Diabetes epidemiology and management最新文献

{"title":"Metabolic consequences of alterations in gut microbiota induced by antidiabetic medications","authors":"Venkata Chaithanya ,&nbsp;Janardanan Kumar ,&nbsp;Kakithakara Vajravelu Leela ,&nbsp;Matcha Angelin ,&nbsp;Abhishek Satheesan ,&nbsp;Ria Murugesan","doi":"10.1016/j.deman.2023.100180","DOIUrl":"https://doi.org/10.1016/j.deman.2023.100180","url":null,"abstract":"<div><p>The mutualistic relationship between human health and gut microbiota has gained growing attention as a result of its far-reaching consequences. Diabetes medications, essential for managing type 2 diabetes, which regulate glucose metabolism, have shown effects that go beyond glycemic control by receiving attention for their possible influence on gut microbiota. Notably, metformin, a cornerstone therapy, has received a lot of attention for its ability to influence the gut microbiota. Metformin administration has been linked to changes in the abundance of specific bacterial taxa, including an uprise in beneficial microbes like <em>Akkermansia muciniphila</em>. These modifications have been linked to increased insulin sensitivity and better metabolic outcomes. Other classes of diabetes drugs, in addition to metformin, have shown potential effects on the gut microbiota. SGLT-2 inhibitors, for example, may contribute to changes in gut microbial communities, which could explain their cardiovascular and metabolic benefits. However, the processes underlying these interactions, are complicated and not entirely understood. Direct interactions between the gut microbiota and drug, changes in intestinal permeability, and modulation of bile acid metabolism are all possible mechanisms. Individual differences and genetic factors complicate the relationship even more. Understanding the intricate interplay between diabetes drugs and gut microbiota holds promise for developing personalized diabetes management approaches. Taking advantage of these interactions could lead to novel therapeutic strategies that improve drug efficacy and overall metabolic health. More studies are required to determine the exact mechanisms underlying these effects and to capitalize on their potential for improved patient outcomes. This review provides a concise overview of the effects of diabetes medications on gut microbiota composition and its importance.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970623000598/pdfft?md5=a6f9c3f9c66218d87de1a61a5edc4f00&pid=1-s2.0-S2666970623000598-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92096551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similar incidence of stroke with SGLT2 inhibitors and GLP-1 receptor agonists in real-world cohort studies among patients with type 2 diabetes","authors":"André J. Scheen","doi":"10.1016/j.deman.2023.100179","DOIUrl":"https://doi.org/10.1016/j.deman.2023.100179","url":null,"abstract":"<div><h3>Background</h3><p>Stroke represents a major burden in patients with type 2 diabetes. Yet, this cerebrovascular complication has been less well studied than coronary artery disease and heart failure. Some cardiovascular outcome data suggested that sodium-glucose cotransporter 2 inhibitors (SGLT2is) exert a less pronounced protection against stroke compared with glucagon peptide-1 receptor agonists (GLP-1RAs) despite similar efficacy regarding major cardiovascular events (MACE-3 points). However, this conclusion was derived from indirect comparisons of placebo- controlled trials (RCTs).</p></div><div><h3>Methods</h3><p>The present comprehensive review analyses the effects of SGLT2is versus GLP-1RAs on nonfatal and fatal/nonfatal strokes in real-life studies carried out worldwide.</p></div><div><h3>Results</h3><p>A large majority of retrospective observational cohort studies (19 out of 21) failed to find any significant difference in the risk of stroke between the two pharmacological classes, independently of the presence of established cardiovascular disease. Available, yet limited, findings suggested that SGLT2is could be more efficacious against haemorrhagic than ischaemic strokes, in patients at risk for atrial fibrillation or with chronic kidney disease.</p></div><div><h3>Conclusion</h3><p>In contrast to what was reported in RCTs, most observational studies showed similar incidence of stroke in SGLT2i users versus GLP-1RA users. Because both indirect comparisons of RCTs and retrospective cohort studies have limitations, a head-to-head RCT comparing the effects on stroke of an SGLT2i versus a GLP-1RA is needed to draw any definite conclusion.