Canadian journal of diabetes最新文献

{"title":"Maternal Serum Polyol Levels Associated With Gestational Diabetes Mellitus and Large-for-Gestational-Age Infants: A Population-Based Nested Case-Control Study.","authors":"Tao Tan, Meng Wang, Yicheng Qi, Yu Liu, Li Qin, Jing Ma","doi":"10.1016/j.jcjd.2026.06.004","DOIUrl":"10.1016/j.jcjd.2026.06.004","url":null,"abstract":"<p><strong>Objective: </strong>Polyols, natural nutritive sweeteners, are often found in the diet during pregnancy. This study investigates the association between maternal serum polyol levels and the risk of gestational diabetes mellitus (GDM) and large-for-gestational-age (LGA) infants.</p><p><strong>Methods: </strong>This nested case-control study matched 218 women (with GDM vs. without GDM) by age and body mass index. After exclusions, the final analytic sample comprised 194 women for glucose metabolism outcomes and 177 women for birth weight and LGA outcomes. Serum polyols (sorbitol, erythritol, xylitol, and maltitol) were quantified using gas chromatography coupled with time-of-flight mass spectrometry. LGA was defined as a birth weight ≥90th percentile or ≥4000 g. Logistic regression was used to assess the associations between polyols and GDM and LGA, with adjustment for confounders.</p><p><strong>Results: </strong>Among the participants, 23.7% had LGA infants, and maternal serum polyol levels were significantly higher in this group. After adjusting for confounders, a 1-standard deviation increase in serum polyol levels was associated with increased odds of LGA (odds ratio=1.71, 95% confidence interval [CI]:1.22 to 2.40) and GDM (OR=1.52, 95% CI: 1.09 to 2.14). Erythritol and sorbitol were significantly associated with the odds of LGA, whereas xylitol and maltitol had no significant associations. Furthermore, a 1-standard deviation increase in serum polyol levels was linked to higher birth weight (beta [β]=95 g, 95% CI: 33 to 157 g) and elevated homeostasis model assessment for insulin resistance (β=0.32, 95% CI: 0.12 to 0.52).</p><p><strong>Conclusions: </strong>Elevated maternal serum polyol levels were positively associated with the risk of GDM, LGA infants, and higher birth weight.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Glycation Endproducts Delay Diabetic Wound Healing by OSR2/SPRR1B Signalling in Keratinocyte's Proliferation and Differentiation.","authors":"Jiaoyun Dong, Xiaozan Cao, Yuzhi Jiang, Zengding Zhou, Ming Tian","doi":"10.1016/j.jcjd.2026.06.002","DOIUrl":"10.1016/j.jcjd.2026.06.002","url":null,"abstract":"<p><strong>Objective: </strong>The deposition of advanced glycation endproducts (AGEs) in skin tissue is a major risk factor leading to refractory diabetic wounds. However, the mechanism of AGEs in diabetic wounds remains unclear. This study aimed to investigate the mechanism and signalling pathway of AGEs in diabetic wound healing.</p><p><strong>Methods: </strong>This study integrated bioinformatics analysis of the Gene Expression Omnibus data set (GSE80178) to identify differentially expressed genes between diabetic foot ulcer and non-diabetic foot ulcer tissues, with small proline-rich protein 1B (SPRR1B) validated as a key target in clinical specimens. Mechanistic investigations were conducted using AGE-stimulated HaCaT cells and db/db diabetic mouse models. We combined cellular functional assays (CCK-8, flow cytometry, western blotting, and immunofluorescence), chromatin immunoprecipitation, and in vivo short hairpin RNA knockdown to explore how the OSR2-SPRR1B axis regulates cell fate and affects diabetic wound healing.</p><p><strong>Results: </strong>SPRR1B and OSR2 levels were upregulated in diabetic wound tissues and HaCat cells with AGE intervention. After knockdown of SPRR1B or OSR2 expression, keratinocyte proliferation was promoted and apoptosis was inhibited, the expression of CK5/CK14 and loricrin increased, and the expression of CK1/CK10 decreased significantly. SPRR1B expression was changed by OSR2 knockdown and overexpression. SPRR1B expression significantly increased with OSR2 inducing directly, as revealed by chromatin immunoprecipitation assays. SPRR1B, OSR2, and AGEs were highly expressed in db/db mice. Knockdown of SPRR1B accelerated diabetic wound healing, increased the Ki67-positive cell rate, decreased the apoptosis rate, increased CK5/CK14 expression in the basal layer and CK1/CK10 between the basal layer and horny layer, and increased loricrin in epidermal tissue in db/db mice.