BMJ Open Diabetes Research & Care最新文献

{"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}

{"title":"Alpha cell dysfunction in type 2 diabetes: associations with insulin resistance and reduced insulin secretion.","authors":"Lina Chang, Linlin Kong, Siyu Yan, Yian Gu, Jing Liu, Yadi Huang, Hui Li, Menghua Yuan, Ming Liu, Qing He","doi":"10.1136/bmjdrc-2025-005653","DOIUrl":"10.1136/bmjdrc-2025-005653","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined how insulin resistance and impaired insulin secretion are associated with hyperglucagonemia during oral glucose tolerance tests (OGTT) in type 2 diabetes mellitus (T2DM).</p><p><strong>Research design and methods: </strong>A retrospective analysis included 247 patients with T2DM treated at Tianjin Medical University General Hospital from October 2022 to March 2025. All underwent a 75 g OGTT, with blood samples collected at 0, 0.5, 1, 2, and 3 hours for glucose, insulin, C-peptide, and glucagon measurement. Insulin resistance was assessed via homeostasis model assessment of insulin resistance (HomaIR) and C-peptide immunoreactivity insulin resistance (CPRIR), while insulin secretion was evaluated using C-peptide area under the curve (AUC_cp), homeostasis model assessment of beta cell function (HomaB), first-phase and second-phase insulin secretion during OGTT (first PH and second PH). Generalized linear models and mediation analyses examined associations between glucagon levels and above indices. Model fitness and robustness were evaluated via residual diagnostics, Cook's distance, and bootstrapped CIs.</p><p><strong>Results: </strong>Glucagon levels during the OGTT were significantly elevated in patients with severe insulin resistance (HomaIR Q3 and CPRIR Q1), even after adjusting for confounders. In contrast, groups with the poorest insulin secretion (AUC_cp Q1, HomaB Q1, first PH Q1, and second PH Q1) did not show elevated glucagon levels compared with those with better secretion. Mediation analysis confirmed that neither AUC_cp nor HomaB mediated the relationship between insulin resistance and glucagon levels. Residual diagnostics demonstrated a satisfactory model fit. Furthermore, sensitivity analyses, both by excluding influential points identified via Cook's distance and by applying bootstrapped CIs, yielded consistent results, thereby affirming the robustness of the model.</p><p><strong>Conclusions: </strong>In T2DM, impaired glucagon suppression during OGTT is associated with insulin resistance closely, highlighting insulin resistance as a key factor in alpha-cell dysfunction.</p>","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/PMC13331004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359484","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":"Hyperosmolar hyperglycaemic state: a systematic review and meta-analysis.","authors":"James French, Lucy Bomphrey, Aspasia Manta, Katie Scandrett, Kashish Malhotra, Punith Kempegowda","doi":"10.1136/bmjdrc-2025-005765","DOIUrl":"10.1136/bmjdrc-2025-005765","url":null,"abstract":"<p><p>Current knowledge of hyperosmolar hyperglycaemic state (HHS) is drawn from case series and small observational cohorts, limiting applicability to broader clinical practice. There is a lack of robust, large-scale studies exploring triggers of HHS and associated mortality. This absence of reliable data impedes prevention strategies, tailored clinical guidelines, and equitable resource allocation. We conducted this systematic review to aggregate all relevant HHS cases, explore precipitating factors and outcomes, and how these vary by region. Searches across Ovid, PubMed, EMBASE, MEDLINE, Scopus, Web of Science, and Cochrane Library followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting HHS cases from database inception to February 2025 were selected. Data on demographics, biochemical results, precipitants, outcomes, and complications were collected. 27 studies with a total of 63 935 cases were included. The median age was 63.8 years (IQR: 56.1-72.0). Common precipitants were non-infective illness (49.5%), infection (44.0%), and new diabetes diagnosis (31.7%). Intensive treatment unit admission was 40.8%, with the highest rate in North America (70.0%). Median hospital stay was 7.5 days, longest in Asia (17.5 days) and shortest in North and South America (4.0 days). Overall mortality was 21.1%, highest in Africa (40.0%), followed by Asia (18.2%), and lowest in North America (4.8%). Complications were acute kidney injury (7.6%), pulmonary oedema (4.8%), and acute coronary syndrome (3.9%). HHS presents with similar biochemistry globally, but outcomes vary significantly. Reducing mortality requires better diabetes diagnosis, harmonised protocols, and resource-adapted management to reduce gaps and inform prevention guidelines.