Frontiers in clinical diabetes and healthcare最新文献

{"title":"Editorial: Pathophysiology of diabetic kidney disease.","authors":"Oscar Lorenzo","doi":"10.3389/fcdhc.2026.1872162","DOIUrl":"https://doi.org/10.3389/fcdhc.2026.1872162","url":null,"abstract":"","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1872162"},"PeriodicalIF":2.2,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13259641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254631","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":"Incidence and factors associated with hypoglycemia in newly diagnosed hospitalized children and adolescents with type 1 diabetes mellitus in China.","authors":"Wang Li, Lin Qin, Zhu Gaohui, Chen Lili, Guo Rong, Wu Liping","doi":"10.3389/fcdhc.2026.1805855","DOIUrl":"10.3389/fcdhc.2026.1805855","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence and associated factors of hypoglycemia in hospitalized children and adolescents with newly diagnosed type 1 diabetes mellitus(T1DM) at a pediatric medical center in China.</p><p><strong>Research design and methods: </strong>This retrospective study included 567 children and adolescents aged <18 years with newly diagnosed T1DM hospitalized between January 1, 2016, and January 1, 2023. Hypoglycemia was defined as blood glucose <3.9 mmol/L (grade 1: 3.0-3.9 mmol/L; grade 2: <3.0 mmol/L).Between-group comparisons were performed using independent samples t-test, χ2-test, Mann-Whitney U-test, and binary logistic regression analysis to identify factors associated with hypoglycemia.</p><p><strong>Results: </strong>Among 567 patients, The total number of blood glucose measurements during hospitalization was 50,626.Hypoglycemia (<3.9 mmol/L) occurred 2,545 times, with an incidence density of 5.03%.Regarding severity 1,995 episodes of grade 1 hypoglycemia occurred(incidence density 3.94%), and 550 episodes of grade 2 hypoglycemia occurred(incidence density 1.08%).In terms of frequency, 81.66% (463/567) of patients had at least 1 hypoglycemia episode during hospitalization. Among those, 15.87% (90/567) had one episode, 12.52% (71/567) had two episodes, and 53.26% (302/567) had three or more episodes. The recurrence rate (≥2 episodes) was 65.78%(373/567 ).Regarding timing, grade 1 hypoglycemia occurred most frequently at night (00:00-06:00), while the highest event density for grade 2 was observed in the pre-lunch period (09:00-12:00). Multifactorial logistic regression analysis showed that age 7-12 years(OR = 0.421,95%CI=0.244-0.727,p<i>=</i>0.002),longer hospitalization days (OR=1.346,95%CI=(1.217-1.488, p<0.001), use of multiple daily injections (MDI) + continuous subcutaneous insulin infusion (CSII) regimen (OR = 3.232, 95%CI=1.399-7.469, p=0.006), fasting C-peptide (OR = 0.200, 95%CI=0.076-0.525, p<i>=</i>0.001), and fasting insulin (OR = 0.938, 95%CI=0.890-0.988, p=0.017) were independently associated with hypoglycemia.</p><p><strong>Conclusions: </strong>Hypoglycemia is common among newly diagnosed hospitalized children and adolescents with T1DM in China, particularly at night for grade 1 events. Age, hospitalization days, insulin regimen, fasting C-peptide, and fasting insulin were associated with hypoglycemia. These associations, particularly for insulin regimen, should be interpreted considering potential confounding by indication due to the observational study design. These findings may inform targeted prevention strategies.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1805855"},"PeriodicalIF":3.5,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221168","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":"Development and internal validation of an interpretable machine-learning model for identifying comorbid atrial fibrillation in patients with diabetic kidney disease.","authors":"Xiaoran Li, Xueying Wang, Shidong Wang, Xuebing Zhang","doi":"10.3389/fcdhc.2026.1785125","DOIUrl":"10.3389/fcdhc.2026.1785125","url":null,"abstract":"<p><strong>Background: </strong>Patients with diabetic kidney disease (DKD) are at increased risk of atrial fibrillation (AF), yet tools to support identification of comorbid AF in this high-burden population remain limited. We aimed to develop and internally validate an interpretable machine-learning (ML) model for identifying concomitant AF in patients with DKD using routinely collected clinical data.</p><p><strong>Methods: </strong>In this retrospective two-center cohort study (January 2021 to October 2025), 787 unique records of patients with DKD were randomly divided into training (70%) and test (30%) sets. AF status was defined as documented atrial fibrillation coexisting with DKD and was ascertained using electrocardiograms, Holter monitoring when available, and ICD-10 diagnostic codes with physician adjudication. Candidate predictors were routine clinical, laboratory, and echocardiographic variables. Least absolute shrinkage and selection operator (LASSO) regression was used for feature selection in the training set. Seven supervised models were trained; performance was assessed by area under the receiver-operating characteristic curve (AUC), calibration, and decision-curve analysis. SHAP quantified feature contributions.