</p><p><strong>Conclusions: </strong>SPRR1B was a key factor in diabetic wounds with AGE deposition, and OSR2 was an upstream control gene of SPRR1B. Inhibition of SPRR1B expression enhanced diabetic wound healing.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148285016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Real-world Analysis of Insulin Pump and Continuous Glucose Monitoring Technology Utilization in a Large Canadian Type 1 Diabetes Clinic.","authors":"Karl Vantomme, Samin Dolatabadi, Bikrampal Sidhu, Wilma M Hopman, Robyn L Houlden","doi":"10.1016/j.jcjd.2026.05.009","DOIUrl":"10.1016/j.jcjd.2026.05.009","url":null,"abstract":"<p><strong>Objective: </strong>We performed a retrospective, real-world analysis of a large outpatient adult type 1 diabetes clinic to assess the patterns of use of diabetes technologies and their impact on glycemic metrics.</p><p><strong>Methods: </strong>Data from the most recent clinic visit between January 2024 and April 2025 were used to capture diabetes technologies used, glycated hemoglobin (A1C), continuous glucose monitoring (CGM) metrics, and incidence of diabetic ketoacidosis and level 3 hypoglycemia during the prior year.</p><p><strong>Results: </strong>A total of 794 people were identified: 56.7% were females, the mean age was 45.6 years (standard deviation [SD]=16.8), the mean diabetes duration was 25.5 years (SD=14.9), basal bolus insulin (BBI) use was 24%, and pump use was 76%. CGM was used by 81.2% of BBI users and 93.4% of pump users. The mean pump duration was 11.3 years (SD=6.9). Automated insulin delivery (AID) was used by 58.7% of pump users: 78% used Tandem Control IQ, 19.2% used Medtronic SmartGuard, and 2.8% used Omnipod with Do-It-Yourself looping. Level 3 hypoglycemia/diabetic ketoacidosis rates were low and insufficient for comparison. Of pump users using CGM, 35.2% were using a CGM not compatible with their pump AID. A1C level did not differ between BBI users without CGM and pump users without CGM or between BBI users with CGM and open-loop pump users with CGM. The use of AID was associated with lower A1C level, more time in range, less time below range and time above range, and less glycemic variability.</p><p><strong>Conclusions: </strong>In this large, real-world Canadian study, the use of AID systems was associated with significantly better glycemic management compared with both BBI and open-loop insulin pump therapy.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creating the Diabetes Mobile Clinic: A Community-Grounded Model for Equitable Diabetes Care in Calgary.","authors":"Tucker Reed, Jeremy Auger, Roland Booth, Emma Wissink, Maureen Evans, Doreen Rabi, Hanan Bassyouni, Maria Ilnyckyj, Julie McKeen, Amity Quinn, David J T Campbell","doi":"10.1016/j.jcjd.2026.05.007","DOIUrl":"10.1016/j.jcjd.2026.05.007","url":null,"abstract":"<p><strong>Background: </strong>Individuals experiencing structural vulnerability face multiple barriers to accessing diabetes specialty care, contributing to disproportionately poor diabetes outcomes, including higher rates of retinopathy, renal replacement therapy, and hospitalizations for glycemic emergencies. Across the literature, patients and health-care providers note that traditional service models do not meet the needs of these populations and that reimagined, flexible approaches to care delivery are needed. This paper describes the co-creation of the Diabetes Mobile Clinic, a community-grounded model designed to bring equitable diabetes care directly into underserved settings.</p><p><strong>Results: </strong>Through the co-creation of the Diabetes Mobile Clinic, 4 descriptive key lessons emerged. First, community engagement built trust and relevance by grounding service design in lived experience and fostering relationships over transactions. Second, partnerships enhanced sustainability and scalability by linking academic, community, and health system leadership through shared power and complementary expertise. Third, embedding lived experience promoted cultural safety by reducing stigma, fostering empathy, and ensuring accountability to community priorities. Finally, flexibility in service delivery overcame access barriers by bringing comprehensive diabetes care directly into community settings and adapting to clients' needs.