), and sural sensory conduction velocity (SCV) and sensory nerve action potential (SNAP). Multivariable generalised linear models evaluated associations between nerve conduction parameters and clinical and glycemic variables, including long-term glycated hemoglobin (HbA1c) and CGM metrics. In 96 participants with paired examinations over 2 years, logistic regression identified predictors of within-patient deterioration.</p><p><strong>Results: </strong>Older age was independently associated with lower peroneal MCV (B = -0.59; p = 0.001). Male sex was associated with higher CMAP values (B = 2.04; p = 0.030), whereas higher 5-year mean HbA1c predicted lower CMAP (B = -3.72; p < 0.001). Longitudinally, higher mean sensor glucose increased the odds of peroneal MCV decline (OR = 1.13; p = 0.025), and longer diabetes duration predicted SNAP deterioration (OR = 1.32; p = 0.021).</p><p><strong>Conclusions: </strong>NCS may detect electrophysiological abnormalities consistent with early nerve dysfunction in pediatric type 1 diabetes. Motor parameters may show earlier vulnerability and relate to cumulative glycemic exposure, whereas sensory axonal involvement may be linked to longer disease duration. Youth with sustained suboptimal glycemic control should be considered at higher risk for early nerve dysfunction. Incorporating NCS into follow-up may allow timely detection and targeted prevention in this population.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70423"},"PeriodicalIF":3.4,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428540","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":"CGM access in Pakistan: Extending the LMIC diabetes technology gap beyond Brazil.","authors":"Saim Jan","doi":"10.1111/dme.70428","DOIUrl":"https://doi.org/10.1111/dme.70428","url":null,"abstract":"","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"e70428"},"PeriodicalIF":3.4,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428559","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}