Acta Diabetologica最新文献

{"title":"Does nutritional guidance reduce cardiovascular events in patients with type 2 diabetes mellitus? A retrospective cohort study using a nationwide claims database","authors":"Misaki Nakahata,&nbsp;Sachiko Tanaka-Mizuno,&nbsp;Fumitaka Yamaguchi,&nbsp;Masato Takeuchi,&nbsp;Koji Kawakami","doi":"10.1007/s00592-023-02147-3","DOIUrl":"10.1007/s00592-023-02147-3","url":null,"abstract":"<div><h3>Aim</h3><p>To examine the effect of nutritional guidance (NG) provided by a registered dietitian under the direction of a physician on the development of subsequent cardiovascular events in patients with early-stage type 2 diabetes mellitus (T2DM).</p><h3>Materials and methods</h3><p>This retrospective cohort study used the JMDC claims database to explore patients aged 18 years or older who first met the diagnostic criteria for T2DM at a health checkup between January 2011 and January 2019. The last day of the observation period was set for 28 February, 2021. Exposure was defined as receiving NG within 180 days of diagnosis of T2DM. The primary outcome was a composite endpoint of coronary artery disease (CAD) and cerebrovascular disease, and the secondary outcomes were each event, and time to event was compared. The propensity score weighting method was used for adjusting the distribution of confounding variables. Cox regression was conducted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</p><h3>Results</h3><p>Overall, 31,378 patients met the eligibility criteria at an annual health checkup. 9.6% received NG (<i>n</i> = 3013). Patients who attended ≥ 1 NG after diagnosis had significantly reduced risk of cardiovascular composite (adjusted HR 0.75, 95% CI 0.58–0.97) and cerebrovascular disease (adjusted HR 0.65, 95% CI 0.47–0.90) during approximately 3.3 years of follow-up. In contrast, no difference was observed for CAD.</p><h3>Conclusions</h3><p>Receiving NG in early-stage diabetes may reduce the incidence of cardiovascular events, especially cerebrovascular events.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 11","pages":"1541 - 1549"},"PeriodicalIF":3.8,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9818042","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":"On the occasion of the centennial of the Nobel Prize in Physiology or Medicine, 1923: Nicolae C. Paulescu—between scientific creativity and political fanatism","authors":"Alberto de Leiva-Hidalgo,&nbsp;Alejandra de Leiva-Pérez","doi":"10.1007/s00592-023-02136-6","DOIUrl":"10.1007/s00592-023-02136-6","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;p&gt;Since the Nobel Prize in Physiology or Medicine was awarded in 1923 to FG Banting and JJR Macleod, many voices have been raised against this decision. The bitterest protest was that of the Romanian scientist Nicolae C. Paulescu. In 2002, The Romanian Academy of Sciences, the European Association for the Study of Diabetes (EASD) and the International Diabetes Federation (IDF) planned to hold a series of academic events the following year in Paris to acknowledge Paulescu's scientific merits in the discovery of the antidiabetic hormone. However, the initiative was cancelled in August 2003, when the European Center of the Simon Wiesenthal Foundation (SWC) accused Paulescu of being antisemitic. The authors of this manuscript have decided to approach \"the Paulescu case\" from its double aspect, scientific and sociopolitical, to analyze the circumstances surrounding the discovery of the antidiabetic hormone, and Paulescu's alleged antisemitic past in the historical context of the Romanian nation in the interwar period.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;We contacted the SWC and people related to the 2003 events in Paris. We performed a comparative review of the documents published by the Toronto group and by Paulescu and analyzed the correspondence and articles generated by international experts from the scientific community interested in the controversy. We carried out an exhaustive bibliographic search through several online catalogs (INDEXCAT, NLM Gateway, EUREKA, MEDHIST). We travelled to Bucharest, where we visited Paulescu's house-museum, interviewed a former student of the Romanian professor, and a prominent medical historian