Frontiers in clinical diabetes and healthcare最新文献

{"title":"Perspectives of type 2 diabetes mellitus management in Algeria: a comprehensive expert review.","authors":"Mohamed Belhadj, Rachid Malek, Houssem Baghous, Mourad Boukheloua, Zakia Arbouche, Nassim Nouri, Mohammed El Amine Amani, Fethia Sersoub, Mohamed Amine Haireche","doi":"10.3389/fcdhc.2025.1495849","DOIUrl":"https://doi.org/10.3389/fcdhc.2025.1495849","url":null,"abstract":"<p><strong>Background: </strong>The health and economic impacts of type 2 diabetes mellitus (T2DM) remain substantial, notably in developing countries.</p><p><strong>Objectives: </strong>To provide an in-depth assessment of the T2DM situation in Algeria to understand its multifaceted burden and identify priority areas of intervention.</p><p><strong>Methods: </strong>A systematic literature search was conducted on all published articles about T2DM in Algeria over the past 30 years, including original research, reviews, and case series. The extracted data were thoroughly analyzed and synthesized by a committee of diabetes experts.</p><p><strong>Results: </strong>Algerian epidemiological data point towards a constant rise of T2DM prevalence, roughly from 8.9% in 2003 to 14.4% in 2016-2017. The mean onset is around 41 years with women experiencing a greater burden at younger age. Low socioeconomic status, limited education, and lack of health insurance exacerbate T2DM risk and health inequities. Lifestyle and metabolic risk factors are prevalent. Despite advancements in glycemic control, prescribing practices lack standardization, with suboptimal use of antidiabetic drugs and absence of novel drugs in the market. Health and economic burdens are dominated by complications, highlighting inadequate primary and tertiary prevention strategies.</p><p><strong>Conclusion: </strong>Notwithstanding the increasing burden of T2DM in Algeria, the healthcare strategies and therapeutic outcomes remain suboptimal. This underscores the necessity for a comprehensive strategy including enhanced prevention, access to novel treatments, standardized practices, along with a patient-centered approach.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1495849"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063406","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":"Prevalence of in-hospital mortality among adult patients with diabetic ketoacidosis in Ethiopia: a systematic review and meta-analysis of observational studies.","authors":"Zenaw Debasu Addisu, Desalegn Getnet Demsie, Dessale Abate Beyene, Chernet Tafere","doi":"10.3389/fcdhc.2025.1501167","DOIUrl":"https://doi.org/10.3389/fcdhc.2025.1501167","url":null,"abstract":"<p><strong>Background: </strong>Diabetic ketoacidosis (DKA) is one of the most common life-threatening acute metabolic complications of diabetes, typically associated with disability, mortality, and significant health costs for all societies. In Ethiopia, available studies on in-hospital mortality rates of people living with DKA have shown high variability. Therefore, this systematic review and meta-analysis aims to summarize and provide quantitative estimates of the prevalence of in-hospital mortality among adult people living with DKA treated in Ethiopian hospitals.</p><p><strong>Methodology: </strong>A systematic literature search was conducted using MEDLINE, Embase, Google Scholar, Web of Science, and Africa-specific databases. Data were extracted in a structured format prepared using Microsoft Excel. The extracted data were exported to R software Version 4.3.0 for analysis. The I² test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval (CI). Based on the test result, a random-effects meta-analysis model was used to estimate Der Simonian and Laird's pooled effect on in-hospital mortality.</p><p><strong>Result: </strong>The review included a total of 5 primary studies. The pooled prevalence of in-hospital mortality among people living with DKA who received treatment in Ethiopia hospitals was found to be 7% (95% CI: 1-12). Most of the included studies reported that nonadherence to insulin treatment followed by infection was the most common triggering factor for the development of DKA.</p><p><strong>Conclusion: </strong>The prevalence of in-hospital mortality among people living with DKA was found to be 7%. This figure is unacceptably high compared to other published reports. Nonadherence to insulin treatment or antidiabetic medication and infection were identified as precipitating factors for developing DKA. Therefore, measures must be taken to improve medication adherence and decrease in-hospital mortality by providing ongoing health education on medication usage, effective in-hospital management of hyperglycemia, and increased access to high-quality care.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD42023432594.