Acta Diabetologica最新文献

{"title":"Integrated care pathway for the management of diabetic foot disease: a position statement from the Italian Diabetic Foot Study Group","authors":"Laura Giurato,&nbsp;Marco Meloni,&nbsp;Alessia Scatena,&nbsp;Roberto De Giglio,&nbsp;Giuseppe Murdolo,&nbsp;Marco Mastinu,&nbsp;Maurizio Gicchino,&nbsp;Desiree Gabriele,&nbsp;Roberto Anichini,&nbsp;Cesare Miranda,&nbsp;Luigi Uccioli,&nbsp;SID-AMD Diabetic Foot Study Group","doi":"10.1007/s00592-026-02741-1","DOIUrl":"10.1007/s00592-026-02741-1","url":null,"abstract":"<div><p>Diabetic foot is one of the most serious chronic complications of diabetes mellitus and reflects the systemic burden of the disease. Preventive strategies and structured management pathways are therefore essential elements of diabetes care. Lifetime occurrence of foot ulceration has been reported in nearly one-third of individuals with diabetes, and these lesions account for most non-traumatic lower-extremity amputations. Furthermore, the estimated five-year mortality following ulceration is 30%. This document aims to ensure an appropriate, multidisciplinary care pathway for patients with diabetic foot, tailored to clinical complexity and aligned with the different levels of care of Italian diabetes centers. The integrated model of diabetic foot care is based on the level of care that diabetes centers (local and hospital) can provide, including available personnel, expertise, and diagnostic and therapeutic resources to manage varying degrees of clinical complexity. Accordingly, three levels of care complexity, low, medium, and high, have been defined, with corresponding key diagnostic and therapeutic activities and healthcare professionals involved.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 10","pages":"1685 - 1695"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-026-02741-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429594","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}

{"title":"Preexisting diabetes and pregnancy: reflections on the joint guidelines of the Endocrine Society and European Society of Endocrinology","authors":"Annunziata Lapolla,&nbsp;Jennifer A. Wyckoff","doi":"10.1007/s00592-026-02737-x","DOIUrl":"10.1007/s00592-026-02737-x","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 11","pages":"1871 - 1873"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429441","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 SGLT2 inhibitors and reporting of phimosis/paraphimosis: a comparative pharmacovigilance analysis of the WHO database","authors":"Jean-Louis Montastruc","doi":"10.1007/s00592-026-02742-0","DOIUrl":"10.1007/s00592-026-02742-0","url":null,"abstract":"<div><h3>Purpose</h3><p>Recent data have discussed occurrence of phimosis with Sodium-glucose co-transporter-2 (SGLT2) inhibitors. However, the potential risk among the different SGLT2 inhibitors is unknown.</p><h3>Methods</h3><p>Using Individual Case Safety Reports (ICSRs) registered in the WHO pharmacovigilance database (01/01/2000-30/06/2025), comparisons between the different SGLT2 inhibitors and versus other drugs used in diabetes (DUD) were performed. Results are shown as Reporting Odds Ratios (ROR).</p><h3>Results</h3><p>Among 11 342 810 ICSRs, 227 were phimosis/paraphimosis with SGLT2 inhibitors, mainly between 45 and 64 years. The higher ROR value was found with empagliflozin followed by dapagliflozin and canagliflozin. ROR for SGLT2 inhibitors was higher that of all other DUD [34.72 (25.86–46.62)]. The reporting risk of phimosis/paraphimosis with SGLT2 inhibitors was also higher than that of each pharmacological class of DUD.</p><h3>Conclusion</h3><p>The results suggest an association between SGLT2 inhibitors use and phimosis ICSRs. Empagliflozin had the higher reporting risk.