Acta Diabetologica最新文献

Correction: Development and validation of prediction model for stage I patients with lower extremity atherosclerotic disease in type 2 diabetes mellitus in China. 修正：中国2型糖尿病I期患者下肢动脉粥样硬化性疾病预测模型的开发和验证。

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-07-16 DOI: 10.1007/s00592-025-02541-z

Rong Zhu, Weifeng Cui, Ruixia Zhao, Huijuan Liu, Shuxun Yan, Mingyi Shao, Haibin Yu, Yu Fu

引用次数: 0

The impact of short maternal height on gestational diabetes. 母亲身高过矮对妊娠期糖尿病的影响。

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-07-05 DOI: 10.1007/s00592-025-02530-2

Joan Crane, Phil Murphy, Donnette O'Brien

{"title":"The impact of short maternal height on gestational diabetes.","authors":"Joan Crane, Phil Murphy, Donnette O'Brien","doi":"10.1007/s00592-025-02530-2","DOIUrl":"https://doi.org/10.1007/s00592-025-02530-2","url":null,"abstract":"Aims: To evaluate the impact of short maternal height on gestational diabetes, by different body mass index (BMI) classes.Methods: We performed this population-based retrospective cohort study including individuals with singleton pregnancies delivering January 1st 2012 to December 31st 2019 in the Eastern Health region of the province of Newfoundland and Labrador, Canada. We divided maternal height into three groups: < 25% (short height), 25-75% (average height), and > 75% (tall height). We performed univariate and multivariate regression analyses (adjusting for potential confounders identified in univariate analyses) to determine if short height was an independent predictor of gestational diabetes, stratified by BMI class.Results: We assessed 15,803 pregnancies, with 1062 (6.7%) experiencing gestational diabetes. Among all BMI categories combined, short height was an independent predictor of gestational diabetes (OR = 1.20, 95% CI 1.02-1.41, p = 0.031). In stratified analyses, short height was an independent predictor of gestational diabetes among those with a normal BMI (OR = 1.75, 95% CI 1.23-2.50, p = 0.002) but not an independent predictor in higher BMI classes.Conclusions: The association between short maternal height and gestational diabetes varies by BMI class. Among those with a normal BMI, short maternal height is associated with the development of gestational diabetes.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-glucose stimulation triggers early transcription of a panel of proinflammatory mediators in rat Muller glia cells and retina primary explants. 在大鼠Muller神经胶质细胞和视网膜原代外植体中，高糖刺激可触发一组促炎介质的早期转录。

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-07-04 DOI: 10.1007/s00592-025-02543-x

Grazia Raffaella Tundo, Maria Grazia Atzori, Alessandra Boccaccini, Dario Cavaterra, Alessio Bocedi, Grazia Graziani, Stefano Marini, Pedro Miguel Lacal, Marika Villa, Flavia Pricci, Monica Varano, Mariacristina Parravano, Diego Sbardella

{"title":"High-glucose stimulation triggers early transcription of a panel of proinflammatory mediators in rat Muller glia cells and retina primary explants.","authors":"Grazia Raffaella Tundo, Maria Grazia Atzori, Alessandra Boccaccini, Dario Cavaterra, Alessio Bocedi, Grazia Graziani, Stefano Marini, Pedro Miguel Lacal, Marika Villa, Flavia Pricci, Monica Varano, Mariacristina Parravano, Diego Sbardella","doi":"10.1007/s00592-025-02543-x","DOIUrl":"https://doi.org/10.1007/s00592-025-02543-x","url":null,"abstract":"Several preclinical data support a main role of Muller glia, a type of retinal glial cells, in sensing hyperglycemia and, subsequently, acquiring a pro-inflammatory polarization during diabetic retinopathy onset and progression. Recently, we reported that stimulation of rat Muller glia cells (rMC1) with high glucose triggers a very early (< 15 min) and atypical signaling cascade, regulated by a Ca2+-calmodulin/proteasome axis, which induces the nuclear translocation of p65-p50 heterodimer, the principal transcription factor of pro-inflammatory NFkB pathway. In the present study, the repertoire of NF-kB pro-inflammatory genes was early monitored after high-glucose stimulation, in rMC1, as compared to cells stimulated with normal glucose or hyper-osmolar mannitol. The occurrence of an early transcriptional upregulation of most stimulated genes was also verified in rat retina cultures isolated from Sprague-Dawley rats. The overall analysis showed that: (i) high glucose triggers a pro-inflammatory polarization of rMC1 much earlier than previously thought and (ii) this early upregulation recapitulates also in rat retinal culture. Importantly, it has emerged a prominent role played by IL-8 in the early stages of hyperglycemic insult, opening to further studies on its role in primary diabetic retinopathy pathogenesis and envisaging the development of novel potential clinical treatments based on IL-8 blockade.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and safety of platelet-rich plasma versus conventional care in diabetic foot ulcers: a meta-analysis of randomized controlled trials. 富血小板血浆治疗糖尿病足溃疡的疗效和安全性：一项随机对照试验的荟萃分析

