Acta Diabetologica最新文献

{"title":"Targeted metabolomics identifies associations of plasma ceramides and their ratios with incident type 2 diabetes mellitus.","authors":"Chuyi Ruan, Yihui Sheng, Ruyu Xue, Hong Huang, Shaoyan Zhang","doi":"10.1007/s00592-026-02765-7","DOIUrl":"https://doi.org/10.1007/s00592-026-02765-7","url":null,"abstract":"<p><strong>Aims: </strong>Limited studies explored the association between ceramides and the risk of type 2 diabetes mellitus (T2DM). We aimed to investigated whether plasma ceramides and their ratios to Cer(d18:1/16:0) would be associated with T2DM in Chinese adult residents.</p><p><strong>Methods: </strong>This investigation was designed as a matched case-control study nested within a community-based longitudinal cohort in Suzhou, China. Plasma concentrations of eight ceramides (C16-C24) were measured quantitatively in 234 cases and 468 matched controls using high-throughput targeted lipidomics. Conditional logistic regression models were used to estimate odds ratios (ORs). We assessed the improvements in risk discrimination by net reclassification improvement (NRI) and integrated discrimination improvement (IDI).</p><p><strong>Results: </strong>Seven ceramides (d18:1/16:0, d18:1/18:0, d18:1/20:0, d18:1/22:0, d18:1/22:1, d18:1/24:0, d18:1/24:1) were positively associated with incident T2DM. Among them, Cer(d18:1/24:0) showed the strongest association with increased T2DM risk (OR = 2.17 (95% CI: 1.29,3.66, P-trend < 0.05). Additionally, the ratios of Cer(d18:1/18:0)/Cer(d18:1/16:0) and Cer(d18:1/20:0)/Cer(d18:1/16:0) were significantly associated with T2DM risk, and adjusted ORs for the highest vs. lowest quartiles were 2.11 (95% CI: 1.27,3.51), and 1.69 (95% CI: 1.04,2.76), respectively (all P-trend < 0.05). The addition of individual ceramides or ceramide ratios to conventional risk factors significantly improved the discrimination and risk reclassification (all P < 0.05).</p><p><strong>Conclusions: </strong>Distinct plasma ceramides are associated with the T2DM risk and Cer(d18:1/24:0) serves as the strongest predictive marker. Moreover, the ratios of Cer(d18:1/18:0)/Cer(d18:1/16:0) and Cer(d18:1/20:0)/Cer(d18:1/16:0) are also particularly robust independent predictors of incident T2DM. Ceramides and their ratios can be used to identify high-risk patients with T2DM, providing targets for the primary and secondary prevention of T2DM.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668037","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":"Methodological considerations in the UK Biobank diabetes‑tinnitus study.","authors":"Axmedova Maxbuba, Abdurazakova Dilbar, Dilbar Urazbaeva, Sanjar Zaripov, Arman Abroumand Gholami","doi":"10.1007/s00592-026-02752-y","DOIUrl":"https://doi.org/10.1007/s00592-026-02752-y","url":null,"abstract":"<p><p>Tinnitus is a common and often debilitating condition that substantially affects quality of life. While diabetes has been suggested as a potential risk factor, the relationship remains poorly understood, particularly in large population-based settings where classification of diabetes type often relies on algorithms rather than confirmatory biomarkers. The recent UK Biobank study by Ji and colleagues addresses this gap by reporting that type 2 diabetes is associated with higher tinnitus prevalence. While the study benefits from a large sample and systematic examination of diabetes-related factors, two methodological concerns warrant consideration before the findings are interpreted as robust evidence. First, diabetes type was determined using algorithmic classification without confirmatory biomarkers such as autoantibodies or C-peptide. Second, the analytical strategy treated age as a simple covariate, implicitly assuming that the diabetes-tinnitus association remains constant across the entire 40-70 year age range. While the study offers valuable hypothesis-generating data, these methodological considerations suggest that the reported associations should be interpreted cautiously until confirmed by biomarker-validated phenotyping and more flexible analytical approaches that account for age-related heterogeneity.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668083","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":"Prediction of coronary atherosclerosis progression in type 2 diabetes mellitus based on AI-derived CCTA parameters and clinical factors: a follow-up study","authors":"Ling Ma,&nbsp;Yangyang Li,&nbsp;Xiaojie Xie,&nbsp;Xiao Cui,&nbsp;Shaolei Kang,&nbsp;Dan Han,&nbsp;Wen Zhao","doi":"10.1007/s00592-026-02761-x","DOIUrl":"10.1007/s00592-026-02761-x","url":null,"abstract":"<div><h3>Objective</h3><p>To develop a predictive model for coronary atherosclerosis progression in patients with type 2 diabetes mellitus (T2DM) based on Artificial intelligence(AI)-derived coronary computed tomography angiography (CCTA) parameters combined with clinical indicators.