Acta Diabetologica最新文献

{"title":"\"She has become my best friend\": a qualitative study on the perspective of elderly with type 2 diabetes regarding the use of an interactive virtual assistant device for diabetes care and mental health promotion.","authors":"Frederico Ludwig da Costa, Lucas Strassburger Matzenbacher, Isabela Semmelmann Maia, Vicenzo Gheno, Maria Antônia Bertuzzo Brum, Laura Gomes Boabaid de Barros, Luiza Machado Blank, Gabriela Heiden Telo","doi":"10.1007/s00592-024-02377-z","DOIUrl":"10.1007/s00592-024-02377-z","url":null,"abstract":"<p><strong>Aims: </strong>To qualitatively evaluate the experiences and emotional responses of elderly individuals with type 2 diabetes regarding the use of an interactive virtual assistant device.</p><p><strong>Methods and results: </strong>This qualitative study included elderly individuals who were diagnosed with type 2 diabetes and who had been using the Smart Speaker EchoDot 3rd Gen (Amazon Echo^®) device for three months. A structured face-to-face interview with open-ended questions was conducted to evaluate their experiences and emotional responses associated with the device. Data analysis was performed using inductive thematic content analysis with deductive coding followed by narrative synthesis to present the overall perceptions of the participants. Thirty individuals with a mean diabetes duration of 17.1 ± 9.45 years and a mean age of 71.9 ± 5.1 years were interviewed to ensure saturation of responses. Three major themes were identified through response analysis: (1) Emotional response to user experience; (2) Humanization feelings in human-device interactions; (3) Diabetes-related self-care. Overall, participants experienced a wide range of feelings regarding the use of the interactive virtual assistant device, predominantly with positive connotations, highlighting aspects of humanization of technology and its use, and experiencing assistance in self-care related to diabetes.</p><p><strong>Conclusion: </strong>Our results highlight the overwhelmingly positive emotional responses and strong sense of humanization expressed by elderly individuals with diabetes toward an interactive virtual assistant device. This underscores its potential to improve mental health and diabetes care, although further studies are warranted to fully explore its impact.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278609","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 effect of ketogenic diet on adipokines levels: a systematic review and meta-analysis of randomized-controlled trials.","authors":"Gui Lian Xiao, Tao Wang, Jiong Kuang, Wen Li Mai, Hua Liu, Shi Ping Ma, Mohammad Hassan Sohouli, Somaye Fatahi, Chengwen Li, Shufang Zou","doi":"10.1007/s00592-024-02362-6","DOIUrl":"https://doi.org/10.1007/s00592-024-02362-6","url":null,"abstract":"<p><strong>Background: </strong>Considering the impact of adipokines on metabolic syndrome-related disorders and even chronic illnesses, it would appear vital to look for efficient treatments for these variables. The goal of this study was to thoroughly examine how the ketogenic diet (KD) affects adipokines.</p><p><strong>Methods: </strong>Using standard keywords, the databases Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase were searched to find all controlled trials looking into how KD affected adipokines (leptin, adiponectin, and ghrelin). By using a random-effects model analysis, pooled weighted mean difference and 95% confidence intervals were obtained.</p><p><strong>Results: </strong>This article featured twenty-two studies. The combined results demonstrated that, as compared to the control group, leptin levels in all populations are significantly lower when KD is adhered to (WMD: - 0.14 ng/ml, 95% CI: - 8.66, - 3.61, P < 0.001). On the other hand, no discernible impact of this diet on ghrelin and adiponectin concentrations was noted. The subgroup analysis results demonstrated that the drop in leptin levels was considerably higher in persons with BMI > 30 kg/m² and in trials that followed the KD for ≤ 8 weeks than in the other groups.</p><p><strong>Conclusions: </strong>Generally speaking, this diet can be utilized as a potentially helpful supplementary therapy to improve this adipokine, given the significance that leptin plays on numerous metabolic illnesses.