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-07-02 DOI: 10.1007/s00592-025-02555-7

Hongyan Xu, Kai Huang, Xiaohong Tao

{"title":"Efficacy and safety of platelet-rich plasma versus conventional care in diabetic foot ulcers: a meta-analysis of randomized controlled trials.","authors":"Hongyan Xu, Kai Huang, Xiaohong Tao","doi":"10.1007/s00592-025-02555-7","DOIUrl":"https://doi.org/10.1007/s00592-025-02555-7","url":null,"abstract":"Purpose: This meta-analysis aims to assess the efficacy and safety of platelet-rich plasma (PRP) through topical application and local injection methods compared to conventional care in patients with diabetic foot ulcers (DFU).Methods: A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases up to November 2024. Randomized controlled trials evaluating the efficacy and safety of PRP versus conventional care in DFU patients were included. Pooled weighted mean differences (WMD) and risk ratios (RR) were calculated with 95% confidence intervals.Results: Fifteen randomized controlled trials (1,010 patients) were included. The PRP group showed significantly improved complete healing rates compared to conventional care (RR: 1.53, 95% CI: 1.39-1.58, P < 0.001), with comparable effectiveness between topical application and local injection methods (P = 0.57). Notably, PRP demonstrated a shorter healing time compared to conventional care (WMD: -19.48 days, 95% CI: -27.91 to -11.05, P < 0.001). The PRP group exhibited lower wound infection rates and amputation rates (RR: 0.51, 95% CI: 0.35 to 0.75, P < 0.001; RR: 0.45, 95% CI: 0.26 to 0.79, P = 0.005). The PRP group did not lead to a higher incidence of treatment-related adverse events compared to conventional care (RR: 0.80, 95% CI: 0.05 to 12.30, P = 0.87).Conclusions: This meta-analysis confirms that PRP application, both topically and via local injection, improves the complete healing rate, reduces healing time, infection rates, and amputations, without increasing adverse events. These findings support the integration of PRP into clinical practice for the management of diabetic foot ulcers.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High glucose mediates diabetic peripheral neuropathy by inducing Schwann cells apoptosis through the Dgkh/PKC-α signaling pathway. 高糖通过Dgkh/PKC-α信号通路诱导雪旺细胞凋亡介导糖尿病周围神经病变。

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-07-02 DOI: 10.1007/s00592-025-02553-9

Linhui Zuo, Minli Qu, Mengru Zhang, Peng Cheng, Min Guo, Dinesh Selvarajah, Solomon Tesfaye, Jing Wu

{"title":"High glucose mediates diabetic peripheral neuropathy by inducing Schwann cells apoptosis through the Dgkh/PKC-α signaling pathway.","authors":"Linhui Zuo, Minli Qu, Mengru Zhang, Peng Cheng, Min Guo, Dinesh Selvarajah, Solomon Tesfaye, Jing Wu","doi":"10.1007/s00592-025-02553-9","DOIUrl":"https://doi.org/10.1007/s00592-025-02553-9","url":null,"abstract":"Objective: Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes. The increased apoptosis of Schwann cells (SCs) induced by high glucose (HG) is significant in the pathogenesis of DPN, but the mechanism remains unclear. Diacylglycerol kinase eta (Dgkh) is a member of the diacylglycerol kinases (DGKs) family that participates in glucose uptake, utilization, and energy homeostasis. But its role in DPN has not been reported.Methods: Streptozotocin (STZ)-induced SD rats were used as an animal model of DPN and human Schwann cells (HSCs) were used as an in vitro model of simulated HG conditions. Behavioral tests, histopathology, the mRNA and protein expression levels were detected in vivo. Further, Dgkh was knocked down in vitro, and PKC-α agonist PMA and inhibitor Ro 31-8220 were added to HSCs to observe the effect of Dgkh/PKC-α on HSCs apoptosis.Results: The mechanical and thermal pain thresholds were significantly decreased in DPN rats induced by STZ. The increased apoptosis of the sciatic nerve in STZ-induced DPN rats is accompanied by the upregulation of Dgkh expression. HG leads to increased HSCs apoptosis by Dgkh increased expression. Meanwhile, the knockdown of Dgkh significantly improved HSCs apoptosis induced by HG. PMA effectively improved apoptosis in HG-induced HSCs, but did not affect Dgkh expression. And we discovered that the apoptosis of HSCs reversed by Dgkh knockdown vanished when the PKC-α inhibitor Ro 31-8220 was added.Conclusion: Dgkh expression increased under HG conditions and triggered apoptosis of HSCs, boosting DPN via inhibiting PKC-α.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unmasking heterogeneity in type 2 diabetes: the clinical relevance of phenotyping in the era of precision medicine. 揭示2型糖尿病的异质性：精准医学时代表型的临床相关性。

