Diabetes epidemiology and management最新文献

{"title":"Continuous Glucose Monitoring (CGM) use in patients with diabetes mellitus type 1 is associated with higher healthcare costs, increased hospitalizations, and social disparities in a real-world setting: Analysis of adoption pattern, impact on health services utilization and cost of care in a large integrated health system","authors":"Ameer Khowaja ,&nbsp;Lina Adil ,&nbsp;Teigan Dwyer ,&nbsp;Tyson Barrett ,&nbsp;Jamil Alkhaddo","doi":"10.1016/j.deman.2025.100274","DOIUrl":"10.1016/j.deman.2025.100274","url":null,"abstract":"<div><h3>Background</h3><div>With the rising prevalence of diabetes mellitus type 1 (DM type 1), continuous glucose monitoring (CGM) has emerged as a key management tool. While studies suggest CGM improves glycemic control, its broader impact on healthcare utilization and costs remains limited. This study evaluates demographic and clinical variations between DM type 1 patients using CGM and non-CGM users; assessing healthcare utilization, glycemic outcomes, costs and impact on Durable Medical Equipment (DME).</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted using health insurance claims and electronic medical records from Allegheny Health Network (AHN) from 2019 to 2021. Patient eligibility required 36 months of continuous medical and drug coverage; insulin use and AHN affiliation. The cohort included 3007 patients, divided into CGM users and non-users. Additionally, patient data was stratified by demographics, social vulnerability index (SVI), healthcare use by per member per month (PMPM) and 1000 person-months.</div></div><div><h3>Results</h3><div>CGM users had higher PMPM and utilization/1000 for all service types, except for DME, when compared to non-CGM users. There was a progressive increase in the cost of prescriptions among CGM users (prescription PMPM, 2019: $621.33, 2020: $723.97, 2021: $851.39). Non-CGM users had greater prescription-related expenses, comprising 43 % of total costs but a higher likelihood of achieving an HbA1c &lt;9.0. Number of hospitalizations was significantly higher among CGM users compared to non-CGM users (18.4 % vs. 10.55 %, <em>p</em> &lt; 0.001). CGM use was more common among non-Caucasian, non-English-speaking, and tobacco-using groups but declined with increasing SVI. CGM users had higher rates of frailty, depression, congestive heart failure and seizures.</div></div><div><h3>Conclusion</h3><div>This study highlights the complexity of CGM uptake and its impact on healthcare costs in DM type 1 patients. Increased healthcare spending associated with CGM use raises concerns about cost-effectiveness and accessibility. Further studies are needed to assess disparities in CGM utilization and diabetes management including diabetes-related complications and associated costs across varying demographics and socioeconomic groups.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100274"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal analysis of diabetes risk factors in HIV-positive patients in a 15-year cohort study","authors":"Tra Thu Doan ,&nbsp;Cuong Duy Do","doi":"10.1016/j.deman.2025.100275","DOIUrl":"10.1016/j.deman.2025.100275","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100275"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation of individuals with type 2 diabetes in a behavioural e-health lifestyle intervention in Denmark: A feasibility study","authors":"Fereshteh Baygi ,&nbsp;Carl J. Brandt ,&nbsp;Kathrine Kjær-Hansen ,&nbsp;Anders Grøntved ,&nbsp;Jan C. Brønd ,&nbsp;Sia K. Nicolaisen ,&nbsp;Jacob V. Stidsen ,&nbsp;Reimar W. Thomsen ,&nbsp;Jens Søndergaard ,&nbsp;Jens S. Nielsen","doi":"10.1016/j.deman.2025.100285","DOIUrl":"10.1016/j.deman.2025.100285","url":null,"abstract":"<div><h3>Background</h3><div>Behavioural lifestyle interventions can support type 2 diabetes (T2D) self-management; however, participation and adherence rates are often low. This feasibility study examined characteristics of individuals with T2D who were willing or unwilling to participate in, complete, and adhere to a personalised e-health behavioural lifestyle intervention in a general practitioner (GP) setting.