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278610","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":"Effectiveness of autologous mononuclear cells as adjuvant therapy in patients with ischaemic diabetic foot ulcers receiving indirect lower limb revascularization","authors":"Meloni Marco, Uccioli Luigi, Ruotolo Valeria, Bellizzi Ermanno, Massoni Carlo, Romano Maria, Andreadi Aikaterini, Giurato Laura, Bellia Alfonso, Lauro Davide","doi":"10.1007/s00592-024-02375-1","DOIUrl":"https://doi.org/10.1007/s00592-024-02375-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Aim</h3><p>The current study aimed to evaluate the effectiveness of peripheral blood mononuclear cells (PB-MNCs) therapy for patients with ischaemic diabetic foot ulcers (DFUs) treated through indirect revascularization.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The study is a prospective non-controlled observational study including patients with neuro-ischaemic DFUs who received indirect peripheral revascularization and showed a persistence of wound ischaemia defined by the absence of angiographic collateral vessels and TcPO2 values &lt; 30 mmHg in the wound angiosome area. All patients received 3 cycles of PB-MNCs therapy administered along the wound related artery based on the angiosome theory. The primary outcomes measures were healing, major amputation, and survival after 1 year of follow-up. The secondary outcomes measures were the evaluation of tissue perfusion by TcPO2 and foot pain defined by the Numerical Rating Scale (NRS).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Overall 52 (9.7%) patients were included. Most patients were aged (&gt; 70 years), all of them were affected by Type 2 Diabetes with a long diabetes duration (&gt; 20 years). Almost 80% were assessed as grade 2D- 3D of Texas University Classification. Forty-four patients (84.6%) patients healed and survived, 2 (3.85%) healed and deceased, 2 (3.85%) not healed and deceased, 4 (7.7%) not healed and survived. No major amputations were recorded. A significant increase of TcPO₂ after PB-MNCs therapy were recorded in comparison to the baseline (43 ± 9 vs 18 ± 8 mmHg, <i>p</i> &lt; 0.0001), such as a concomitant reduction of foot pain (1.8 ± 1.2 vs 6.2 ± 2.1, <i>p</i> &lt; 0.0001).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>PB-MNCs resulted effective to promote wound healing and limb salvage in diabetic patients with ischaemic DFUs who received indirect revascularization.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"26 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261217","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":"Concentric remodeling and the metabolic-associated steatotic liver disease in patients with type 1 diabetes: an exploratory study","authors":"Klaudia Czarnik, Zbigniew Sablik, Anna Borkowska, Jarosław Drożdż, Katarzyna Cypryk","doi":"10.1007/s00592-024-02365-3","DOIUrl":"https://doi.org/10.1007/s00592-024-02365-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Diabetic cardiomyopathy in young patients with type 1 diabetes (T1D) usually presents as asymptomatic diastolic heart dysfunction with left ventricle (LV) remodeling. Its prevalence seems to be underestimated. One of the factors seemingly influencing LV remodeling is a metabolic-associated steatotic liver disease (MASLD), which was extensively investigated in patients with type 2 diabetes but not with T1D. This study aimed to describe the correlation between MASLD risk and relative wall thickness (RWT) in young patients with T1D without heart failure symptoms <u>or</u> treatment.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>Study participants were recruited at the inpatient diabetology department, in admission order. Patients underwent a set of laboratory tests and echocardiographic examinations. The risk of MASLD was estimated using fatty liver index (FLI). Acquired data was then statistically analyzed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The study group consisted of 55 patients. 