BMJ Open Diabetes Research & Care最新文献

{"title":"Body composition displays expected and unexpected contributions to blood pressure and glycemia in young South African women.","authors":"Ravi Retnakaran, Junwei Shen, Rayjean J Hung, Stephen J Lye, Shane A Norris","doi":"10.1136/bmjdrc-2026-006131","DOIUrl":"https://doi.org/10.1136/bmjdrc-2026-006131","url":null,"abstract":"<p><strong>Introduction: </strong>Sub-Saharan Africa is undergoing rapid demographic, sociocultural, and economic transitions that are contributing to rising rates of overweight/obesity, which in turn may drive cardiometabolic sequelae such as diabetes and hypertension. However, the extent to which excess adiposity may contribute to the prevalence of such sequelae in sub-Saharan Africa remains uncertain. We thus sought to systematically evaluate body composition by dual-energy X-ray absorptiometry (DEXA) and its associations with glycemia and blood pressure (BP) in young women in Soweto, South Africa.</p><p><strong>Research design and methods: </strong>This study was performed in 7735 women (median age of 22.4 years) undergoing assessment for a clinical trial. Whole-body DEXA scan yielded 12 measures of body composition (reflecting whole-body fat, central adiposity, peripheral adiposity, and lean mass/soft tissue) that were assessed as predictors of A1c, systolic BP, and diastolic BP, respectively.</p><p><strong>Results: </strong>The study population had high rates of overweight/obesity (49.6%), pre-diabetes/diabetes (10.9%), and hypertension (11.9%). While specific adiposity measures (fat mass (FM), visceral adipose tissue, subcutaneous adipose tissue (SAT), android fat) were significantly associated with A1c, these associations were exceedingly modest, with these measures additionally explaining only 0.14% to 0.37% of the variance in A1c. In contrast, all 12 body composition measures showed significant associations with systolic BP and diastolic BP. Indices of lean mass/soft tissue (lean mass index, lean mass, fat-free soft tissue mass) explained 5.8% to 6.3% of the variance in systolic BP, while measures of adiposity (android fat, SAT, FM) reconciled 4.6% to 4.8% of the variance in diastolic BP, reflecting much stronger associations with BP than with A1c.</p><p><strong>Conclusion: </strong>In this young adult population with high rates of overweight/obesity and pre-diabetes/diabetes, DEXA-derived adiposity exhibits modest associations with glycemia, underscoring the atypical nature of diabetes in sub-Saharan Africa.</p><p><strong>Trial registration number: </strong>PACTR201903750173871.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of stress hyperglycemia ratio in patients undergoing percutaneous coronary intervention: a dose-response meta-analysis.","authors":"Jinyu He, Qianxiang Wang, Junhua He, Chunyu Zhang, Haojie Xue, Jing Wang, Yi Zhong, Jian Feng, Li Deng","doi":"10.1136/bmjdrc-2025-005656","DOIUrl":"10.1136/bmjdrc-2025-005656","url":null,"abstract":"<p><strong>Background: </strong>Stress hyperglycemia is common during percutaneous coronary intervention (PCI) and is associated with worse outcomes. The stress hyperglycemia ratio (SHR), which standardizes acute glucose levels to chronic glycemic status, may provide superior prognostic information compared with admission glucose alone.</p><p><strong>Objective: </strong>To systematically evaluate the association between SHR and clinical outcomes in PCI patients and to quantify the exposure-response relationship.</p><p><strong>Data sources: </strong>PubMed, Embase, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov were searched from inception to August 5, 2025.</p><p><strong>Study selection: </strong>Observational studies reporting SHR prior to PCI and subsequent clinical outcomes were included.</p><p><strong>Data extraction: </strong>Two investigators independently extracted study characteristics, SHR definitions, and adjusted effect estimates. Risk of bias was assessed using ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions), and certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation framework.</p><p><strong>Data synthesis: </strong>Thirteen studies comprising 41 096 PCI patients were included. Elevated SHR was associated with increased risks of all-cause mortality, major adverse cardiac and cerebrovascular events (MACCE), cardiovascular mortality, recurrent myocardial infarction, and stroke, but not with repeat revascularization. Sensitivity analyses yielded consistent results. The dose-response analysis suggested an approximately linear dose-response pattern between SHR and MACCE.