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-07-01 DOI: 10.1007/s00592-025-02556-6

Salvatore Corrao, Massimo Federici

{"title":"Unmasking heterogeneity in type 2 diabetes: the clinical relevance of phenotyping in the era of precision medicine.","authors":"Salvatore Corrao, Massimo Federici","doi":"10.1007/s00592-025-02556-6","DOIUrl":"https://doi.org/10.1007/s00592-025-02556-6","url":null,"abstract":"Despite its widespread use in clinical practice, the traditional dichotomous classification of diabetes into type 1 and type 2 fails to capture the marked heterogeneity observed in real-world patients, particularly those with type 2 diabetes mellitus (T2DM). The increasing recognition of the complex interplay between insulin resistance, beta-cell dysfunction, autoimmunity, and genetic predisposition has led to the development of phenotypic classification systems that aim to individualize care beyond glycemic targets. Ahlqvist et al. made a major contribution to this field by identifying five clinically meaningful clusters of adult-onset diabetes using routine clinical variables. These clusters differ in their metabolic profiles, complication risks, and therapeutic needs, offering a pragmatic starting point for personalized diabetology. Their clinical relevance has been further explored and validated by follow-up studies that include detailed metabolic phenotyping, cardiac imaging, and genetic analyses. Nevertheless, enthusiasm for cluster-based models must be tempered by critical appraisal. Evidence from large trials suggests that continuous clinical features may better predict disease progression and treatment response than static cluster assignments. Furthermore, these models have yet to be integrated into clinical guidelines or electronic decision-support systems. This Perspective argues for a multidimensional and dynamic approach to diabetes phenotyping, combining clinical, biochemical, imaging, and genetic data to reflect the evolving nature of the disease. Such a framework could enable more precise stratification and intervention, moving toward truly personalized diabetes care. Integrating these models into real-world settings represents the next frontier in precision diabetology.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New generation agents for glycemic control and diabetic retinopathy progression: what we need to know? 控制血糖和糖尿病视网膜病变进展的新一代药物：我们需要知道什么？

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-06-30 DOI: 10.1007/s00592-025-02552-w

Stela Vujosevic, Caterina Toma, Anna Ferrulli, Stefano De Cillà, Paolo Nucci, Livio Luzi

{"title":"New generation agents for glycemic control and diabetic retinopathy progression: what we need to know?","authors":"Stela Vujosevic, Caterina Toma, Anna Ferrulli, Stefano De Cillà, Paolo Nucci, Livio Luzi","doi":"10.1007/s00592-025-02552-w","DOIUrl":"https://doi.org/10.1007/s00592-025-02552-w","url":null,"abstract":"Aims: To report on the current evidence of early worsening of diabetic retinopathy (EWDR) in patients treated with new-generation antidiabetic agents, with a focus on glucagon-like peptide-1 receptor agonists (GLP1-RA).Methods: A comprehensive analysis of current literature was conducted, with a focus on studies evaluating the impact of glycemic control strategies and GLP1-RA on DR progression. References from landmark studies and recent trials were analyzed.Results: Intensive glycemic control, while effective in reducing long-term microvascular complications including DR, has been associated with EWDR, particularly in cases with rapid HbA1c reductions. Emerging evidence links novel antidiabetic agents, including GLP1-RA, with increased risk of EWDR, though different studies have conflicting results. However, the risk of EWDR seems not to be directly linked to retinal toxicity from specific antidiabetic agents, but more likely to the rapid glycemic improvement. Risk factors for EWDR in these patients include higher baseline HbA1c, rapid and significant reductions in HbA1c levels during the first months of treatment, longer duration of diabetes, and more advanced stages of DR at baseline, while mild or moderate non-proliferative DR seem not be at higher risk of DR progression.Conclusions: While new antidiabetic therapies offer significant benefits for diabetes management, clinicians must be cautious when implementing intensive glycemic control in patients at risk for EWDR. Individualized treatment plans and close monitoring are essential to mitigate risks and optimize outcomes for patients with DR.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations between MASLD phenotypes and the risk of carotid artery plaque: a cross-sectional study among railway workers. MASLD表型与颈动脉斑块风险之间的关系：铁路工人的横断面研究。