25 participants had RWT &gt; 0.42, suggesting LV remodeling. Study participants did not differ in HbA1c, NT-proBNP, HDL, LDL, non-HDL, and uric acid concentrations. However, patients with RWT &gt; 0.42 had higher FLI (40.97 vs. 13.82, <i>p</i> &lt; 0.01) and BMI (27.3 vs. 22.5, <i>p</i> &lt; 0.01) and differed in transaminase concentrations. Moreover, patients with RWT &gt; 0.42 had significantly higher LV mass index (85.6 vs. 68.2 g/m2) and altered mitral ring velocities. In univariable logistic regression, FLI correlated with LV remodeling risk (OR 1.028, <i>p</i> = 0.05). The optimal cutoff point for FLI predicting the RWT &gt; 0.42 was 26.38 (OR 10.6, <i>p</i> = 0.04, sensitivity 0.857, specificity 0.657).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>FLI correlates with RWT in patients with T1D independently of diabetes metabolic control and hypothetically may support recognizing T1D patients with a higher risk of LV remodeling.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"83 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261216","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 socio-environmental determinants of diabetes and their consequences","authors":"Angelo Avogaro,&nbsp;Mauro Rigato,&nbsp;Eugenio di Brino,&nbsp;Daniela Bianco,&nbsp;Irene Gianotto,&nbsp;Giovanni Brusaporco","doi":"10.1007/s00592-024-02373-3","DOIUrl":"10.1007/s00592-024-02373-3","url":null,"abstract":"<div><h3>Aims</h3><p>The intricate connections between health and the environment are often overlooked globally, yet they play a pivotal role in shaping our well-being.</p><h3>Results</h3><p>Astonishingly, environmental risk factors contribute to nearly 24% of the global disease burden, underscoring the critical impact of our surroundings on health. At the crossroads of this issue lies Diabetes, a rapidly growing non-communicable disease that highlights the delicate balance between human health and environmental sustainability. This epidemic offers a unique lens through which to explore how environmental factors contribute to the prevalence of Diabetes, revealing the complex interplay at work. Despite growing awareness, healthcare systems worldwide face challenges integrating environmental threats into more effective diabetes care strategies</p><h3>Conclusions</h3><p>This perspective highlights the urgent need for collaborative efforts and innovative solutions that address the environmental dimensions of diabetes management. Doing so can build healthier communities and pave the way for a more sustainable future.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"61 10","pages":"1205 - 1210"},"PeriodicalIF":3.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261224","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":"Punica granatum L. peel extract protects diabetic nephropathy by activating the Nrf-2/HO-1 pathway","authors":"Betul Apaydin Yildirim, Tuba Dogan, Esra Aktas Senocak, Serkan Yildirim, Saban Kordali, Fatih Yildirim","doi":"10.1007/s00592-024-02371-5","DOIUrl":"https://doi.org/10.1007/s00592-024-02371-5","url":null,"abstract":"<p>Diabetes raises cardiovascular morbidity and mortality worldwide and causes retinopathy, neuropathy, and nephropathy. <i>Punica granatum</i> L. (Pomegranate) is a fruit that has been used for its medicinal properties in various cultures. This article aims to investigate the antioxidant, anti-inflammatory, anti-apoptotic activity of <i>Punica granatum</i> L. peel ethanol extract (PGE) and its efficacy on NF-κB and Nrf-2/HO-1 signaling pathways in kidney tissue of rats with streptozotocin-induced diabetes. Single dose STZ 60 mg/kg/i.p. rats were given to induce diabetes and blood glucose measurements were taken 7 days later. PGE 10 mg/kg/p.o. administered to the treatment groups for 20 days. Blood, kidney, and pancreas samples taken from anesthetized rats were analyzed biochemically and histopathologically. It was observed that STZ increased the levels of urea, uric acid and creatine in the blood, while PGE significantly decreased these parameters. The diabetic group had higher MDA and lower renal tissue GSH level, CAT, GPx, and SOD activity than the control group. STZ also enhanced inflammation, apoptosis, Bax, Caspase-3, and NF-κB expression, and decreased Bcl-2, HO-1, and Nrf-2 expression. Experimental results showed that PGE has the potential to alleviate the harmful effects on the kidney and pancreas by altering the mentioned parameters in diabetic rats.