</p><p><strong>Limitations: </strong>Most studies were observational, SHR definitions varied, and residual confounding cannot be excluded. The limited number of studies restricted the interpretability of dose-response analyses.</p><p><strong>Conclusions: </strong>Elevated SHR was associated with an increased risk of adverse outcomes after PCI. The dose-response analysis suggested an approximately linear dose-response pattern between SHR and MACCE. However, these findings should be interpreted cautiously given the observational nature of the evidence and the limited number of studies for certain analyses.</p><p><strong>Prospero registration number: </strong>CRD420251045853.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early loss and progressive deterioration of glucagon responses to hypoglycemia in children with type 1 diabetes.","authors":"Antoine Harvengt, Maude Beckers, Ilektra Iakovidou, Anaïs Maure, Zain Syed, Laure Boutsen, Dominique Beckers, Philippe A Lysy","doi":"10.1136/bmjdrc-2026-005959","DOIUrl":"10.1136/bmjdrc-2026-005959","url":null,"abstract":"<p><strong>Introduction: </strong>Impaired glucagon counterregulation is a major contributor to hypoglycemia risk in type 1 diabetes (T1D). While well described in adults, the timing, trajectory, and determinants of glucagon dysfunction in children remain poorly defined. Our objective was to characterize the evolution of glucagon secretion during insulin-induced hypoglycemia in children with newly diagnosed T1D and to identify biomarkers of counterregulatory failure.</p><p><strong>Research design and methods: </strong>GLUcagon REsponse to hypoglycemia in children and adolescents with new-onset type 1 DIAbetes (GLUREDIA) - Work Package (WP) 1 is a prospective, multicenter longitudinal study including 22 children and adolescents (aged 2-17 years) with newly diagnosed T1D and eight healthy first-degree relatives. Participants underwent standardized insulin-induced hypoglycemia tests (IIHTs). In patients with T1D, IIHTs were performed at diagnosis and at 6, 12, and 18 months. Plasma glucagon and counterregulatory hormones were measured at baseline and during hypoglycemia. Continuous glucose monitoring (CGM) metrics and circulating biomarkers were analyzed using longitudinal mixed models and regression analyses.</p><p><strong>Results: </strong>In healthy participants, IIHT elicited a robust physiological increase in glucagon during hypoglycemia (p<0.001). In contrast, children with T1D showed no significant glucagon response despite deeper hypoglycemia. Longitudinally, glucagon responsiveness was absent at diagnosis, transiently improved at 6 months (p=0.04), absent at 12 months, and paradoxically suppressed at 18 months (p=0.02). Basal glucagon levels remained stable over time. Glucagon responses correlated positively with CGM time-in-range (70-180 mg/dL) and negatively with glycemic variability and hypoglycemia frequency. A CGM-based logistic model integrating these metrics predicted impaired glucagon responses with good discrimination (area under the curve 0.79). Circulating glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1, tumor necrosis factor-α, and interferon-γ correlated positively with glucagon secretion, whereas partial remission status did not.</p><p><strong>Conclusions: </strong>Glucagon counterregulation is profoundly impaired early in pediatric T1D and deteriorates dynamically within the first 18 months after diagnosis. Glycemic instability and recurrent hypoglycemia are key determinants of α-cell dysfunction. CGM-derived metrics may serve as non-invasive surrogates of impaired counterregulation and support early risk stratification for hypoglycemia in children with T1D.</p><p><strong>Trial registration number: </strong>NCT06770621.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like peptide-1 receptor agonists for primary cardiovascular disease prevention in type 2 diabetes, a systematic review.","authors":"Guillaume Grenet, Raha Eskandari, Joyce Ko, Stephen P Adams, Douglas M Salzwedel, Balraj S Heran, Anshula Ambasta, Ken Bassett, Wade Thompson","doi":"10.1136/bmjdrc-2026-006225","DOIUrl":"10.1136/bmjdrc-2026-006225","url":null,"abstract":"<p><p>We aimed to estimate the cardiovascular (CV) benefit of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D) without a history of CV disease (CVD) (primary CVD prevention). We searched MEDLINE and the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) and Epistemonikos for systematic reviews (up to July 4, 2025). We included RCTs of patients with T2D comparing a GLP-1 RA to placebo using a CV or renal primary outcome. 