who was knowledgeable about Paulescu's scientific and political biography. Dan Angelescu†, son of Dr. Constantin Angelescu (1904–1990), Paulescu's nephew and collaborator, provided us with a copy of all the available documentation from Paulescu's personal archive. It constitutes an essential source for understanding Paulescu's personal, political and academic biography. &lt;i&gt;Archives consulted:&lt;/i&gt; Românǎ Academy (Bucharest). Personal Archive of Paulescu, House -Museum (Bucharest)*. Romanian Jewish Heritage (Bucharest). http://romanianjewish.org/ **. Simon Wiesenthal Center (Los Angeles, CA) http://www.wiesenthal.com **. Romanian Patent Office. Oficiul de Stat pentru Invenții şi Mǎrci (OSIM) (Bucharest)***. Nobel Archives (Stockholm) https://www.nobelprize.org. Internet Archive (San Francisco, CA) https://archive.org **. Wellcome Library (London) https://wellcomelibrary.org **. The European Library https://www.theeuropeanlibrary.org/ **. US National Library of Medicine, NLM historical collections http://www.nlm.nih.gov/hmd/index.html **. US. Holocaust Memorial Museum http://www.ushmm.org/ (*: archive consulted on site; **: material found in the online catalog of the archive; ***: archivists sent us digitized copies of archival material). &lt;i&gt;Books consulted for information on the history of Romania and antisemitism:&lt;/i&gt; ","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 11","pages":"1513 - 1530"},"PeriodicalIF":3.8,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-023-02136-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812053","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":"GLP-1RAs and cardiovascular disease: is the endothelium a relevant platform?","authors":"Rossella Menghini,&nbsp;Viviana Casagrande,&nbsp;Stefano Rizza,&nbsp;Massimo Federici","doi":"10.1007/s00592-023-02124-w","DOIUrl":"10.1007/s00592-023-02124-w","url":null,"abstract":"<div><p>Hyperglycemia strongly affects endothelial function and activation, which in turn increases the risk of atherosclerotic cardiovascular disease. Among pharmacotherapies aimed at lowering blood glucose levels, glucagon-like peptide 1 receptor agonists (GLP-1RA) represent a class of drugs involved in the improvement of the endothelium damage and the progression of cardiovascular diseases. They show antihypertensive and antiatherosclerotic actions due at least in part to direct favorable actions on the coronary vascular endothelium, such as oxidative stress reduction and nitric oxide increase. However, cumulative peripheral indirect actions could also contribute to the antiatherosclerotic functions of GLP-1/GLP-1R agonists, including metabolism and gut microbiome regulation. Therefore, further research is necessary to clarify the specific role of this drug class in the management of cardiovascular disease and to identify specific cellular targets involved in the protective signal transduction. In the present review, we provide an overview of the effects of GLP-1RAs treatment on cardiovascular disease with particular attention on potential molecular mechanisms involving endothelium function on formation and progression of atherosclerotic plaque.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 11","pages":"1441 - 1448"},"PeriodicalIF":3.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-023-02124-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744907","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":"Position paper of the Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), and the Italian Study Group of Diabetes in pregnancy: Metformin use in pregnancy","authors":"Laura Sciacca,&nbsp;Cristina Bianchi,&nbsp;Silvia Burlina,&nbsp;Gloria Formoso,&nbsp;Elisa Manicardi,&nbsp;Maria Angela Sculli,&nbsp;Veronica Resi","doi":"10.1007/s00592-023-02137-5","DOIUrl":"10.1007/s00592-023-02137-5","url":null,"abstract":"<div><h3>Objective</h3><p>This document purpose is to create an evidence-based position statement on the role of metformin therapy in pregnancy complicated by obesity, gestational diabetes (GDM), type 2 diabetes mellitus (T2DM), polycystic ovary syndrome (PCOS) and in women undergoing assisted reproductive technology (ART).