Acta Diabetologica最新文献

{"title":"Effectiveness of most common adjuvant wound treatments (skin substitutes, negative pressure wound therapy, hyperbaric oxygen therapy, platelet-rich plasma/fibrin, and growth factors) for the management of hard-to-heal diabetic foot ulcers: a meta-analysis of randomized controlled trials for the development of the Italian Guidelines for the Treatment of Diabetic Foot Syndrome.","authors":"Matteo Monami, Alessia Scatena, Benedetta Ragghianti, Cesare Miranda, Luca Monge, Antonio Silverii, Luigi Uccioli, Cristiana Vermigli","doi":"10.1007/s00592-024-02426-7","DOIUrl":"https://doi.org/10.1007/s00592-024-02426-7","url":null,"abstract":"<p><strong>Aim: </strong>To assess the effects of several adjuvant therapies (AT) commonly used in the treatment of diabetic foot ulcers (DFU). The present meta-analysis was designed to support the development of the Italian Guidelines for the Treatment of Diabetic Foot Syndrome.</p><p><strong>Methods: </strong>A Medline and Embase search were performed up to May 20th, 2024 collecting all RCTs including diabetic patients or reporting subgroup analyses on diabetic patients with DFU comparing AT with placebo/standard of care (SoC), with a duration of at least 12 weeks. Prespecified endpoints were: ulcer healing (principal), time-to-healing, major and minor amputation, serious adverse events (SAE), and all-cause mortality. AT assessed were: growth factors (GF), Platelet-rich plasma and fibrin (PRP/F), skin substitutes (SS), negative pressure wound therapy (NPWT), and hyperbaric oxygen therapy (HBOT). Mantel-Haenzel Odds ratios and 95% confidence intervals (MH-OR, 95% CIs) were either calculated or extracted directly from the publications. Weighted mean differences and 95% CIs were calculated for continuous variables.</p><p><strong>Results: </strong>Fifty-one studies fulfilled all inclusion criteria (3, 5, 27, 8, and 8 with GF, PRP/F, SS, NPWT, and HBOT, respectively). Participants treated with any of the explored AT had a significantly higher ulcer healing rate (MH-OR ranging from 2.17 to 4.18) and shorter time-to-healing in comparison with SoC/placebo. Only PRP/F and HBOT showed a significantly lower risk of major amputation (MH-OR: 0.32(0.11;0,93; p = 0.04 and 0.28(0.10;0,79; p = 0.02, respectively), despite a higher risk of SAE. No other significant effects on the above-reported prespecified endpoints were observed. For the primary endpoint, the quality of evidence was rated as \"high\" for all the AT, except for NPWT (\"moderate\").</p><p><strong>Conclusions: </strong>In conclusion, AT can actively promote wound healing and shorten time-to-healing in patients with DFU. HBOT and PRP/F also showed a reduction of the risk of major amputation, despite a higher rate of SAE.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891347","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 resistance training on cardiovascular risk factors in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials","authors":"Yan Sun,&nbsp;Mingwei Sun,&nbsp;Xia Zeng,&nbsp;Liojuan Xiang Je,&nbsp;Zhannguo Su Guo","doi":"10.1007/s00592-024-02413-y","DOIUrl":"10.1007/s00592-024-02413-y","url":null,"abstract":"<div><h3>Aims</h3><p>Type 2 diabetes mellitus (T2DM) is prevalent worldwide, often manageable through lifestyle changes like physical activity. This meta-analysis aimed to determine the effect of resistance training (RT) on cardiovascular risk factors in adults with T2DM.</p><h3>Methods</h3><p>Four databases were searched up to March 2024. The mean difference (MD) was calculated by a random effect model with 95% confidence interval (CI).</p><h3>Results</h3><p>Forty-eight articles were included in the review. There was a significant pooled effect size for the meta-analysis comparing RT vs. control on hemoglobin A1C (MD = -0.49, 95% CI: -0.66, -0.33; <i>P</i> &lt; 0.00001), fasting blood sugar (MD = -11.58, 95% CI: -18.61, -4.55; <i>P</i> = 0.001), insulin (ES = -1.65, 95% CI: -2.87, -0.42; <i>P</i> = 0.008), HOMA-IR (MD = -1.20, 95% CI: -1.85, -0.55; <i>P</i> = 0.0003), triglyceride (MD = -18.14, 95% CI: -30.32, -5.96; <i>P</i> = 0.004), and high-density lipoprotein (MD = 2.71, 95% CI: 0.78, 4.64; <i>P</i> = 0.006). Moreover, RT was effective for reducing body weight (MD = -0.81, 95% CI: -1.50, -0.13; <i>P</i> = 0.02), fat percentage (MD = -0.92, 95% CI: -1.62, -0.22; <i>P</i> = 0.010), and waist circumference (MD = -2.14, 95% CI: -3.00, -1.28; <i>P</i> &lt; 0.00001).