11 drug manufacturer-funded trials (77 419 participants) were included. We used version 1 of the Cochrane risk of bias tool. Our primary analysis was the pooled estimate of the treatment effect in primary CVD prevention. Outcomes of interest were major adverse cardiovascular events (MACE, primary outcome), all-cause mortality, CV mortality, myocardial infarction, stroke, and serious adverse events (secondary outcomes). Only 26% of participants were primary CVD prevention patients. The pooled estimates of treatment effect for primary CVD prevention were not significant for the primary outcome, MACE (pooled HR 0.88, 95% CI 0.74 to 1.05, based on eight trials, n=16 672), and all secondary outcomes. The certainty of the evidence was rated as low due to trials' risk of bias and imprecision. Our review was limited to subgroup analyses of aggregated data from studies not powered for primary prevention alone. Current evidence is insufficient to establish CV benefits of GLP-1 RAs in T2D without a history of CVD, and dedicated primary prevention trials are needed.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic factors and risk of dementia in people with type 2 diabetes in England: a large retrospective cohort study.","authors":"Heidi Tm Lai, Kiara Chang, Mansour Ta Sharabiani, Jonathan Valabhji, Edward W Gregg, Lefkos T Middleton, Azeem Majeed, Jonathan Pearson-Stuttard, Christopher J Millett, Alex Bottle, Eszter P Vamos","doi":"10.1136/bmjdrc-2025-005743","DOIUrl":"10.1136/bmjdrc-2025-005743","url":null,"abstract":"<p><strong>Introduction: </strong>People with type 2 diabetes (T2D) have a higher dementia risk. Cardiometabolic factors may influence dementia development, but long-term links among people with T2D remain unclear. Prior studies show mixed findings and have not considered how the time before dementia diagnosis at which cardiometabolic factors are measured affects their association with dementia risk.</p><p><strong>Methods: </strong>We examined the associations between eight routinely measured cardiometabolic factors (including blood pressure, lipid, and glycemic markers) and the risk of dementia in 249 958 adults with T2D from the Clinical Practice Research Datalink (1999-2018). Multivariable Cox proportional hazards regression was applied with age as the timescale and stratified by follow-up time at 5, 5-10, and ≥10 years before dementia diagnosis. Cardiometabolic factors were analyzed continuously and categorically using clinically relevant cut-offs.</p><p><strong>Results: </strong>22 492 incident dementia cases were observed (1 257 998 person-years of follow-up). Higher systolic blood pressure was associated with a lower dementia risk, particularly when measured closer to the time of dementia diagnosis. Higher diastolic blood pressure (DBP) (90 vs 80 mm Hg) was associated with a 21% greater risk of dementia (95% CI 15% to 27%). Dementia risk was 32% (27%-36%) lower for those with a body mass index (BMI) ≥30 (vs <25 kg/m²) when measured within 5 years of dementia diagnosis, but 15% (7%-23%) and 43% (31%-56%) higher if measured 5-10 and ≥10 years before diagnosis, respectively. Higher levels of glycemic measures were consistently associated with a greater dementia risk. Findings for total cholesterol and low-density lipoprotein were largely null.</p><p><strong>Conclusions: </strong>Higher DBP, BMI, and glycemic measures measured over 10 years before dementia diagnosis were linked to a greater dementia risk among adults with T2D. Associations varied depending on when cardiometabolic factors were measured relative to dementia diagnosis, demonstrating the importance of distinguishing potential long-term risk factors from short-term markers of dementia development.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of the twiist Automated Insulin Delivery System: first study with twiist.","authors":"Adriana Ruiz, Ann Mcdonough, Ken Snow, Bruce Bode, Joanna Mitri","doi":"10.1136/bmjdrc-2026-006307","DOIUrl":"10.1136/bmjdrc-2026-006307","url":null,"abstract":"<p><strong>Introduction: </strong>Randomized controlled trials and real-world studies have demonstrated that automated insulin delivery (AID) systems enhance glycemic control and mitigate hypoglycemia risk in individuals with type 1 diabetes. This study evaluated the safety, effectiveness, and usability of the twiist AID System on glycemic outcomes in adults with type 1 diabetes.</p><p><strong>Research design and methods: </strong>This 8-week, prospective, single-center, single-arm study included 20 adults with type 1 diabetes. The primary outcome measures were the percent of time spent in established continuous glucose monitoring (CGM) glycemic target ranges at 8 weeks. The primary efficacy outcome was percent time in range (%TIR; 70-180 mg/dL) at 8 weeks. Secondary outcomes were the change in glucose pre-occlusion detection; the effects of total daily insulin delivery (TDD) on glucose pre- and post-occlusion detection; the effect of Max basal ratio on %TIR; the effect of users' correction range on %TIR; and change in glycated haemoglobin (HbA1c). Changes in TDD and body weight were also assessed.