</p><h3>Methods</h3><p>This retrospective study enrolled 114 patients with T2DM and non-obstructive coronary artery disease (1%–49% stenosis) who underwent CCTA at our hospital between September 2019 and September 2024. After follow-up of 1–5 years, patients were stratified into a progression group (<i>n</i> = 48) and a control group (<i>n</i> = 66). Progression was defined as the occurrence of acute myocardial infarction, revascularization, or stenosis progression to ≥ 50% on follow-up CCTA. Clinical data and AI-derived quantitative parameters of pericoronary adipose tissue(PCAT) and coronary plaques were compared. A predictive model was then developed using stepwise logistic regression and its performance evaluated.</p><h3>Results</h3><p>The progression group had significantly higher glycated hemoglobin (HbA1c) and troponin, and lower high-density lipoprotein cholesterol (HDL-C) (all <i>P</i> &lt; 0.05).CCTA analysis revealed that the progression group had a significantly greater pericoronary fat attenuation index around the left anterior descending (LAD-FAI) and left circumflex (LCX-FAI) arteries, as well as increased plaque length, total plaque volume, and specific plaque component volumes (all <i>P</i> &lt; 0.05). Multivariate logistic regression analysis identified HbA1c, LAD-FAI, and plaque length as independent predictors of progression. A nomogram based on these predictors achieved an AUC of 0.8332.</p><h3>Conclusion</h3><p>LAD-FAI and plaque length and HbA1c are independent predictors for the progression of non-obstructive coronary lesions in T2DM patients. The proposed nomogram may provide a noninvasive and cost-effective tool for early risk stratification and preventive management.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 10","pages":"1783 - 1795"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652722","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":"Healthy lifestyle and related metabolomic signatures associated with decreased risk and delayed progression of type 2 diabetes mellitus transitions: a large prospective cohort study","authors":"Peng Hu,&nbsp;Yuqin Wang,&nbsp;Guzhengyue Zheng,&nbsp;Zhengmin (Min) Qian,&nbsp;Ge Chen,&nbsp;Fei Tian,&nbsp;Shengtao Wei,&nbsp;Zitong Zhuang,&nbsp;Michael Elliott,&nbsp;Maya Kavuri,&nbsp;Zhenhe Huang,&nbsp;Hualiang Lin","doi":"10.1007/s00592-026-02764-8","DOIUrl":"10.1007/s00592-026-02764-8","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate dynamic associations of a comprehensive healthy lifestyle and related metabolic signatures with the progression trajectory of type 2 diabetes mellitus (T2DM).</p><h3>Methods</h3><p>From the UK Biobank cohort, we identified 305,349 participants without diabetes or diabetes-related complications, 152,901 of whom had available metabolite data. A healthy lifestyle score (HLS) was constructed using eight factors. Elastic net regression models were used to identify lifestyle-related metabolomic signatures. Multistate models were used to evaluate the dynamic associations of HLS and related metabolomic signatures with the incidence and progression of T2DM. Accelerated failure time models assessed whether HLS and related metabolomic signatures were associated with relative time delays in T2DM progression.</p><h3>Results</h3><p>During a median follow-up of 13.84 years, 7998 participants developed incident T2DM. We identified 139 metabolites representing healthy lifestyles. HLS and related metabolomic signatures were inversely associated with the risk of T2DM transitions. The HRs per SD increase of lifestyle-related metabolites were 0.96, 0.89, 0.95, and 0.87 for transitions from non-T2DM to incident T2DM, to death, from incident T2DM to complications, and to death. HLS and related metabolomic signatures were both significantly associated with delays in transitions from non-T2DM to incident T2DM, to death, and from T2DM to complications, to death, with prolonged onset time ranging from 0.22 to 1.75 years for HLS and 0.24 to 0.74 years for metabolomic signatures, respectively.</p><h3>Conclusions</h3><p>The findings highlight the significance of adherence to a healthy lifestyle in preventing the onset and progression of T2DM from behaviors and metabolomics perspectives.