BMJ Open Diabetes Research & Care最新文献

{"title":"Obesity reclassification under the ADA 2026 criteria and elevated measured blood pressure in adults aged 20-59 years: an analysis of 45 population-based surveys.","authors":"Víctor Juan Vera-Ponce","doi":"10.1136/bmjdrc-2026-006430","DOIUrl":"10.1136/bmjdrc-2026-006430","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 6","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13735335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149318040","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":"Management of dysglycemia in critically ill adults: current evidence, clinical practice and future directions.","authors":"Thaer Idrees, Srija Nalabolu, Omolade Oladejo, Ghada Elshimy, Claudia Orobio, Guillermo E Umpierrez","doi":"10.1136/bmjdrc-2026-006533","DOIUrl":"10.1136/bmjdrc-2026-006533","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262837","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":"Impact of type 2 diabetes mellitus in patients with congenital heart disease (CHD): a study from the Australian National CHD Registry.","authors":"Larissa Lloyd, Calum Nicholson, Geoff Strange, David Stephen Celermajer","doi":"10.1136/bmjdrc-2026-006465","DOIUrl":"10.1136/bmjdrc-2026-006465","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13691787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236845","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":"Real-world accuracy, extended-wear performance, and user satisfaction with a novel 21-day continuous glucose monitoring system in pediatric type 1 diabetes.","authors":"Erdal Eren, Yasemin Denkboy Ongen, Burcu Eryilmaz, Zeynep Yildizer Senoglu, Zehra Kuscu","doi":"10.1136/bmjdrc-2026-006467","DOIUrl":"10.1136/bmjdrc-2026-006467","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13691871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236835","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 weight/body mass index and insulin dose requirements in gestational diabetes: a retrospective cohort study.","authors":"Sinziana Turlea, Afnan Randhawa, Lama Almohtasib, Vincent Simpson, Isabelle Kathryn Mayne, Andrew Peter McGovern","doi":"10.1136/bmjdrc-2026-006285","DOIUrl":"10.1136/bmjdrc-2026-006285","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179324","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":"Efficacy of low-dose pioglitazone in combination with exenatide on glucose control in patients with T2DM.","authors":"Muhammad A Abdul-Ghani, Mohamed Abu-Farha, Curtiss Puckett, Tamam Abdul-Ghani, Gozde Baskoy, Siham Abdelgani, Hussein Zaitoon, Aurora Merovci, John Adams, Curtis Triplitt, Mustafa Kanat, Ralph A DeFronzo, Amin Jayyousi, Fahd Al-Mulla","doi":"10.1136/bmjdrc-2026-006294","DOIUrl":"10.1136/bmjdrc-2026-006294","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179418","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":"Changes in ectopic lipids, insulin sensitivity, and beta cell function after a low-fat vegan diet in adults with type 2 diabetes: a 16-week single-arm clinical trial.","authors":"Hana Kahleova, Kitt Petersen, Gerald I Shulman, Tatiana Znayenko-Miller, Sylvie Dufour, Haley Brennan, Cristina Maracine, Andrea Tura, Richard Holubkov, Neal D Barnard","doi":"10.1136/bmjdrc-2026-006472","DOIUrl":"10.1136/bmjdrc-2026-006472","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore the effects of a low-fat plant-based diet on hepatocellular and intramyocellular lipids, advanced glycation end products (AGEs), insulin resistance, and beta-cell function in adults with type 2 diabetes.</p><p><strong>Research design and methods: </strong>Participants (n=25) were asked to follow a low-fat vegan diet for 16 weeks. Dual X-ray absorptiometry was used to measure body composition. Hepatocellular and intramyocellular lipids were quantified by ¹H magnetic resonance spectroscopy. Tissue accumulation of AGEs was measured using a skin fluorescence technique. Insulin resistance was assessed in a fasting state with the Homeostasis Model Assessment (HOMA-IR) index. Postprandial insulin sensitivity was assessed with the predicted insulin sensitivity index (PREDIM). Beta-cell function was calculated by a mathematical model after a standard meal, using C-peptide deconvolution.