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 9","pages":"1615 - 1619"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429575","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":"Sustained metabolic control in latent autoimmune diabetes in adults (LADA) with semaglutide therapy in a patient with multiple autoimmune comorbidities: a case report and literature review.","authors":"Settimio D'Andrea, Antonella Berardicurti, Vincenza Di Stasi, Anna Tortora, Livia Santarelli, Marco Giorgio Baroni, Onorina Berardicurti","doi":"10.1007/s00592-026-02739-9","DOIUrl":"10.1007/s00592-026-02739-9","url":null,"abstract":"<p><p>Latent Autoimmune Diabetes in Adults (LADA) is a complex form of autoimmune diabetes characterised by the presence of pancreatic autoantibodies and a progressive β-cell decline, often leading to eventual insulin dependence. Evidence supporting glucagon-like peptide-1 receptor agonists (GLP-1RAs)-notably semaglutide-in LADA remains limited. Here, we present the case of a 55-year-old woman, initially diagnosed with type 2 diabetes mellitus, who exhibited class II obesity and multiple autoimmune disorders, including vitiligo, celiac disease, autoimmune thyroiditis, and undifferentiated arthritis. Laboratory evaluation revealed positive anti-glutamic acid decarboxylase antibodies and preserved fasting C-peptide, prompting a revised diagnosis of LADA. Given her obesity and residual β-cell function, metformin was discontinued and semaglutide initiated. Over five years of follow-up, the patient maintained durable glycemic control, significant weight loss, and stable β-cell function without requiring insulin. A temporary transition from injectable to oral semaglutide due to supply constraints did not compromise metabolic stability. To contextualize these findings, we conducted a systematic review of literature regarding semaglutide in LADA, identifying only two eligible case reports-underscoring the paucity of data. This case highlights the potential value of early LADA recognition in adults with preserved β-cell function, enabling a personalised approach with semaglutide to achieve metabolic control and possibly delay insulin requirement. Larger, prospective studies are warranted to elucidate the role of GLP-1 receptor agonists in LADA management and to define predictors of therapeutic response.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429581","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":"Sustained and attenuated effects of transitioning from supervised to self-managed resistance training in older adults with type 2 diabetes and sarcopenia: a randomized controlled trial","authors":"Yueh-Chu Wu,&nbsp;Li-Na Liao,&nbsp;Yu-Fen Lai,&nbsp;Hung-En Huang,&nbsp;Wen-Chun Liao,&nbsp;Chien-Ning Huang","doi":"10.1007/s00592-026-02736-y","DOIUrl":"10.1007/s00592-026-02736-y","url":null,"abstract":"<div><h3>Aims</h3><p>This randomized controlled trial examined whether benefits achieved during supervised resistance training (SRT) were sustained after transitioning to self-managed home-based training in older adults with type 2 diabetes mellitus (T2DM) and sarcopenia.</p><h3>Methods</h3><p>In this single-center, parallel-group trial, adults aged ≥ 65 years with T2DM and sarcopenia were randomized 1:1 to a 24-week resistance-training intervention or control. The intervention comprised 12 weeks of SRT followed by 12 weeks of self-managed home-based training. Co-primary outcomes were skeletal muscle index (SMI), handgrip strength (HGS), five-times-sit-to-stand (5TSTS), and SARC-CalF score. Secondary outcomes were HbA_1c and SF-12 physical and mental component summary scores. Longitudinal changes were evaluated using generalized estimating equations.</p><h3>Results</h3><p>Sixty-two participants were randomized (median age, 72 years; 67.7% female). At 12 weeks, SRT significantly improved HGS, 5TSTS performance, and SARC-CalF score, whereas SMI showed no significant between-group difference. At 24 weeks, SMI showed a modest favorable change, but earlier improvements in HGS, 5TSTS performance, and SARC-CalF score were attenuated after transition to self-managed training. SF-12 scores showed supportive, favorable patterns through 24 weeks, whereas HbA_1c showed no clear intervention-related change.