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 10","pages":"1797 - 1809"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652730","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 dawn phenomenon in diabetes: pathophysiology from periphery to central nervous system and circadian rhythm-based therapeutic strategies.","authors":"Yujue Wang, Shuaiyan Wang, Weiqian Wang, Tongtong Zhang, Bin Xu, Guanhu Yang, Tiancheng Xu","doi":"10.1007/s00592-026-02763-9","DOIUrl":"https://doi.org/10.1007/s00592-026-02763-9","url":null,"abstract":"<p><p>The Dawn Phenomenon (DP) denotes the occurrence of spontaneous early-morning hyperglycemia in the absence of overnight hypoglycemia, or that necessitating an elevation in insulin to sustain normal morning blood glucose levels. Studies exhibit considerable variability, with some indicating that DP is a spontaneous occurrence reported in a substantial percentage of individuals. Patients with DP demonstrate increased average blood glucose variability over a 24-h period compared to those without DP, presenting considerable problems for clinical diabetes pharmacotherapy and nutritional regulation. Moreover, given the ambiguity surrounding the precise pathophysiology and targeted therapies for DP, therapeutic care predominantly emphasizes symptom alleviation. Conventional perspectives ascribe DP to physiological surges in the secretion of counterregulatory hormones, including cortisol, catecholamines, and growth hormone, in the early morning hours. These hormones enhance hepatic glucose production while concurrently diminishing peripheral tissue sensitivity to insulin. This article examines the contemporary pathophysiological underpinnings of DP to offer insights for clinical diagnosis and treatment in diabetes. This article focuses mainly on the dawn phenomenon in type 2 diabetes (T2DM), while evidence related to type 1 diabetes (T1DM) is addressed independently.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617949","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 gut-brain-mitochondria axis in type 2 diabetes-associated cognitive decline: mechanistic convergence, biomarkers, and therapeutic opportunities.","authors":"Nitish Nirala, Omkar Kumar Kuwar, Dhrubalochan Rana, Mamta Sachdeva Dhingra","doi":"10.1007/s00592-026-02749-7","DOIUrl":"https://doi.org/10.1007/s00592-026-02749-7","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is increasingly recognized as a major risk factor for cognitive impairment and dementia, extending beyond its traditional metabolic complications. Emerging evidence suggests that cognitive decline in T2DM arises from a complex interplay among gut dysbiosis, chronic inflammation, impaired insulin signaling, blood-brain barrier dysfunction, and mitochondrial abnormalities. The gut-brain-mitochondria (GBM) axis has recently emerged as an integrated mechanistic framework linking peripheral metabolic disturbances to central neurodegenerative processes. Within this axis, alterations in gut microbial composition and function promote intestinal barrier disruption, endotoxemia, and aberrant production of microbial metabolites, which collectively contribute to systemic inflammation, neuroinflammation, and neuronal insulin resistance. Mitochondria occupy a central position in this network by regulating cellular bioenergetics, redox homeostasis, calcium signaling, and neuronal survival. Mitochondrial dysfunction amplifies oxidative stress, impairs synaptic plasticity, disrupts adult hippocampal neurogenesis, and accelerates neurodegenerative signaling pathways associated with cognitive decline. Furthermore, bidirectional communication between gut-derived metabolites and mitochondrial pathways influences neuronal resilience and disease progression. This review synthesizes current evidence describing the mechanistic convergence of gut dysbiosis, mitochondrial dysfunction, and neuroinflammation in T2DM-associated cognitive impairment. We also discuss emerging biomarkers, including mitochondrial DNA copy number, circulating lactate, lipopolysaccharide, zonulin, and microbial metabolite signatures, that may facilitate early disease detection and patient stratification. Finally, we critically evaluate therapeutic strategies targeting the GBM axis, including microbiota-directed interventions, mitochondrial-targeted antioxidants, metabolic modulators, and lifestyle-based approaches. Understanding the integrated role of the GBM axis may provide novel opportunities for precision-based interventions to prevent or slow diabetes-associated cognitive decline.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617875","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":"Long-term effectiveness of a reminder system for postpartum glucose intolerance screening in gestational diabetes","authors":"Niels Bochanen,&nbsp;Sabine Verstraete,&nbsp;Annouschka Laenen,&nbsp;Luk Buyse,&nbsp;Johan Wens,&nbsp;Christophe De Block,&nbsp;Katrien Benhalima","doi":"10.1007/s00592-026-02756-8","DOIUrl":"10.1007/s00592-026-02756-8","url":null,"abstract":"<div><h3>Background and aims</h3><p>Women with a history of gestational diabetes (GDM) have an increased risk of developing type 2 diabetes later in life. We evaluated the long-term feasibility and effectiveness of a regionally implemented GDM recall register to stimulate postpartum screening and assess (pre)diabetes prevalence up to 10 years postpartum.