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67739978","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":"Once-Weekly Insulin Icodec vs Once-Daily Insulin Glargine U100 for type 2 diabetes in insulin naive patients: a systemic review and meta-analysis","authors":"Faiza Zakaria, Ahmed Kunwer Naveed, Mushood Ahmed, Rameen Rao, Areeba Shaikh, Anusha Abdul Muqeet Farid, Tehreem Ali, Muhammad Hasanain","doi":"10.1016/j.deman.2023.100181","DOIUrl":"https://doi.org/10.1016/j.deman.2023.100181","url":null,"abstract":": Insulin Therapy is essential for managing diabetes, but difficulties such as daily injections and hypoglycemia risk hinder patient compliance. Recent advancements have brought basal insulin analogs such as insulin icodec and insulin glargine U100 so in this study we aimed to assess the efficacy and safety of Once-Weekly Insulin icodec and Once-Daily insulin glargine-U100 in Insulin-Naive type 2 diabetic patients (T2DM). : The PRISMA guidelines were followed in conducting this meta-analysis. An electronic search was conducted utilizing databases such as PubMed, Google Scholar, OvidSP, and the Cochrane Database of Controlled Studies (CENTRAL). The analysis findings were combined using a random-effects model. Continuous outcomes were expressed as mean difference (MD), whereas dichotomous outcomes were represented as odds ratios (ORs) with 95% confidence intervals (95% CIs). : 3 randomized control trials (RCTs) comprising 1436 patients were included in our analysis. Pooled analysis showed a significant difference in improved time with glucose range (%TIR) between icodec group and glargine U100 (MD=4.89; 95% CI= 2.95 to 6.82; P=<0.00001; I2=0%), reduction in HbA1c (MD=-0.19; 95% CI= -0.30 to -0.08; P=0.0009; I2=0%), risk of hypoglycemia alert (OR=1.47; 95% CI=1.18-1.84; P=0.0006; I2=0%). There was no significant difference in pooled analysis for fasting plasma glucose levels, severe hypoglycemia, and any adverse effects or hyperactivity events. : Our systematic review and meta-analysis provided evidence that favored Once-Weekly Insulin Icodec over Once-Daily Insulin Glargine U100 for patients with T2DM.","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"165 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135389060","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":"Hypoglycemia avoidance behaviour in active Qatari adults with type 1 diabetes under blood glucose monitoring device","authors":"Georges Jabbour,&nbsp;Souhail Hermassi","doi":"10.1016/j.deman.2023.100176","DOIUrl":"10.1016/j.deman.2023.100176","url":null,"abstract":"<div><h3>Aims</h3><p>The present study aimed to explore the relationship between fear of hypoglycemia and exercise management strategies in active Qatari adults with T1D during the COVID-19 pandemic, and to explore the potential role of continuous glucose monitoring (CGM) devices in promoting safe physical activity practices.</p></div><div><h3>Methods</h3><p>Participants completed the Hypoglycemia Fear Survey (HFS) questionnaire and the International Physical Activity Questionnaire (IPAQ). Out of the 102 participants, 41 were considered \"active\" and under CGM and were included in the analysis.</p></div><div><h3>Results</h3><p>Multiple linear regression analysis revealed a significant positive correlation between the behavior dimension of the HFS scores and both vigorous physical activity and MET-minutes per week (<em>R</em>² adj. = 0.055; β = 0.56; <em>p</em> = 0.05 and <em>R</em>² adj. = 0.039; β = 0.38; <em>p</em> = 0.04). The results showed a significant positive association between HbA1c levels and the behavior dimension of the HFS (<em>R</em> = 0.39, <em>p</em> = 0.005), as well as between the number of episodes of severe hypoglycemia and the behavior dimension (<em>R</em> = 0.46, <em>p</em> = 0.042).</p></div><div><h3>Conclusion</h3><p>These findings highlight the need for effective strategies to manage fear of hypoglycemia and promote physical activity in individuals with T1D. The use of CGM devices may provide added safety to physical activity practices by reducing the risk of hypoglycemia.