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-06-24 DOI: 10.1007/s00592-025-02536-w

Jia Pan, Honglian Zeng, Yongyan Song, Xiaoli Zhang, Zihang Wang, Lei Tang, Bo Xie, Rong Peng, Yuanyuan Zhou, Beizhong Liu

{"title":"Associations between MASLD phenotypes and the risk of carotid artery plaque: a cross-sectional study among railway workers.","authors":"Jia Pan, Honglian Zeng, Yongyan Song, Xiaoli Zhang, Zihang Wang, Lei Tang, Bo Xie, Rong Peng, Yuanyuan Zhou, Beizhong Liu","doi":"10.1007/s00592-025-02536-w","DOIUrl":"https://doi.org/10.1007/s00592-025-02536-w","url":null,"abstract":"Aims: Current evidence on the association between metabolic dysfunction-associated steatotic liver disease (MASLD) phenotypes to carotid artery plaque (CAP) remains limited. This study aims to investigate both the association and the potential mediating effects of MASLD phenotypes on the risk of CAP.Methods: In this cross-sectional study, 8644 participants were categorized into five groups based on hepatic steatosis and cardiometabolic criteria: Non-hepatic steatosis, Dysglycemia-MASLD, Overweight-MASLD, Lean-MASLD, and other hepatic steatosis. Multivariable logistic regression analysis was conducted to evaluate the association between MASLD phenotypes and CAP. Mediation analyses were performed to evaluate the mediating effect of dysglycemia and body mass index (BMI) on the relationship between MASLD and CAP.Results: The Dysglycemia-MASLD group exhibited the highest prevalence of CAP of 26.28%, followed by the Lean-MASLD (18.55%) and Overweight-MASLD (14.39%) groups. After adjusting for covariates, Dysglycemia-MASLD patients had a significantly higher risk of CAP, with an OR of 1.599 (95% CI 1.348, 1.896). Notably, individuals under 45 in the Dysglycemia-MASLD and Lean-MASLD subgroups had more than a two-fold increased risk of CAP compared to the Non-hepatic steatosis group, with ORs of 2.393 (95% CI 1.660, 3.416) and 2.724 (95% CI 1.002, 6.221), respectively. Mediation analysis indicated that dysglycemia and BMI mediated 30.86% and 24.49% of the association of MASLD with CAP.Conclusion: The risk of developing CAP varies across MASLD phenotypes, with Dysglycemia-MASLD and Lean-MASLD patients exhibiting the highest risk. Therefore, personalized health management strategies are essential for different MASLD phenotypes.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of a health education intervention based on the behavior change wheel on fear of hypoglycemia behavior in type 2 diabetes mellitus patients: a randomized controlled pilot trial. 基于行为改变轮的健康教育干预对2型糖尿病患者低血糖恐惧行为的影响：一项随机对照先导试验

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-06-23 DOI: 10.1007/s00592-025-02549-5

Yueqi Zhao, Lu Zhang, Juan Pang, Jiahui Qiu, Yuying He, Ziwei Xu, Mengyao Han, Lin Liu, Xiaojuan Wan, Jinping Wang, Yu Zhang