</p><p><strong>Conclusion: </strong>Co-creating the Diabetes Mobile Clinic with individuals with lived experience, clinic leadership, and community organizations has demonstrated early promise in bringing equitable diabetes care directly to populations facing structural vulnerabilities in Calgary. Ongoing studies evaluating the clinic's effectiveness are essential to generate empirical evidence that can support sustained funding and long-term operation.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and Metabolic Basis of Increased Diabetes Mellitus Risk in Down Syndrome: A Narrative Review.","authors":"Madhan Krishnan, Kamal Kumar Chawla, Anusha Gudimalla, Shyamaladevi Babu, Alfred Solomon, Azmathullah Rahmathullah, Billy Asir","doi":"10.1016/j.jcjd.2026.05.008","DOIUrl":"10.1016/j.jcjd.2026.05.008","url":null,"abstract":"<p><p>Down syndrome (DS), caused by trisomy 21, is associated with a range of comorbidities, including a significantly increased risk of diabetes mellitus (DM). Type 1 DM (T1DM) and type 2 DM (T2DM) are more prevalent in individuals with DS compared with the general population, presenting significant clinical challenges. This review explores the genetic and metabolic factors underlying this elevated risk, focusing on the interplay of gene dosage effects, immune dysregulation, insulin resistance, and endocrine dysfunction. A systematic and critical assessment of the current literature reveals that the triplication of chromosome 21 leads to gene dosage effects that disrupt immune regulation, thereby promoting autoimmunity and increasing susceptibility to T1DM. Simultaneously, insulin resistance associated with obesity and altered adipokine secretion contributes to the development of T2DM. Endocrine abnormalities, particularly hypothyroidism, further impair beta-cell function and exacerbate peripheral insulin resistance. These combined mechanisms create a complex metabolic environment that predisposes individuals with DS to both forms of diabetes. Understanding these interconnected pathways is essential for early diagnosis and the development of tailored management strategies. Continued research is necessary to identify specific biomarkers and refine therapeutic approaches to improve clinical outcomes in this vulnerable population.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional and Rural-Urban Differences in Incidence Rates of Types 1 and 2 Diabetes Mellitus-Related Foot Complications and Lower-Extremity Amputation in Selected Canadian Provinces and Territories.","authors":"Angela Y Kim, James Hanley, Rebecca Fuhrer, Charles de Mestral","doi":"10.1016/j.jcjd.2026.05.006","DOIUrl":"10.1016/j.jcjd.2026.05.006","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate provincial/territorial and rural-urban differences in rates of diabetes-related foot complications (DFCs) and amputations across Canada.</p><p><strong>Methods: </strong>Canadian adults, excluding Québec residents, who were hospitalized for a first DFC, major (above-ankle) amputation, or major or minor (toe or partial-foot) amputation were identified from the Canadian Institute for Health Information's Discharge Abstract Database (April 1, 2017, to March 31, 2022). Age- and sex-adjusted mean annual event rates (per 100,000 residents) were calculated and compared across provinces/territories and by rural/urban residence.</p><p><strong>Results: </strong>The mean annual rate of major amputation was 8.7 per 100,000 residents, ranging from 6.6 to 15.3 per 100,000 across provinces/territories. The highest rates of major amputation were in Manitoba, Newfoundland and Labrador, and Nova Scotia. The lowest rates of major amputation were in the Territories, British Columbia, and Prince Edward Island. Rates of major or minor amputation and DFC ranged across provinces/territories from 10.3 to 29.6 per 100,000 and from 16.9 to 36.4 per 100,000, respectively. The rate of all events was approximately 2 times higher among residents of rural regions compared with urban regions. However, provinces and territories with the highest proportion of rural residents did not consistently exhibit the highest amputation rates.