Diabetes care最新文献

{"title":"Comparing Approaches for Deriving Diabetes Care Cascades to Inform Policy: A Cross-sectional Analysis Using National Data From 88 Countries.","authors":"Felix Teufel, Michaela Theilmann, Maja E Marcus, Mubarak A Sulola, David Guwatudde, Hedley K Quintana, José R Banegas, Aamna Soniwala, Sophia Kim, Krishna Aryal, Silver Bahendeka, Brice Bicaba, Albertino Damasceno, Farshad Farzadfar, Corine Houehanou, Christina Howitt, Khem Karki, Nuno Lunet, João Martins, Mary T Mayige, Kibachio J Mwangi, Sarah Quesnel-Crooks, Reina G Roa Rodríguez, Fernando Rodríguez-Artalejo, Sahar Saeedi Moghaddam, Abla M Sibai, Lela Sturua, Lindiwe Tsabedze, Zhaxybay Zhumadilov, Till Bärnighausen, Pascal Geldsetzer, Rifat Atun, Sebastian Vollmer, Jennifer Manne-Goehler, David Flood, Edward W Gregg, Justine I Davies, Mohammed K Ali, Jithin Sam Varghese","doi":"10.2337/dc26-0267","DOIUrl":"10.2337/dc26-0267","url":null,"abstract":"<p><strong>Objective: </strong>Care cascade indicators are widely used to monitor national diabetes control efforts. However, diabetes definitions used to derive care cascades vary across studies, which may markedly affect results and subsequent policy decisions. Here, we examine the magnitude of resultant differences between approaches.</p><p><strong>Research design and methods: </strong>We analyzed nationally representative, cross-sectional data of 800,348 individuals aged ≥25 years from 88 countries in 2008-2021. We used two different diabetes definitions: elevated biomarkers (glycated hemoglobin [HbA1c] ≥6.5%; fasting plasma glucose ≥7.0 mmol/L; or random plasma glucose ≥11.1 mmol/L) or self-reported diagnosis (\"diagnosis-based definition\") versus elevated biomarkers or self-reported treatment (\"treatment-based definition\"). Care cascade estimates included 1) proportions of individuals with diabetes who were diagnosed, and proportions of individuals with diagnosed diabetes who 2) received treatment and 3) attained glycemic control. We benchmarked results against World Health Organization (WHO) diabetes targets.</p><p><strong>Results: </strong>Diabetes prevalence was 12.9% (95% CI 12.1-13.8) applying the diagnosis-based definition and 11.3% (95% CI 10.5-12.1) with the treatment-based definition. Using the diagnosis-based rather than treatment-based diabetes definition to derive care cascades consistently increased the percentages of those who attain diagnosis and control stages but decreased percentages of those receiving treatment. Across countries, median differences between approaches were 11.3% (interquartile range [IQR] 5.1-24.7) for diabetes diagnosis, 21.6% (IQR 14.5-37.8) for treatment, and 16.4% (IQR 7.8-26.8) for control. The WHO 80% glycemic control target was met by 22% versus 6% of countries when using the diagnosis-based versus treatment-based definition, respectively.</p><p><strong>Conclusions: </strong>Care cascade estimates diverged substantially and consistently across diabetes definitions, skewing policy implications in predictable ways. Harmonizing diabetes performance metrics may improve decision-making and facilitate cross-country comparisons.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"49 6","pages":"1106-1114"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984758","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":"Food Coloring Additives and Incidence of Type 2 Diabetes in the NutriNet-Santé Prospective Cohort.","authors":"Sanam Shah, Anaïs Hasenböhler, Guillaume Javaux, Marie Payen de la Garanderie, Fabien Szabo de Edelenyi, Paola Yvroud, Cédric Agaësse, Alexandre De Sa, Inge Huybrechts, Fabrice Pierre, Marc Audebert, Xavier Coumoul, Chantal Julia, Emmanuelle Kesse-Guyot, Benjamin Allès, Valérie Deschamps, Serge Hercberg, Benoit Chassaing, Emmanuel Cosson, Sopio Tatulashvili, Mélanie Deschasaux-Tanguy, Bernard Srour, Mathilde Touvier","doi":"10.2337/dc25-2727","DOIUrl":"10.2337/dc25-2727","url":null,"abstract":"<p><strong>Objective: </strong>To investigate potential association between exposure to food coloring additives and type 2 diabetes incidence.