</div></div><div><h3>Method</h3><div>Nurses at two Danish GP setting invited patients with T2D to participate in a one-year smartphone-based intervention. Patient characteristics were obtained from Danish health registers, GP records, and previously collected data. The personalized intervention included three face-to-face consultations (at baseline, 2 months, and 12 months) to set personal goals and measure weight, height, waist, and hip circumferences. Physical and mental health were assessed using the SF-12v1 survey. All other support and interactions occurred via app. Adherence to the app usage was evaluated by tracking logins, messages sent, and response times during the first and final three months of the intervention.</div></div><div><h3>Results</h3><div>Of the 63 eligible individuals with T2D, 20 (31.7 %) agreed to participate. Those who were willing to participate were predominantly men (75 %), younger (median age 57 years [IQR 52; 66] vs. 65 years [IQR: 57; 73]), had a longer duration of diabetes (6.6 years [2.9; 8.2] vs. 5.5 years [3.7; 7.0], higher fasting glucose levels (8.5 mmol/L [6.8; 10.4] vs. 7.9 mmol/L [7.1; 9.3]), and lower mental component scores (48.8 [38.5; 52.0] vs. 54.7 [47.3; 58.7]) compared to those unwilling. Of 20 individuals who were willing to participate, 13 (65 %) completed the intervention. After 2 months their mental component scores were 47.4 (40.6; 50.5), compared to 31.5 (31.5; 45.8) among those who dropped out. Additionally, completers demonstrated more consistent app usage, whereas app engagement among dropouts declined significantly over the first two months.</div></div><div><h3>Conclusion</h3><div>Willingness to participate in the behavioural intervention among individual with T2D was modest. Those willing to participate and completed the intervention were more often men, had better mental health, and showed higher app engagement than dropouts. These findings underscore the need for personalized strategies to improve participation and adherence in e-health lifestyle interventions.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100285"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin therapy adherence and associated factors among diabetes mellitus patients in Southern Ethiopia","authors":"Mulualem Gete Feleke,&nbsp;Tadele Lankrew Ayalew,&nbsp;Kidist Ashager,&nbsp;Bizuayehu Atinafu Ataro,&nbsp;Hailu Asmare Beyene","doi":"10.1016/j.deman.2025.100284","DOIUrl":"10.1016/j.deman.2025.100284","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetes mellitus is a major global public health challenge. Insulin adherence is crucial to prevent complications, yet poor adherence remains common. This study assessed insulin adherence and associated factors among diabetic patients in Wolaita Zone Hospitals, Southern Ethiopia.</div></div><div><h3>Methods</h3><div>A multicenter cross-sectional study was conducted from November 2023 to January 2024 among 394 diabetic patients. Participants were selected using proportional allocation and systematic random sampling. Logistic regression was used to identify factors associated with insulin adherence, with results reported as adjusted odds ratios (AORs) and 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The prevalence of insulin adherence was 40.1 % (95 % CI: 35.5–44.9 %). Higher adherence was associated with college education or above (AOR=3.03; 95 % CI: 1.36–7.18), owning a glucometer (AOR=2.79; 95 % CI: 1.35–5.75), good knowledge (AOR=3.14; 95 % CI: 1.71–5.77), positive attitude toward insulin (AOR=6.12; 95 % CI: 3.38–11.09), and regular monthly follow-up (AOR=3.81; 95 % CI: 1.73–8.40). Conversely, having comorbidities (AOR=0.42; 95 % CI: 0.23–0.77) and diabetes duration ≥15 years (AOR=0.27; 95 % CI: 0.11–0.67) were negatively associated with adherence.</div></div><div><h3>Conclusion</h3><div>Insulin adherence was low. Patient-centered interventions focusing on education, attitude improvement, and promote regular follow-up are vital to enhance adherence and reduce complications.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100284"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between canagliflozin use and sarcopenia: Real-world data from the United States","authors":"Zhong Yuan ,&nbsp;Jill Hardin ,&nbsp;James P. Gilbert ,&nbsp;Jordy Mehawej ,&nbsp;Saberi Rana Ali ,&nbsp;Carolyn Jeffcoat ,&nbsp;Sergio Fonseca","doi":"10.1016/j.deman.2025.100280","DOIUrl":"10.1016/j.deman.2025.100280","url":null,"abstract":"<div><h3>Aims</h3><div>Real-world data were analyzed to evaluate the incidence and risk of sarcopenia for canagliflozin compared with other antihyperglycemic agents (AHAs) including dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), empagliflozin, and dapagliflozin.