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1501167"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055338","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":"Using blood biomarkers and ophthalmological indicators of optical coherence tomography and angiography for the diagnosis of fundus lesions in patients with diabetes mellitus.","authors":"Fanny Huang, Miaomiao Yu, Laura Huang, Ruikang K Wang, Theodore Leng, Sophia Y Wang, Yaping Joyce Liao","doi":"10.3389/fcdhc.2025.1499344","DOIUrl":"https://doi.org/10.3389/fcdhc.2025.1499344","url":null,"abstract":"<p><strong>Purpose: </strong>To assess long-term ophthalmic and clinical blood test changes in patients with different severities of diabetic retinopathy (DR).</p><p><strong>Methods: </strong>We performed a longitudinal case-control study of 130 patients with diabetes mellitus (DM) and 67 controls, including visual acuities from 2,201 eye clinic visits and 44,833 blood tests. We also analyzed optic disc and macular structure and vasculature using optical coherence tomography (OCT) and angiography (OCTA).</p><p><strong>Results: </strong>Ninety-one percent of eyes in diabetic patients had stable visual acuity (better than 20/40) over 7 years. Cluster analysis revealed most prominent blood test changes in the DM included elevated glucose and hemoglobin A1c and evidence of nephropathy. Optic disc OCTA was most correlated with OCT in the superior and inferior quadrants. Notably, peripapillary and macular OCTA measurements revealed evidence of microvascular drop out even in those with DR grade 0.</p><p><strong>Conclusions: </strong>Majority of patients with DM monitored by physicians maintained good visual acuity over years. Ophthalmic imaging revealed evidence of early vascular changes even in patients without evidence of DR on clinical exam and color fundus imaging. In addition to ophthalmic functional and structural assessments, clinical blood tests for renal function are also important early biomarkers of end organ damage in DM.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1499344"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047611","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":"System accuracy evaluation of the new blood glucose monitoring meter \"GLUCOCARD S onyx\" beyond ISO 15197:2013/EN ISO 15197:2015 requirements and with new patient safety features.","authors":"Daisuke Azuma, Hisashi Okuda, Beate Saeger","doi":"10.3389/fcdhc.2025.1465732","DOIUrl":"https://doi.org/10.3389/fcdhc.2025.1465732","url":null,"abstract":"<p><strong>Introduction: </strong>Blood glucose monitoring meters (BGM) have not become redundant yet. The accuracy and precision of \"GLUCOCARD S onyx,\" a new BGM with Bluetooth function, has been evaluated and proven to exceed the actual ISO 15197:2013/EN ISO 15197:2015 guidelines besides offering features for better patient safety and telemedicine.</p><p><strong>Methods: </strong>100 finger-prick whole blood samples from subjects with diabetes and 32 without diabetes were collected and measured with GLUCOCARD S onyx. Plasma blood glucose levels were measured using YSI2300 STAT PLUS as reference analyzer for comparison. The evaluation followed ISO 15197:2013, section 6.3 accuracy criteria. Furthermore, the MARD factor was calculated for the overall clinical important range (with n=132 samples).</p><p><strong>Results: </strong>The performance of GLUCOCARD S onyx was evaluated according to ISO 15197:2013, revealing that 99.7% (598/600) of the results fell within ±15% or ±0.8 mmol/L (± 15 mg/dL) of difference over the total clinically relevant glucose range compared to the YSI2300 STAT PLUS. 100% (600/600) of the measurement results over the total range fell within Clark Error Grid Zone A. An overall mean absolute relative difference (MARD) factor of 4.15% was obtained; 5.05% for glucose <5.6 mmol/L (<100 mg/dL), and 3.65% for glucose ≥5.6 mmol/L (≥100 mg/dL).</p><p><strong>Discussion: </strong>GLUCOCARD S onyx shows clinically satisfactory accuracy and reliability, even exceeding the ISO 15197:2013 criteria, for hypoglycemic cases with glucose critically low as <3.9 mmol/L (<70 mg/dL) and hyperglycemic cases with glucose ≥10.0 mmol/L (≥180 mg/dL). Healthcare organizations as well as manufacturers are aiming to offer new BGM systems that go beyond the ISO criteria and offer systems that can be consulted instead or besides CGM (Continuous Glucose Monitoring) in case of e.g. severe hypo- and/or hyperglycemic episodes. A MARD factor of 4.15% revealed an excellent system accuracy over the total clinically relevant glucose range. With additional user-friendly features, this BGM can be seen as a useful tool for efficient diabetes therapy, especially in the event of severe blood glucose fluctuations.