BMJ Open Diabetes Research & Care最新文献

{"title":"Role of 2-hour plasma glucose in assessing pre-diabetes risk: insights from the vitamin D and type 2 diabetes (D2d) study cohort.","authors":"Sun H Kim, Vanita R Aroda, Ranee Chatterjee, Erin S LeBlanc, Jason Nelson, Neda Rasouli, Myrlene A Staten, Ellen M Vickery, Anastassios G Pittas, Daniel S Hsia","doi":"10.1136/bmjdrc-2025-004953","DOIUrl":"https://doi.org/10.1136/bmjdrc-2025-004953","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466873","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":"Incidence of metabolic and bariatric surgery among US adults with obesity by diabetes status: 2016-2020.","authors":"Yiling J Cheng, Kai McKeever Bullard, Israel Hora, Brook Belay, Fang Xu, Christopher S Holliday, Roberto Simons-Linares, Stephen R Benoit","doi":"10.1136/bmjdrc-2024-004614","DOIUrl":"10.1136/bmjdrc-2024-004614","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic and bariatric surgery (MBS) is an effective intervention to manage diabetes and obesity. The population-based incidence of MBS is unknown.</p><p><strong>Objective: </strong>To estimate the incidence of MBS among US adults with obesity by diabetes status and selected sociodemographic characteristics.</p><p><strong>Research design and methods: </strong>This cross-sectional study used data from the 2016-2020 Nationwide Inpatient Sample and Nationwide Ambulatory Surgery Sample to capture MBS procedures. The National Health Interview Survey was used to establish the denominator for incidence calculations. Participants included US non-pregnant adults aged ≥18 years with obesity. The main outcome was incident MBS without previous MBS, defined by International Classification of Diseases, Tenth Revision Procedure Codes, Diagnosis Related Group system codes, and Current Procedural Terminology codes. Adjusted incidence and annual percentage change (2016-2019) were estimated using logistic regression.</p><p><strong>Results: </strong>Among US adults with obesity, over 900 000 MBS procedures were performed in inpatient and hospital-owned ambulatory surgical centers in the USA during 2016-2020. The age- and sex-adjusted incidence of MBS per 1000 adults was 5.9 (95% CI 5.4 to 6.4) for adults with diabetes and 2.0 (95% CI 1.9 to 2.1) for adults without diabetes. MBS incidence was significantly higher for women and adults with class III obesity regardless of diabetes status. The highest incidence of MBS occurred in the Northeast region. Sleeve gastrectomy was the most common MBS surgical approach.</p><p><strong>Conclusions: </strong>Incident MBS procedures were nearly threefold higher among adults with obesity and diabetes than those with obesity but without diabetes. Continued monitoring of the trends of MBS and other treatment modalities can inform our understanding of treatment accessibility to guide prevention efforts aimed at reducing obesity and diabetes.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448145","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":"Predicting diabetes self-management education engagement: machine learning algorithms and models.","authors":"Xiangxiang Jiang, Gang Lv, Minghui Li, Jing Yuan, Z Kevin Lu","doi":"10.1136/bmjdrc-2024-004632","DOIUrl":"10.1136/bmjdrc-2024-004632","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes self-management education (DSME) is endorsed by the American Diabetes Association (ADA) as an essential component of diabetes management. However, the utilization of DSME remains limited in the USA. This study aimed to investigate current DSME participation among the older population and to identify comprehensive factors of DSME engagement through employing various machine learning (ML) models based on a US nationally representative survey linked to claims data.</p><p><strong>Research design and methods: </strong>Data from the Medicare Current Beneficiary Survey were employed, and this study included data on US Medicare beneficiaries with diabetes from 2017 to 2019. Comprehensive variables following the National Institute on Aging Health Disparities Research Framework were employed to ensure a comprehensive evaluation of factors associated with DSME using five common ML approaches.</p><p><strong>Results: </strong>In our study, 37.94% of participants received DSME after the application of inclusion and exclusion criteria. A total of 95 variables were used and all ML models achieved accuracy scores exceeding 70%. Random forest had better predictive performance, with an accuracy of 85%. Seventy-four of 95 variables were identified as key variables. Racial/ethnic disparities in predictors for DSME were identified in this study.</p><p><strong>Conclusions: </strong>This study identified comprehensive and critical factors associated with DSME engagement from biological, behavioral, sociocultural, and environmental domains using different ML models, as well as related racial/ethnic disparities. Aligning these findings with the DSME National Standards from the ADA would enhance the guidelines' effectiveness, promoting tailored and equal diabetes management approaches that cater to diverse races/ethnicities.