Frontiers in clinical diabetes and healthcare最新文献

{"title":"Global research landscape and trends of metabolomics in diabetic kidney disease: focus on immunometabolic interactions.","authors":"Yuting Li, Changlin Li, Jiamin Duan, Qingli Yang, Jing Zhang, Duo Yu, Yuwei Chen, Jianing Ni, Xiaomeng Lin, Xudong Cai","doi":"10.3389/fcdhc.2026.1791774","DOIUrl":"10.3389/fcdhc.2026.1791774","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic kidney disease (DKD), a devastating microvascular complication of diabetes mellitus, arises from intricate crosstalk between metabolic disorders and immune dysregulation. Metabolomics has emerged as a powerful tool to unravel the immunometabolic mechanisms underlying DKD, facilitating early disease diagnosis, mechanistic pathway interpretation, and therapeutic biomarker discovery. This study aimed to systematically delineate the global research landscape and evolutionary trends of DKD metabolomics, with a key emphasis on immunometabolic interactions.</p><p><strong>Methods: </strong>Relevant publications on DKD metabolomics published between 2015 and 2025 were comprehensively retrieved from the Web of Science Core Collection and PubMed databases. Multiple bibliometric and visualisation tools, including CiteSpace and the online bibliometric platform (https://bibliometric.com/), were utilised for data processing, visual mapping, and integrated quantitative and qualitative analysis.</p><p><strong>Results: </strong>A total of 1,410 eligible articles were included in the final analysis, among which 1,110 were sourced from the Web of Science and 299 from PubMed, demonstrating a sustained annual growth in publication volume. China contributed the largest number of publications (663 articles), followed by the United States (207 articles). The University of Michigan and Shandong University were the most productive research institutions. Li Ping and Sharma Kumar were identified as the leading productive and highly cited authors, respectively, with Kidney International recognised as the flagship journal in this research field. Keyword co-occurrence and co-citation analyses confirmed that DKD pathogenesis is predominantly governed by immunometabolic crosstalk. Specifically, renal lipotoxicity, oxidative stress, and insulin resistance trigger persistent renal inflammatory responses, while aberrant glucose metabolism, amino acid dysfunction, and gut microbiota disturbance disrupt renal immune homeostasis via the gut-kidney axis. Branched-chain amino acids and gut microbiota-derived metabolites serve as pivotal immunometabolic biomarkers. Clinical trial data from PubMed further validate the potential applications of these biomarkers, alongside the functional roles of immune regulatory molecules and their correlations with pathological alterations in DKD.</p><p><strong>Conclusions: </strong>This bibliometric study systematically profiles the global research panorama of DKD metabolomics with a focus on immunometabolic regulation. It consolidates well-established research domains covering lipid- and oxidative stress-induced immune disorders, and further identifies amino acid metabolism-related immunomodulation as a burgeoning research frontier. These findings establish a refined research roadmap for future mechanistic investigations and the development of targeted immunometabolic therapeutic strategies for DKD.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1791774"},"PeriodicalIF":3.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622799","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":"Is maternal diabetes associated with autism spectrum disorder and ADHD in the offspring? A short review.","authors":"Salam Alshammaa, Bashair M Mussa, Amena Sadiya, Salah Abusnana","doi":"10.3389/fcdhc.2026.1855251","DOIUrl":"10.3389/fcdhc.2026.1855251","url":null,"abstract":"<p><p>Maternal diabetes, encompassing gestational diabetes mellitus and pre-existing type 1 and type 2 diabetes are associated with adverse perinatal outcomes. Emerging evidence suggests that maternal hyperglycemia and insulin resistance may be associated with long-term neurodevelopmental outcomes, particularly increasing the risk of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This review synthesizes current epidemiological and mechanistic evidence linking maternal diabetes with the incidence of ASD and ADHD in offspring. Large population-based cohort studies consistently demonstrate an elevated risk of ASD and ADHD among children exposed to maternal diabetes <i>in utero</i>, with risk magnitude varying according to diabetes type, timing of diagnosis, and treatment modality. ADHD appears to show a stronger and more consistent association, particularly in offspring of mothers with type 1 diabetes. Proposed biological mechanisms include hyperglycemia-induced oxidative stress, epigenetic modifications, hormonal dysregulation involving estrogen, progesterone, and androgens, and an increased incidence of preterm birth. Maternal factors such as obesity, advanced age, and fertility treatments further modulate risk. Despite accumulating evidence, heterogeneity across studies and residual confounding limit causal inference. Future prospective studies integrating detailed glycemic profiling, hormonal assessments, and neurodevelopmental phenotyping are required to elucidate underlying mechanisms and inform preventive strategies for pregnancies complicated by diabetes.