BMJ Open Diabetes Research & Care最新文献

{"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}

{"title":"Resetting the glucose sensor: dorzagliatin and the evolution of glucokinase activation in diabetes therapy.","authors":"Mingxing Chang, Peipu Shen, Guifang Shen","doi":"10.1136/bmjdrc-2026-006217","DOIUrl":"10.1136/bmjdrc-2026-006217","url":null,"abstract":"<p><p>The progressive decline in functional β-cell mass represents a fundamental, unmet challenge in type 2 diabetes (T2DM) management. Dorzagliatin (HMS5552), a fourth-generation, dual-acting, and glucose-dependent glucokinase activator (GKA), offers a distinct mechanistic approach that aims to move beyond symptomatic glycemic control toward potential glucose sensor modulation. This review critically synthesizes the development of dorzagliatin, designed to overcome the hypoglycemia and tachyphylaxis of earlier GKAs. While its unique allosteric mechanism enables synchronized restoration of insulin secretion and hepatic glucose metabolism, we critically evaluate its clinical positioning. Observational data from the DREAM study suggest sustained drug-free glycemic maintenance; however, we emphasize that these findings do not yet meet the rigorous 2021 American Diabetes Association/European Association for the Study of Diabetes consensus definition of \"diabetes remission\" and require validation through randomized withdrawal trials. Furthermore, we address the critical absence of long-term cardiovascular outcomes trials (CVOTs) and the theoretical concerns regarding hepatic de novo lipogenesis. We also propose a synergistic framework for combining dorzagliatin with sodium-glucose cotransporter-2 inhibitors to counteract compensatory endogenous glucose production, positioning it as a precision-driven component in the evolving T2DM therapeutic landscape. Should future CVOTs demonstrate safety and efficacy, GKAs like dorzagliatin could potentially be integrated into treatment guidelines, possibly as a \"sensor-calibrator\" for a subset of patients identified through metabolic and genetic phenotyping. However, it must be emphasized that no CVOT data are currently available for dorzagliatin.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058235","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 Life's Essential 8 cardiovascular health score with prevalent microvascular complications stratified by sex and menopausal status in Chinese adults with type 2 diabetes: a cross-sectional study.","authors":"Lin Qiu, Yuyao Feng, Yanning Zhou, Xiaoting Chen, Jingjia Yu, Li Li, Kaushik Chattopadhyay, Miao Xu, Jialin Li","doi":"10.1136/bmjdrc-2026-006185","DOIUrl":"10.1136/bmjdrc-2026-006185","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between Life's Essential 8 (LE8) cardiovascular health score and prevalent microvascular complications in Chinese adults with type 2 diabetes mellitus (T2DM) and to explore whether this association differed by sex and menopausal status.</p><p><strong>Research design and methods: </strong>We conducted a cross-sectional analysis of 4527 adults with T2DM in the Metabolic Management Center (MMC) registry. LE8 scores were calculated based on the American Heart Association framework and categorized into low, moderate and high tiers using the 25th and 75th percentiles as cut-offs. Prevalent composite microvascular complications were defined as diabetic kidney disease, diabetic retinopathy and/or diabetic peripheral neuropathy. Multivariable logistic regression estimated prevalence ORs and 95% CIs for the associations of LE8 scores with prevalent microvascular complications. Restricted cubic spline (RCS) analyses and interaction testing by sex and menopausal status were also conducted.</p><p><strong>Results: </strong>Participants included 2894 men (63.9%), 557 premenopausal women (12.3%) and 1076 postmenopausal women (23.8%). Higher LE8 scores were associated with lower prevalence odds of microvascular complications. Compared with the low LE8 group, the adjusted prevalence OR for the high LE8 group was 0.43 (95% CI 0.36 to 0.52). The inverse association differed by sex and menopausal status (p for interaction=0.027) and appeared strongest in premenopausal women (high LE8 OR: 0.17, 95% CI 0.09 to 0.33). The RCS curves showed broadly similar inverse associations across groups.</p><p><strong>Conclusions: </strong>Higher LE8 scores are inversely associated with prevalent microvascular complications in Chinese adults with T2DM. The inverse association appeared strongest in premenopausal women. These findings suggest that sex and menopausal status should be considered when interpreting the observed association.