<b>PROSPERO registration number</b>CRD42025625923.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350937","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":"Discordant high remnant cholesterol with LDL-C increases the metabolic dysfunction-associated steatotic liver disease risk in patients with type 2 diabetes mellitus.","authors":"Ying Zhao, Zhaoyue Li, Tian Yu, Yan Yang, Tingting Du","doi":"10.1136/bmjdrc-2025-005841","DOIUrl":"10.1136/bmjdrc-2025-005841","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD) frequently coexist in the same individual. Dyslipidemia plays a central role in the pathogenesis of MASLD. Remnant cholesterol (RC) is the cholesterol content carried in triglyceride-rich lipoproteins. We aimed to examine the association of RC, its discordance with low-density lipoprotein cholesterol (LDL-C) in terms of MASLD risk in patients with T2DM.</p><p><strong>Research design and methods: </strong>A total of 26 302 T2DM patients who were hospitalized were cross-sectionally assessed. Logistic regression models were employed to assess the associations. We used three approaches to assess the effects of the discordance between RC and LDL-C on MASLD risk: clinical cut-off points, differences of >10 percentile points and residuals.</p><p><strong>Results: </strong>The median age was 62.0 years, and 48.3% had MASLD. RC was more closely associated with MASLD than LDL-C. Furthermore, discordantly high RC was associated with higher MASLD risk than discordantly high LDL-C, regardless of which method of discordance analysis is used. For example, for the residual approach, in a regression model including LDL-C and RC residual, the latter, representing the portion of RC not explained by LDL-C, was more associated with MASLD risk than LDL-C (OR=1.26, 95% CI 1.22 to 1.30 for RC residual and OR=1.04, 95% CI 1.01 to 1.07 for LDL-C); in a regression model including RC and LDL-C residual, the latter representing the portion of LDL-C not explained by RC, RC was more associated with MASLD risk than LDL-C residual (OR=1.24, 95% CI 1.20 to 1.29 for RC and OR=1.09, 95% CI 1.06 to 1.12 for LDL-C residual).</p><p><strong>Conclusions: </strong>Discordantly high RC was associated with higher MASLD risk than discordantly high LDL-C. Our findings suggest that RC may serve as a potential target for prevention and intervention for MASLD.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263378","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":"Factors associated with hypoglycemic or hyperglycemic events during Ramadan among persons with diabetes in Qatar.","authors":"Zahir M Tag, Laith J Abu-Raddad, Amel A Mustafa, Hiam Chemaitelly, Abdulla O Alhamaq, Katie G El-Nahas","doi":"10.1136/bmjdrc-2026-006076","DOIUrl":"10.1136/bmjdrc-2026-006076","url":null,"abstract":"<p><strong>Background: </strong>Despite the high prevalence of diabetes in Qatar, Ramadan-related glycemic events remain inadequately characterized. This study examined sociodemographic, clinical and behavioral factors independently associated with hypoglycemic or hyperglycemic events among patients with diabetes during Ramadan in Qatar.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using routinely collected data from the Qatar Diabetes Association (QDA) Ramadan support program covering three Ramadan seasons (2022-2024). Patients with type 1 or type 2 diabetes who attended QDA diabetes education or dietetic clinics were included, regardless of fasting intention. Those with pre-diabetes or gestational diabetes were excluded. Assessments began 6-8 weeks before Ramadan, with structured follow-up throughout the month. Primary outcomes-based on patient-recorded blood glucose readings-were defined to capture the overall risk of glycemic instability during Ramadan and included (1) any hypoglycemic (<70 mg/dL) or hyperglycemic (>250 mg/dL) event and (2) any such events during fasting hours. Generalized estimating equation logistic regression models identified factors associated with hypoglycemic or hyperglycemic outcomes. Missing data were <5% and handled by complete-case analysis. Statistical significance was defined as 95% CIs excluding 1.</p><p><strong>Results: </strong>The study included 374 patients; 95.5% of observations were from patients with type 2 diabetes and 43.3% reflected longer diabetes duration. Adjusted ORs indicated higher odds of hypoglycemia or hyperglycemia at any time among patients with a longer diabetes duration, a high International Diabetes Federation-Diabetes and Ramadan risk score, those who discussed a fasting plan with a physician, those who used medications known to increase hypoglycemia risk, and those who used continuous glucose-monitoring devices. During fasting hours, higher odds were observed among patients with type 1 diabetes and those with a higher daily number of recorded blood glucose readings.