</p><p><strong>Results: </strong>19 participants completed the study. At 8 weeks, the mean %TIR was 70.3±15.5%. Participants achieved or maintained glycemic targets for all CGM metrics except time above >250 mg/dL. A total of 67 occlusion events occurred in 15 participants. These events were detected within 30 min of rising glucose. Higher max basal ratio settings were associated with higher %TIR. The %TIR for participants with a correction range <100 mg/dL was 79.2±13.4% vs 67.2±15.0% for those with a correction range >100 mg/dL. HbA1c levels decreased (-0.4%±0.5%) in participants with baseline HbA1c >7%. A slight increase in TDD (1.3±16.2 U) and a decrease in body weight (-0.09±2.9 kg) were observed. No serious adverse events were reported.</p><p><strong>Conclusions: </strong>Eight-week use of twiist enabled participants to achieve or maintain established glycemic targets and suggests the system's ability to detect occlusions before clinically significant glucose rise regardless of TDD. Larger and longer term studies are needed.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between liver fibrosis severity and impaired myocardial glucose metabolism in subjects with different degrees of glucose tolerance.","authors":"Elena Succurro, Valeria Mazza, Ilaria Gattuso, Patrizia Vizza, Teresa Vanessa Fiorentino, Maria Perticone, Gaia Chiara Mannino, Angela Sciacqua, Pietro Hiram Guzzi, Francesco Andreozzi, Pierangelo Veltri, Giuseppe Lucio Cascini, Giorgio Sesti","doi":"10.1136/bmjdrc-2026-006005","DOIUrl":"10.1136/bmjdrc-2026-006005","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing evidence suggests that liver fibrosis is an independent risk factor for cardiovascular disease. However, the mechanisms underlying this increased risk are still unsettled. The aim of this study was to explore the relationship between myocardial glucose metabolism and the severity of liver fibrosis.</p><p><strong>Research design and methods: </strong>We evaluated insulin-stimulated myocardial glucose metabolic rate (MrGlu) using cardiac dynamic positron emission tomography (PET) with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) combined with a euglycemic-hyperinsulinemic clamp and liver fibrosis severity, estimated by the fibrosis-4 (FIB-4) index, in 57 individuals with varying degrees of glucose tolerance. According to the FIB-4 index, subjects were stratified into three groups: low risk of fibrosis (<1.3; n=37), intermediate risk of fibrosis (≥1.3 to <2.67; n=16), and high risk of fibrosis (≥2.67; n=4).</p><p><strong>Results: </strong>Subjects with a high risk of advanced fibrosis exhibited an age-adjusted decrease of myocardial MrGlu compared with both individuals with a low FIB-4 index category (4.6±4.3 µmol/min/100 g vs 21.7±11.2 µmol/min/100 g; p=0.009) and intermediate FIB-4 index category (20.±11.03 µmol/min/100 g; p=0.01, respectively). No significant differences in glycemic and anthropometric parameters, whole-body insulin sensitivity, or blood pressure were found between groups.In a multivariable regression analysis, the only variable significantly associated with advanced liver fibrosis risk was myocardial MrGlu (β=-0.286; p=0.003), explaining 28.6% of the variation.</p><p><strong>Conclusions: </strong>These data suggest that impairment of insulin-stimulated myocardial glucose metabolism is associated with a high risk of advanced liver fibrosis in individuals with varying degrees of glucose tolerance.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in self-reported current diabetes care use, socioeconomic inequalities, and associated factors in Japan: evidence from the Comprehensive Survey of Living Conditions (1986-2022).","authors":"Tshewang Gyeltshen, Hirokazu Tanaka, Kota Katanoda","doi":"10.1136/bmjdrc-2026-006042","DOIUrl":"10.1136/bmjdrc-2026-006042","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term trends in diabetes care use and socioeconomic inequalities are not well described in Japan.  RESEARCH DESIGN AND METHODS: We analyzed nationally representative data from the Comprehensive Survey of Living Conditions (1986-2022). Diabetes care use was defined as self-reported current medical facility attendance for diabetes. Age-standardized prevalence was calculated as the proportion of adults currently receiving outpatient diabetes care; undiagnosed cases and diagnosed individuals not currently in treatment were therefore not captured. In the 2022 survey, a survey-weighted Poisson regression model was used to estimate prevalence ratios (PRs) of factors associated with current diabetes care use, including educational level and occupational class.