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort analysis of patients with type 2 diabetes mellitus (T2DM) included new users of canagliflozin or the AHAs (2016 to 2023) in 7 United States healthcare databases. Large-scale regularized regression generated propensity scores (PS) were used for matching and controlling confounding. A conditional Cox proportional hazards model assessed the treatment effect, presented as hazard ratios (HR). A self-controlled case series (SCCS) analysis assessed the incidence rate ratio between exposed and non-exposed periods among canagliflozin users.</div></div><div><h3>Results</h3><div>The PS-matched analyses showed no statistically significant increased risk of sarcopenia with canagliflozin versus any AHA comparator, though confidence intervals (CIs) were wide due to low event rates. The calibrated HRs (95 % CI) were 0.71 (0.26, 1.91) for canagliflozin versus empagliflozin, 1.16 (0.28, 4.70) for canagliflozin versus dapagliflozin, 8.79 (0.66, 116.96) for canagliflozin versus GLP-1RAs, and 0.88 (0.26, 2.98) for canagliflozin versus DPP-4 inhibitors. The crude incidence rates of sarcopenia (per 10,000 person-years) varied across databases: canagliflozin (0.0 to 1.0), dapagliflozin (0.4 to 7.9), empagliflozin (0.7 to 3.4), DPP-4 inhibitors (0.4 to 4.8), and GLP-1RAs (0.5 to 3.4). The SCCS analysis indicated an incidence ratio of 0.83 (0.50, 1.37).</div></div><div><h3>Conclusions</h3><div>The incidence rates of sarcopenia were low among patients with T2DM treated with canagliflozin or other comparator AHAs. There is no evidence suggesting an increased risk of sarcopenia associated with canagliflozin compared with other AHAs.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100280"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between glycated hemoglobin (HbA1c) levels and hearing threshold elevation in Saudi adults with type 2 diabetes: a cross-sectional study","authors":"Hind Maher Alenzi ,&nbsp;Raghad Abdullah Alsagri ,&nbsp;Manal Alfakhri ,&nbsp;Safa Alqudah ,&nbsp;Margaret Zuriekat ,&nbsp;Manal Alshareef ,&nbsp;Aseel Hamad Alkhamees","doi":"10.1016/j.deman.2025.100281","DOIUrl":"10.1016/j.deman.2025.100281","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes mellitus (T2DM) has been associated with sensorineural hearing loss through microvascular and neural pathways. Although T2DM prevalence is high in Saudi Arabia, limited research has examined the relationship between glycemic control and auditory function in this population.</div></div><div><h3>Objective</h3><div>To investigate the association between glycated hemoglobin (HbA1c) levels and hearing threshold levels (HTL) in Saudi adults with T2DM.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study analyzed medical records of 41 Saudi adults with T2DM (aged 20–57 years, 27 males, 14 females) who underwent pure tone audiometry and HbA1c testing at Royal Commission Medical Center, Yanbu, between 2021–2024. Linear regression analyses examined associations between HbA1c and HTL across low-frequency (0.25–2 kHz) and high-frequency (4–8 kHz) ranges.</div></div><div><h3>Results</h3><div>Mean participant age was 49.1 ± 7.8 years, with mean HbA1c of 6.9 ± 1.2 %. Linear regression revealed significant positive associations between HbA1c and HTL in both low-frequency (β = 0.93, 95 % CI: 2.30–2.98, <em>p</em> &lt; 0.001) and high-frequency ranges (β = 0.91, 95 % CI: 4.05–5.46, <em>p</em> &lt; 0.001). Age was also significantly associated with HTL in both frequency ranges (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Elevated HbA1c levels are significantly associated with increased hearing thresholds in Saudi adults with T2DM, suggesting that poor glycemic control may contribute to auditory dysfunction. These findings support incorporating routine audiological assessments into diabetes care protocols.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100281"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and clinical presentation of Type 1 Diabetes Mellitus among children and adolescents in Yanbu, Saudi Arabia","authors":"Yasser Alghanmi,&nbsp;Hanan Alothmani,&nbsp;Sami Alruhaily,&nbsp;Haifa Sindi,&nbsp;Adel Elgawish,&nbsp;Ebrahim Abdelfattah Alkashlan,&nbsp;Mohammed Mostafa Shaaban","doi":"10.1016/j.deman.2025.100283","DOIUrl":"10.1016/j.deman.2025.100283","url":null,"abstract":"<div><h3>Background</h3><div>Type 1 diabetes mellitus (T1DM) is one of the most common metabolic disorders in children and adolescents. Saudi Arabia is among the countries with the highest reported incidence of T1DM worldwide.