Acta Diabetologica最新文献

{"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":"<p><strong>Aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","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}

{"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":"<p><strong>Aims: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Trial registration: </strong>The study was retrospective registered on ClinicalTrials.gov (identifier: NCT06197360), registration date: 05/1/2024.</p>","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}

{"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":"<p><strong>Aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>This study highlights the importance of treating even mild IADPSG-GDM to improve pregnancy outcomes.</p>","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}

{"title":"Maternal liver fibrosis indices as predictors of adverse perinatal outcomes in patients with gestational diabetes mellitus.","authors":"Murad Gezer, Ümit Taşdemir, Ömer Gökhan Eyisoy, Sevdenur Yiğit, Mucize Eriç Özdemir, Oya Demirci","doi":"10.1007/s00592-025-02547-7","DOIUrl":"10.1007/s00592-025-02547-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the FIB-4 and APRI scores in patients with gestational diabetes mellitus (GDM) and investigate their associations with neonatal outcomes. Additionally, the predictive value of these non-invasive fibrosis indices for GDM and adverse perinatal outcomes was assessed.</p><p><strong>Materials and methods: </strong>In this retrospective case-control study, 200 pregnant women diagnosed with GDM and 200 healthy controls were analyzed. Data on maternal demographics, laboratory parameters (ALT, AST, platelet count), FIB-4 and APRI scores, perinatal and neonatal outcomes including fetal growth restriction (FGR), oligohydramnios, polyhydramnios, birth weight, gestational age at birth, neonatal cord blood pH, neonatal hypoglycemia, Apgar 1 min. and 5 min. scores, and neonatal intensive care unit (NICU) admission were collected. Logistic regression analyses were performed to identify independent predictors of adverse perinatal outcomes among GDM patients. ROC analysis was used to determine the diagnostic performance of both indices.</p><p><strong>Results: </strong>FIB-4 and APRI scores were significantly higher in GDM patients compared to controls (p < 0.05). Among GDM patients, those with FGR, NICU admission, or neonatal death had significantly elevated FIB-4 scores. Stratification by FIB-4 risk categories revealed that patients with high FIB-4 scores had increased rates of FGR, fetal hypoglycemia, adverse perinatal outcomes, and NICU admission (p < 0.01). ROC analysis for predicting GDM yielded AUC values of 0.577 for FIB-4 and 0.571 for APRI. For predicting adverse perinatal outcomes, the FIB-4 AUC was 0.590, while APRI showed limited predictive ability (AUC = 0.511).</p><p><strong>Conclusion: </strong>FIB-4 can serve as a valuable non-invasive marker for liver dysfunction in GDM and is significantly associated with adverse perinatal outcomes. Despite limited predictive power, these scores may serve as early indicators of hepatic involvement in GDM.</p>","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":"144332242","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}

{"title":"Polygenic score from MODY genes is associated with type 1 diabetes and disease characteristics.","authors":"Eulalia Catamo, Andrea Conti, Roberto Franceschi, Klemen Dovc, Camilla Morosini, Davide Tinti, Luana Aldegheri, Stefania Cappellani, Gianluca Tamaro, Angela Zanfardino, Elena Faleschini, Ivana Rabbone, Riccardo Bonfanti, Tadej Battelino, Dario Iafusco, Gianluca Tornese, Antonietta Robino","doi":"10.1007/s00592-025-02544-w","DOIUrl":"10.1007/s00592-025-02544-w","url":null,"abstract":"<p><strong>Aims: </strong>This study evaluates the contribution of common variants in Maturity-Onset Diabetes of the Young (MODY) genes on type 1 diabetes (T1D), using a polygenic score (PGS) approach.</p><p><strong>Methods: </strong>485 children and youth diagnosed with T1D from at least 1 year and 271 healthy controls (HC) were recruited. Personal information (i.e. age, sex, height, weight) were collected for each participant, and clinical information (i.e. age at diagnosis, disease duration, presence of autoantibodies and ketoacidosis at onset (DKA)) were also obtained for T1D subjects. Participants were genotyped using Illumina Infinium Global Screening Array. PGS based on Single Nucleotide Polymorphisms (SNPs) in 16 MODY genes were developed. The association of this PGS with T1D susceptibility and clinical disease characteristics was assessed by regression analysis.</p><p><strong>Results: </strong>A PGS including 335 SNPs in MODY genes discriminates T1D from HC (AUC = 60.1%, AIC = 787.6). This PGS was significantly higher in T1D compared to HC (p-value = 0.0004, pseudo-R2 = 2.85%). Moreover, regression analysis between PGS and T1D clinical characteristics showed higher PGS values in T1D subjects with zinc transporter 8 autoantibodies (ZnT8A) compared with T1D subjects without ZnT8A (p-value = 0.04). A similar trend was also observed for antibodies directed against glutamic acid decarboxylase (GADA), although the association did not reach statistical significance (p-value = 0.06).</p><p><strong>Conclusions: </strong>Our study suggests that a polygenic approach based on MODY genes may discriminate T1D from HC and may contribute to patient stratification, helping to better understand T1D heterogeneity.</p>","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":"144332270","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}