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1465732"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052092","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":"Gestational diabetes mellitus - more than the eye can see - a warning sign for future maternal health with transgenerational impact.","authors":"Manal Massalha, Rula Iskander, Haya Hassan, Etty Spiegel, Offer Erez, Zohar Nachum","doi":"10.3389/fcdhc.2025.1527076","DOIUrl":"https://doi.org/10.3389/fcdhc.2025.1527076","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) is regarded by many as maternal maladaptation to physiological insulin resistance during the second half of pregnancy. However, recent evidence indicates that alterations in carbohydrate metabolism can already be detected in early pregnancy. This observation, the increasing prevalence of GDM, and the significant short and long-term implications for the mother and offspring call for reevaluation of the conceptual paradigm of GDM as a syndrome. This review will present evidence for the syndromic nature of GDM and the controversies regarding screening, diagnosis, management, and treatment.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1527076"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028379","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":"The effect of exercise on the adverse neonatal outcomes related to women with gestational diabetes mellitus: a systematic review and meta-analysis.","authors":"Hangyu Cui, Hua Li, Jing Huang, Yi Wu, Yuan Wei, Mingzi Li","doi":"10.3389/fcdhc.2025.1566577","DOIUrl":"https://doi.org/10.3389/fcdhc.2025.1566577","url":null,"abstract":"<p><p>This meta-analysis aimed to evaluate the benefits of prenatal exercise on neonatal outcomes in women with gestational diabetes mellitus (GDM). Systematic searches were conducted in PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus from their inception to September 9, 2023. ClinicalTrials.gov was also searched to ensure comprehensive coverage. We included studies that investigated the association between prenatal exercise and at least one adverse neonatal outcome of interest. A total of 4,268 publications were retrieved, and 3,060 records remained after removing duplicates. After screening abstracts, 107 studies were selected for full-text assessment, and ultimately, 17 articles (including 4 identified through manual searching) were included for data extraction. Extracted information included the first author, publication year, study design, geographical location, sample size, participants' demographic characteristics, intervention characteristics, and relevant outcome variables.Pooled results from random-effects models showed that prenatal exercise significantly reduced the risk of adverse neonatal outcomes, including: Cesarean delivery (OR = 0.91, 95% CI: 0.88-0.94), Premature birth (OR = 0.49, 95% CI: 0.27-0.90), Macrosomia (OR = 0.58, 95% CI: 0.40-0.83), Fetal growth restriction (OR = 0.21, 95% CI: 0.08-0.52), and Birth trauma (OR = 0.26, 95% CI: 0.13-0.54). Subgroup analyses indicated that single-component exercise programs were more effective than multi-component programs in reducing the risk of macrosomia (P = 0.06). In conclusion, prenatal exercise substantially reduces the risk of multiple adverse neonatal outcomes in women with GDM, including macrosomia, preterm birth, cesarean delivery, fetal growth restriction, and birth trauma. These findings highlight the outstanding benefits of antenatal exercise for fetal health, supporting its inclusion as a key component of prenatal care for women with GDM. This meta-analysis is registered with PROSPERO (Registration Number: CRD42023485375).</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1566577"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993739","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":"Effect of dapagliflozin, a sodium-glucose co-transporter 2 inhibitor, on ventricular repolarization electrocardiographic parameters in type 2 diabetes patients: DAPA - ECG study.","authors":"Rodrigo Noronha Campos, Dalmo Antônio Ribeiro Moreira, Gabriel Mostaro da Fonseca","doi":"10.3389/fcdhc.2025.1537005","DOIUrl":"https://doi.org/10.3389/fcdhc.2025.1537005","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes (T2DM) is a chronic metabolic disorder that affects approximately 10.5% of the world's population and is an independent risk factor for cardiovascular complications, including sudden cardiac death (SCD). Inhibitors of sodium-glucose co-transporter type 2 (iSGLT2), particularly dapagliflozin, have emerged as promising treatments in patients with T2DM and with heart failure and chronic kidney disease, demonstrating the ability to significantly reduce major cardiovascular events. However, the exact mechanisms that promote the observed benefits are still not fully understood.