</p><p><strong>Results: </strong>LASSO retained 14 features, including 24-hour urine total protein (24UTP), serum creatinine (SCr), age, and atrial dimensions. In the test set, the k-nearest neighbors (KNN) model achieved an AUC of 0.927, with an accuracy of 0.886, sensitivity of 0.920, and specificity of 0.856. Calibration was satisfactory, and decision-curve analysis showed net benefit across commonly used thresholds. Five-fold cross-validation yielded mean AUC 0.90 ± 0.02. SHAP analysis identified proteinuria burden, renal dysfunction, age, and atrial size as major contributors to model output. The final model was translated into a preliminary web-based calculator based on routinely available inputs.</p><p><strong>Conclusions: </strong>An interpretable ML model incorporating routinely collected clinical and echocardiographic variables showed stable internal performance for identifying comorbid atrial fibrillation in patients with DKD. Because the model is intended to identify concomitant AF status rather than predict incident AF and has undergone internal validation only, further external and prospective validation is required before broader clinical application.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1785125"},"PeriodicalIF":3.5,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221161","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":"Feasibility and preliminary outcomes of a peer-led diabetes self-management support program for black men: the michigan men's diabetes project (MenD II).","authors":"Jaclynn M Hawkins, Alana M Ewen, Maricruz Moya, Katherine A Kloss, Hannah Burgess, Srijani Sengupta, Martha Funnell, Robin Nwankwo, Gretchen Piatt","doi":"10.3389/fcdhc.2026.1755183","DOIUrl":"10.3389/fcdhc.2026.1755183","url":null,"abstract":"<p><strong>Background: </strong>Black men face disproportionately high rates of type 2 diabetes (T2D), yet are underrepresented in diabetes self-management support (DSMS) interventions. Peer-led DSMS (PLDSMS) shows promise for minoritized populations, but few programs target Black men specifically.</p><p><strong>Objective: </strong>This pilot study examined feasibility and preliminary effectiveness of a culturally adapted, PLDSMS intervention for Black men with T2D in Metro Detroit.</p><p><strong>Methods: </strong>We conducted a 15-month randomized pilot trial (N = 48) comparing PLDSMS plus DSMES to DSMES alone (enhanced usual care). PLDSMS included monthly peer-led virtual sessions for six months post-DSME, plus six months of optional support. Primary outcomes included HbA1c and perceived diabetes self-management (PDSMS). Secondary outcomes included diabetes distress and social support at baseline, 3, 9, and 15 months.</p><p><strong>Results: </strong>Participants (mean age=63 years) demonstrated successful recruitment (N = 60) and high retention (>80% at 15 months). No between-group differences in HbA1c emerged (p=0.32). Perceived self-management showed significant group-by-time interaction (p=0.03); the control group scored 5.36 points higher at 3 months (p=0.02), but differences were not sustained at 9 months (p=0.67). Diabetes distress and social support did not differ between groups, though provider-related distress declined significantly across both arms (B=-0.54, p=0.001).</p><p><strong>Conclusion: </strong>This pilot demonstrates feasibility of a PLDSMS program for Black men. Glycemic control remained stable, and although between-group differences in perceived self-management were not sustained over time, findings are consistent with the hypothesis that peer-led support may help sustain self-management gains as the initial benefits of DSME alone begin to wane. Future fully powered trials are needed to test this hypothesis.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1755183"},"PeriodicalIF":3.5,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221185","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 prevalence of diabetes and its association with comorbidities, demographic and behavioral factors: a cross-sectional survey among attendees of primary healthcare centers in Riyadh.","authors":"Seema Nasser, Mamdouh M Shubair, Mariam A A El-Metwally, Awad Alshahrani, Lubna Alnaim, Amani Alharthy, Mona Ibrahim Bin Amer, Faris Fatani, Raed Aldahash, Khadijah Angawi, Badr F Al-Khateeb","doi":"10.3389/fcdhc.2026.1796490","DOIUrl":"10.3389/fcdhc.2026.1796490","url":null,"abstract":"<p><strong>Background: </strong>Type 2 Diabetes (T2D) has been found to affect a quarter of the population in Saudi Arabia, a higher burden than worldwide. Given that there is a lack of robust epidemiological evidence regarding T2D among Saudi population, a need assessment is necessary to identify risk factors of diabetes. Hence, this study aimed to estimate prevalence of diabetes and its demographic and behavioral risk factors among Saudi Arabian population.