{"title":"Mitochondrial DNA variations and risk of incident gestational diabetes mellitus: a nested case-control study.","authors":"Yuqing Liu, Xiao Li, Maoning Zhao, Yun Zhao, Yuanzhong Zhou, Hongsong Yu, Kai Zhao, Shigang Zhao, Xuejun Shang","doi":"10.1007/s00592-025-02546-8","DOIUrl":"10.1007/s00592-025-02546-8","url":null,"abstract":"<p><strong>Aims: </strong>Gestational diabetes mellitus (GDM) is associated with mitochondrial dysfunction. Mitochondrial DNA (mtDNA) plays a critical role in mitochondrial function, affecting cellular oxidative phosphorylation and ATP supply. This study aims to explore the association between mtDNA variations and GDM in Han Chinese women.</p><p><strong>Methods: </strong>This nested case-control study was conducted among 701 women who developed GDM and 859 contemporaneous controls based on the Chinese Birth Cohort of Environmental and Genetic Factors between 2018 and 2022. Next-generation sequencing was performed on the samples to detect variations in the whole mitochondrial genome. The sequencing data were analyzed, and the differences in the number of mtDNA variations between the two groups were assessed using a t-test. Haplogroup analysis was conducted through the chi-square test. Logistic regression analysis was performed, adjusting for age, BMI, gravidity, and parity, to identify significantly different mtDNA variations between the two groups.</p><p><strong>Results: </strong>Pregnant women with GDM carried fewer mtDNA variants in the D-loop region (11.35 ± 2.77 vs. 11.80 ± 2.86, p = 0.002). Results indicated that m.73A>G (OR: 0.46, 95% CI: 0.28-0.77, p = 0.003), m.185G>A (OR: 0.41, 95% CI: 0.18-0.92, p = 0.030), m.16051A>G (OR: 0.24, 95% CI: 0.07-0.84, p = 0.026), m.16092T>A (OR: 9.21, 95% CI: 1.11-76.42, p = 0.040) and m.16291C>T (OR: 2.35, 95% CI: 1.29-4.28, p = 0.005) in the D-loop region and m.6228C>T (OR: 9.41, 95% CI: 1.14-77.59, p = 0.037) in MT-CO1 gene were found to be significantly different between GDM cases and the controls.</p><p><strong>Conclusions: </strong>This study revealed an association between mtDNA variations and GDM, highlighting the potential that screening for specific mtDNA variants in early pregnancy may predict the development of GDM.</p>","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":"144332243","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}