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1855251"},"PeriodicalIF":3.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622857","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":"Correction: Neuropathy predicts early renal impairment in diabetes mellitus-the almost forgotten historical evidence. In memoriam Professor Göran Sundkvist.","authors":"Peter Kempler, Dóra Marietta Balogh, Viktor J Horváth, Adrienn Menyhárt, Manfredi Rizzo, Solomon Tesfaye, Vincenza Spallone","doi":"10.3389/fcdhc.2026.1918820","DOIUrl":"https://doi.org/10.3389/fcdhc.2026.1918820","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fcdhc.2026.1875311.].</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1918820"},"PeriodicalIF":3.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622812","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":"Quantitative and preliminary clinical assessment of glycohypoxia as an oxygen-unloading defect linking chronic hyperglycemia to low-grade tissue hypoxia in type 2 diabetes: a targeted translational meta-regression with exploratory blood-sample validation.","authors":"Maher Akl, Amr Ahmed","doi":"10.3389/fcdhc.2026.1897413","DOIUrl":"10.3389/fcdhc.2026.1897413","url":null,"abstract":"<p><strong>Background: </strong>Chronic hyperglycemia may impair tissue oxygen delivery by glycating hemoglobin, increasing oxygen affinity, shifting the oxyhemoglobin dissociation curve leftward, and reducing oxygen unloading, a state termed glycohypoxia. This study quantified HbA1c-dependent oxygen-release impairment and tested whether the modeled signal is supported by preliminary clinical validation in type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>Six human studies (1984-2012; N = 450) reporting HbA1c and oxygen-release metrics were synthesized using random-effects meta-regression. The pooled ΔP50 was translated into oxygen-unloading changes using the Hill equation across microvascular PO₂ values of 20-40 mmHg. In parallel, 90 T2DM patients were stratified by HbA1c into controlled, moderately uncontrolled, and poorly controlled groups for assessment of P50, 2,3-BPG, arterial oxygenation, SpO₂-SaO₂ bias, lactate, and modeled unloading.</p><p><strong>Results: </strong>Sensitivity-adjusted meta-regression showed ΔP50 = -0.19 mmHg per 1% HbA1c (95% CI: -0.26 to -0.11; P < 0.001; I2 = 45%), predicting 0.5-1.3% less oxygen unloading per 1% HbA1c and 1.5-3.9% cumulatively from HbA1c 6-9%. Clinically, higher HbA1c was associated with lower P50 (27.0 ± 0.5 to 26.2 ± 0.7 mmHg; P < 0.01), reduced 2,3-BPG (4.8 ± 0.4 to 4.2 ± 0.5 µmol/g Hb), increased SpO₂-SaO₂ bias (+0.2 ± 0.4% to +1.8 ± 0.6%; P < 0.01), and higher lactate (1.2 ± 0.3 to 1.9 ± 0.5 mmol/L), despite preserved PaO2.</p><p><strong>Conclusions: </strong>Quantitative modeling and exploratory clinical validation converged to support glycohypoxia as a measurable oxygen-handling phenotype in T2DM. This pattern may indicate a chronic low-grade functional hypoxic burden that accumulates with glycemic exposure and contributes to T2DM diabetic complications.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1897413"},"PeriodicalIF":3.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622816","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":"Dietary perceptions and challenges in the management of type 2 diabetes in rural communities of the Eastern Cape, South Africa: a qualitative study.","authors":"Ncebakazi Nkaule, Ntiyiso Vinny Khosa, Ziphelele Ncane, Sibusio Cyprian Nomatshila","doi":"10.3389/fcdhc.2026.1835644","DOIUrl":"10.3389/fcdhc.2026.1835644","url":null,"abstract":"<p><p>Diabetes mellitus (DM) is an increasing public health concern globally, particularly in low- and middle-income countries (LMICs). Socioeconomic challenges complicate disease management. Dietary management is central to diabetes care; however, adherence to recommended dietary practices remains difficult in many rural and resource-constrained settings. This study explored perceptions of healthy eating and barriers influencing dietary practices among individuals living with diabetes in rural communities of the Mnquma sub-region in the Eastern Cape (EC), South Africa (SA). A qualitative descriptive study was conducted among adults diagnosed with type 2 diabetes attending four primary healthcare clinics. Purposive sampling was used to recruit 35 participants. Data were collected through semi-structured interviews conducted in IsiXhosa or English, audio-recorded, transcribed verbatim, translated into English, and analysed using thematic analysis. Four major themes and fifteen sub-themes emerged: knowledge and perceptions of diabetes and healthy eating; emotional and psychological factors affecting eating habits; structural, economic, and environmental barriers to healthy eating; and the role of healthcare providers and support systems. Understanding of diabetes and healthy eating, with dietary practices often shaped by personal experiences rather than formal health education. Emotional responses to diagnosis, including fear and distress, influenced self-management behaviours. Financial insecurity, food