</p><p><strong>Results: </strong>Mean body weight decreased by 6.0 kg (95% CI -7.0 to -5.1; p<0.001), a 6.6% (95% CI -7.5 to -5.8) decrease relative to baseline. This was largely due to the reduction in fat mass (-4.2 kg, 95% CI -5.7 to -2.7; p<0.001). Visceral fat volume decreased by 290 cm³ (95% CI -467 to -114; p=0.003). Hepatocellular lipids decreased by 33.0% (95% CI -48.7 to -17.3; p<0.001). The AGE score decreased by 0.4 (95% CI -0.6 to -0.2; p=0.002). The HOMA-IR index, a measure of insulin resistance, fell (-2.5, 95% CI -4.1 to -0.9; p=0.004), whereas PREDIM, a measure of insulin sensitivity, increased on the vegan diet (+1.3 mg/min/kg, 95% CI +0.6 to +2.1; p=0.002). Several markers of beta-cell function improved on the vegan diet. Specifically, insulin secretion at 6 and 7 mmol/L glucose, beta-cell glucose sensitivity, rate sensitivity, and potentiation factor all increased.</p><p><strong>Conclusions: </strong>On an ad libitum low-fat plant-based (vegan) dietary intervention, the participants with type 2 diabetes experienced reductions in ectopic fat, particularly visceral and hepatocellular fat, improvements in insulin sensitivity, reductions in AGEs, and improvements in beta-cell function.</p><p><strong>Trial registration number: </strong>NCT06106035.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134485","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 stress-related exposures and risk of pre-diabetes and type 2 diabetes: results from the population-based Lifelines cohort study.","authors":"Shengxin Liu, Eva Corpeleijn, Mirela Habibovic, Sabita S Soedamah-Muthu","doi":"10.1136/bmjdrc-2026-006219","DOIUrl":"10.1136/bmjdrc-2026-006219","url":null,"abstract":"<p><strong>Introduction: </strong>To examine the associations between chronic and acute stress-related exposures and incident pre-diabetes and type 2 diabetes (T2D) and to explore how stress domains cluster with socioeconomic and lifestyle factors.</p><p><strong>Research design and methods: </strong>We conducted a prospective population-based cohort study using data from the Lifelines cohort study in the Netherlands, with baseline assessments conducted between 2006 and 2013 and follow-up between 2014 and 2018. The study included 152 861 adults without diabetes at baseline. Chronic stress was measured by the Life Difficulties Inventory (LDI), and acute stress was measured by the List of Threatening Experiences (LTE). Stress exposures were assessed at baseline and follow-up and modeled as time-varying exposures. Outcomes were incident pre-diabetes, defined as fasting plasma glucose 6.1 to <7.0 mmol/L and/or glycated hemoglobin (HbA1c) 6.0% to 6.5%, and incident T2D, defined by self-report, fasting plasma glucose ≥7.0 mmol/L and/or HbA1c ≥6.5%. Cox proportional hazards models were sequentially adjusted for demographic, socioeconomic and lifestyle factors. False discovery rate correction was applied. Exploratory network analyses examined structural relationships between stress domains, socioeconomic factors and lifestyle factors.</p><p><strong>Results: </strong>During follow-up, 7499 participants developed pre-diabetes and 3127 developed T2D. In lifestyle-adjusted models, cumulative LDI and LTE scores showed limited associations with outcomes. The LDI sum score was modestly associated with T2D (HR 1.03, 95% CI 1.01 to 1.04), but not with pre-diabetes. Domain-specific analyses showed that moderate financial strain (LDI) was associated with pre-diabetes (HR 1.17, 95% CI 1.10 to 1.25) and T2D (HR 1.28, 95% CI 1.17 to 1.41). Restricted free time was associated with pre-diabetes, while health-related stress was associated with T2D. Major financial crisis (LTE) was also associated with both outcomes. Network analyses demonstrated clustering of stress domains with socioeconomic factors, particularly marital status and income, and structural links to behavioral factors.</p><p><strong>Conclusions: </strong>Stress-related exposures were modestly and selectively associated with incident pre-diabetes and T2D, with domain-specific rather than cumulative patterns. Stress clustered with socioeconomic and lifestyle factors, suggesting that its contribution to diabetes risk may operate primarily through interconnected social and lifestyle pathways rather than as a strong independent determinant.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134536","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":"Associations of dietary macronutrients and energy intake with diabetic kidney disease and all-cause mortality in diabetes: evidence from NHANES.","authors":"Qiuhong Li, Xiaomeng Lv, Liuwei Wang, Yulin Wang, Yanhong Guo, Lu Yu, Zihan Zhai, Zhibin Huang, Lin Tang","doi":"10.1136/bmjdrc-2026-005941","DOIUrl":"https://doi.org/10.1136/bmjdrc-2026-005941","url":null,"abstract":"<p><strong>Introduction: </strong>Dietary management is crucial for diabetes, yet the impact of macronutrient and energy intake on diabetic kidney disease (DKD) and all-cause mortality remains unclear. This study aimed to investigate these associations and to identify intake levels that were associated with the lowest odds of DKD and mortality.