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448146","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":"Alterations of hepatic lipid content following COVID-19 in persons with type 2 diabetes.","authors":"Yuliya Kupriyanova, Iryna Yurchenko, Pavel Bobrov, Frederik Bartels, Stefan Wierichs, Marc Jonuscheit, Benedict Korzekwa, Katsiaryna Prystupa, Martin Schön, Dania Mendez, Sandra Trenkamp, Volker Burkart, Robert Wagner, Vera Schrauwen-Hinderling, Michael Roden","doi":"10.1136/bmjdrc-2024-004727","DOIUrl":"10.1136/bmjdrc-2024-004727","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to assess the effect of COVID-19 on hepatic lipid (HL) content, fibrosis risk, and adiposity in persons with type 2 diabetes.</p><p><strong>Research design and methods: </strong>Participants with type 2 diabetes with a history of mild COVID-19 (n=15, age 58±12 years, body mass index 30.9±5.2 kg/m²) were examined before (baseline) and 1 year (12±2 months) after (follow-up) recovery from COVID-19. Investigations for changes in metabolic risk comprised clinical examination, fasting blood sampling and MR-based measurements. Potential changes were corrected with the time course of the respective parameters in a group of participants who did not contract COVID-19 over the same time course (n=14, 61±6 years, 30.0±4.6 kg/m²).</p><p><strong>Results: </strong>COVID-19 resulted in a relative increase in HL content of 56% (95% CI 18%, 106%; p=0.04) measured as proton density fat fraction (HL-PDFF), corrected for the time course in the absence of COVID-19. While no changes in hepatic stiffness and volume, intramyocellular lipids, whole-body, subcutaneous and visceral adipose tissue volumes as well as homeostatic model assessment of insulin resistance and beta-cell function were observed.</p><p><strong>Conclusions: </strong>History of COVID-19 in persons with type 2 diabetes is associated with higher HL-PDFF after 1 year following recovery from infection.</p><p><strong>Trial registration number: </strong>NCT01055093.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448144","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":"Three-protein signature is associated with baseline and persistently elevated or recurrent depressive symptoms in individuals with recent-onset diabetes.","authors":"Maria C Spagnuolo, Pascal Gottmann, Jana Sommer, Sandra Olivia Borgmann, Klaus Strassburger, Wolfgang Rathmann, Oana Patricia Zaharia, Sandra Trenkamp, Robert Wagner, Andrea Icks, Christian Herder, Michael Roden, Haifa Maalmi","doi":"10.1136/bmjdrc-2024-004396","DOIUrl":"10.1136/bmjdrc-2024-004396","url":null,"abstract":"<p><p>Depression is associated with diabetes, but the underlying causes remain unclear. To better understand depression in diabetes, this study investigated associations between 135 inflammatory and neurological protein biomarkers and depressive symptoms in individuals with diabetes.This cross-sectional study included 430 adults with a known diabetes duration <1 year from the German Diabetes Study (GDS), in whom biomarkers were measured in serum and depressive symptoms were evaluated at baseline and annually over 5 years using the Center for Epidemiological Studies Depression Scale (CES-D). Based on the information on depressive symptoms from the baseline and follow-up visits (n=305, ≥3 time points), we subdivided the sample into individuals with persistent or recurrent and transient or never depressive symptoms. We assessed the associations of each biomarker with baseline CES-D score (continuous) and persistent/recurrent depressive symptoms using multiple linear and logistic regression models, respectively.After adjustment for covariates, we identified a three-protein signature associated with baseline CES-D score and persistent/recurrent depressive symptoms. CUB domain-containing protein 1 (CDCP1) and NAD-dependent protein deacetylase sirtuin-2 (SIRT2) were positively associated with baseline (β 1.24 (95% CI 0.19 to 2.29); β 0.89 (95% CI 0.06 to 1.72)), respectively) and persistent/recurrent depressive symptoms (OR 1.58 (95% CI 1.08 to 2.31); OR 1.32 (95% CI 1.03 to 1.71), respectively), whereas leptin receptor (LEPR) was inversely associated with baseline (β -0.99 (95% CI -1.87 to -0.11)) and persistent/recurrent depressive symptoms (OR 0.70 (95% CI 0.49 to 0.99)). However, results were not significant after adjustment for multiple testing.In conclusion, the three-protein signature identified may provide insights into mechanisms underlying depressive symptoms in diabetes and might open new therapeutic avenues.The trial registration number of the study is NCT01055093.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448147","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 increase in carotid intima-media thickness in women with childhood-onset type 1 diabetes compared with healthy peers: the Norwegian Atherosclerosis and Childhood Diabetes study.","authors":"Aida Simeunovic, Cathrine Brunborg, Martin Heier, Tore Julsrud Berg, Knut Dahl-Jorgensen, Hanna Dis Margeirsdottir","doi":"10.1136/bmjdrc-2024-004505","DOIUrl":"10.1136/bmjdrc-2024-004505","url":null,"abstract":"<p><strong>Introduction: </strong>The risk of cardiovascular disease is increased in individuals with type 1 diabetes, despite good glycemic control. This study aims to evaluate early signs of atherosclerosis and predisposing factors in individuals with childhood-onset type 1 diabetes compared with healthy controls.