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"23 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205695","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":"“Emerging clinical approaches in diabetic cardiomyopathy: insights from clinical trials and future directions”","authors":"Murali Krishna Moka, Sriram. D. K, Melvin George","doi":"10.1007/s00592-024-02363-5","DOIUrl":"https://doi.org/10.1007/s00592-024-02363-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Aim</h3><p>We aim to explore the potential of diverse treatments, including perhexiline, calcium channel blockers, anti-hypertensives, PDE5 inhibitors, anti-anginal drugs, aldose reductase inhibitors, and SGLT-2 inhibitors, supported by clinical evidence. Additionally, this review seeks to identify novel therapeutic targets and future avenues for improving cardiovascular outcomes in diabetic populations. </p><h3 data-test=\"abstract-sub-heading\">Method</h3><p>We performed a comprehensive literature review of English-language studies across multiple electronic databases, such as PubMed, ScienceDirect, Scopus, and Google Scholar, focusing on clinical trials. The search utilized keywords including ‘Anti-hyperglycaemic drug,’ ‘Diabetic cardiomyopathy,’ ‘DPP-4 inhibitors,’ ‘GLP-1 receptor agonists,’ ‘Heart failure,’ and ‘SGLT-2 inhibitors.’</p><h3 data-test=\"abstract-sub-heading\">Result</h3><p>We assessed clinical investigations in the treatment of cardiomyopathy and diabetes mellitus (DM) that are enhancing our understanding through trials evaluating the Polypill, Perhexiline, Eplerenone, IMB-1018972, AT-001, tadalafil, and dapagliflozin inhibitors. The development of new targeted interventions is of paramount importance due to the overlooked early symptoms, the complexity of the cellular and molecular pathways involved, and the absence of effective drug therapies.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Pharmacological treatments like GLP-1 agonists, SGLT-2 inhibitors, NHE-1, NHE-3, and PPAR-γ agonists show promise for treating DCM. These treatments improve myocardial glucose absorption, address dysregulated glucose and lipid metabolism, and lower heart failure and cardiovascular events. Further research is needed to confirm effectiveness and safety.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"57 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205696","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":"SARS-CoV-2 booster vaccination does not worsen glycemia in people with type 1 diabetes using insulin pumps: an observational study","authors":"Braden Engelbogen, Laura Donaldson, Sybil McAuley, Spiros Fourlanos","doi":"10.1007/s00592-024-02372-4","DOIUrl":"https://doi.org/10.1007/s00592-024-02372-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Despite an increased risk for adverse outcomes from SARS-CoV-2 infection among individuals with type 1 diabetes (T1D), vaccine hesitancy persists due to safety concerns including dysglycemia. The impact of booster vaccination on individuals using automated insulin delivery (AID) systems remains unclear.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We used continuous glucose monitoring (CGM) data from 53 individuals with T1D using insulin pump therapy who received their third and/or fourth COVID-19 vaccination. CGM data from the 14 days before and 3 and 7 days after each vaccination were compared. The primary outcome was glucose time in range (TIR) (70–180 mg/dL) 3 and 7 days post-vaccination compared with the 14 days prior. Secondary outcomes included other CGM metrics such as time below range (&lt; 70 mg/dL), time above range (&gt; 180 mg/dL), mean glucose, co-efficient of variation and average total daily insulin.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The cohort comprised 53 adults (64% women, 64% AID), totaling 74 vaccination periods (84% Pfizer-BioNTech boosters), mean ± SD age 40.0 ± 15.9 years, duration of diabetes 26.0 ± 15.4 years. There was no significant difference between pre-vaccination TIR (61.0%±18.5) versus 3 (60.5%±22.8) and 7 days post-vaccination (60.2%±21.8; <i>p</i> = 0.79). Level 1 hypoglycemia, time in range 54–69 mg/dL, was lower 3 (1.1%±1.7) and 7 days post-vaccination (1.1%±1.6), compared with 14 days pre-vaccination (1.4%±1.4; <i>p</i> = 0.021).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The study provides evidence that SARS-CoV-2 booster vaccination does not acutely worsen glycemia in people with T1D receiving insulin pump therapy.