</p><p><strong>Research design and methods: </strong>The study followed 108,723 participants (79.2% female, mean age 42.5 [SD 14.6] years) from the French NutriNet-Santé cohort (2009-2023). Dietary data were assessed using repeated 24-h dietary records, including industrial food brands. Cumulative time-dependent exposure to food additives was evaluated through multiple composition databases and ad hoc laboratory assays in food matrices. Associations between exposures to food coloring additives (sex-specific tertiles if proportion of exposed participants was more than two-thirds, or nonexposed/lower/higher exposed based on sex-specific median otherwise) and type 2 diabetes incidence were assessed using multivariable Cox proportional hazards models.</p><p><strong>Results: </strong>There were 1,131 incident type 2 diabetes cases diagnosed (median follow-up, 8.05 years). After false discovery rate correction, intakes of the following colors were associated with higher type 2 diabetes incidence: total food coloring additives (hazard ratio [HR]higher vs. non/lower consumers 1.38 [95% CI 1.17-1.63], P = 0.0002), total caramel (1.43 [1.21-1.67], P = 0.0002), plain caramel (1.46 [1.26-1.70], P = 0.0002), sulfite ammonia caramel (1.30 [1.07-1.59], P = 0.007), total carotene (1.27 [1.08-1.48], P = 0.007), carotenoids (1.39 [1.19-1.62], P = 0.0002), β-carotene (1.44 [1.23-1.68], P = 0.0002), paprika-capsanthin-capsorubin (1.26 [1.08-1.46], P = 0.004), lutein (1.20 [1.02-1.40], P = 0.0002), curcumin (1.49 [1.29-1.73], P = 0.0002), cochineal-carminic acid-carmines (1.27 [1.10-1.48], P = 0.003), and anthocyanins (1.40 [1.17-1.68], P = 0.0002).</p><p><strong>Conclusions: </strong>Several positive associations were observed between exposure to natural and synthetic food coloring additives and type 2 diabetes incidence. Further studies are needed to gain insights into underlying mechanisms, and if confirmed, call for reevaluation of food coloring additives to protect consumer health.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"49 6","pages":"1067-1077"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Rossing et al. Nuances in Interpretation: Assessing the Interaction Between Semaglutide and MRAs in the FLOW Trial.","authors":"Qian Liu, Jing-Feng Yang, Zhi-Gang Wang","doi":"10.2337/dc25-2808","DOIUrl":"10.2337/dc25-2808","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"e91"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in and Opportunities for Individualizing Diabetes Technology: A Position Statement by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) Diabetes Technology Working Group.","authors":"Daniela Bruttomesso, John R Petrie, Mark Evans, G Alexander Fleming, Helene Hanaire, Reinhard W Holl, Jennifer L Sherr, Richard M Bergenstal, Lutz Heinemann, Anne L Peters","doi":"10.2337/dci26-0018","DOIUrl":"10.2337/dci26-0018","url":null,"abstract":"<p><p>From finger-stick blood glucose monitoring and mechanical insulin pens in the 1970s to modern automated insulin delivery systems, rapidly progressing advances in diabetes technology are transforming management options for people with diabetes, particularly those with type 1 diabetes but also, increasingly, people with type 2 diabetes. However, access to life-changing diabetes technologies is neither uniform nor universally covered, and there is no one-size-fits-all approach. In this position statement, we emphasize to health care professionals the importance of supporting individuals with diabetes to access and use the right diabetes technology according to personal needs, capabilities, and preferences. In doing so, we highlight the equal importance of avoiding disparities in the provision of diabetes technology by challenging preconceived barriers, which can be overcome with education and determination. We also make a series of suggestions for action to advance the more widespread adoption of diabetes technology while minimizing the \"digital divide.\"</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"916-930"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438628","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":"Insulin Hypersecretion and Increased Ectopic Fat in South Asian American Adolescents and Young Adults Compared With White and African American Peers: The CHARISMA Study.","authors":"Talia A Hitt, Andrea Kelly, Darko Stefanovski, Babette S Zemel, Robert McCarter, Lisa Yanek, Ghazal Zandieh, Ipek Özdemir, Ihab R Kamel, Steve C N Hui, Peter Barker, Sheela N Magge","doi":"10.2337/dc25-2976","DOIUrl":"10.2337/dc25-2976","url":null,"abstract":"<p><strong>Objective: </strong>South Asian individuals are at elevated diabetes risk attributed to insulin resistance, insulin deficiency, and ectopic fat. The CHARISMA study compared metabolic mechanisms in South Asian, White, and African American adolescents and young adults (AYAs) to investigate early diabetes risk in South Asian individuals.