</p><h3>Methods</h3><p>We evaluated the “Sweet Pregnancy” GDM recall register, implemented in the northern part of Belgium, from 2009 to 2025. Women with a history of GDM received annual reminders for screening with a fasting plasma glucose in primary care. Response rates, self-reported screening uptake, and cumulative incidence of (pre)diabetes were analyzed.</p><h3>Results</h3><p>27,173 women were registered with a mean follow-up of 4.4 years. The yearly response rates (among both responders and non-responders combined) varied from 48.4% (11,048) after the first year to 34.3% (4,116) after the fifth year, and 27.6% (1,190) after 10 years. Among responders, during the follow-up period of 3 and 5 years, 80.4% and 81.9% received at least one screening test, respectively. Non-responders were more often under 30 years of age (45.4% vs. 42.0%, <i>p</i> &lt; 0.001) and obese (32.6% vs. 24.8%, <i>p</i> &lt; 0.001) compared to responders. After 10 years, the cumulative incidence of diabetes was 11.0% and of impaired fasting glucose 34.7%.</p><h3>Conclusion</h3><p>This large-scale register implemented in normal routine, up to 10 years of follow-up, indicates a feasible and effective reminder system to stimulate postpartum diabetes screening in women with prior GDM. The high cumulative incidence of (pre)diabetes underscores the importance of long-term follow-up and targeted interventions to prevent progression to type 2 diabetes in this high-risk population.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 10","pages":"1771 - 1782"},"PeriodicalIF":3.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617937","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":"Immune cell-derived circulating extracellular vesicles mediate metabolic dysfunction in preclinical and clinical type 1 diabetes","authors":"Bingbing Qu,&nbsp;Bingjun Zeng,&nbsp;Yurui Yuan,&nbsp;Xiuling He,&nbsp;Lina Ren,&nbsp;Hang Zhu,&nbsp;Xuanke Guan","doi":"10.1007/s00592-026-02769-3","DOIUrl":"10.1007/s00592-026-02769-3","url":null,"abstract":"<div><h3>Background</h3><p>Type 1 diabetes (T1D) is an autoimmune disease that destroys insulin-producing β-cells. Extracellular vesicles (EVs), including exosomes, are now recognized as important mediators of intercellular communication in immune regulation and metabolic homeostasis. Yet how immune cell-derived circulating EVs contribute to metabolic dysfunction across the disease spectrum—from preclinical to clinical T1D—has not been systematically examined.</p><h3>Methods</h3><p>We integrated four publicly available GEO datasets: GSE97123 (plasma-derived exosome miRNA profiling in long-duration T1D patients, <i>n</i> = 24), GSE92439 (T lymphocyte-derived exosome effects on pancreatic islets, <i>n</i> = 6), GSE316823 (ductal cell EV-mediated β-cell alterations, <i>n</i> = 8), and GSE160391 (cytokine-stressed islet and EV miRNA profiles, <i>n</i> = 48). Differential expression analysis was performed using Welch’s <i>t</i>-test with Benjamini-Hochberg correction. Pathway enrichment, EV marker characterization, and cross-dataset integration were carried out to identify convergent mechanisms.</p><h3>Results</h3><p>In GSE97123, 292 differentially expressed miRNAs (<i>p</i> &lt; 0.05) were identified in circulating exosomes from T1D patients compared with controls, with upregulation of pro-inflammatory mediators including miR-155-5p and miR-146a-5p. In GSE92439, T lymphocyte-derived exosomes altered 8,189 genes in pancreatic islets, with changes in insulin secretion, apoptosis, and immune recognition pathways. In GSE316823, cytokine-stimulated ductal cell EVs induced 599 differentially expressed genes in β-cells, with notable upregulation of HLA class I molecules (HLA-A, HLA-B, HLA-C) and inflammatory chemokines (CXCL9, CXCL10, CXCL11, IDO1, GBP4). In GSE160391, cytokine stress caused distinct miRNA packaging into EVs versus islet fractions, with miR-155-5p and miR-146a-5p as the only two miRNAs consistently upregulated in both compartments across sexes. Cross-dataset integration showed convergent dysregulation of antigen presentation, insulin signaling, and apoptotic pathways.</p><h3>Conclusions</h3><p>Immune cell-derived EVs appear to transfer pro-inflammatory and metabolic-disruptive cargo to β-cells, supporting a pathogenic axis in T1D that has received limited attention. These findings suggest that EV-mediated communication could be a therapeutic target and that circulating EV miRNAs may serve as biomarkers for T1D progression.