\u0000</p><h3>Methods</h3><p>A comprehensive review of international diabetes guidelines and a search of medical literature was performed to identify studies presenting data on the use of metformin in pregnancy. The document was approved by the councils of the two scientific societies.\u0000</p><h3>Results</h3><p>In condition affecting the fertility, as PCOS, metformin use in pre-conception or early in pregnancy may be beneficial for clinical pregnancy, even in ART treatment, and in obese-PCOS women may reduce preterm delivery. In obese women, even in the presence of GDM or T2DM, metformin use in pregnancy is associated with a lower gestational weight gain. In pregnancy complicated by diabetes (GDM or T2DM), metformin improves maternal glycemic control and may reduce insulin dose. Neonatal and infant outcomes related to metformin exposure in utero are lacking. Metformin use in women with GDM or T2DM is associated with lower birth weight. However, an increased tendency to overweight–obesity has been observed in children, later in life.\u0000</p><h3>Conclusions</h3><p>Metformin may represent a therapeutic option in selected women with obesity, PCOS, GDM, T2DM, and in women undergoing ART. However, more research is required specifically on the long-term effects of in utero exposition to metformin.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 10","pages":"1421 - 1437"},"PeriodicalIF":3.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-023-02137-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10411951","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":"Pregestational exposure to hormonal combined contraceptives and risk of gestational diabetes: an observational retrospective population study","authors":"Giuseppe Seghieri,&nbsp;Elisa Gualdani,&nbsp;Flavia Franconi,&nbsp;Ilaria Campesi,&nbsp;Graziano Di Cianni,&nbsp;Paolo Francesconi","doi":"10.1007/s00592-023-02143-7","DOIUrl":"10.1007/s00592-023-02143-7","url":null,"abstract":"<div><h3>Aims</h3><p>To investigate whether pregestational exposure to oral combined hormonal contraception (CHC) is associated with a rise in the risk of gestational diabetes (GDM).</p><h3>Methods</h3><p>Prevailing GDM was assessed for all pregnancies that occurred in Tuscany, Italy, from years 2010 to 2018, using administrative data coupled with information about CHC prescriptions in the year prior to pregnancy retrieved from the regional registry of drug prescription claims. The relation between exposure to CHC and risk of GDM, expressed as Odds Ratio: OR (95% Confidence Intervals, CI), was calculated separately based on citizenship of mothers using multiple logistic regression analysis models, after adjusting for confounders.</p><h3>Results</h3><p>Among 210,791 pregnancies from 170,126 mothers, GDM was present in 22,166 (10.5%) pregnancies. CHC prescription within 12 months before the index pregnancy was present in 9065 (4.3%) mothers. The risk of GDM was weakly but significantly higher in pregnancies exposed to pregestational CHC only in pregnancies of mothers of Italian citizenship: OR:1.11 (95% CI 1.02–1.21); <i>p</i> = 0.02, after adjusting for age, parity, calendar year and pregestational body-mass index. The CHC-mediated effect was no longer present in pregnancies of mothers at higher risk of GDM, such as pregestational obesity, migrating from countries at higher GDM risk or after adjusting for the entire panel of confounders including employment status, prior spontaneous abortions, and education degree.</p><h3>Conclusions</h3><p>CHC had a modest effect on GDM risk, which became insignificant when added to basal prevailing risk factors for impaired glucose metabolism in pregnancy, such as pregestational obesity or originating from countries at high GDM risk.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 11","pages":"1505 - 1511"},"PeriodicalIF":3.8,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737166","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 CEBPA-FGF21 regulatory network may participate in the T2DM-induced skeletal muscle atrophy by regulating the autophagy-lysosomal pathway","authors":"Kai Wu,&nbsp;Sha Huang,&nbsp;Fan Zheng,&nbsp;Yuan Liu","doi":"10.1007/s00592-023-02131-x","DOIUrl":"10.1007/s00592-023-02131-x","url":null,"abstract":"<div><h3>Aims</h3><p>Recent years have witnessed an increasing research interest in the roles of transcription factor (TF)-gene regulatory network in type 2 diabetes mellitus (T2DM). Thus, we sought to characterize the mechanistic insights based on the TF-gene regulatory network in skeletal muscle atrophy in T2DM.