</div></div><div><h3>Objective</h3><div>To estimate the incidence of T1DM among children and adolescents in Yanbu province, Saudi Arabia; characterize the clinical presentation and severity of diabetic ketoacidosis (DKA) at diagnosis; and analyze the distribution of cases by age group, sex, and season.</div></div><div><h3>Methods</h3><div>This retrospective study included all children aged 0–14 years newly diagnosed with T1DM at the Royal Commission Medical Center in Yanbu between July 2020 and June 2023. Data were extracted from medical records. Patients were categorized by age group, clinical presentation, DKA severity, and season of diagnosis. Incidence rates were calculated using 2022 Saudi Census data. Statistical analysis was performed using SPSS v26.0.</div></div><div><h3>Results</h3><div>A total of 108 children and adolescents aged 0–14 years were newly diagnosed with T1DM during the three-year study period. The average annual incidence was 30.8 per 100,000 (95 % CI: 26.7–35.8). The median age at diagnosis was 6.9 years (IQR: 4–9.8), with the highest proportion in the 6–&lt;11 year age group (46.3 %). Males and females were equally represented. Most patients (68.5 %) presented with hyperglycemic symptoms, while 31.5 % had DKA; of the DKA cases, 70.6 % were mild to moderate and 29.4 % were severe. A significant association was observed between age group and clinical presentation (<em>p</em> = 0.009), with younger children (0–&lt;3 years) contributing disproportionately to severe DKA cases. Seasonal variation showed more cases diagnosed in summer and spring, though not statistically significant. No mortality or major morbidity was documented.</div></div><div><h3>Conclusions</h3><div>Yanbu province demonstrates a high incidence of T1DM among children and adolescents. Most cases presented with hyperglycemic symptoms rather than DKA, and the majority of DKA cases were of mild to moderate severity. These findings highlight the importance of early recognition and timely management of T1DM to prevent severe complications.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100283"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DRESS syndrome with the use of dapagliflozin: A case report and review of literature","authors":"Rebecca Badawi ,&nbsp;Layal Akl ,&nbsp;Karima Chafai ,&nbsp;Jean-Louis Nguewa ,&nbsp;Jean-François Gautier","doi":"10.1016/j.deman.2025.100278","DOIUrl":"10.1016/j.deman.2025.100278","url":null,"abstract":"<div><h3>Background</h3><div>The global prevalence of diabetes has quadrupled between 1980 and 2014, paralleled by a rise in mortality due to end-organ damage. Since their introduction in 2013, SGLT2 inhibitors (SGLT2i) have become a central component of diabetes management, supported by landmark cardiovascular outcome trials and randomized controlled studies that demonstrated significant cardiovascular and renal benefits. Although generally well tolerated, SGLT2i use has been associated with dermatologic adverse effects, ranging from mild rashes to severe conditions like Fournier’s gangrene. However, drug reaction with eosinophilia and systemic symptoms (DRESS) has not been previously reported in association with this drug class. DRESS, though rare, is a serious hypersensitivity reaction linked to several commonly prescribed medications.</div></div><div><h3>Case Presentation</h3><div>We report a 52-year-old man with type 2 diabetes who developed DRESS syndrome one month after initiating dapagliflozin. He presented with a morbilliform rash affecting &gt;50 % of body surface area, mucosal involvement, fever, acute kidney injury, and elevated liver enzymes. Skin biopsy confirmed the diagnosis. Treatment with topical corticosteroids led to rapid improvement within 48 h.</div></div><div><h3>Conclusion</h3><div>This case highlights a rare adverse effect of dapagliflozin—DRESS syndrome—underscoring the importance of vigilance even with medications that typically have favorable safety profiles.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100278"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of insulin prescriptions and their association with glycemic control in adults with type 2 diabetes mellitus","authors":"Helen Chen ,&nbsp;Lappui Chung ,&nbsp;Michael Weiner ,&nbsp;Mark Fu ,&nbsp;Patrick Balius ,&nbsp;Julian Wolfson","doi":"10.1016/j.deman.2025.100260","DOIUrl":"10.1016/j.deman.2025.100260","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed the association between insulin prescription characteristics and glycemic control.