insecurity, household food practices, agricultural instability, competing health conditions, and inconsistent dietary information emerged as major barriers to healthy eating. Although healthcare professionals were viewed as trusted sources of information, participants reported limited dietary counselling and fragmented health messages, while family support varied across households. These findings highlight that healthy eating among individuals living with diabetes in rural Mnquma is shaped by complex interactions between knowledge, emotional experiences, socioeconomic conditions, and health system support. While consistent with the Theory of Planned Behaviour (TPB), the results also highlight the importance of broader socioecological influences in shaping behaviour in resource-constrained settings. These findings underscore the need for context-sensitive diabetes interventions that extend beyond individual-level education to strengthen family and community support, improve dietary counselling within primary healthcare, and address broader socioecological and structural determinants, including food insecurity, poverty, and constrained food environments in rural settings.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1835644"},"PeriodicalIF":3.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564030","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":"Correction: 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.2026.1914250","DOIUrl":"10.3389/fcdhc.2026.1914250","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fcdhc.2025.1520389.].</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1914250"},"PeriodicalIF":3.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610640","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":"Pemafibrate is associated with greater reductions in MDA-LDL and small dense LDL fractions with exploratory PBMC gene-expression changes: a prespecified subanalysis of the PARADISE in Kagoshima study.","authors":"Toru Kubo, Takahisa Deguchi, Kaori Matsuzaki, Atsushi Shinnakasu, Shigeru Kawade, Aiko Arimura, Hiroshi Hashiguchi, Kazuma Ogiso, Tetsuro Kamada, Mihoko Kurano, Katsutaro Morino, Yoshihiko Nishio","doi":"10.3389/fcdhc.2026.1850470","DOIUrl":"10.3389/fcdhc.2026.1850470","url":null,"abstract":"<p><strong>Background: </strong>Pemafibrate, a selective peroxisome proliferator-activated receptor alpha (PPARα) modulator, lowers triglycerides and improves lipid parameters. However, its effects on oxidized LDL-related markers, including malondialdehyde-modified low-density lipoprotein (MDA-LDL), and associated <i>in vivo</i> gene-expression changes in humans remain limited. In addition, whether pemafibrate-associated changes in oxidized LDL-related biomarkers have clinical implications for atherosclerotic progression or cardiovascular risk remains uncertain.</p><p><strong>Methods: </strong>In this prespecified subanalysis of the randomized, open-label, parallel-group PARADISE in Kagoshima study, 51 participants assigned to pemafibrate and 46 assigned to eicosapentaenoic acid (EPA) were included in the clinical analysis. All participants had type 2 diabetes and hypertriglyceridemia and received treatment for 16 weeks. We evaluated changes in MDA-LDL, lipoprotein fractions including small dense LDL-related fractions, and exploratory peripheral blood mononuclear cell (PBMC) gene expression. PBMC gene expression was assessed in 11 participants in the Pemafibrate group and 7 in the EPA group, and was considered exploratory and hypothesis-generating.</p><p><strong>Results: </strong>Compared with EPA, pemafibrate produced a significantly greater reduction in triglycerides (least-squares mean difference, -79.2 mg/dL; 95% confidence interval [CI], -117 to -41.5; P < 0.001), and a greater increase in HDL-C (4.64 mg/dL; 95% CI, 2.43 to 6.84; P < 0.001). The mean change in MDA-LDL from baseline to week 16 was -30.3 ± 32.4 U/L in the Pemafibrate group and -9.2 ± 44.3 U/L in the EPA group, yielding a least-squares mean difference of -21.2 U/L (95% CI, -36.9 to -5.4; P = 0.009). In the exploratory PBMC analysis, ABCA1 and LCAT remained significant after false discovery rate adjustment, whereas other genes showed only nominal differences.</p><p><strong>Conclusion: </strong>Pemafibrate was associated with greater 16-week reductions in MDA-LDL and small dense LDL fractions than EPA in patients with type 2 diabetes and hypertriglyceridemia. These findings suggest modification of selected lipid-quality biomarkers. Their clinical relevance remains to be established.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1850470"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457911","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":"Economic impact of education and empowerment interventions in diabetes care: a two-year prospective longitudinal analysis in a tertiary care population.","authors":"Supriya Raghav, Santosh Kumar, Hamid Ashraf, Poonam Khanna, Alok Raghav","doi":"10.3389/fcdhc.2026.1825788","DOIUrl":"10.3389/fcdhc.2026.1825788","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus imposes a substantial economic burden on patients and healthcare systems, particularly in low- and middle-income countries.