{"title":"The association of peripheral blood METTL3 mRNA expression levels with prediabetes and type 2 diabetes mellitus: the Henan rural cohort study.","authors":"Yujie Jiang, Xiaoying Ren, Yuqian Li, Gaohua Chang, Xintao Pan, Yahui Zhang, Chongjian Wang, Xiaotian Liu","doi":"10.1007/s00592-025-02542-y","DOIUrl":"10.1007/s00592-025-02542-y","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to investigate the association of peripheral blood METTL3 (Methyltransferase Like 3) mRNA expression levels with impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM).</p><p><strong>Materials and methods: </strong>A case-control study including 1501 participants from the Henan Rural Cohort study was performed. Peripheral blood METTL3 mRNA expression levels were quantified by qRT-PCR. Binary logistic regression was used to generate odds ratio (OR) and 95% confidence intervals (CI) for the risk of IFG and T2DM. Restricted cubic spline was used to generate the dose-response relationship between METTL3 mRNA expression levels and IFG and T2DM.</p><p><strong>Results: </strong>METTL3 mRNA expression levels were downregulated in T2DM compared with normal glucose tolerance (NGT) (4.03 ± 1.09 vs. 3.96 ± 0.93). After adjusting covariates, the risk of developing IFG in METTL3 mRNA high expression levels group was 30% higher than that in the low expression levels group (OR = 1.30,95%CI:1.02,1.65). Conversely, METTL3 mRNA expression levels were negatively correlated with T2DM(OR = 0.83,95%CI:0.72,0.96) compared to the NGT group. METTL3 mRNA expression levels showed a non-linear correlation with both IFG and T2DM.</p><p><strong>Conclusion: </strong>METTL3 mRNA expression levels exhibited opposing effects on IFG and T2DM. Elevated METTL3 mRNA levels were positively associated with IFG risk but inversely associated with T2DM risk.</p>","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":"144332272","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}

{"title":"Needle characteristics and the insulin injection experience in patients with diabetes.","authors":"Edoardo Mannucci, Basilio Pintaudi, Maria Elena Lunati, Paolo Fiorina","doi":"10.1007/s00592-025-02538-8","DOIUrl":"https://doi.org/10.1007/s00592-025-02538-8","url":null,"abstract":"<p><strong>Background: </strong>Fear of pain during insulin injection, using pen injectors, still represents a barrier to diabetes treatment. The development of smaller and thinner needles has improved comfort during the injection, but the influence of other needle geometry features, has been less thoroughly assessed. The aim of this review, is to evaluate the role that pen needle geometry plays in determining patient experience during insulin injection.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed and Scopus to identify the publications assessing the effect of needle geometry and quality on insertion force and pain, experienced by the patient during injection. 22 studies were included in this review. All studies included, at minimum, an evaluation of the perceived injection pain, using a Visual Analogue Scale (VAS).</p><p><strong>Results: </strong>The clinical evidence demonstrated that in addition to the pain reduction experienced with increasing needle gauge, other geometrical features such as shorter needle length, thinner wall design, improved tip geometry and coating with lubricant, are associated with reduced injection pain and improved patient experience. Furthermore, it was indicated that the needle features shown to help reduce the experienced pain, would not negatively affect the frequency and intensity of injection related site reactions or needle-related failures, such as breakage and bending.</p><p><strong>Conclusions: </strong>Pen needle geometry affects the insulin injection experience of diabetic patients. Increased needle gauge, shorter length, improved tip design and mechanical characteristics of the needle are all associated with a perceived reduction of the pain during insulin injection and an overall improved patient experience.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245667","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}