</p><p><strong>Methods: </strong>A cross-sectional survey using a validated and reliable questionnaire was conducted from March to July 2023 In Riyadh, Saudi Arabia. Altogether, 14,239 patients, aged 18 years or older were selected from 48 primary healthcare centers. SPSS version 26.0 was used to analyze data.</p><p><strong>Results: </strong>About 12.4% of Saudi residents were diabetic and 11% were hypertensive. Compared to younger participants of <50 years, those ≥75 years older were 6.30 times more likely to be diabetic (AOR: 6.30; 95% CI: 5.11, 7.77). The risk of T2D was higher among males and obese individuals by 33% (AOR: 1.33; 95% CI: 1.17, 1.51) and 39% (AOR: 1.39; 95% CI: 1.11, 1.75), respectively. Compared to employed Saudi residents, unemployed residents were 1.49 times more likely to be diabetic (AOR: 1.49; 95% CI: 1.30, 1.70). Hypertensive patients were 10.42 times more likely to experience diabetes than non-hypertensive patients (AOR: 10.42; 95% CI: 9.02, 12.03). Patients with high cholesterol were 3.13 times more likely to develop diabetes than patients with low cholesterol levels (AOR: 3.13; 95% CI: 2.64, 3.72).</p><p><strong>Conclusion: </strong>The prevalence of diabetes appears to be high in Saudi Arabia. Older-aged males and unemployed Saudi residents were at higher risk of developing Diabetes than younger, employed, and female residents. Hypertension, obesity, and high cholesterol were other strong risk factors for T2D. Education was found to be a protective factor for Diabetes among Saudi population.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1796490"},"PeriodicalIF":3.5,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213608","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":"Optimization of nursing strategies for semaglutide treatment in overweight type 2 diabetes based on gene polymorphism.","authors":"Xing Chen, Miaoqing Zhou, Liang Guo, Kui Zhu","doi":"10.3389/fcdhc.2026.1815726","DOIUrl":"10.3389/fcdhc.2026.1815726","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of a gene polymorphism-based individualized nursing strategy on the efficacy of semaglutide in overweight type 2 diabetes (T2DM) patients and to assess its role in mitigating genotype-driven outcome disparities.</p><p><strong>Methods: </strong>Eighty-three overweight T2DM patients initiating semaglutide were enrolled. The TCF7L2 rs7903146 polymorphism was detected via PCR-RFLP. Patients were stratified into a genetically advantageous group (Group A, CC genotype, n=49) and a non-advantageous group (Group B, CT/TT genotypes, n=34). Both groups received standard semaglutide therapy and routine care for the first month. Subsequently, Group B received a tailored, optimized nursing intervention for two additional months, while Group A continued routine care. Glycemic control, body weight, adverse events, and satisfaction were compared at baseline, 1 month, and 3 months.</p><p><strong>Results: </strong>At 1 month, Group A showed superior reductions in fasting glucose, HbA1c, weight, and BMI compared to Group B (all P<0.05), with a higher composite target achievement rate (93.94% vs. 84.00%, P<0.05). After Group B received the optimized strategy, between-group differences in all efficacy parameters became non-significant by 3 months (P>0.05). Group B also demonstrated a significantly lower rate of gastrointestinal adverse reactions (11.76% vs. 28.57%, P<0.05) and higher nursing satisfaction (97.06% vs. 81.63%, P<0.05) at the study endpoint.</p><p><strong>Conclusion: </strong>TCF7L2 CC genotype patients respond more rapidly to semaglutide. Implementing a genotype-informed optimized nursing strategy for CT/TT carriers after the first month reduces the initial efficacy gap, leading to similar outcomes by 3 months while improving tolerability and patient satisfaction. This approach merits further prospective evaluation.