</p><p><strong>Conclusions: </strong>DFCs and amputation rates vary widely across provinces/territories and are higher among people living in rural areas. Further research is required to better understand risk factor management and amputation prevention efforts in provinces/territories with a high proportion of rural residents but comparatively low amputation rates.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Mellitus and Survival Outcomes in Women With Early-Stage Triple-Negative Breast Cancer: A Multicentre Population-Based Cohort Study From Saskatchewan.","authors":"Rabia K Shahid, Michelle Brabant, Prosanta Mondal, Osama Ahmed, Mita Manna, Shahid Ahmed","doi":"10.1016/j.jcjd.2026.05.005","DOIUrl":"10.1016/j.jcjd.2026.05.005","url":null,"abstract":"<p><strong>Objective: </strong>Diabetes mellitus has been associated with worse outcomes in several malignancies, yet its impact on women with early-stage triple-negative breast cancer (TNBC) remains unclear. This multicentre population-based cohort study evaluated the association between diabetes and survival outcomes in women with TNBC treated with neoadjuvant and/or adjuvant (curative-intent) chemotherapy.</p><p><strong>Methods: </strong>Adult women diagnosed with stages I to III TNBC in Saskatchewan, Canada (2010 to 2018), were identified. Patients were categorized by diabetes status. Overall survival (OS), disease-free survival (DFS), and invasive DFS were assessed using Kaplan-Meier methods, with multivariable Cox regression and inverse probability of treatment weighting (IPTW) to control for confounding factors.</p><p><strong>Results: </strong>Among 357 eligible women, 36 (10%) had diabetes. With a median follow-up of 88 months, women with diabetes experienced significantly inferior 5-year OS (61% vs 83%) and DFS (56% vs 78%) compared with women without diabetes (p<0.001). Diabetes was independently associated with worse DFS (hazard ratio: 2.95, 95% confidence interval: 1.73 to 5.04) and OS (hazard ratio: 2.73, 95% confidence interval: 1.55 to 4.79). Inverse probability of treatment weighting analysis confirmed the adverse impact of diabetes on survival.</p><p><strong>Conclusions: </strong>Diabetes is independently associated with significantly inferior DFS and OS in women receiving curative-intent chemotherapy for early-stage TNBC. Improved diabetes management during cancer care may represent an opportunity to enhance outcomes. Further prospective studies are warranted.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Sleep Duration and Glycemic Levels in Adults With Prediabetes: A Population-based Study.","authors":"Zhongqing Mou, Yan Zhou, Zaiquan Dong","doi":"10.1016/j.jcjd.2026.05.001","DOIUrl":"10.1016/j.jcjd.2026.05.001","url":null,"abstract":"<p><strong>Objective: </strong>Sleep duration is increasingly recognized as a modifiable risk factor for diabetes. Evidence specific to adults with prediabetes, a critical period for diabetes prevention, remains limited. This study aimed to investigate the association between sleep duration and glycemic levels in a nationally representative sample of adults with prediabetes.</p><p><strong>Methods: </strong>A total of 1,090 participants with prediabetes were included from the 2017-2020 National Health and Nutrition Examination Survey. Prediabetes was defined by a fasting plasma glucose (FPG) level of 5.6 to <7.0 mmol/L or a glycated hemoglobin (HbA1C) level of 5.7 to <6.5% without diagnosed diabetes. Sleep duration was calculated using weekday and weekend sleep hours. Survey-weighted multiple linear regression and smooth curve fitting were applied to evaluate the linear and nonlinear associations between sleep duration and glycemic levels (FPG and HbA1C). Threshold effects were evaluated using a 2-piecewise linear regression model, and subgroup analyses were performed.</p><p><strong>Results: </strong>Multiple linear regression analysis demonstrated a nonlinear association between sleep duration and FPG levels, with an inflection point at 6 hours per night. Below this threshold, each additional hour of sleep was associated with a lower FPG level (beta = -0.126, 95% confidence interval: -0.194 to -0.058; p=0.0003). No significant association was observed between sleep duration and FPG levels above 6 hours or between sleep duration and HbA1C levels in the fully adjusted model. Subgroup analyses indicated that associations differed by sex and race/ethnicity, with significant inverse associations observed in men and among Mexican American adults.