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44817312","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":"Role of lowered level of serum vitamin D on diabetic foot ulcer and its possible pathomechanism: A systematic review, meta-analysis, and meta-regression","authors":"Muhammad Iqhrammullah ,&nbsp;Teuku Fais Duta ,&nbsp;Meulu Alina ,&nbsp;Intan Qanita ,&nbsp;Muhammad Alif Naufal ,&nbsp;Najlaika Henira ,&nbsp;Ghina Tsurayya ,&nbsp;Raisha Fathima ,&nbsp;Arita Yuda Katiara Rizki ,&nbsp;Shakira Amirah","doi":"10.1016/j.deman.2023.100175","DOIUrl":"10.1016/j.deman.2023.100175","url":null,"abstract":"<div><h3>Aim</h3><p>To investigate the association between serum vitamin D (SVD) level and DFU development and to emphasize the involved pathomechanism.</p></div><div><h3>Methods</h3><p>The search was performed on 12 databases for literature published until 10 March 2023. The protocol has been registered on PROSPERO (CRD42023415744). The selection for the included records followed PRISMA framework. Meta-analyses using random effects model were performed and the data were presented as SMD and 95% CI. Meta-regression was performed to identify factors contributing to the heterogeneity in the pooled analysis.</p></div><div><h3>Results</h3><p>Twenty-one studies were included in the systematic review with a total number of patients reaching 9,570. Of which, as many as 18 studies were eligible for the meta-analysis. The SDV level is significantly lower in DFU group (<em>p</em>-total=0.0037; SMD= -1.2758; [95% CI: -2.0786 to -0.4730]). Based on the meta-regression, age, study location (based on the continent), and total cholesterol level contribute to the high heterogeneity (<em>p</em>&lt;0.01). In the pooled analysis, inflammatory markers such as serum levels of CRP (<em>n</em> = 4), ESR (<em>n</em> = 3), IL-6 (<em>n</em> = 3), and IL-8 (<em>n</em> = 2) are found significantly higher in DFU group at <em>p</em>&lt;0.01.</p></div><div><h3>Conclusion</h3><p>Lowered SVD level is associated with DFU, where the pathomechanism for this relationship might involve inflammation and infection susceptibility.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970623000549/pdfft?md5=a793bb5ca98f0b390dd67ecff08899f0&pid=1-s2.0-S2666970623000549-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47167251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-rich plasma (PRP) as therapy for diabetic foot ulcer (DFU): A systematic review and meta-analysis of the latest randomized controlled trials","authors":"Fara Syafira ,&nbsp;Muhammad Baharul Iman ,&nbsp;Pariyana ,&nbsp;Rita Sriwulandari","doi":"10.1016/j.deman.2023.100178","DOIUrl":"10.1016/j.deman.2023.100178","url":null,"abstract":"<div><h3>Objectives</h3><p>Diabetic foot ulcer (DFU) is a prevalent and serious complication of diabetes, associated with significant morbidity and mortality rates. Platelet-rich plasma (PRP) is a promising therapy for accelerating DFU healing, with numerous randomized controlled trials (RCTs) supporting its efficacy and safety. Therefore, this systematic review aims to identify, critically assess, and synthesize the most recent available RCTs regarding the effectiveness of clinical PRP for treating DFU compared to standard treatment or other alternative therapies.</p></div><div><h3>Methods</h3><p>This study uses a comprehensive review and synthesis of existing research according to the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched selected databases using a combination of search terms: “((PRP) OR (\"platelet-rich plasma\")) AND (\"diabetic foot ulcer\")) OR (\"diabetic lower-extremity ulcer\"))” from PubMed, ProQuest, ScienceDirect, and Google Scholar in the last five years (2018–2023). Following a systematic review protocol, we selected 9 eligible articles for final analysis. Pertinent data was examined using MedCalc ver 20.215 then the results were displayed visually using forest plots.</p></div><div><h3>Results</h3><p>The findings from the meta-analysis revealed that PRP exhibited a healing rate that was twice as high as the control group (Relative Effects (REs) = 2.338; 95% Confidence Interval (CI) = 1.056 to 1.857, <em>P</em> = 0.019). Additionally, the healing time was shortened by 2 days (REs = -2.815; 95% CI = -3.252 to -0.576, <em>P</em> = 0.005), and there was a difference of 0.482 cm² in the reduction of ulcer area between the two groups (REs = 0.482; 95% CI = -2.428 to 4.002, <em>P</em> = 0.630). Importantly, none of the Randomized Controlled Trials (RCT) studies reported any adverse events in the PRP group.