</p><h3>Conclusions</h3><p>In older adults with T2DM and sarcopenia, transition from SRT to self-managed home-based training produced outcome-specific effects. Functional gains diminished after supervision ended, whereas SMI showed a modest, delayed, favorable change. These findings suggest that hybrid support models incorporating periodic supervision, remote monitoring, automated reminders, and feedback-guided exercise logs may be needed to sustain adherence, exercise quality, and functional capacity.</p><h3>Trial registration</h3><p>Retrospectively registered at ClinicalTrials.gov (NCT07398495), February 23, 2026.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 9","pages":"1601 - 1613"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-026-02736-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429540","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}

{"title":"Interpretable single-cell machine learning identifies PINK1-centred mitophagy as a determinant of metabolic fitness in type 2 diabetes","authors":"Bingjun Zeng,&nbsp;Da Qin,&nbsp;Xiaowei Xu,&nbsp;Dayun Tao,&nbsp;Ying Jiang,&nbsp;Hao Zhou,&nbsp;Yanli Wang","doi":"10.1007/s00592-026-02743-z","DOIUrl":"10.1007/s00592-026-02743-z","url":null,"abstract":"<div><h3>Background</h3><p>Progressive pancreatic β-cell dysfunction constitutes a hallmark of type 2 diabetes (T2D), yet the molecular programmes governing metabolic fitness deterioration remain incompletely characterised at single-cell resolution.</p><h3>Methods</h3><p>Single-cell transcriptomic data (GSE221156) encompassing pancreatic islet cells from 48 donors (non-diabetic [ND], <i>n</i> = 17; pre-diabetic [PD], <i>n</i> = 14; T2D, <i>n</i> = 17) were analysed using an interpretable machine learning framework that integrated sparse rule-based classification, pathway-constrained modelling, and mitochondrial fitness indexing.</p><h3>Results</h3><p>Five transcriptionally distinct β-cell subtypes (β1–β5) were resolved. The β1 subtype exhibited peak proportional representation in PD donors (35.0%) compared with ND (16.7%) and T2D (21.1%), consistent with stress-induced adaptive expansion. Mitochondrial biogenesis and ER stress emerged as the top-ranked programmes discriminating T2D from ND β-cells (importance scores = 0.329 and 0.329). Within the mitophagy gene set, MFN2 exhibited the highest feature importance (|logFC| = 0.472), followed by PINK1 (|logFC| = 0.199). PINK1 expression progressively declined across β1→β5 subtypes. A mitochondrial fitness index integrating mitophagy, proteostasis, biogenesis, and oxidative phosphorylation achieved R² = 0.65 against module-based quality scores. Hypergeometric enrichment analysis of differentially expressed genes between the adaptive β1 subtype and dysfunctional β2–β5 subtypes revealed significant enrichment of insulin secretion (<i>p</i> = 0.0019), endoplasmic reticulum stress (<i>p</i> = 0.0013), and oxidative phosphorylation (<i>p</i> = 0.045) pathways.</p><h3>Conclusions</h3><p>PINK1-centred mitophagy represents a critical determinant of β-cell metabolic fitness in T2D, with implications for therapeutic strategies aimed at preserving islet function during disease progression.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 9","pages":"1621 - 1628"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429562","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 end of the primary–secondary prevention dichotomy in high-risk diabetes? Lessons from VESALIUS-CV","authors":"Salvatore Corrao,&nbsp;Massimo Federici","doi":"10.1007/s00592-026-02748-8","DOIUrl":"10.1007/s00592-026-02748-8","url":null,"abstract":"<div><p>The VESALIUS-CV trial was the first dedicated cardiovascular-outcomes study to demonstrate that adding the PCSK9 inhibitor evolocumab to statin therapy prevents a first major cardiovascular event in patients without a previous myocardial infarction or stroke. A prespecified analysis extended this benefit to patients with diabetes and no known significant atherosclerosis, in whom intensive low-density lipoprotein cholesterol (LDL-C) lowering reduced major adverse cardiovascular events by approximately one third. These findings challenge the long-standing reliance on the primary–secondary prevention distinction to determine the intensity of lipid-lowering therapy. We argue that in high-risk diabetes—a systemic immunometabolic syndrome characterised by adiposopathy, insulin resistance, chronic inflammation and atherogenic dyslipidaemia—the arterial wall is biologically diseased long before a first clinical event. Cardiovascular prevention in this population should therefore move from an event-based to a biology-based paradigm, governed by biological risk rather than by event history.