</p><p><strong>Results: </strong>Age-standardized self-reported current diabetes care use increased from 1986 to 2022, rising from 2.2% to 8.3% in men and from 1.7% to 4.4% in women, with a significant widening of the sex inequalities over the study period. Educational differences were evident, particularly among working-age adults. In 2022, compared with the high-education group, PRs were 1.17 (95% CI 1.13 to 1.22) for the middle-education group and 1.22 (95% CI 1.13 to 1.32) for the low-education group for both sexes. Occupational differences were more modest. Compared with upper non-manual workers, lower non-manual workers had a lower PR=0.92 (95% CI 0.86 to 0.98), while non-employed individuals had a higher PR=1.10 (95% CI 1.01 to 1.21); manual workers, self-employed individuals, and farmers did not differ significantly from the reference group. Older age, men, hypertension, depression, and current smoking were also associated with higher current diabetes care use.</p><p><strong>Conclusions: </strong>Self-reported diabetes care use increased from 1986 to 2022 in Japan, with lower educational level associated with higher current diabetes care use, particularly among working-age adults. These findings help inform continued monitoring of socioeconomic inequalities in diabetes care.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, incidence, mortality, and years of life lost to diabetes from 1996 to 2024 in Denmark.","authors":"Rasmus Wibaek, Vanja Kosjerina, Stine Byberg, Hjalte S Mikkelsen, Christina J-Y Lee, Peter Rossing, Bendix Carstensen, Pernille Falberg Rønn","doi":"10.1136/bmjdrc-2026-006129","DOIUrl":"10.1136/bmjdrc-2026-006129","url":null,"abstract":"<p><strong>Introduction: </strong>Population-based surveillance is essential for quantifying the burden of diabetes and monitoring temporal changes. In Denmark, nationwide health registers enable long-term surveillance of type 1 diabetes (T1D) and type 2 diabetes (T2D). We aimed to estimate trends in prevalence, incidence, mortality and years of life lost to diabetes in Denmark from 1996 to 2024.</p><p><strong>Research design and methods: </strong>We conducted a nationwide register-based cohort study from 1996 to 2024. We used an updated national diabetes register integrating hospital, prescription, clinical, and laboratory data to identify diabetes type and date of onset. Prevalence was estimated annually using a binomial model. Incidence, mortality and standardized mortality ratios (SMR) were analyzed using age-period-cohort models. Analyses were stratified by sex and diabetes type. A multistate model was used to assess the lifetime risk and years of life lost to diabetes.</p><p><strong>Results: </strong>As of January 1, 2025, a total of 366 174 individuals (6.1% of the population) had diabetes identified through national healthcare registers; of these, 8.2% had T1D and 91.8% had T2D. Since 1996, diabetes prevalence more than tripled, largely driven by an overall annual increase in T2D of ~4.1%. T1D prevalence remained stable, with increases in individuals aged <40 years and decreases in older age groups. From 1996 to 2024, a total of 567 510 incident diabetes cases were recorded, of which 4.6% were T1D. T1D incidence declined on average by 1.1% annually, with increasing rates at younger ages and declining rates at older ages. T2D incidence showed a non-linear pattern, with a decline from 2010 to 2015 followed by an increase in recent years, resulting in an overall upward trend from 1996 to 2024. Men had higher T2D incidence than women across age and calendar years. Mortality declined for T1D after 2008 and for T2D until 2012, then stabilized. SMRs decreased for T1D after 2008 but increased for T2D, converging by 2025.</p><p><strong>Conclusions: </strong>In Denmark, diabetes prevalence and incidence increased markedly since 1996, largely driven by T2D. Although mortality declined, particularly for T1D, excess mortality remains, emphasizing the need for continued surveillance and prevention efforts.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From beta-cell failure to islet dysfunction: the emerging role of the alpha cell.","authors":"Nubia Eréndira Ramírez-Villegas, Froylan David Martínez-Sánchez","doi":"10.1136/bmjdrc-2026-006339","DOIUrl":"10.1136/bmjdrc-2026-006339","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}