</p><p><strong>Research design and methods: </strong>AYAs aged 12-21 years with a BMI ≥23 kg/m2 or ≥80 percentile underwent MRI/MRS to quantify fat; OGTT with minimal modeling to calculate insulin sensitivity (Si), AUC insulin secretory rate (ISR), and disposition index (DI); DXA; and glucose-potentiated arginine stimulation test.</p><p><strong>Results: </strong>South Asian AYAs (n = 53, median [interquartile range] age 20.3 [18.9, 21.4] years) compared with White (n = 53, 19.1 [17.6, 20.8] years) and African American (n = 49, 18.8 [17.7, 20.5] years) AYAs (P = 0.02) of similar sex, pubertal stage, and BMI-Z had higher visceral fat on MRI (P < 0.001 vs. White; P = 0.009 vs. African American) and liver fat on MRS (P < 0.001 vs. both). South Asian AYAs had lower Si (P = 0.006) and higher dynamic AUC-ISR (P = 0.003) vs. White AYAs, higher total and static AUC-ISR vs. both White and African American AYAs (P < 0.001), and lower dynamic DI vs. African American AYAs (P = 0.039). South Asian AYAs had lower insulin clearance than White (P = 0.027) and African American (P = 0.007) AYAs. First-pass hepatic insulin extraction was lower in African American than South Asian (P < 0.0001) and White (P = 0.027) AYAs. Group differences in Si, dynamic AUC-ISR, and dynamic DI lost significance when visceral or liver fat was added to models, but higher total and static AUC-ISR in South Asian AYAs persisted.</p><p><strong>Conclusions: </strong>Compared with White and African American AYAs, South Asian AYAs have higher visceral and liver fat. These findings, along with lower Si and dynamic DI, suggest elevated metabolic risk in South Asian individuals, even at young ages. Higher total and static phase insulin secretion in South Asian AYAs may precede insulin deficiency, reported in adults.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1057-1066"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Trends From Continuous Glucose Monitoring With DPP-4 Inhibitor Therapy in Patients With Type 2 Diabetes-Redefining the Role of an Overlooked Agent.","authors":"Arthi Thirumalai, Irl B Hirsch","doi":"10.2337/dci26-0040","DOIUrl":"10.2337/dci26-0040","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"49 6","pages":"940-942"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984780","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":"Hepatic Events Prevention by Antihyperglycemic Therapies and Intervention Comparisons in Type 2 Diabetes: The HEPATIC-T2DM Network Meta-analysis.","authors":"Pedro Robson Costa Passos, Rodrigo Motta, Valbert Oliveira Costa Filho, Mariana Macambira Noronha, Roberto Cavalcante Venâncio, Guilherme Grossi Lopes Cançado, Amanda Adler, Jeremy F Cobbold, Jeremy W Tomlinson","doi":"10.2337/dc26-0336","DOIUrl":"10.2337/dc26-0336","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) amplifies liver disease burden, yet the comparative hepatic effects of glucose-lowering drugs remain poorly defined.</p><p><strong>Purpose: </strong>To compare associations between glucose-lowering drug classes and major adverse liver outcomes (MALOs) in adults with T2DM.</p><p><strong>Data sources: </strong>PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched from December 1946 through 23 August 2025.</p><p><strong>Study selection: </strong>Studies enrolling adults with T2DM that evaluated associations between glucose-lowering drug classes with regard to MALOs were included.</p><p><strong>Data extraction: </strong>Data were extracted on study characteristics, drug exposures, and MALOs.</p><p><strong>Data synthesis: </strong>A three-level Bayesian network meta-analysis with study- and database-level random effects was performed. Outcomes are reported as hazard ratios (HRs) and ranked using the surface under the cumulative ranking curve. Forty-six observational studies (N = 7,124,845) were included. Thiazolidinediones were least associated with hepatocellular carcinoma incidence and significantly lower than dipeptidyl peptidase 4 (DPP-4) inhibitors (HR 0.50), glucagon-like peptide 1 receptor agonists (GLP-1RAs) (HR 0.72), insulin (HR 0.20), and sulfonylureas (HR 0.69). For decompensation (composite), GLP-1RAs were associated with the lowest hazard compared with all other classes (HRs 0.16-0.91; all significant). Sodium-glucose cotransporter 2 (SGLT2) inhibitors were least associated with cirrhosis (HR 0.66 vs. DPP-4 inhibitors; HR 0.66 vs. GLP-1RAs). GLP-1RAs were least associated with variceal bleeding and hepatic encephalopathy, whereas SGLT2 inhibitors were least associated with liver-related mortality.