</p><h3>Conclusion</h3><p>RT effectively improves cardiovascular risk factors in T2DM adults, suggesting potential as treatment or prevention. Future studies can consider investigating the optimal RT regimen to achieve effective T2DM management in adults.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"62 1","pages":"11 - 24"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845500","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":"Association between estimated glucose disposal rate and kidney function decline in different glucose tolerance statuses from the 4 C study.","authors":"Peiqiong Luo, Danpei Li, Yaming Guo, Xiaoyu Meng, Ranran Kan, Xuefeng Yu","doi":"10.1007/s00592-024-02432-9","DOIUrl":"https://doi.org/10.1007/s00592-024-02432-9","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the association between estimated glucose disposal rate (eGDR) and kidney function decline among populations with different glucose tolerance statuses including normal glucose tolerance (NGT), prediabetes, and diabetes.</p><p><strong>Methods: </strong>The present study analyzed 5,069 participants from a cohort study. The association between eGDR and kidney function decline was assessed using binary logistic regression. Restricted cubic splines (RCS) analyses were also performed to investigate the dose-dependent associations.</p><p><strong>Results: </strong>During up to 5 years of follow-up, 116 (2.30%) individuals experienced kidney function decline. Binary logistic regression showed that an increased level of eGDR was associated with decreased risk of kidney function decline after full adjustment, in all participants (Q4 vs. Q1 HR 0.13, 95% CI 0.05-0.30, p = 0.001), prediabetes (Q4 vs. Q1HR 0.11, 95% CI 0.01-0.44, p = 0.007), and diabetes (Q4 vs. Q1 HR 0.06, 95% CI 0.00-0.37, p = 0.012), but not in those with NGT. RCS analyses suggested dose-dependent relationships of eGDR with the risk of kidney function decline in all participants (L-shaped curve) and those with prediabetes (inverted U-shaped curve) and diabetes (L-shaped curve).</p><p><strong>Conclusions: </strong>The association between elevated baseline eGDR and reduced risk of kidney function decline was significant in participants with prediabetes and diabetes, but not in those with NGT. These dose-dependent associations may have important implications for the assessment of high-risk patients by healthcare professionals and may lead to the development of more tailored and effective prevention strategies.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845487","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":"Comparing medication persistence with oral and subcutaneous semaglutide in a real-world setting.","authors":"Matteo Conti, Lorenzo Pontiggia, Michela Vergani, Emanuele Muraca, Rosa Cannistraci, Silvia Perra, Guido Lattuada, Gianluca Perseghin, Stefano Ciardullo","doi":"10.1007/s00592-024-02424-9","DOIUrl":"https://doi.org/10.1007/s00592-024-02424-9","url":null,"abstract":"<p><strong>Aims: </strong>To compare medication persistence and efficacy of oral and subcutaneous semaglutide, in a real-world setting.</p><p><strong>Materials and methods: </strong>This is a single-center, retrospective observational cohort study. Patients with type 2 diabetes mellitus (T2DM) starting treatment with either formulation of semaglutide between January 1 2019 and July 31 2023 and with at least one follow-up visit were included. The primary endpoint was the difference in the proportion of patients that continued treatment after 6, 12 and 18 months. Main secondary endpoints were change in HbA1c and body weight.</p><p><strong>Results: </strong>We included 242 patients on oral (n = 121) and subcutaneous (n = 121) semaglutide. At baseline, patients in the oral semaglutide group were significantly older (mean age: 67 ± 11 vs. 63 ± 11 years, p = 0.002) and had a lower body mass index (BMI: 30.5 ± 5.6 vs. 33.9 ± 7.1 kg/m², p < 0.001). The proportion of patients persistent to treatment was significantly lower in the oral group at 6 (85.3% vs. 94.8%; p < 0.001), 12 (72.3% vs. 92.4%, p < 0.001) and 18 (46.0% vs. 83.8%; p < 0.001) months. Most common reasons for discontinuation were gastro-intestinal side effects. When adjusted for age and BMI, body weight and HbA1c reduction were not significantly different between the two formulations, as the proportion of patients achieving the composite outcome of weight loss ≥ 5% and HbA1c < 7.0%.