</p><p><strong>Research design and methods: </strong>The Atherosclerosis and Childhood Diabetes study is a prospective population-based cohort study with follow-up every fifth year. The cohort consists of 329 subjects with type 1 diabetes and 173 controls. Carotid intima-media thickness (cIMT) was measured at baseline and 5 and 10 years of follow-up. Data from the Norwegian Childhood Diabetes Registry were used in assessment of traditional risk factors.</p><p><strong>Results: </strong>Mean cIMT in young women with type 1 diabetes increased significantly over a 10-year period compared with healthy controls (∆0.019 mm (0.001-0.035), p=0.035). At the 10-year follow-up the group with type 1 diabetes had a mean age of 24.2±2.9 years (13.7±2.8 years at baseline), diabetes duration of 15.6±3.4 years (5.4±3.3 years at baseline) and HbA1c of 8.2±3.6% (66±16 mmol/mol) (8.4±3.4% (68±13 mmol/mol) at baseline). Women with type 1 diabetes had significantly higher mean weight, body mass index, waist circumference, diastolic blood pressure (DBP), serum low-density lipoprotein (LDL)-cholesterol and apolipoprotein B, while men with type 1 diabetes had significantly higher mean DBP and urinary albumin-creatinine ratio compared with the control group. Mean cIMT change over time was not associated with long-term HbA1c or LDL-cholesterol burden in childhood and adolescence.</p><p><strong>Conclusion: </strong>Young women with childhood-onset type 1 diabetes of relatively short diabetes duration had a higher mean cIMT over a 10-year period compared with their healthy female controls, with values similar to males.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432661","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 of glycemic control with Long COVID in patients with type 2 diabetes: findings from the National COVID Cohort Collaborative (N3C).","authors":"Samuel Soff, Yun Jae Yoo, Carolyn Bramante, Jane E B Reusch, Jared Davis Huling, Margaret A Hall, Daniel Brannock, Til Sturmer, Zachary Butzin-Dozier, Rachel Wong, Richard Moffitt","doi":"10.1136/bmjdrc-2024-004536","DOIUrl":"10.1136/bmjdrc-2024-004536","url":null,"abstract":"<p><strong>Introduction: </strong>Elevated glycosylated hemoglobin (HbA1c) in individuals with type 2 diabetes is associated with increased risk of hospitalization and death after acute COVID-19, however the effect of HbA1c on Long COVID is unclear.</p><p><strong>Objective: </strong>Evaluate the association of glycemic control with the development of Long COVID in patients with type 2 diabetes (T2D).</p><p><strong>Research design and methods: </strong>We conducted a retrospective cohort study using electronic health record data from the National COVID Cohort Collaborative. Our cohort included individuals with T2D from eight sites with longitudinal natural language processing (NLP) data. The primary outcome was death or new-onset recurrent Long COVID symptoms within 30-180 days after COVID-19. Symptoms were identified as keywords from clinical notes using NLP in respiratory, brain fog, fatigue, loss of smell/taste, cough, cardiovascular and musculoskeletal symptom categories. Logistic regression was used to evaluate the risk of Long COVID by HbA1c range, adjusting for demographics, body mass index, comorbidities, and diabetes medication. A COVID-negative group was used as a control.</p><p><strong>Results: </strong>Among 7430 COVID-positive patients, 1491 (20.1%) developed symptomatic Long COVID, and 380 (5.1%) died. The primary outcome of death or Long COVID was increased in patients with HbA1c 8% to <10% (OR 1.20, 95% CI 1.02 to 1.41) and ≥10% (OR 1.40, 95% CI 1.14 to 1.72) compared with those with HbA1c 6.5% to <8%. This association was not seen in the COVID-negative group. Higher HbA1c levels were associated with increased risk of Long COVID symptoms, especially respiratory and brain fog. There was no association between HbA1c levels and risk of death within 30-180 days following COVID-19. NLP identified more patients with Long COVID symptoms compared with diagnosis codes.</p><p><strong>Conclusion: </strong>Poor glycemic control (HbA1c≥8%) in people with T2D was associated with higher risk of Long COVID symptoms 30-180 days following COVID-19. Notably, this risk increased as HbA1c levels rose. However, this association was not observed in patients with T2D without a history of COVID-19. An NLP-based definition of Long COVID identified more patients than diagnosis codes and should be considered in future studies.