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1815726"},"PeriodicalIF":3.5,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152338","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":"Pathogenesis of diabetic cardiomyopathy and emerging therapeutic strategies: a network-based perspective.","authors":"Haoqing Ren, Hengli Lai","doi":"10.3389/fcdhc.2026.1823872","DOIUrl":"10.3389/fcdhc.2026.1823872","url":null,"abstract":"<p><p>Diabetic cardiomyopathy (DCM) is a distinct myocardial disease in diabetic patients, independent of coronary artery disease or hypertension, and a leading cause of heart failure. Its pathogenesis has evolved from a linear \"glucolipotoxicity\" model to a complex, dynamic network involving metabolic disturbances, mitochondrial dysfunction, oxidative stress, chronic inflammation, diverse programmed cell death pathways, cellular senescence, and cardiac autonomic neuropathy. These interconnected events are amplified through positive feedback loops, driving progressive myocardial damage. This review provides a systems-level synthesis of the networked pathogenesis of DCM, integrating evidence across core mechanistic components and their dynamic interactions. We discuss how metabolic disturbances initiate and propagate injury signals through mitochondrial dysfunction, inflammatory activation, and alterations in cardiomyocyte fate-including apoptosis, necroptosis, ferroptosis, and senescence. Distinct from prior reviews, this article explores two emerging integrative concepts: \"metabolic-structural coupling\"-abnormal physical interactions between metabolic molecules and myocardial structural proteins-and \"metabolic memory\"-epigenetically mediated persistence of injury despite glycemic control. We further provide a horizontal comparison and stage-specific assessment of emerging therapeutic strategies, including the pleiotropic network effects of SGLT2 inhibitors, the cardiovascular benefits of GLP-1 receptor agonists, targeting ferroptosis (e.g. irisin, alpha-lipoic acid), senolytics (e.g. dasatinib + quercetin), and the modulation of lipid droplet dynamics and the farnesoid X receptor (FXR). Finally, we critically evaluate the current evidence levels and translational barriers for these emerging therapies-from preclinical targets to completed randomized controlled trials-and propose a forward-looking roadmap to advance precision medicine in DCM. This roadmap emphasizes the multi-omics dissection of clinical heterogeneity, the development of mechanism-based biomarkers, and the validation of targeted combination therapies in well-designed clinical trials, with metabolic-structural coupling and metabolic memory serving as integrative links between classical pathways and disease persistence.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1823872"},"PeriodicalIF":3.5,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152288","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":"Racial and ethnic disparities in diabetes-related healthcare service use.","authors":"Gaole Song, C Anderson Johnson, Wei-Chin Hwang, Yawen Li, Bin Xie","doi":"10.3389/fcdhc.2026.1675970","DOIUrl":"10.3389/fcdhc.2026.1675970","url":null,"abstract":"<p><strong>Background: </strong>Compared to non-Hispanic White adults, racial/ethnic minority adults have a higher risk of developing diabetes and its complications. Proper use of healthcare services is important for reducing the prevalence of diabetes and the risk of complications. However, minority populations tend to receive a lower quality of healthcare service and have greater barriers to diabetes self-management. This study aims to determine racial/ethnic disparities in the utilization of diabetes-related healthcare services and estimate factors that are associated with the utilization.</p><p><strong>Methods: </strong>This study used the 2016-2021 Behavioral Risk Factor Surveillance System data. Accomplishment of diabetes-related healthcare services (annual clinical care, self-care) among patients with diabetes and diabetes screening rates among adults at risk of developing diabetes were assessed. Chi-square tests explored associations between race/ethnicity and healthcare service use. Weighted logistic regression models estimated factors independently associated with utilization, controlling for covariates.</p><p><strong>Results: </strong>Patients with diabetes who reported fully completing annual clinical care exams were less than 50% for all racial and ethnic groups. Asian American patients reported the lowest percentage of fully completing self-care practices (1.2%). Compared to non-Hispanic White patients, Hispanic and Latino patients had the lowest odds of fully completing all annual exams (OR = 0.10, 95% CI, 0.07, 0.14) and self-care practices (OR = 0.63, 95% CI, 0.43, 0.92). Except for non-Hispanic Black adults, asymptomatic adults at risk from other racial and ethnic minority groups had significantly lower odds of having screening, and Asian American adults had the lowest odds of screening uptake (OR = 0.55, 95% CI, 0.52, 0.59) compared to non-Hispanic White adults. Healthcare insurance coverage, access to healthcare, self-rated general health status, and alcohol consumption were significantly associated with diabetes-related healthcare utilization status.</p><p><strong>Conclusions: </strong>Racial and ethnic disparities exist in diabetes-related healthcare service utilization. These findings underscore an urgent need to improve diabetes-related healthcare service use for racial and ethnic minority groups.