</p><p><strong>Conclusions: </strong>The present real-world study suggests that persistence is significantly lower when semaglutide is administered as a once-daily tablet compared with a weekly injection, while there are no differences in efficacy between the two formulations.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827146","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":"Adipose mesenchymal stem cell-derived extracellular vesicles regulate PINK1/parkin-mediated mitophagy to repair high glucose-induced dermal fibroblast senescence and promote wound healing in rats with diabetic foot ulcer.","authors":"Yinji Luo, Qijie Guo, Chang Liu, Yuxuan Zheng, Yichong Wang, Bin Wang","doi":"10.1007/s00592-024-02422-x","DOIUrl":"https://doi.org/10.1007/s00592-024-02422-x","url":null,"abstract":"<p><strong>Aims: </strong>Diabetic foot ulcers (DFUs) cause prominent morbidity and mortality. Adipose mesenchymal stem cell (ASC)-derived extracellular vesicles (EVs) show property in facilitating diabetic wound healing, and we explored their role in DFU rats.</p><p><strong>Methods: </strong>ASCs were cultured in vitro, passaged and then identified by flow cytometry and induction of osteogenic/adipogenic differentiation. ASC-EVs were extracted and identified. DFU rat model was treated with ASC-EVs. High glucose (HG)-induced rat dermal fibroblasts were treated with ASC-EVs or 3-MA and sh-PINK1 plasmid in vitro. Wound healing was observed. Histological changes, inflammatory cytokines (TNF-α, IL-1β), and α-SMA and p21 double-positive cell level were assessed by HE staining, ELISA, and immunofluorescence. Mitochondrial membrane potential (MMP), cell viability and senescence, and ROS production in cells were assessed by fluorescence dye JC-1, CCK-8, SA-β-gal staining, and ROS kit. p21, LC3II/I, p62, PINK1 and parkin protein levels were determined by Western blot.</p><p><strong>Results: </strong>DFU rats had slow wound healing and elevated levels of IL-1β, TNF-α, α-SMA and p21 double-positive cells, and SA-β-gal, while HG-induced cells had weakened viability, elevated ROS, SA-β-gal, p21 and p62 protein levels, and decreased LC3II/I, PINK1 and parkin protein levels and MMP, which were reversed by ASC-EVs. HG inhibited mitophagy by suppressing the PINK1/parkin pathway to accelerate dermal fibroblast senescence. The PINK1/parkin pathway inhibition partly mitigated the effect of ASC-EVs. ASC-EVs promoted mitophagy by activating the PINK1/parkin pathway in vivo.</p><p><strong>Conclusions: </strong>ASC-EVs mediated mitophagy by activating the PINK1/parkin pathway, thereby impeding HG-induced rat dermal fibroblast senescence and promoting wound healing in DFU rats.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827143","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":"Factors associated with intensive care unit admission due to diabetic ketoacidosis in adults: a validated predictive model.","authors":"Fernando Sebastian-Valles, Andrés Carlos Von Wernitz Teleki, Maria Sara Tapia-Sanchiz, Victor Navas-Moreno, Marta Lopez-Ruano, Carmen Martinez-Otero, Elena Carrillo-López, Carolina Sager-La Ganga, Juan José Raposo-López, Selma Amar, Sara González Castañar, Jose Alfonso Arranz-Martin, Carmen Del Arco, Mónica Marazuela","doi":"10.1007/s00592-024-02421-y","DOIUrl":"https://doi.org/10.1007/s00592-024-02421-y","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to develop a predictive model capable of determining the need for intensive care unit (ICU) admission of patients with diabetic ketoacidosis (DKA) during their assessment in the Emergency Department.</p><p><strong>Methods: </strong>This is an observational study of consecutive cases including all adult patients diagnosed with DKA at a tertiary hospital between 2010 and 2024. Variables from medical history, physical examination, and laboratory tests at admission were collected and studied for their association with ICU admission. The sample was divided into two randomized parts: one to build a logistic regression model and another to validate it.