</p></div><div><h3>Conclusions</h3><p>PRP represents a feasible and secure supplementary therapeutic alternative for managing DFU.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970623000574/pdfft?md5=1ee81b675261c67273496cc19986f9a2&pid=1-s2.0-S2666970623000574-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47333016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of the burden of diabetes among adults and children in Québec, Canada, from 2001 to 2019: A population-based longitudinal surveillance study","authors":"Sarah O'Connor ,&nbsp;Philippe Robert ,&nbsp;Jacinthe Leclerc ,&nbsp;Paul Poirier ,&nbsp;Marjolaine Dubé ,&nbsp;Pierre-Luc Trépanier ,&nbsp;Linda Perron ,&nbsp;Claudia Blais","doi":"10.1016/j.deman.2023.100177","DOIUrl":"10.1016/j.deman.2023.100177","url":null,"abstract":"<div><h3>Introduction</h3><p>Many developed countries, including Canada, have observed reductions in incidence of diabetes. Given the latest improvements in the case definition of diabetes for the younger population in Quebec, Canada, we sought to examine the evolution of diabetes among adults and children in Quebec, between 2001 and 2019.</p></div><div><h3>Methods</h3><p>Crude and age-standardized incidence and prevalence of diabetes among individuals ≥1 year were calculated using data from the Quebec Integrated Chronic Disease Surveillance System (n≈8,351,500 in 2019), using two case definitions for adults and the youth respectively. Age-standardized all-cause hospitalizations and mortality proportions were calculated among the population ≥20 years.</p></div><div><h3>Results</h3><p>Between 2001 and 2019, age-standardized incidence decreased by 30%, with a crude incidence of 4.6 per 1,000 in 2019. Incidence rates decreased from age group ≥50 years but increased by 25% for the group of 1-19 years. Age-standardized prevalence increased by 42% (crude prevalence in 2019: 8.1%). Males had higher incidence and prevalence of diabetes, with an incremental gap between sexes increasing with age. All-cause hospitalization and mortality proportions among individuals with diabetes declined by 21% and 29% respectively between 2001 and 2019. Age-standardized hospitalizations and mortality ratios for individuals with/without diabetes remained stable and were 2.7 (99% Confidence Intervals [CI]: 2.7-2.8) and 2.2 (99% CI: 2.1-2.3) in 2019, respectively.</p></div><div><h3>Conclusion</h3><p>Despite the reduction of incidence among adults, diabetes incidence increased among the youth and remained high among adults, especially for males. These results highlight the importance of improving earlier preventive care and initiatives for reducing the diabetes burden in Quebec.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41367649","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":"Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data","authors":"Michael Müller-Korbsch ,&nbsp;Antonia Kietaibl ,&nbsp;Yves Haufe ,&nbsp;Peter Fasching","doi":"10.1016/j.deman.2023.100150","DOIUrl":"10.1016/j.deman.2023.100150","url":null,"abstract":"<div><p>The number of available automated insulin delivery (AID) systems is increasing in Austria and people with diabetes (PwD) replace sensor-augmented pump (SAP) therapy more and more frequently. The present study is the two years follow-up of our prior monocentric, retrospective analysis conducted between 2019 and 2021, comparing SAP and open-source AID systems in people with type 1 diabetes. This second-year analysis included 25 PwD and investigated glycemic changes based on ambulatory glucose profiles (AGP). In comparison to the first year, a worsening of mean glucose (125.4 to 135.2 mg/dl, <em>P</em> = 0.038), time in range ((TIR), 84.2 to 77.0%, <em>P</em> = 0.012), time above range ((TAR), 11.6% to 18.5%, <em>P</em> = 0.017) and glycemia risk index ((GRI), 24.8 to 35.0%, <em>P</em> = 0.026) was observed. The reduction of mean glucose and glucose variability with AID in the first year was due to a significant decrease in time in hyperglycemia with resulting higher TIR and lower GRI. In this second-year follow up, TIR and GRI showed a significant deterioration, a familiar phenomenon in diabetology. However, open-source AID systems showed continuous safety, as there was no increase in time below range (TBR) even after two years. Despite the slight deterioration in the glycemic parameters, open-source AID systems were able to demonstrate sufficient glycemic control according to international consensus guidelines while offering the characteristic benefits of a reduced burden of diabetes management. A descriptive comparison of different AID algorithms indicated an improved glycemic control with more advanced features such as basal rate modification, auto bolus function and autotuning.