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029938","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":"Selective glomerular hypofiltration syndrome: a novel renal phenotype associated with cardiovascular disease and adverse outcomes in diabetic kidney disease.","authors":"Yuan Fang, Xiaodan Guo, Liuting Zhong, Xinyan He, Xiaohong Zhang, Jianxin Wan","doi":"10.1136/bmjdrc-2026-006417","DOIUrl":"10.1136/bmjdrc-2026-006417","url":null,"abstract":"<p><strong>Introduction: </strong>Selective glomerular hypofiltration syndrome (SGHS), defined by a low ratio of estimated glomerular filtration rate using cystatin C (eGFRcys) to estimated glomerular filtration rate using creatinine (eGFRcr), has emerged as a novel kidney dysfunction phenotype. Its role in diabetic kidney disease (DKD) remains unknown. This study aimed to investigate the association between SGHS and the prevalence of cardiovascular disease (CVD) at the time of renal biopsy-diagnosed DKD, as well as its association with long-term renal outcomes.</p><p><strong>Research design and methods: </strong>This study included 182 patients with biopsy-proven DKD. SGHS was defined as eGFRcys/eGFRcr ratio <0.60. Predictive value of the SGHS for the prevalence of CVD was assessed using receiver operating characteristic (ROC) curves. Independent risk factors for CVD prevalence were identified by logistic regression and used to construct a nomogram. ROC curves, calibration curves, decision curve analysis, and clinical impact curves were used for assessment of model performance. The impact of SGHS on renal outcomes was assessed using Kaplan-Meier curves and Cox regression. Subgroup analyses stratified by gender and body mass index categories were performed. Sensitivity analysis was conducted by redefining SGHS as eGFRcys/eGFRcr ratio <0.70.</p><p><strong>Results: </strong>Of 182 patients, 41 (22.5%) had SGHS. The eGFRcys/eGFRcr ratio better predicted CVD (area under the curve (AUC) 0.730, 95% CI 0.643 to 0.816) than eGFRcr (AUC 0.602, 95% CI 0.507 to 0.697), eGFRcys (AUC 0.701, 95% CI 0.615 to 0.786), estimated glomerular filtration rate based on creatinine and cystatin C (AUC 0.685, 95% CI 0.595 to 0.774), and urinary albumin-to-creatinine ratio (AUC 0.633, 95% CI 0.540 to 0.725). SGHS was independently associated with CVD after adjustment (OR 9.27, 95% CI 3.20 to 26.84; p<0.001). A nomogram incorporating SGHS demonstrated good discrimination (AUC 0.834; bias-corrected C-index 0.808) and calibration. Over a median follow-up of 30.1 months, patients with SGHS had higher cumulative DKD progression probability (log-rank test: χ²=11.79, p<0.001), and SGHS was an independent risk factor for DKD progression (HR 2.645, 95% CI 1.564 to 4.472; p<0.001). Subgroup analyses and sensitivity analysis confirmed the robustness of these findings.</p><p><strong>Conclusions: </strong>SGHS is independently associated with the prevalence of CVD at the time of DKD diagnosis, and independently predicts adverse renal outcomes in patients with DKD. As an easily obtainable parameter, the eGFRcys/eGFRcr ratio may serve as a valuable risk assessment tool in patients with DKD.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988142","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":"Differences in screen-detected type 2 diabetes in two targeted community-based screening campaigns in Denmark.","authors":"Nuri Cayuelas Mateu, Peter Rossing, Kirsten Piepgras Neergaard, Tanja Thybo","doi":"10.1136/bmjdrc-2026-006034","DOIUrl":"10.1136/bmjdrc-2026-006034","url":null,"abstract":"<p><strong>Objective: </strong>Targeted type 2 diabetes screening campaigns aim to improve patients' quality of life and life expectancy and reduce healthcare costs, although different setups may yield varying detection outcomes. The aim of this study is to assess whether at-home self-sampling improves the detection rates of prediabetes and diabetes compared with standard mobile unit screening.</p><p><strong>Research design and methods: </strong>Between June 2022 and November 2024, the Danish Diabetes Association offered free capillary HbA1c tests to individuals at high risk of diabetes based on the Leicester's Risk Assessment score. Two community-based screening setups were applied: (a) a mobile unit using a point-of-care device and (b) at-home self-sampling screening tests using mailed Hemoglobin Capillary Collection System analyzed by high-performance liquid chromatography.</p><p><strong>Results: </strong>In total, 4051 individuals were tested via the mobile unit and 5609 via the at-home setup. In the mobile unit setup, the proportion of individuals aged ≥65 years was 54.3%, whereas in the at-home setup, they constituted 38.1%. HbA1c ≥48 mmol/mol (≥6.5%) was found in 3.1% of participants in the mobile unit and 3.5% in the at-home setup, while HbA1c values of 42-47 mmol/mol (6.0-6.4%) occurred in 9.1% and 15.2%, respectively.</p><p><strong>Conclusions: </strong>Mobile units and at-home self-sampling are complementary screening approaches, finding similar rates of screen detection with HbA1c ≥48 mmol/mol (≥6.5%), though the latter is more efficient in detecting individuals with HbA1c values of 42-47 mmol/mol (6.0-6.4%).</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975827","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}