</p><h3>Methods</h3><p>Differentially expressed TFs (DETFs) and mRNAs (DEmRNAs) were obtained in T2DM-related gene expression profiles (GSE12643, GSE55650, GSE166502, and GSE29221), followed by WGCNA, and GO and KEGG enrichment analyses. Next, the iRegulon plug-in unit of Cytoscape software was used to construct a TF-mRNA regulatory network. Besides, RT-qPCR and ChIP-seq were utilized to measure the expression of CEBPA and FGF21 in the skeletal muscle tissues or cells of T2DM rat models. At last, the effect of overexpression of FGF21 on the autophagy-lysosomal pathway was examined in skeletal muscle cells of T2DM rats.</p><h3>Results</h3><p>Totally, 12 DETFs and 102 DEmRNAs were found in the skeletal muscle tissues of T2DM samples. The DEmRNAs were mainly enriched in the autophagy-lysosomal pathway. CEBPA affected the skeletal muscle atrophy in T2DM by regulating 5 target genes via the autophagy-lysosomal pathway. CEBPA could target FGF21. In addition, the expression of CEBPA was elevated, while the expression of FGF21 was diminished in the skeletal muscle tissues or cells of T2DM rats. The CEBPA-FGF21 regulatory network promoted skeletal muscle atrophy in T2DM by activating the autophagy-lysosomal pathway.</p><h3>Conclusion</h3><p>The CEBPA-FGF21 regulatory network may participate in the T2DM-induced skeletal muscle atrophy by regulating the autophagy-lysosomal pathway. Thus, our study provides interesting targets for prevention of skeletal muscle atrophy in T2DM.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 11","pages":"1491 - 1503"},"PeriodicalIF":3.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10088421","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":"Identification of factors associated with fear of hypoglycemia using the capability, opportunity, motivation and behavior model in people with type 2 diabetes mellitus: a cross-sectional study","authors":"Juan Pang,&nbsp;Lu Zhang,&nbsp;Xiangning Li,&nbsp;Fenfen Sun,&nbsp;Jiahui Qiu,&nbsp;Yueqi Zhao,&nbsp;Jinping Wang,&nbsp;Lin Liu,&nbsp;Xiaojuan Wan,&nbsp;Yu Zhang","doi":"10.1007/s00592-023-02132-w","DOIUrl":"10.1007/s00592-023-02132-w","url":null,"abstract":"<div><h3>Aims</h3><p>To examined the relationship between fear of hypoglycemia and certain variables in people with type 2 diabetes mellitus (T2DM) based on the Capability, Opportunity, Motivation, and Behavior model, combined with the context unique to people with diabetes to provide a basis for developing targeted nursing interventions.</p><h3>Methods</h3><p>In this cross-sectional study, 212 people with T2DM were recruited from February 2021 to July 2021. Data were collected using the Hypoglycaemia Fear Survey, Gold score, Patient Assessment of Chronic Illness Care (PACIC) scale and Diabetic Self-Management Attitudes Scale. Multiple linear regression analysis was performed to determine the predictors of fear of hypoglycemia using SPSS 26.0.</p><h3>Results</h3><p>The mean fear of hypoglycemia score was 74.88 ± 18.28 (range: 37.00–132.00). In people with T2DM, the frequency of blood glucose monitoring, the frequency of hypoglycemia in the past half-year, degree of understanding of hypoglycemia, impaired awareness of hypoglycemia, PACIC, and self-management attitude of diabetes were the influencing factors of fear of hypoglycemia (<i>adjusted R</i>^<i>2</i> = 0.560, <i>F</i>_[21,190] = 13.800, <i>P</i> &lt; 0.001). These variables explained 56.0% of the variance in the fear of hypoglycemia.</p><h3>Conclusions</h3><p>The level of fear of hypoglycemia in people with T2DM was relatively high. In addition to paying attention to the disease characteristics of people with T2DM, medical staff should also pay attention to patients’ own perception and handling ability of disease and hypoglycemia, attitude toward self-management behavior and external environment support, all of which have a positive effect on improving the fear of hypoglycemia in people with T2DM, optimizing the self-management level and improving quality of life.