{"title":"Continuous interstitial glucose monitoring in diabetic and non-diabetic critically ill patients is simple and accurate: comparison with venous, arterial and capillary glucose measurements.","authors":"Davide Chiumello, Mattia Passeri, Silvia Coppola, Elena Chiodaroli, Simone Carnier, Marialaura Montante, Tommaso Pozzi, Ilaria Goggi, Francesco Bifari, Umberto Mortola, Lucia Centofanti, Franco Folli","doi":"10.1007/s00592-025-02531-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02531-1","url":null,"abstract":"<p><strong>Introduction: </strong>To reduce mortality, thigh glycemic control is recommended in critically ill patients due to their extreme glycemic variability. Continuous glucose monitoring (CGM) devices allows frequent determination of blood glucose levels; however, conflicting results have been reported from studies assessing their accuracy in critically ill patients. Aim of this study was to assess the repeatability and the analytical and clinical accuracy of FreeStyle Libre 2 (FSL-)CGM.</p><p><strong>Materials and methods: </strong>Prospective single-center observational study enrolling 40 critically ill patients. For four consecutive days, we measured three consecutive interstitial FSL-CGM-derived glucose levels, along with one arterial and venous blood gas analysis and a capillary-derived blood glucose level, obtaining a total of 480 FSL-CGM-derived glucose measurements and 160 measurements from arterial and venous blood gas analysis and from capillary glucose.</p><p><strong>Results: </strong>The mean blood glucose levels in the three daily timepoints from FSL-CGM were 130 ± 35, 131 ± 35 and 131 ± 35 mg/dL (p = 0.660). The Bland-Altman analysis comparing arterial BGA- and FSL-CGM-derived blood glucose levels had a bias of 10.3 mg/dL with limits of agreement from - 27.2 to 47.7. The mean absolute relative difference (MARD) between FSL-CGM and arterial blood gas analysis was 12 ± 10%. The Clarke, Parkes and Surveillance error grid analyses comparing arterial BGA- and FSL-CGM-derived blood glucose levels showed a good clinical accuracy. The presence of diabetes did not influence analytical accuracy, while the use of vasopressors was associated with a higher MARD.</p><p><strong>Conclusions: </strong>FSL-CGM demonstrated reproducibility and reliable analytical and clinical accuracy in critically ill patients, without difference between diabetic and non-diabetic patients, over a period of up to 96 h (4 days).</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245666","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}

{"title":"Beyond GLP-1: efficacy and safety of dual and triple incretin agonists in personalized type 2 diabetes care-a systematic review and network meta-analysis.","authors":"Kangling Yan, Haichuan Yu, Benoît Blaise","doi":"10.1007/s00592-025-02534-y","DOIUrl":"https://doi.org/10.1007/s00592-025-02534-y","url":null,"abstract":"<p><strong>Background: </strong>Dual and triple incretin-based agonists, targeting combinations of GLP-1, GIP, and glucagon receptors, represent an innovative approach in T2DM care. However, comparative efficacy and safety analyses tailored to receptor-specific strategies are limited.</p><p><strong>Purpose: </strong>This systematic review and network meta-analysis uniquely evaluates the efficacy and safety of dual and triple incretin agonists compared to standard therapies, offering insights into personalized, receptor-specific T2DM therapies.</p><p><strong>Data sources: </strong>Systematic searches in PubMed, Web of Science, Cochrane Library, and Embase (up to July 2024) identified RCTs.</p><p><strong>Study selection: </strong>Trials assessing dual or triple incretin therapies in T2DM with outcomes on weight, HbA1c, FBG, AEs, and SAEs were included.</p><p><strong>Data extraction: </strong>Data on efficacy and safety were extracted by independent reviewers and assessed for quality using the NIH Quality Assessment Tool.</p><p><strong>Data synthesis: </strong>Retatrutide achieved the greatest weight reduction (MD: - 8.601; 95% CrI: - 11.20 to - 5.95) while Tirzepatide was most effective in lowering FBG (MD: - 57.30) and HbA1c ( - 1.88), with 95% CrIs of - 65.41 to - 48.9 and - 2.15 to - 1.64 respectively. Tirzepatide (RR 1.15) and Cotadutide (1.38) increased AEs, while Semaglutide reduced SAEs (0.35); 95% Crls: 1.04-1.33, 1.16-1.68, and 0.13-0.78, respectively.</p><p><strong>Limitations: </strong>Small sample sizes, short study durations, and reliance on indirect comparisons in some cases may limit the certainty of these findings. Direct head-to-head trials are needed to confirm these results.</p><p><strong>Conclusion: </strong>Receptor-specific targeting optimizes T2DM treatment, with Semaglutide supporting glycemic control, Tirzepatide enhancing weight loss and glucose regulation, and Retatrutide potentially offering broader metabolic benefits, advancing receptor-targeted, personalized therapy.</p><p><strong>Prospero registration number: </strong>CRD42024532368.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223983","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}