</p><p><strong>Conclusions: </strong>The findings underscore the importance of structured pre-Ramadan risk assessment, patient-centered education, close and rigorous follow-up and individualized treatment adjustment-particularly for high-risk groups-to optimize safety and enhance the overall Ramadan experience among persons with diabetes.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223308","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":"Suvorexant protects from ocular complications of diabetes in db/db mice.","authors":"Rupinder Kaur Sodhi, Neha Mahajan, Surabhi D Abhyankar, Ashay Dilip Bhatwadekar","doi":"10.1136/bmjdrc-2025-005476","DOIUrl":"10.1136/bmjdrc-2025-005476","url":null,"abstract":"<p><strong>Introduction: </strong>Orexins, hypothalamic neuropeptides, play a critical role in promoting wakefulness. Suvorexant, a dual orexin receptor antagonist, which is primarily indicated for the treatment of insomnia, also lowers blood glucose. Similarly, in rodent studies, suvorexant has shown beneficial effects on overall glucose homeostasis. Using an animal model of type 2 diabetes (T2D) db/db mice, we hypothesized that suvorexant treatment could improve the ocular complications of T2D.</p><p><strong>Reseach design and methods: </strong>Male db/db mice were treated daily with suvorexant (30 mg/kg, intraperitoneal) or vehicle at Zeitgeber time 0-2 for 12 weeks. The following visual assessments were performed to study the effects of suvorexant: electroretinogram, optomotor response test, and fluorescein angiography. Glucose and insulin tolerance tests were performed to assess the impact on glycemic control. After euthanasia, retinas were isolated, and qPCR and immunofluorescence staining were performed.</p><p><strong>Results: </strong>Suvorexant treatment improved visual acuity and vascular parameters, including reduced avascular and increased vascular areas. There was a decrease in scotopic a-wave and b-wave amplitudes in suvorexant-treated mice, along with increased b-wave implicit time. Suvorexant downregulated mRNA of phospholipase C γ1 and protein kinase C beta, as well as inflammatory markers tumor necrosis factor-α (<i>Tnf-a</i>) and interleukin 1β (<i>Il-1b</i>). Consistent with changes in mRNA levels, suvorexant reduced protein expression of PKCβ and CD45 in immunofluorescence studies of retinal transverse sections. Furthermore, suvorexant-treated mice demonstrated improved glucose tolerance compared with vehicle-treated mice.</p><p><strong>Conclusions: </strong>We found that suvorexant improved visual acuity and retinal vascular insufficiency by reducing retinal inflammation and improving glucose homeostasis in db/db mice. Our findings suggest that orexin receptor inhibition, with suvorexant, may be a potential treatment for ocular complications associated with T2D.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216258","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":"Screening, Diagnosis, Evaluation, and Staging of Obesity in Adults: Standards of Care in Overweight and Obesity-2026.","authors":"","doi":"10.1136/bmjdrc-2026-006247","DOIUrl":"10.1136/bmjdrc-2026-006247","url":null,"abstract":"<p><p>Obesity is a heterogeneous chronic disease in which excess adiposity increases the risk of morbidity and mortality. The Obesity Association, a division of the American Diabetes Association (ADA), developed comprehensive, evidence-based guidelines on screening, diagnosis, evaluation, and staging of overweight and obesity in adults. Monitoring for consistent increases in weight over time may facilitate early intervention to prevent obesity and its complications, and screening for excess adiposity should be performed at least annually using BMI. The recommended diagnostic criteria for overweight and obesity include race- and ethnicity-specific BMI thresholds supplemented with waist circumference-based measures for certain individuals to reduce the risk of underdiagnosis. healthcare professionals should perform a comprehensive clinical evaluation, including risk stratification and staging, of all adults diagnosed with overweight or obesity, which will inform the management plan and follow-up care. The ADA's Obesity Association encourages healthcare professionals to adopt these guidelines for evaluating obesity in adults.</p>","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 Suppl 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161771","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}