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 10","pages":"1405 - 1415"},"PeriodicalIF":3.8,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-023-02132-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044028","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":"Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with type 2 diabetes: randomised controlled trial (Dapa-Hospital trial)","authors":"Mohammad Shafi Kuchay,&nbsp;Pushpender Khatana,&nbsp;Mitali Mishra,&nbsp;Parvathi Surendran,&nbsp;Parjeet Kaur,&nbsp;Jasjeet Singh Wasir,&nbsp;Harmandeep Kaur Gill,&nbsp;Apanshu Singh,&nbsp;Rujul Jain,&nbsp;Chhavi Kohli,&nbsp;Gazal Bakshi,&nbsp;Vishnupriya Radhika,&nbsp;Sumayya Saheer,&nbsp;Manish Kumar Singh,&nbsp;Sunil Kumar Mishra","doi":"10.1007/s00592-023-02138-4","DOIUrl":"10.1007/s00592-023-02138-4","url":null,"abstract":"<div><h3>Aims</h3><p>To examine the efficacy and safety of dapagliflozin in the treatment of hyperglycemia in cardiac surgery patients with type 2 diabetes (T2D).</p><h3>Methods</h3><p>Cardiac surgery patients with T2D (<i>n</i> = 250) were randomly assigned (1:1) to receive dapagliflozin plus basal-bolus insulin (DAPA group) or basal-bolus insulin alone (INSULIN group) in the early postoperative period. The primary outcome was mean difference in daily blood glucose (BG) concentrations between groups. The major safety outcomes were the occurrence of severe ketonemia/diabetic ketoacidosis (DKA) and hypoglycemia. All analyses were performed according to the intention-to-treat principle.</p><h3>Results</h3><p>The median age of the patients was 61 years (range, 55–61), and 219 (87.6%) were men. Overall, the randomization blood glucose was 165 mg/dL (SD, 37) and glycated hemoglobin was 7.7% (SD, 1.4). There were no differences in mean daily BG concentrations (149 vs. 150 mg/dL), mean percentage of readings within target BG of 70–180 mg/dL (82.7% vs. 82.5%), total daily insulin dose (mean, 39 vs. 40 units/day), number of daily insulin injections (median, 3.9 vs. 4), length of hospital stay (median, 10 vs. 10 days), or hospital complications (21.6% vs. 24.8%) between the DAPA and INSULIN groups. The mean plasma ketone levels were significantly higher in the DAPA group than in the INSULIN group at day 3 (0.71 vs. 0.30 mmol/L) and day 5 (0.42 vs. 0.19 mmol/L) of randomization. Six patients in the DAPA group developed severe ketonemia, but no patient developed DKA. There were no differences in the proportion of patients with BG &lt; 70 mg/dL (9.6% vs. 7.2%) between the two groups.</p><h3>Conclusion</h3><p>Dapagliflozin complementary to basal-bolus insulin does not improve glycemia further over and above the basal-bolus insulin alone in hospitalized cardiac surgery patients. Dapagliflozin significantly increases plasma ketones levels. Safety of dapagliflozin in hospitalized patients needs further investigation.</p><p><i>Trial registration</i> ClinicalTrials.gov NCT05457933.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 11","pages":"1481 - 1490"},"PeriodicalIF":3.8,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9686514","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":"Evaluation of the efficacy of anti-vascular endothelial growth factors in diabetic macular edema with retinal inner and outer layers disorganization","authors":"Yıldırım Kocapınar,&nbsp;Fatih Bilgehan Kaplan,&nbsp;Ayşe Demirciler Sönmez,&nbsp;Banu Açıkalın","doi":"10.1007/s00592-023-02121-z","DOIUrl":"10.1007/s00592-023-02121-z","url":null,"abstract":"<div><h3>Aims</h3><p>This study aims to compare the effectiveness of treatment between anti-vascular endothelial growth factor (anti-VEGF) agents in diabetic macular edema (DME) patients with disorganization of retinal inner layers (DRIL). Epiretinal membrane, serous macular detachment, ellipsoid zone (EZ) disorder, external limiting membrane (ELM) disorder, and hyperreflective foci were also examined.\u0000</p><h3>Methods</h3><p>Patients treated for DME and also had DRIL were included in the study. The study design was retrospective and cross-sectional. The complete ophthalmologic records and imaging were scanned at the beginning, 3rd-month, 6th-month, and 12th-month follow-up, and the treatments administered were recorded. Anti-VEGF agents administered to the patients were examined in three groups: bevacizumab, ranibizumab, and aflibercept.