</p><p><strong>Conclusions: </strong>Short sleep duration (<6 hours per night) was independently associated with elevated FPG levels in adults with prediabetes. These findings indicate that improving sleep duration may be a potentially modifiable factor for glycemic management in populations with prediabetes.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canadian Patient Perspectives on Facilitators and Barriers to Diabetic Foot Ulcer Care: A Scoping Review.","authors":"Shireen Fikree, Rudra Pandya, Virginie Blanchette, Tom Weisz, Alla Iansavitchene, Charles de Mestral","doi":"10.1016/j.jcjd.2026.04.009","DOIUrl":"10.1016/j.jcjd.2026.04.009","url":null,"abstract":"<p><p>Our aim in this study was to review Canadian patient and caregiver perspectives on the facilitators and barriers to diabetic foot ulcer (DFU) care. We conducted a scoping review in collaboration with a patient partner, following the PRISMA-ScR guidelines. Grey literature and primary studies from MEDLINE, CINAHL and Embase were searched from inception to February 2024. Studies of adults with active or healed DFUs and their caregivers were included. Data were independently screened and extracted by 2 reviewers and key themes were synthesized collaboratively. Twenty-two studies representing 400 patients or caregivers were included, with most individuals living in Ontario (n=15 articles, 68.1%). Five overarching themes capturing facilitators and barriers to DFU care were identified: Prevention, Access to Care, Patient Education, Wound Care, and Patient Impact. Reported barriers included emotional distress, limited mobility, low awareness of self-management strategies, and delayed referrals, while key facilitators involved caregiver and community support as well as education from health care providers. Canadian diabetic foot screening and DFU treatment (preservation) programs should focus on improving access, empowering patients through education, and leveraging community support partners to promote self-management and amputation prevention.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Exercises on Healing Dynamics and Physical Activity Levels in Individuals With Diabetic Foot Ulcer: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Sohini Raje, Radhika Aditya Jadhav, Megha Nataraj, G Arun Maiya, S S Prasad, M Mukhyaprana Prabhu, Rakshith G Maiya","doi":"10.1016/j.jcjd.2026.04.006","DOIUrl":"10.1016/j.jcjd.2026.04.006","url":null,"abstract":"<p><strong>Objectives: </strong>The burden of diabetic foot ulcers (DFUs) is increasing, causing morbidity and mortality. The management of DFUs involves surgical, pharmacologic, offloading, and lifestyle interventions. Reviews have suggested that exercise is safe in individuals with DFUs, but the evidence is variable and limited. The objective of this review was to examine the effect of exercise on DFU healing as well as physical activity levels.</p><p><strong>Methods: </strong>This review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Checklist 2020. Studies were included if they were randomized controlled trials (RCTs) in active DFUs with exercise intervention and measured DFU healing parameters and/or physical activity. The Cochrane RoB2 tool was used to assess the risk of bias. RevMan version 5.4.1 was used to perform the meta-analysis, with the random-effects model and suitable tests for heterogeneity.</p><p><strong>Results: </strong>Six RCTs were included in our review. The meta-analysis revealed that exercise intervention was effective in reducing the ulcer area in DFUs. However, the 12-week intervention was not sufficient to achieve a statistically significant difference (standardized mean difference -0.56 cm², 95% confidence interval -1.35 to 0.22; 280 participants, 5 studies; I²=90%). The studies had an overall risk of bias with \"some concerns.\" None of the studies reported physical activity as an outcome.</p><p><strong>Conclusions: </strong>This review highlighted that non-weight-bearing exercises reduced wound area in DFUs; however, a 12-week intervention was insufficient to reveal a significant change (Wagner grades 1 and 2). A trend toward improvement could be observed. High-quality RCTs are needed to transition the evidence into clinical practice.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}