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 9","pages":"1629 - 1632"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429548","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":"Combined respiratory muscle training and photobiomodulation improve systemic and tissue-specific redox homeostasis in a rat model of type 2 diabetes","authors":"Maria Elaine Trevisan,&nbsp;Nubia Gonzatti,&nbsp;Carlos Cassiano Figueiró da Silva,&nbsp;Larissa da Silva Tonetto,&nbsp;Camille Gaube Guex,&nbsp;Gustavo Orione Puntel,&nbsp;Antônio Marcos Vargas da Silva,&nbsp;Luis Ulisses Signori,&nbsp;Cinthia Melazzo de Andrade,&nbsp;Pedro Dal Lago,&nbsp;Liliane de Freitas Bauermann,&nbsp;Rodrigo Boemo Jaenisch","doi":"10.1007/s00592-026-02723-3","DOIUrl":"10.1007/s00592-026-02723-3","url":null,"abstract":"<div><h3>Aims</h3><p>Oxidative stress plays a central role in the pathophysiology of type 2 diabetes and contributes to multiorgan dysfunction. Non-pharmacological strategies targeting redox imbalance may provide complementary benefits beyond glycemic control. This study investigated the effects of combined respiratory muscle training (RMT) and photobiomodulation (PBM) on systemic and tissue-specific redox homeostasis in an experimental model of type 2 diabetes.</p><h3>Methods</h3><p>Male rats were allocated into four groups: sedentary Sham (non-diabetic), Sham submitted to RMT combined with PBM, sedentary type 2 diabetes, and type 2 diabetes submitted to the RMT/PBM protocol. Type 2 diabetes was induced by a high-fat diet associated with low-dose streptozotocin. Interventions were performed five days per week for six weeks. Hematological and biochemical parameters were evaluated. Oxidative stress was assessed by lipid peroxidation (thiobarbituric acid reactive substances) and reactive oxygen species production (dichlorofluorescein), while antioxidant defenses were determined by superoxide dismutase activity and non-protein thiol levels in plasma and multiple tissues.</p><h3>Results</h3><p>In diabetic rats, the combined RMT/PBM protocol increased mean corpuscular hemoglobin concentration, reduced leukocyte and monocyte counts, and restored plasma protein levels. Oxidative damage was attenuated in plasma, diaphragm, lungs, and kidneys, while antioxidant defenses were enhanced, particularly in the diaphragm, heart, and kidneys. In normoglycemic rats, RMT/PBM also enhanced tissue antioxidant capacity, indicating preserved redox responsiveness.</p><h3>Conclusions</h3><p>Combined RMT and PBM promote systemic and tissue-specific redox adaptations and improve hematological and biochemical parameters in diabetic rats. These findings support the potential of this combined intervention as a non-pharmacological strategy to mitigate oxidative dysfunction associated with type 2 diabetes.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 9","pages":"1587 - 1600"},"PeriodicalIF":3.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-026-02723-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148314948","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}