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"12 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205697","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":"SMART DIABETES HOSPITAL: CLINICAL IMPACT IN COMPLEX SURGICAL UNITS OF A TERTIARY HOSPITAL.","authors":"Olga Simó-Servat, Judit Amigó, Ángel Ortiz-Zúñiga, Mónica Sánchez, Fátima Cuadra, Marcos Dos Santos, Alba Rojano, Maria José Abadías, Antonio Roman, Cristina Hernández, Rafael Simó","doi":"10.1007/s00592-024-02370-6","DOIUrl":"https://doi.org/10.1007/s00592-024-02370-6","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the impact of a proactive action of a specialized diabetes team (SDT) on different health outcomes in patients hospitalized in high complexity surgery units, including solid organ transplant surgical units, of a tertiary hospital.</p><p><strong>Methods: </strong>Nested case control study matched (1:1) by age and gender. The control group consisted of patients (n = 120) who were under the standard of care diabetes management admitted three months' prior the cases. The cases were admitted in the same surgical units (n = 120) and were treated in the setting of the so called \"Smart Diabetes Hospital\" (SDH) consisting in a SDT that prioritized their actions through a digital map showing blood glucose levels obtained during the previous 24 h.</p><p><strong>Results: </strong>SDH implementation resulted in a significant reduction in both blood glucose levels (mean 162.1 ± SD 44.4 vs. mean 145.5 ± SD 48.0; p = 0.008) and hypoglycaemic episodes (19.7% vs. 8.4%: p = 0.002). Furthermore, a reduction of 3 days in the length of stay (LOS) was observed (15.6 ± 10.3 vs. 12.4 ± 6.0), which represents a significant cost-saving. Moreover, more new cases of diabetes were detected during the SDT period (2.5% vs. 6.7%, p = 0.04).</p><p><strong>Conclusion: </strong>SDH is effective in diabetes management and reduce LOS in complex surgical units.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138963","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":"IDegLira improves time in range in a cohort of patients with type 2 diabetes: TiREX study.","authors":"Maria Elena Malighetti, Laura Molteni, Emanuela Orsi, Roberta Serra, Alessia Gaglio, Federica Mazzoleni, Filomena Russo, Antonio Carlo Bossi","doi":"10.1007/s00592-024-02361-7","DOIUrl":"https://doi.org/10.1007/s00592-024-02361-7","url":null,"abstract":"<p><strong>Aims: </strong>To assess the effects of IDegLira on glucometric indices deriving from intermittently scanned Continuous Glucose Monitoring (isCGM) in patients with type 2 diabetes (T2D).</p><p><strong>Methods: </strong>Retrospective, observational, cohort, multi-center, \"pre - post\" study. All adults consecutively identified in the medical records who started treatment with IDegLira, and for whom an isCGM report before and after the initiation of IDegLira was available were included in the study. Time in range (TIR) represented the primary endpoint. Additional glucometric indices, insulin doses and body weight were also assessed.</p><p><strong>Results: </strong>Overall, 87 patients were included by 5 diabetes centers [mean age 70.2 ± 11.0 years, mean duration of T2D 15.5 ± 9.6 years; BMI 29.4 ± 5.4 kg/m², baseline HbA1c 9.1 ± 2.1%, 33% insulin naïve, 20.7% treated with basal-oral therapy (BOT), and 46% treated with multiple daily injections of insulin (MDI)]. After an average of 1.7 weeks from IDegLira initiation, TIR significantly increased from 56.8 ± 23.5% to 81.3 ± 13.5% (p < 0.0001), TAR decreased from 42.3 ± 24.2% to 17.1 ± 13.6% (p < 0.0001), while TBR remained steadily low (from 1.3 ± 2.3% to 1.4 ± 2.6%; p = 0.62). Estimated HbA1c decreased from 9.1 ± 2.1% to 6.7 ± 0.6% (p < 0.0001) and percentage of patients with a blood glucose coefficient of variation ≥ 36% dropped from 33.2 to 13.8% (p = 0.0005). In patients on MDI, the reduction in the total insulin dose was substantial (from 55.8 ± 31.2 IU to 27.2 ± 12.3 U).</p><p><strong>Conclusions: </strong>In T2D patients with poor metabolic control, either insulin naïve or treated with BOT or MDI, the introduction of IDegLira produces a significant increase in the time spent in good metabolic control and a marked reduction in glycemic fluctuations.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131566","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}