{"title":"Effects of a health education intervention based on the behavior change wheel on fear of hypoglycemia behavior in type 2 diabetes mellitus patients: a randomized controlled pilot trial.","authors":"Yueqi Zhao, Lu Zhang, Juan Pang, Jiahui Qiu, Yuying He, Ziwei Xu, Mengyao Han, Lin Liu, Xiaojuan Wan, Jinping Wang, Yu Zhang","doi":"10.1007/s00592-025-02549-5","DOIUrl":"https://doi.org/10.1007/s00592-025-02549-5","url":null,"abstract":"Aims: To conduct a pilot randomized trial of an intervention based on the behavior change wheel (BCW) to reduce fear of hypoglycemia (FoH) behavior in person with Type 2 diabetes mellitus. Additionally, the study assessed the program's feasibility, acceptability, and preliminary effects.Methods: This study utilized a single-blind, parallel randomized controlled trial design. The intervention included in-person education during hospitalization, online coaching post-discharge and follow-up. Effectiveness was assessed by comparing changes in primary outcomes (FoH behavior and worry), secondary outcomes (impaired hypoglycemia awareness, medical support, and self-management attitudes).Results: Recruitment (82%) and completion rate (100%) indicated feasibility. Qualitative interviews and satisfaction surveys indicated acceptability. The intervention group significantly reduced FoH (behavior and worry) scores compared to the controls (F = 49.060-98.057, P < 0.001, η = 0.632-0.774). Also, lower impaired hypoglycemia awareness (F = 4.036, P = 0.024, η = 0.082) and improved medical support (F = 58.925, P < 0.001, η = 0.664), self-management attitudes (F = 7.931, P = 0.001, η = 0.143) were observed.Conclusion: The BCW-based intervention is feasible, acceptable, and improves not only FoH behavior and worry, but also impaired awareness of hypoglycemia, medical support, and self-management attitudes.Trial registration: The study was retrospective registered on ClinicalTrials.gov (identifier: NCT06197360), registration date: 05/1/2024.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Should we treat mild gestational diabetes? An Australian multicentre retrospective cohort study. 我们应该治疗轻度妊娠糖尿病吗？一项澳大利亚多中心回顾性队列研究。

IF 3.1 3区医学

Acta Diabetologica Pub Date : 2025-06-20 DOI: 10.1007/s00592-025-02548-6

Victoria L Rudland, Emily Hibbert, Jeff Flack, Tang Wong, Vincent W Wong, Mark McLean, Dharmintra Pasupathy, David Simmons, N Wah Cheung

{"title":"Should we treat mild gestational diabetes? An Australian multicentre retrospective cohort study.","authors":"Victoria L Rudland, Emily Hibbert, Jeff Flack, Tang Wong, Vincent W Wong, Mark McLean, Dharmintra Pasupathy, David Simmons, N Wah Cheung","doi":"10.1007/s00592-025-02548-6","DOIUrl":"10.1007/s00592-025-02548-6","url":null,"abstract":"Aims: The International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria for gestational diabetes (GDM) were widely implemented in Australia, despite limited evidence of better pregnancy outcomes compared to the Australasian Diabetes in Pregnancy Society 1998 (ADIPS1998) criteria. We aimed to evaluate the effect of treatment on pregnancy outcomes for women with 'mild' GDM, defined as GDM diagnosed by one, but not both, sets of criteria.Methods: This multicentre, retrospective cohort study included 17,512 pregnant women in six neighbouring tertiary hospitals in Sydney, Australia, during 2016-2017, all of whom were screened for GDM using a three-point 75 g oral glucose tolerance test. Three hospitals diagnosed and treated GDM according to ADIPS1998 criteria, and three according to IADPSG criteria. For women with 'mild' GDM, we evaluated the effect of treatment versus no treatment on pregnancy outcomes. The primary outcome was large for gestational age. Secondary outcomes were small for gestational age, induction of labour, caesarean section, gestational hypertension, and preeclampsia.Results: 2320 (13.2%) pregnant women had 'mild' GDM. Treatment of women with IADPSG-only GDM (i.e. fasting glucose 5.1-5.4 mmol/L (91-97 mg/dL) and/or 1-hour glucose ≥ 10.0 mmol/L (≥ 180 mg/dL)) was associated with less large for gestational age infants than no treatment (RR 0.66, 95%CI 0.49-0.88, p = 0.004) but more induction of labour (RR 1.55, 95%CI 1.03-2.34, p = 0.032). Treatment of women with ADIPS1998-only GDM (i.e. 2-hour glucose 8.0-8.4 mmol/L (144-151 mg/dL)) did not significantly change pregnancy outcomes compared with no treatment.Conclusions: This study highlights the importance of treating even mild IADPSG-GDM to improve pregnancy outcomes.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0