</p><h3>Result</h3><p>A total of 141 eyes of 100 patients were included in our study. One hundred and fifteen eyes (81.6%) had a BCVA of 0, 5, or less at the beginning. There was no statistically significant difference between the three groups regarding initial BCVA and CMT and the change in BCVA and CMT at the beginning and the 12th month (<i>p</i> &gt; 0.05). There was a negative correlation between EZ and ELM disorders in patients and the change in BCVA at 12 months (<i>r</i>: 0.45 <i>p</i> &lt; 0.001, <i>r</i>: 0.32 <i>p</i> &lt; 0.001, respectively). The number of injections over five was positively correlated with the change in CMT but not with BCVA (<i>r</i>: − 2.35 <i>p</i> = 0.005 and <i>r</i>: 0.147 <i>p</i> = 0.082, respectively).</p><h3>Conclusions</h3><p>No statistically significant difference was found between anti-VEGF agents when treating DME patients with DRIL.\u0000</p><p>In addition, we have shown that anatomically better results were obtained in those who had five or more injections, although not in terms of BCVA.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 10","pages":"1391 - 1398"},"PeriodicalIF":3.8,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10035029","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":"Previous traumatic brain injury is associated with an increased odds for gestational diabetes: a nationwide register-based cohort study in finland","authors":"Matias Vaajala,&nbsp;Ilari Kuitunen,&nbsp;Rasmus Liukkonen,&nbsp;Ville Ponkilainen,&nbsp;Maiju Kekki,&nbsp;Ville M. Mattila","doi":"10.1007/s00592-023-02129-5","DOIUrl":"10.1007/s00592-023-02129-5","url":null,"abstract":"<div><h3>Aims</h3><p>Despite recent findings that traumatic brain injury (TBI) is a possible risk factor for type 2 diabetes (DM2) and that a strong association exists between gestational diabetes (GDM) and the risk for the development of DM2, no previous studies have investigated the effects of TBI on the risk for the development of GDM. Therefore, this study aims to determine the possible association between a previous traumatic brain injury and later gestational diabetes.</p><h3>Methods</h3><p>In this retrospective register-based cohort study, data from the National Medical Birth Register were combined with data from the Care Register for Health Care. Women who had sustained a TBI before pregnancy were included in the patient group. Women who had sustained previous fractures of the upper extremity, pelvis, or lower extremity were included in the control group. A logistic regression model was used to assess the risk for the development of GDM during pregnancy. Adjusted odds ratios (aOR) with 95% confidence intervals between the groups were compared. The model was adjusted by prepregnancy body mass index (BMI) and maternal age during pregnancy, the use of in vitro fertilization (IVF), maternal smoking status, and multiple pregnancies. The risk for the development of GDM during different periods following the injury (0–3 years, 3–6 years, 6–9 years, and 9+ years) was calculated.</p><h3>Results</h3><p>In total, a 75 g 2-h oral glucose tolerance test (OGTT) was performed on 6802 pregnancies of women who had sustained a TBI and on 11 717 pregnancies of women who sustained fractures of the upper extremity, pelvis, or lower extremity. Of these, 1889 (27.8%) pregnancies were diagnosed with GDM in the patient group and 3117 (26.6%) in the control group. The total odds for GDM were higher after TBI compared to the other traumas (aOR 1.14, CI 1.06–1.22). The odds were highest at 9 + years after the injury (aOR 1.22, CI 1.07–1.39).</p><h3>Conclusion</h3><p>The total odds for the development of GDM after TBI were higher when compared to the control group. Based on our findings, more research on this topic is warranted. Moreover, a history of TBI should be considered a possible risk factor for the development of GDM.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 10","pages":"1399 - 1404"},"PeriodicalIF":3.8,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-023-02129-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10430697","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}