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1675970"},"PeriodicalIF":3.5,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152314","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":"Mapping the storm: a scoping review of diabetic emergencies in Africa.","authors":"Alexis Harerimana, Gugu Mchunu","doi":"10.3389/fcdhc.2026.1822436","DOIUrl":"10.3389/fcdhc.2026.1822436","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review aimed to map the evidence on the patterns and burden of diabetic emergencies among people with diabetes in Africa.</p><p><strong>Methods: </strong>The review followed the Levac et al. framework and the PRISMA-ScR guidelines. A systematic search was conducted across five electronic databases (CINAHL, Embase, MEDLINE, Scopus, and Web of Science), and manual searches in Google and Google Scholar were conducted for studies published between 2015 and 2025. From 1,207 records, 25 studies met the inclusion criteria. Extracted data were analyzed using thematic analysis and descriptive numerical summaries.</p><p><strong>Findings: </strong>Of the 25 reviewed studies, diabetic ketoacidosis (DKA) was the most commonly reported emergency, appearing in 17 studies, with proportions ranging from 2.0% to 92.6%. This was followed by hyperosmolar hyperglycemic state (HHS), reported in 11 studies (4.5%-50.6%), and hypoglycemia, reported in 9 studies (0.8%-28.3%). Common determinants included infections and intercurrent illness, poor glycemic control, treatment non-adherence or discontinuation, and limited access to ongoing care. Reported in-hospital mortality ranged from 5% to 17.1%, with DKA case fatality reaching 30% in some studies. Median hospital stay generally ranged from 6 to 9 days.</p><p><strong>Conclusion: </strong>Diabetic emergencies are a major, yet largely preventable, cause of illness and death among people with diabetes in Africa. Conditions such as DKA place a heavy strain on African healthcare systems. To reduce the rates of these avoidable complications, it is essential to improve primary care for early detection and ensure consistent access to insulin and glucose monitoring.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1822436"},"PeriodicalIF":3.5,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152361","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":"Cultural specificity and linguistic diversity in medical nutrition therapy education resources for type 2 diabetes.","authors":"Olivia Y Wu, Anna Schwerdfeger, Tamara R Cohen","doi":"10.3389/fcdhc.2026.1823506","DOIUrl":"10.3389/fcdhc.2026.1823506","url":null,"abstract":"<p><strong>Introduction: </strong>Culturally tailored nutrition care improves diabetes-related health outcomes, yet little is known about the cultural specificity and multilingual accessibility of education resources used in medical nutrition therapy for type 2 diabetes. This mini review examined the cultural specificity and linguistic diversity of Canadian diabetes nutrition therapy resources and compared resources' characteristics based on the presence of these features.</p><p><strong>Methods: </strong>A mini review adopting systematic search methods for gray literature was conducted. Data sources include bibliographic and gray literature databases, customized search engines, targeted sites, and consultations with dietitian diabetes educators. Eligible resources were freely available online, in English, and published by Canadian organizations. Resources' cultural specificity, language availability, year, publisher, format, and contents were extracted. Quality was assessed using Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist.</p><p><strong>Results: </strong>We identified 341 (46 professional- and 295 patient-facing) resources. A third of resources (37% of professional and 28% of patient) contained culturally specific guidance, most frequently for Indigenous and South and Southeast Asian groups. Guidance for African, Caribbean, Middle Eastern, East Asian, and Latin American groups was sparse. Just 9% of patient resources were available in languages other than English or French, and 4% had both cultural specificity and third-language translations. Culturally specific professional resources had less comprehensive content coverage than general resources. Culturally or linguistically diverse patient resources were comprehensive but often outdated.</p><p><strong>Discussion: </strong>Professional and patient education resources with expanded cultural diversity and multilingual options are needed to support medical nutrition therapy for ethnoculturally diverse Canadians with type 2 diabetes.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1823506"},"PeriodicalIF":3.5,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139974","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}