</p><p><strong>Objective: </strong>In this study, we sought to understand the mechanisms associated with the benefits of dapagliflozin by evaluating various electrophysiological parameters of the electrocardiogram (ECG) in patients with T2DM. A randomized, multicenter, prospective study with 174 patients with T2DM divided into two groups: one receiving dapagliflozin plus optimized guideline directed medical therapy (GDMT) and the other optimized GDMT without SGLT2 inhibitors. Clinical, electrocardiographic, laboratory, and echocardiographic evaluations were performed initially and after three months. Descriptive and inferential statistics were used, with a significance level of 0.05.</p><p><strong>Result: </strong>This study shows that in patients treated with dapagliflozin plus GDMT, a significant reduction in the duration of the interval from the peak of the T wave to the end of the T wave (TpTe), the QTc interval, and the ratio between the TpTe/QT intervals was observed, with no change in other electrocardiographic variables such as QT interval dispersion, JT peak interval, or changes in the QRS complex and T wave axes (QRS-T angle).</p><p><strong>Conclusion: </strong>In patients with T2DM, dapagliflozin significantly shortened the TpTe and QTc intervals, as well as the TpTe/QT ratio. These results suggest a reduction in ventricular electrical remodeling, highlighting a potential cardioprotective effect of dapagliflozin.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT06721442, identifier NCT06721442.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1537005"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042982","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":"Exploring factors predicting the effectiveness of oral semaglutide in Japanese individuals with type 2 diabetes switching from dipeptidyl peptidase 4 inhibitors: a pilot study.","authors":"Takao Hirotsu, Kanta Taniguchi, Rimei Nishimura","doi":"10.3389/fcdhc.2025.1520389","DOIUrl":"10.3389/fcdhc.2025.1520389","url":null,"abstract":"<p><strong>Introduction: </strong>Oral semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) approved for the treatment of type 2 diabetes mellitus (T2DM). Findings from randomized controlled trials (RCTs) and real-world studies indicate that oral semaglutide leads to significant improvements in HbA1c and body weight, comparable to those observed with injectable GLP-1 RAs. Consequently, oral semaglutide is expected to significantly reduce barriers to initiating GLP-1 RA therapy in individuals with diabetes and may lead to an increased transition from dipeptidyl peptidase-4 inhibitors (DPP-4is) to GLP-1 RA therapy. This study was conducted to prospectively investigate the clinical characteristics predicting the achievement of HbA1c < 7% (52 mmol/mol) in Japanese individuals with T2DM who switched from DPP-4is to oral semaglutide.</p><p><strong>Methods: </strong>The study enrolled a total of 74 patients who switched from DPP-4is to oral semaglutide between December 2021 and October 2022, with the dose being uptitrated to achieve HbA1c < 7% (52 mmol/mol) in these patients.</p><p><strong>Results: </strong>The study included a total of 44 individuals who achieved the target with oral semaglutide 3 mg (n=7), 7 mg (n=24), or 14 mg (n=13), and 17 individuals who did not (un-achieved group; n=17), based on their clinical characteristics and hematological findings. In the comparison between the Un-achieved group and the Achieved (3 to 14 mg) group, the proportions of \"Current alcohol drinking (<i>p</i> = 0.030)\" and \"Current alcohol drinking and smoking (<i>p</i> = 0.029)\" were higher in the Un-achieved group, whereas the proportion of \"Taking 31 minutes or longer to have breakfast after drug administration (<i>p</i> = 0.022)\" was higher in the Achieved (3 to 14 mg) group. A logistic regression analysis using the stepwise method identified \"No current history of both smoking and alcohol drinking (0.083[0.014-0.485]; <i>p =</i> 0.006)\" and \"Taking 31 minutes or longer to eat breakfast after drug administration (0.117[0.029-0.480]; <i>p =</i> 0.003)\" as factors predicting the achievement of the HbA1c < 7% (52 mmol/mol).</p><p><strong>Conclusion: </strong>Study findings suggest when considering switching T2D patients from DPP-4is to oral semaglutide, a detailed assessment of \"current alcohol drinking and smoking status\" and \"the duration between the administration of oral semaglutide and breakfast\" may be useful as a predictive indicator for achieving HbA1c < 7% (52 mmol/mol).