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188364","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":"Retraction: Circulating long non-coding RNAs NKILA, NEAT1, MALAT1, and MIAT expression and their association in type 2 diabetes mellitus.","authors":"","doi":"10.1136/bmjdrc-2020-001821.ret","DOIUrl":"10.1136/bmjdrc-2020-001821.ret","url":null,"abstract":"","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063767","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":"Ethnic disparities in HbA1c and hypoglycemia among youth with type 1 diabetes: beyond access to technology, social deprivation and mean blood glucose.","authors":"John Stuart Pemberton, Zhide Fang, Stuart A Chalew, Suma Uday","doi":"10.1136/bmjdrc-2024-004369","DOIUrl":"10.1136/bmjdrc-2024-004369","url":null,"abstract":"<p><strong>Introduction: </strong>The UK national pediatric diabetes audit reports higher HbA1c for children and young people (CYP) with type 1 diabetes (T1D) of Black ethnicity compared with White counterparts. This is presumably related to higher mean blood glucose (MBG) due to lower socioeconomic status (SES) and less access to technology. We aimed to determine if HbA1c ethnic disparity persists after accounting for the above variables.</p><p><strong>Research design and methods: </strong>A retrospective analysis of participants who received structured education in continuous glucose monitoring (CGM) use was conducted at a tertiary center. HbA1c was paired with glucose metrics from 90-day CGM data. The influence of ethnicity, SES determined by Index of Multiple Deprivation (IMD), MBG and other covariates on HbA1c was evaluated using multiple variable regression analysis. Occurrence of hypoglycemia was evaluated.</p><p><strong>Results: </strong>A total of 168 (79 White, 61 South Asian, 28 Black) CYP with T1D were included. There were no differences between groups for age, MBG, time in range (3.9-10.0 mmol/L), diabetes duration, gender, insulin delivery method (multiple daily injections vs continuous subcutaneous insulin infusion), or percent sensor use (PSU). In multiple variable analysis, MBG (p<0.0001), ethnicity (p<0.0001), age (p<0.001), duration of diabetes (p<0.01) and PSU (p<0.05) accounted for 81% of the variability in HbA1c. Adjusted HbA1c in the Black group (67 mmol/mol) was higher than both South Asian (63 mmol/mol) and White groups (62 mmol/mol) (p<0.001). Despite significant IMD differences between groups, it did not influence HbA1c. Multiple variable analysis showed that the Black group experienced more hypoglycemia than South Asian and White groups (<3.9 and <3.0 mmol/L, p<0.05).</p><p><strong>Conclusions: </strong>CYP from Black ethnic backgrounds have a higher HbA1c compared with their South Asian and White counterparts which is clinically significant and independent of MBG, potentially contributing to increased complications risk. Additionally, the Black group experienced a higher incidence of hypoglycemia, possibly due to a treat-to-HbA1c target approach.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036972","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 use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort study.","authors":"Zarin Abdullah, Ying Cui, Robert W Platt, Christel Renoux, Laurent Azoulay, Chenjie Xia, Oriana Hoi Yun Yu","doi":"10.1136/bmjdrc-2024-004541","DOIUrl":"10.1136/bmjdrc-2024-004541","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the association between sodium-glucose co-transporter-2 inhibitor (SGLT-2i) use and the risk of incident dementia compared with dipeptidyl peptidase-4 inhibitors (DPP-4i) use among individuals with type 2 diabetes.</p><p><strong>Design: </strong>A population-based retrospective cohort study.</p><p><strong>Setting: </strong>The Clinical Practice Research Datalink (CPRD) Aurum database from the UK.</p><p><strong>Participants: </strong>Individuals with type 2 diabetes, aged 40 years or older, newly prescribed SGLT-2i or DPP-4i on or after 2013-2021, registered in the CPRD Aurum database.</p><p><strong>Main outcome measure: </strong>The primary outcome was incident dementia, and the secondary outcome was incident mild cognitive impairment (MCI). Cox proportional hazard models were used to estimate the HR and corresponding 95% CI for the primary and secondary outcomes. Propensity score fine stratification weights were used to adjust for confounding.</p><p><strong>Results: </strong>Among a cohort of 118 006 individuals, the incident rate (IR) of dementia was 0.56/1000 person-years over a median follow-up period of 1.54 years among SGLT-2i users compared with 2.67/1000 person-years in DPP-4i users, over a median follow-up period of 1.79 years. The adjusted HR for SGLT-2i use compared with DPP-4i use for dementia was 0.78 (95% CI 0.55 to 1.12), while for MCI was 0.86 (95% CI 0.80 to 0.92). The age-specific stratified analysis demonstrated the adjusted HR for SGLT-2i use compared with DPP-4i use for the risk of incident dementia among elderly, aged ≥65 years, was 0.50 (95% CI 0.31 to 0.80).</p><p><strong>Conclusion: </strong>Primary findings did not yield conclusive evidence to infer an association between SGLT-2i use and the risk of incident dementia.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022053","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}