{"title":"Quality of care for migrant populations with type 2 diabetes mellitus in Italy: a retrospective analysis of data from the the Italian AMD (Associations of Medical Diabetologists) annals initiative","authors":"Margherita Occhipinti,&nbsp;Ivana Ragusa,&nbsp;Valeria Manicardi,&nbsp;Federica Bellone,&nbsp;Maria Calabrese,&nbsp;Laura Esposito,&nbsp;Elisa Manicardi,&nbsp;Antonio Nicolucci,&nbsp;Antonio Ceriello,&nbsp;Alberto Rocca,&nbsp;Maria Chiara Rossi,&nbsp;Giuseppina Russo,&nbsp;Riccardo Candido,&nbsp;Graziano di Cianni","doi":"10.1007/s00592-026-02675-8","DOIUrl":"10.1007/s00592-026-02675-8","url":null,"abstract":"<div><h3>Purpose</h3><p>Italy is a major hub for migration routes. Disparities in health management across different geographic regions, particularly among individuals with type 2 diabetes mellitus (T2D), are well recognized, yet comprehensive data on the quality of T2D care in migrant populations remain limited.</p><h3>Methods</h3><p>Quality indicators of T2D care were analyzed for foreign patients compared with European patients using the 2022 AMD Annals database. The Italian National Institute of Statistics classification defined geographic origins.</p><h3>Results</h3><p>Data on country of origin were available for 179,536 T2D patients, with 19.3% being foreign, mainly from North Africa, Central and Eastern Europe, Central and South Asia, Central and South America.Foreign T2D patients were generally younger, resulting in shorter disease duration. While annual screening rates for risk factors and major complications were as European subjects, critical gaps were noted in microalbuminuria and retinopathy assessments. Treatment intensity was lower for patients from North and West Africa and Central and South Asia, though the use of innovative therapies like GLP-1RAs and SGLT2i was comparable to European patients. The overall quality of care, measured by the Q-score, was lowest in West African patients (26.4 ± 9.1 vs. 29.1 ± 8.0), while 51.6% of those from Central and South Asia had satisfactory care quality (Q-score &gt; 25).</p><h3>Conclusion</h3><p>Study showed differences in age, disease duration, and treatment among patients from various geographic regions, while indicating equitable access to therapies and comparable overall quality of care. These findings may inform management strategies to improve T2D care for migrant populations.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 9","pages":"1577 - 1586"},"PeriodicalIF":3.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-026-02675-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148306583","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}

{"title":"Therapeutic footwear in patients with diabetes: a position statement from the Italian diabetic foot study group","authors":"Laura Giurato,&nbsp;Alessia Scatena,&nbsp;Roberto De Giglio,&nbsp;Giuseppe Murdolo,&nbsp;Marco Mastinu,&nbsp;Maurizio Gicchino,&nbsp;Desiree Gabriele,&nbsp;Cristiana Vermigli,&nbsp;Andrea Panunzi,&nbsp;Luigi Uccioli,&nbsp;Roberto Da Ros,&nbsp;SID-AMD Diabetic Foot Study Group","doi":"10.1007/s00592-026-02722-4","DOIUrl":"10.1007/s00592-026-02722-4","url":null,"abstract":"<div><p>Prevention of diabetic foot ulcers is crucial, given the high risk of ulcer development (34%) and recurrence (&gt; 40%), with up to 85% of amputations being preceded by ulceration. The most effective preventive intervention is the use of therapeutic footwear combined with custom-made insoles, which should be considered a true therapeutic strategy, comparable to metabolic control. Scientific evidence demonstrates that therapeutic footwear, particularly rigid-soled models with multilayer total-contact insoles, significantly reduces the risk of ulcer recurrence, provided that specific plantar pressure targets are achieved (&lt; 200 kPa or a ≥ 30% reduction). Moreover, treatment adherence (at least 60–80% of daily active time) represents a critical determinant of effectiveness. This document aims to provide a practical approach to orthotic therapy by identifying the most appropriate prescription according to the patient’s ulceration risk level (IWGDF classification) and the presence of foot deformities, while matching orthotic features to the clinical status of the foot for protective purposes. Prescriptions should be individualized and validated by a multidisciplinary team.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"63 9","pages":"1553 - 1562"},"PeriodicalIF":3.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300356","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}