</p><p><strong>Limitations: </strong>All included studies were observational, precluding causal inference.</p><p><strong>Conclusions: </strong>Liver-specific risk reduction is not uniform across antihyperglycemic drug classes. Randomized trials are needed to determine whether these associations reflect true drug effects.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1144-1153"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679617","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":"Response to Comment on Rossing et al. Nuances in Interpretation: Assessing the Interaction Between Semaglutide and MRAs in the FLOW Trial.","authors":"Peter Rossing, Vlado Perkovic, Søren Rasmussen, Johannes F E Mann","doi":"10.2337/dc26-0466","DOIUrl":"10.2337/dc26-0466","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"49 6","pages":"e92-e93"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Liu et al. Low-Carbohydrate Diets of Varying Macronutrient Quality and Risk of Type 2 Diabetes in Three U.S. Prospective Cohort Studies. Diabetes Care 2025;48:2095-2102.","authors":"Jue Shi, Guang Ji, Ziqi Zhang, Li Zhang","doi":"10.2337/dc26-0037","DOIUrl":"10.2337/dc26-0037","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"49 6","pages":"e101-e102"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperglycemia During Acute Pancreatitis and Progression to Early-Onset Diabetes After Recovery: Preliminary Findings From the Diabetes Related to Acute Pancreatitis and Its Mechanisms (DREAM) Study.","authors":"Kathleen M Dungan, Vernon M Chinchilli, Ariana Pichardo-Lowden, Nazia Raja-Khan, Melena D Bellin, Dhiraj Yadav, Phil A Hart, Marina Basina, James L Buxbaum, Anna Casu, Carmella Evans-Molina, Darwin L Conwell, Evan L Fogel, Chris E Forsmark, Mark O Goodarzi, Rita R Kalyani, Brian T Layden, Sandra M Lord, Georgios I Papachristou, Walter G Park, Richard Pratley, Vikesh K Singh, Cate Speake, Guru Trikudanathan, Maren Laughlin, Frederico G S Toledo","doi":"10.2337/dc25-2885","DOIUrl":"10.2337/dc25-2885","url":null,"abstract":"<p><strong>Objective: </strong>Hyperglycemia during acute pancreatitis (HDAP) likely reflects both stress hormone responses and pancreatic islet injury, distinguishing it from typical stress-induced hyperglycemia. The aim of this study was to determine the prevalence of HDAP and its prognostic significance for early-onset diabetes following acute pancreatitis (AP).</p><p><strong>Research design and methods: </strong>Diabetes Related to Acute Pancreatitis and Its Mechanisms (DREAM) is a prospective multicenter study examining the development of diabetes following AP. This analysis included 395 participants without prior diabetes with an AP episode, focusing on their glucose levels during the event. Two definitions of HDAP were examined: peak glucose >140 mg/dL (HDAP140) and >200 mg/dL (HDAP200). Outpatient glycemic status after recovery (median: 111 days post-AP) was evaluated using fasting glucose, oral glucose tolerance test, and HbA1c.</p><p><strong>Results: </strong>HDAP140 and HDAP200 were present in 37.5% and 7.1% of participants, respectively. Age, race, etiology, and AP severity were significant predictors of HDAP140. Among participants with HDAP140, 14.8% developed early-onset diabetes after AP recovery vs. 1.2% in those without (P = 0.0001). In those with HDAP200, 42.9% developed early-onset diabetes vs. 3.5% in those without (P = 0.0001). The absence of HDAP140 and HDAP200 was associated with negative predictive values of 99% and 97%, respectively, for diabetes.</p><p><strong>Conclusions: </strong>HDAP can be common in individuals without diabetes and is associated with early-onset diabetes following AP. Individuals without HDAP have a low risk of diabetes short term, while those with HDAP200 are at high risk. Monitoring glycemia during AP can identify individuals best suited for early targeted postdischarge care.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1040-1047"},"PeriodicalIF":16.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}