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 10","pages":"1757 - 1769"},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617958","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 glucose monitoring and glycaemic variability in acute ischaemic stroke: a systematic review with narrative synthesis.","authors":"Kausik Chatterjee, Jisna Vincent, Rithin Punnackal Joseph","doi":"10.1007/s00592-026-02766-6","DOIUrl":"https://doi.org/10.1007/s00592-026-02766-6","url":null,"abstract":"<p><p>Dysglycaemia is common after acute ischaemic stroke and is associated with adverse outcomes. Continuous glucose monitoring (CGM) provides frequent interstitial glucose measurements and may identify glycaemic variability and excursions missed by intermittent testing. This systematic review evaluated CGM feasibility, accuracy, glycaemic patterns and clinical associations in acute ischaemic stroke. MEDLINE, Embase and CENTRAL were searched to January 2026 for studies of adults undergoing CGM within seven days of stroke onset or admission. Risk of bias was assessed using RoB 2 or the Newcastle-Ottawa Scale, and certainty of evidence using GRADE. Seven studies enrolled 595 participants; monitoring lasted 24 h to 4.5 days. Mean glucose ranged from approximately 118 to 149 mg/dL and coefficient of variation from 4% to 21%. Observational studies provided low- or very-low-certainty evidence that greater hyperglycaemic exposure or variability was associated with death or dependency, unfavourable outcome after thrombectomy and reduced in-hospital neurological improvement. An unadjusted time-above-range difference between functional-trajectory groups was not independently significant after adjustment. One diabetes-only randomised trial evaluated a multi-component intervention combining structured nursing, insulin-pump therapy and CGM. Two-week neurological, motor, self-care and quality-of-life measures favoured the intervention, but modified Rankin Scale and longer-term outcomes were not reported, and the effect of CGM could not be isolated. CGM appears feasible, but evidence is heterogeneous and insufficient to support routine implementation. Standardised metrics and adequately powered multicentre trials are required.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617944","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":"Migration background and diabetes technology use at diagnosis and follow-up in children and adolescents with type 1 diabetes: a single-centre study","authors":"Dagmar Meraner,&nbsp;Marjan Arvandi,&nbsp;Katharina Pajk,&nbsp;Eva Vonmetz,&nbsp;Wilhelm Oberaigner,&nbsp;Veronika Haslwanter,&nbsp;Sibylle Puntscher,&nbsp;Elisabeth Binder,&nbsp;Elisabeth Steichen,&nbsp;Uwe Siebert,&nbsp;Ines Schaffer,&nbsp;Sabine E. Hofer,&nbsp;Daniela Schmid","doi":"10.1007/s00592-026-02758-6","DOIUrl":"10.1007/s00592-026-02758-6","url":null,"abstract":"<div><h3>Aims</h3><p>To investigate whether migration background is associated with diabetes technology use at diagnosis and during follow-up in children and adolescents with type 1 diabetes.</p><h3>Methods</h3><p>This cross-sectional study included children and adolescents aged 4–19 years with type 1 diabetes duration ≥ 1 year. Insulin pump therapy at diagnosis and diabetes technology use at follow-up (defined as insulin pump therapy or automated insulin delivery [AID]) were compared between participants with and without migration background. Multivariable logistic regression was used to assess factors associated with technology use.</p><h3>Results</h3><p>A total of 143 participants (mean age 13.2 ± 3.7 years) were included, of whom 24.5% had a migration background. At diabetes onset, insulin pump therapy was less frequent in participants with migration background compared to those without (28.6% vs. 50.0%, <i>p</i> = 0.027). At follow-up, diabetes technology use was numerically lower in participants with migration background (60.0% vs. 76.8%); however, the difference did not reach statistical significance (<i>p</i> = 0.052). In adjusted analyses, migration background was not significantly associated with diabetes technology use at follow-up (OR 2.33, 95% CI 0.92–5.89), whereas younger age and longer diabetes duration were independently associated with technology use.</p><h3>Conclusions</h3><p>Children with migration background were less likely to receive insulin pump therapy at diagnosis. At follow-up, differences in diabetes technology use were smaller and not statistically significant. These findings are consistent with the hypothesis of delayed technology uptake, although longitudinal studies are required to determine the timing of diabetes technology initiation.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 10","pages":"1749 - 1755"},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-026-02758-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}