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44132854","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":"Quantifying the incidence of lower limb amputation in people with and without diabetes in Wales between 2008–2018","authors":"J Hayes ,&nbsp;JM Rafferty ,&nbsp;WY Cheung ,&nbsp;A Akbari ,&nbsp;R Thomas ,&nbsp;S Bain ,&nbsp;C Topliss ,&nbsp;JW Stephens","doi":"10.1016/j.deman.2023.100144","DOIUrl":"10.1016/j.deman.2023.100144","url":null,"abstract":"<div><h3>Background</h3><p>There is variance in the incidence of lower extremity amputation across and within countries including within the UK. National data shows up to a fourfold variance in the amputation rate throughout the regions of England and differences in amputation incidence have been reported in Scotland and Ireland. Lower extremity amputation rate has yet to be documented within Wales. The aim of this cohort study was to examine trends in diabetes and non-diabetes related lower extremity amputation incidence within the Welsh population and to examine the influence of diabetes on the relative risk of amputation.</p></div><div><h3>Materials and Methods</h3><p>All first-time amputations between 2008-2018 were extracted from SAIL, a repository of all routine medical data of residents of Wales. People with diabetes were identified using an algorithm utilising data from several clinical and non-clinical sources. Crude and direct age and sex adjusted incidences were estimated over time.</p></div><div><h3>Results</h3><p>Over the period 3505 major amputations and 4335 minor amputations occurred. The diabetes population greater than 17 years of age increased by 29.4% from 143,595 in 2008 to 206,818 in 2018. There was a statistically significant rate reduction in major amputation in both populations. In the diabetes population the number of major amputations reduced from 6.9 [5.5–8.5]/10 000 person years (PY) in 2008 to 4.9 [5.4–6.2]/10 000 PY in 2018. However, for major amputation, the risk of incident amputation in people with diabetes was 7.3 fold higher [7.1–7.5] than those without diabetes. The relative risk of minor amputation for those with diabetes was higher at 11.9 [11.8 –1.01]. There was no reduction in this risk over the period.</p></div><div><h3>Conclusion</h3><p>This study found that rates of major amputation decreased over the study period but the risk of amputation for persons with diabetes remained substantial. As the population with diabetes increases so do crude rates of amputation, providing a substantial financial and societal cost to the Welsh Population.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45065478","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":"Technologies will not make diabetes disappear: how to integrate the concept of diabetes distress into care","authors":"Guy Fagherazzi","doi":"10.1016/j.deman.2023.100140","DOIUrl":"10.1016/j.deman.2023.100140","url":null,"abstract":"<div><p>Diabetes epidemiology has evolved rapidly since the 90 s and so are the technologies for diabetes treatment and care. With each new innovation coming to the market, hopes that technologies will solve the numerous, complex, issues related to diabetes are present. However, if it is now demonstrated that, overall, those technologies - when available - bring major benefits to people living with diabetes, they do not make the disease disappear. In this short review, we discuss the interconnections between technologies and diabetes distress, an often underlooked consequence of the continuous demands of diabetes. We define the concept of diabetes distress, discuss which dimensions can be positively impacted thanks to the use of diabetes technologies and what will likely not be solved by them. With the emergence of closed-loop insulin delivery systems, it is of utmost importance to give sufficient space to the assessment of the emotional dimension of diabetes care in clinical routine.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43314709","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}