</div></div><div><h3>Methods</h3><div>Electronic health records (2017–2023) were used to identify adults with type 2 diabetes prescribed insulin from outpatient visits on the same day as a hemoglobin A1c (HbA1c) result in a Midwest US region. Insulin prescription characteristics were total daily dose, providing a maximum dose, and instruction types (dosing frequency, carbohydrate (carb) counting, correction, and sliding scale). Mixed-effects linear and logistic regression modeled HbA1c and meeting HbA1c target (&lt;7 for age18–64 and &lt;8 for age <span><math><mo>≥</mo></math></span> 65).</div></div><div><h3>Results</h3><div>Among 11,179 subjects, mean age was 53; 49 % were male, and 58 % White. Overall cohort glycemic control was low, median HbA1c was 9.3; 16 % met HbA1c target; mean HbA1c at last follow-up was 8.7 %. Instruction types were 88 % dosing frequency, 7 % correction, 3 % sliding scale, and 1 % carb counting. HbA1c reduction was associated with carb counting (−0.4, <em>p</em> = 0.009), correction (−0.2, <em>p</em> &lt; 0.001), sliding scale (−0.1, <em>p</em> = 0.014), and providing a maximum daily insulin dose (−0.02, <em>p</em> &lt; 0.001). An increase in total daily insulin dose by 10 units was associated with a 0.001 increase in HbA1c (<em>p</em> = 0.003). Correction instruction was 1.4 times more likely than dosing frequency to meet HbA1c target (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Insulin instruction type was associated with glycemic control, but control was low.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100260"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between diabetes status and falls: a 9-year prospective cohort study using the China health and retirement longitudinal study","authors":"Zhilong Cai ,&nbsp;Shuoyu Rui ,&nbsp;Jianhua Chen ,&nbsp;Nanqu Huang ,&nbsp;Yong Luo ,&nbsp;Fei Feng","doi":"10.1016/j.deman.2025.100282","DOIUrl":"10.1016/j.deman.2025.100282","url":null,"abstract":"<div><h3>Background</h3><div>Falls represent a significant health burden among individuals with diabetes, yet the long-term relationship between diabetes status and fall risk remains inadequately characterized in Asian populations. This study aimed to investigate the association between diabetes status and incident falls among Chinese middle-aged and older adults using nationally representative longitudinal data.</div></div><div><h3>Methods</h3><div>Utilizing China Health and Retirement Longitudinal Study (CHARLS) 2011–2020 data, we included 9553 participants (aged ≥45 years) for a 9-year prospective cohort study. Diabetes was classified as normal glucose metabolism, prediabetes, or diabetes based on self-reported diagnosis, fasting plasma glucose (FPG), or HbA1c levels. Incident falls were assessed via self-reports across four survey waves from 2011 to 2020. Multivariable logistic regression models were to evaluate the independent association between diabetes and falls and subgroup/sensitivity analyses were conducted.</div></div><div><h3>Results</h3><div>The study included 7131 (74.6 %) participants with normal glucose levels, 1254 (13.1 %) with prediabetes, and 1168 (12.2 %) with diabetes. Mean age was 58.1 ± 9.0 years, with 46.9 % males. Fall incidence rates were significantly higher in the diabetes group (55.1 %) compared to prediabetes (48.3 %) and normal glucose groups (47.3 %) (<em>P</em> &lt; 0.001). After full adjustment for potential confounders, diabetes was associated with a 27 % increased risk of incident falls (OR=1.27, 95 % CI: 1.11–1.45, <em>P</em> &lt; 0.001), while prediabetes showed no significant association (OR=0.99, 95 % CI: 0.87–1.12, <em>P</em> = 0.817). Subgroup analyses revealed stronger associations in older adults aged ≥60 years (OR=1.45, 95 % CI: 1.18–1.78) compared to those &lt;60 years (OR=1.17, 95 % CI: 0.98–1.39), with similar effects in both sexes. Sensitivity analyses confirmed the robustness of these findings.</div></div><div><h3>Conclusions</h3><div>Diabetes significantly increases the risk of incident falls among Chinese middle-aged and older adults, with a 27 % higher risk persisting after comprehensive adjustment. This association appears to be specific to established diabetes rather than prediabetes, suggesting a pathophysiological threshold effect. The findings support the integration of fall prevention strategies into routine diabetes care, particularly for older adults, and have important implications for clinical practice guidelines and public health policy in China's rapidly aging population.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100282"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}