</p><p><strong>Research design and methods: </strong>Using combined cross-sectional and prospective data from NHANES (2011-2018), we analyzed 3066 diabetic adults (representing 30.3 million individuals in the USA). Weighted logistic regression was used to assess the prevalence of DKD, while Cox regression was employed to evaluate associations with all-cause mortality, incorporating dose-response analyses and mediation testing.</p><p><strong>Results: </strong>After multivariable adjustment, higher protein and dietary fiber intake showed significant inverse linear associations with DKD (P-trend <0.05). Compared with the lowest quartile (Q1), the highest quartile (Q4) had significantly lower DKD odds: protein (OR=0.41, 95% CI 0.21 to 0.79) and fiber (OR=0.50, 95% CI 0.31 to 0.82). The statistical inflection points associated with lower DKD odds were protein >74 g/day and fiber >14 g/day. Exploratory mediation analysis suggested that body mass index and hemoglobin partially explained the associations of proteins and fibers with DKD, respectively. Prospectively, after 48 months median follow-up (366 deaths, representing 3.36 million), only energy intake exhibited a significant U-shaped association with mortality risk (non-linear p<0.05). Mortality was lowest with daily energy intake between 1750 kcal and 1810 kcal.</p><p><strong>Conclusions: </strong>In this observational analysis, higher protein (>74 g/day) and fiber intake (>14 g/day) were associated with lower DKD prevalence in diabetes, while maintaining daily energy within 1750-1810 kcal is associated with the lowest all-cause mortality risk. These findings suggest potential reference values for dietary patterns in diabetes management.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103963","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":"Economic evaluation of NT-proBNP testing plus standard clinical assessment versus standard clinical assessment alone for the prevention of heart failure in older adults with type 2 diabetes.","authors":"James L Januzzi, Katherine Zhang, Cheryl McDade, Brian Clay, Paul Neveux, Stephanie Earnshaw, Rodica Pop-Busui","doi":"10.1136/bmjdrc-2026-006304","DOIUrl":"10.1136/bmjdrc-2026-006304","url":null,"abstract":"<p><strong>Introduction: </strong>N-terminal pro-B-type natriuretic peptide (NT-proBNP) testing for early heart failure (HF) detection in asymptomatic older adults with diabetes in the USA remains limited despite guideline recommendations. This study evaluated the cost-effectiveness of incorporating NT-proBNP testing into routine clinical assessments for adults aged ≥65 years from a Medicare perspective.</p><p><strong>Research design and methods: </strong>A five-state Markov model with an embedded decision tree compared NT-proBNP testing plus standard clinical assessments with standard assessments alone in adults aged ≥65 years with type 2 diabetes, with or without other HF risk factors. Model inputs (ie, baseline event rates, treatment effects, utilities, and costs) were derived from published literature and publicly available Medicare data. Outcomes, including direct medical costs (ie, diagnostic testing, cardioprotective treatments, HF-related hospitalization, and chronic/advanced HF treatment), life-years (LYs), and quality-adjusted life-years (QALYs), were calculated over a lifetime horizon. Sensitivity and scenario analyses were performed.</p><p><strong>Results: </strong>Compared with standard clinical assessment alone, NT-proBNP testing prolonged survival (6.27 vs 4.99 LYs) and improved quality of life (3.45 vs 2.84 QALYs). Although lifetime HF hospitalizations were similar (0.43 vs 0.43), LY-adjusted hospitalizations were lower with NT-proBNP testing (0.29 vs 0.43). Lifetime costs were higher with NT-proBNP testing (US$117 010 vs US$92 283), reflecting longer survival and greater use of appropriate cardioprotective treatments. NT-proBNP was cost-effective, with an incremental cost per QALY gained of US$40 883. Results were robust, with the model most sensitive to changes in diabetes management costs, mortality among high-risk individuals, and cardioprotective drug effectiveness.</p><p><strong>Conclusions: </strong>Annual NT-proBNP testing in older adults with type 2 diabetes is cost-effective for early HF detection in a Medicare setting, supporting broader adoption of guideline-recommended testing in this high-risk population.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073510","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}