</p><p><strong>Objective: </strong>To evaluate longitudinal changes in direct and indirect costs of diabetes care and identify predictors of cost reduction following an educational and empowerment-based intervention.</p><p><strong>Methods: </strong>A prospective longitudinal controlled interventional study (quasi-experimental) was conducted over 24 months among adults with type 2 diabetes mellitus at a tertiary care hospital. Patient-level data on direct medical expenses, ancillary costs, and clinical parameters were analyzed using mixed-effects and regression models.</p><p><strong>Results: </strong>A significant reduction in direct cost and ancillary fees, such as travel and parking, was observed from baseline to 24 months (p<0.001). Mixed-effects modeling confirmed significant temporal reductions in costs at each follow-up (β = -3,117.05 at 24 months; 95% CI: -3,224.01 to -3,010.09). Furthermore, clusters of moderate, gradual, and high responders were identified. Multivariable regression showed that baseline cost (β = 0.582, p<0.001) and HbA1c (β = -611.53, p < 0.001) as independent predictors of cost reduction.</p><p><strong>Conclusion: </strong>Education and empowerment lead to reductions in direct and indirect costs over two years, suggesting improved cost efficiency in diabetes mellitus management.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1825788"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457822","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":"Editorial: Pharmaceutical care and wellness of diabetes.","authors":"Havagiray R Chitme, Mirza Muhammad Faran Ashraf Baig, Ajay Kumar Gupta","doi":"10.3389/fcdhc.2026.1910046","DOIUrl":"https://doi.org/10.3389/fcdhc.2026.1910046","url":null,"abstract":"","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1910046"},"PeriodicalIF":3.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450896","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":"Implementing virtual diabetes self-management education in two health systems (VIDA): a mixed-methods pilot study.","authors":"Manuel Panzardi, Andrea Gomez, Courtney Borsuk, Abigail M Durgan, Erin M Staab, Nikita C Thomas, Chasity Kasir, Wen Wan, Michael Quinn, Iridian A Guzman, Morgan Lindsey, Claudia P Garcia, Kenyetta Sims, Amanda Campbell, Cynthia T Schaefer, Danielle Lazar, Arshiya A Baig","doi":"10.3389/fcdhc.2026.1784495","DOIUrl":"10.3389/fcdhc.2026.1784495","url":null,"abstract":"<p><strong>Introduction: </strong>Group-based diabetes self-management education (DSME) has long been shown to improve health outcomes, but how to effectively adapt these programs to virtual settings in diverse healthcare systems remains unclear. Utilizing the RE-AIM implementation framework, this mixed-methods pilot study evaluated the feasibility, benefits, and challenges of implementing virtual group DSME for adults with Type 2 diabetes mellitus in two distinct systems: a federally qualified health center and a private, not-for-profit health system.</p><p><strong>Methods: </strong>Adults with elevated glycosylated hemoglobin (A1c) levels and at least one cardiovascular comorbidity were invited to participate in six monthly 60- to 90-minute online group education sessions led by diabetes educators. Sessions focused on disease and lifestyle education, peer support, and structured goal setting. Quantitative data captured patient recruitment, attendance, and engagement metrics. Semi-structured interviews with patients, providers, and staff explored perceived benefits, barriers, and implementation experiences.</p><p><strong>Results: </strong>Of 97 eligible patients, 50 were reached and 11 enrolled, with 10 completing at least one session. Participants had an average age of 63.5 years old, were 90% African American and 80% female, and had an average A1c of 8.7% (SD 0.7). The average attendance rate was 3.6 (SD 1.9) sessions. The most frequent reasons for declining enrollment in the study were competing responsibilities and stating they did not need additional diabetes education, while accessing technology was rarely a limiting factor. Participants reported high satisfaction with the program, emphasizing the value of shared experiences, increased accountability, improved disease knowledge, and convenience of attending virtually from home. Providers and staff viewed the sessions as a valuable adjunct to clinical care that reinforced behavioral goals beyond the limits of brief primary care visits. Reported challenges included scheduling conflicts with patients and mistrust in medical advice. The intervention demonstrated strong fidelity to implementing the treatment design and curriculum, with most patients successfully formulating goals related to exercise and blood glucose monitoring.</p><p><strong>Discussion: </strong>This study provides initial evidence that virtual group DSME can be feasible, well-received, and adaptable across different healthcare environments. It provides initial evidence in understanding how technology-enabled group models can deliver chronic disease education in different health system contexts while empowering self-management in diverse urban populations.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1784495"},"PeriodicalIF":3.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427045","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}