</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1520389"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804928","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":"Validation of the IDF-DAR risk assessment tool for Ramadan fasting in patients with diabetes in primary care.","authors":"Latifa Baynouna Alketbi, Bachar Afandi, Nico Nagelkerke, Hanan Abdubaqi, Ruqaya Abdulla Al Nuaimi, Mariam Rashed Al Saedi, Fatima Ibrahim Al Blooshi, Noura Salem Al Blooshi, Aysha Mohammed AlAryani, Nouf Mohammed Al Marzooqi, Amal Abdullah Al Khouri, Shamsa Ahmed Al Mansoori, Mohammad Hassanein","doi":"10.3389/fcdhc.2025.1426120","DOIUrl":"10.3389/fcdhc.2025.1426120","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with diabetes intending to fast, Ramadan, risk assessment, and stratification are essential for an individualized treatment plan. It seems that the new IDF-DAR risk stratification tool (International Diabetes Federation - Diabetes and Ramadan Alliance) has become the primary tool in this setting. This study aims to validate this tool in the Abu Dhabi population.</p><p><strong>Method: </strong>The assessment was performed before Ramadan, followed by an evaluation of any significant outcome after Ramadan through tele-interview and an electronic medical records review. Patients were included if the attending physicians used the tool in the risk assessment of the patients within 6 weeks before Ramadan 1,444 (CE 2022) in the AHS healthcare center.</p><p><strong>Results: </strong>The study included 435 patients. Half (51.7%) were in the low-risk category of the IDF-DAR risk stratification tool, 28.5% were in the moderate-risk category, and 19.8% were in the higher-risk category. Of the total patients, 81.3% fasted during the entire Ramadan period and 18.7% attempted to fast. A total of 14 (3.8%) patients were admitted at least once, and 56 (12.9%) had at least one significant event, including admission to the hospital. Using univariable logistic regression, the occurrence of adverse events was significantly associated with more days not fasted, <i>B</i> = -0.126, <i>p</i> < 0.001, OR = 0.88 (0.839-0.927). Using multivariable logistic regression, and after controlling for all variables studied, other risk factors identified with the occurrence of adverse events in this study were as follows: being in the low-risk category of the DAR risk assessment tool, <i>B</i> = -1.1, OR = 0.34 (0.157-0.744), <i>p</i> = 0.0072; being in the frail category compared to the reference category, the robust category, <i>B</i> = 1.54, OR = 4.6 (1.3-16.6), <i>p</i> = 0.018; and older age <i>B</i> = -0.034, OR = 0.966 (0.938-0.995). There was no significant difference between moderate- and high-risk categories in the occurrence of significant adverse events (SAEs). Similar determinants of fasting were identified during the entire Ramadan period using multivariable logistic regression.</p><p><strong>Conclusion: </strong>According to the IDF-DAR risk assessment, patients with diabetes in the low-risk category had a better outcome than those in the moderate- or high-risk categories regarding SAEs. Another independent risk factor is if the patient is frail, according to the FRAIL scoring.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1426120"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797167","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":"Exploring usability metrics in continuous glucose monitoring systems: insights from the voice of people with diabetes in Italy.","authors":"Martina Manzoni, Davide Minotti, Giovanni Toletti, Andrea Boaretto","doi":"10.3389/fcdhc.2025.1472471","DOIUrl":"10.3389/fcdhc.2025.1472471","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous Glucose Monitoring (CGM) systems are crucial in diabetes management, offering clinical and psychological benefits despite operational challenges. Usability assessment of real-time and intermittently-scanned CGM systems is a notable research gap. This study, in collaboration with diabetes patient associations, explores CGM usability from the perspective of Italian individuals with diabetes.</p><p><strong>Methods: </strong>A roundtable discussion with patient association representatives was conducted to discuss CGM usability, followed by a detailed online survey of 281 Italian patients on CGM usage, satisfaction, and feature preferences.</p><p><strong>Results: </strong>Findings show a significant positive impact on Quality of Life (87/100) and moderate usability (66/100). Core CGM functions are widely used, while data sharing with healthcare professionals is underutilized. The study offers diverse insights into CGM usability from both the roundtable and survey data.</p><p><strong>Conclusions: </strong>The study underscores the importance of CGM in diabetes management and highlights the need for continuous technological improvements. It emphasizes the role of patient associations in enhancing communication with manufacturers and CGM education. Effective collaboration between healthcare professionals and patients is vital for optimal CGM use, advocating for personalized care strategies tailored to individual patient needs.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1472471"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782178","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}