</p><p><strong>Results: </strong>Two hundred and thirty-one DKA events were included. Individuals had a mean age of 49.6 ± 19.9 years and 50.2% were male. Forty-eight point five percent of cases required ICU admission, and 30-day mortality was 4.8%. The best model to predict ICU admission included Glasgow Coma Scale (odds ratio [OR] = 0.64, p = 0.003), pH (OR = 0.0088, p = 0.005), bilirubin (OR = 0.13, p = 0.036), bicarbonate (OR = 0.0091, p = 0.013), and pH-bicarbonate interaction (OR = 3.78, p = 0.015). The model had an R² of 0.561, and the area under the curve (AUC) in the validation cohort was 0.842. Internal validation by bootstrap resampling showed an AUC = 0.871.</p><p><strong>Conclusion: </strong>Variables associated with the severity of acidosis in patients with DKA predict the need for ICU admission better and earlier than other clinical variables.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827148","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":"Incidence of type 1 diabetes in Gansu Province, Northwest China from 2018 to 2022: a multicenter, hospitalization-based study.","authors":"Yue Zhang, Xiaoning Liu, Shaolun Yang, Xueni Yang, Mengmeng Shang, Yujie Zhang, Limin Tian","doi":"10.1007/s00592-024-02427-6","DOIUrl":"https://doi.org/10.1007/s00592-024-02427-6","url":null,"abstract":"<p><strong>Objective: </strong>To survey the epidemiology of type 1 diabetes in all age groups living in the Gansu Province, China during 2018-2022.</p><p><strong>Methods: </strong>Using the data from the Gansu Province Health Commission Information Center and medical records, the crude incidence and 95%CI were calculated by region, age group, and sex assuming a Poisson distribution. The incidence differences were evaluated using the χ2 test. Spearman correlation was used to analyze the relation between latitude and incidence. The seasonality was analyzed using concentration, seasonal index and circular distribution method.</p><p><strong>Results: </strong>1393 cases of newly diagnosed type 1 diabetes were ascertained. The crude incidence of type 1 diabetes per 100,000 person-years in all individuals in Gansu Province was 1.09(95% confidence interval 1.03 to 1.15). The estimated incidence per 100,000 person-years by age group was 1.39 (95%CI:1.24-1.54) for 0-14 years, 3.58 (95%CI:3.33-3.83) for 15-29 years, 0.33(95%CI:0.29-0.37) for ≥ 30 years, with a peak in age group 15-19 years. There was a difference between males and females. Incidence of type 1 diabetes in Gansu Province was strongly correlated with latitude among children aged 0-29 years, and all age groups, but such correlation was not observed in adults aged ≥ 30 years. The seasonality of the type 1 diabetes is not obvious.</p><p><strong>Conclusion: </strong>The incidence of type 1 diabetes was relatively lower from 2018 to 2022 in Gansu Province, with variations across different regions and a positive correlation with latitude observed in all age groups. The incidence peak was noted in the 15-19 years group, and the incidence among males was higher than in females in all age groups. There was no significant seasonal variation in the incidence of type 1 diabetes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816974","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":"Improving glycaemic control in children under 3 years using MiniMed™ 780G in SmartGuard™ AHCL with diluted insulin: a case series report.","authors":"Phuong Phan, Justine Cunningham, Ohn Nyunt, Charles F Verge, Helen Woodhead, Amy Wanaguru, Kristen A Neville","doi":"10.1007/s00592-024-02434-7","DOIUrl":"https://doi.org/10.1007/s00592-024-02434-7","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811870","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 potential of precision diabetology for type 2 diabetes treatment-evidence from a meta-regression for all-cause mortality from large cardiovascular outcome trials.","authors":"Oliver Kuss, Michael Roden, Sabrina Schlesinger, Annika Hoyer","doi":"10.1007/s00592-024-02425-8","DOIUrl":"https://doi.org/10.1007/s00592-024-02425-8","url":null,"abstract":"<p><strong>Aims: </strong>Two prerequisites must be met for the precision treatment approach to be beneficial for treated individuals. First, there must be treatment heterogeneity; second, in case of treatment heterogeneity, clinical predictors to identify people who would benefit from one treatment more than from others must be available. There is an established meta-regression approach to assess these two prerequisites that relies on measuring the variability of a clinical outcome after treatment in placebo-controlled randomised trials. We recently applied this approach to the treatment of type 2 diabetes for the clinical outcomes of glycaemic control and body weight and repeat it for the clinical outcome of all-cause mortality.</p><p><strong>Methods: </strong>We performed a meta-regression analysis using digitalized individual participant information on time to death from 10 large cardiovascular outcome trials (7563 deaths from 99,746 participants) on DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors with respect to the variability of all-cause mortality and its potential predictors after treatment.</p><p><strong>Results: </strong>The adjusted difference in log(SD) values of time to death between the verum and placebo arms was -0.036 (95%-CI: -0.059; -0.013), showing larger variability of time to death in the placebo arms. No clinical predictors were found to explain treatment heterogeneity.</p><p><strong>Conclusions: </strong>This analysis suggests that the potential of the precision treatment approach in type 2 diabetes is low, at least with regard to improvement of all-cause mortality in population with high cardiovascular risk. This extends our previous findings for the clinical outcomes of glycaemic control and body weight.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811871","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":"Cluster-based subgroups of prediabetes and its association with prediabetes progression and regression: a prospective cohort study.","authors":"Yan Liu, Yu Liu, Min Zhang, Xinchen Wang, Xiaoying Zhou, Haijian Guo, Bei Wang, Duolao Wang, Zilin Sun, Shanhu Qiu","doi":"10.1007/s00592-024-02433-8","DOIUrl":"https://doi.org/10.1007/s00592-024-02433-8","url":null,"abstract":"<p><strong>Background: </strong>Cluster analysis provides an effective approach in stratifying prediabetes into different subgroups; however, the association of the cluster-based subgroups with prediabetes progression and regression has not been investigated. We aimed to address this issue in a Chinese population.</p><p><strong>Methods: </strong>A total of 4,128 participants with prediabetes were included to generate cluster-based subgroups of prediabetes based on age, body mass index (BMI), triglyceride-and-glucose (TyG) index, and hemoglobin A1c (HbA1c), using a k-means clustering model. Among them, 1,554 participants were followed-up for about three years to ascertain prediabetes progression and regression. Their association with the cluster-based subgroups of prediabetes was assessed using multinomial logistic regression analyses.</p><p><strong>Results: </strong>Three clusters of prediabetes were identified among the 4,128 participants, with cluster 0, 1 and 2 accounting for 28.0%, 31.4% and 40.6%, respectively. Participants with prediabetes were featured by the youngest age and the lowest HbA1c in cluster 0, the highest BMI and TyG index in cluster 1, and the oldest age and the lowest BMI in cluster 2. After multivariable-adjustment, both cluster 1 [odds ratio (OR) 3.31, 95% confidence interval (CI): 2.01-5.44] and cluster 2 (OR 2.58, 95% CI: 1.60-4.18) were associated with increased odds of progression to diabetes when compared with cluster 0. They were also associated with decreased odds of regression to normoglycemia (OR 0.54, and 0.56, respectively).</p><p><strong>Conclusions: </strong>Prediabetes participants featured by older age, higher degree of insulin resistance, higher BMI and worse glycemic condition had higher probability of progression to diabetes but lower chance of regression to normoglycemia.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811839","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}