Diabetes care最新文献_第2页

Cost-Effectiveness of Continuous Glucose Monitoring With Remote Patient Monitoring in Pediatric Patients With Newly Diagnosed Type 1 Diabetes in the U.S. 美国新诊断的1型糖尿病儿童患者持续血糖监测与远程患者监测的成本-效果

IF 16.6

Diabetes care Pub Date : 2026-05-01 DOI: 10.2337/dc25-2825

Paul Dupenloup, Yupeng Chen, Priya Prahalad, Ramesh Johari, Ananta Addala, Dessi P Zaharieva, Ming Yeh Lee, David M Maahs, David Scheinker, Margaret L Brandeau

{"title":"Cost-Effectiveness of Continuous Glucose Monitoring With Remote Patient Monitoring in Pediatric Patients With Newly Diagnosed Type 1 Diabetes in the U.S.","authors":"Paul Dupenloup, Yupeng Chen, Priya Prahalad, Ramesh Johari, Ananta Addala, Dessi P Zaharieva, Ming Yeh Lee, David M Maahs, David Scheinker, Margaret L Brandeau","doi":"10.2337/dc25-2825","DOIUrl":"10.2337/dc25-2825","url":null,"abstract":"Objective: The use of continuous glucose monitoring (CGM) with remote patient monitoring (RPM) continues to grow. We evaluated the cost-effectiveness of CGM with RPM compared with self-monitoring of blood glucose (SMBG) and CGM alone.Research design and methods: We simulated type 1 diabetes progression with a Markov model in 5-year-old patients over a 20-year, 50-year, and lifetime horizon. We tracked diabetic ketoacidosis (DKA), severe hypoglycemia (SH), and seven chronic complications: retinopathy, neuropathy, nephropathy, cardiovascular disease, end-stage renal disease, lower-extremity amputation, and blindness. We compared three interventions: SMBG, CGM, and CGM with RPM. Efficacy estimates were derived from meta-analyses of pediatric CGM studies and the results of the Teamwork, Targets, Technology, and Tight Glycemia Study (4T Study 1). We evaluated quality-adjusted life years (QALYs) and health care costs (2022 U.S. dollars) discounted at 3% annually. We performed extensive sensitivity analyses.Results: Compared with SMBG, CGM increased QALYs by 0.09 and costs by $8,900 over 20 years; CGM with RPM increased QALYs by 0.37, and costs by $10,300. CGM with RPM yielded more QALYs at a lower incremental cost-effectiveness ratio compared with CGM ($27,400/QALY vs. $103,700/QALY, respectively). Results were robust across sensitivity analyses and time horizons. CGM with RPM remained cost-effective when achieving at least 30% of 4T's clinical efficacy.Conclusions: CGM with RPM delivers superior health outcomes compared with SMBG and CGM and is likely cost-effective for patients with newly diagnosed type 1 diabetes. Despite higher intervention costs, CGM with RPM can reduce complications costs and generate net health care savings.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"889-897"},"PeriodicalIF":16.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517751","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}

引用次数: 0

Sleep Extension Improves Sleep Health but Not Insulin Sensitivity in People With Overweight or Obesity Who Maintain Habitual Short Sleep Schedules. 延长睡眠时间可以改善超重/肥胖人群的睡眠健康，但不能改善他们的胰岛素敏感性。

IF 16.6

Diabetes care Pub Date : 2026-05-01 DOI: 10.2337/dc25-2083

Joseph W Beals, Gordon I Smith, Sarah S Farabi, Bruce W Patterson, Brendan P Lucey, Josiane L Broussard, Kenneth P Wright, Samuel Klein

{"title":"Sleep Extension Improves Sleep Health but Not Insulin Sensitivity in People With Overweight or Obesity Who Maintain Habitual Short Sleep Schedules.","authors":"Joseph W Beals, Gordon I Smith, Sarah S Farabi, Bruce W Patterson, Brendan P Lucey, Josiane L Broussard, Kenneth P Wright, Samuel Klein","doi":"10.2337/dc25-2083","DOIUrl":"10.2337/dc25-2083","url":null,"abstract":"Objective: To determine whether extending sleep improves insulin sensitivity in people with overweight or obesity, insulin resistance, and habitual short sleep schedules (<7 h/night).Research design and methods: Participants were randomized to habitual sleep (HS) (n = 15) or extended sleep (ES) (n = 14) for ∼6 weeks. Multiorgan (whole-body [primarily muscle], hepatic, and adipose tissue) insulin sensitivity (assessed by the hyperinsulinemic-euglycemic clamp procedure with tracer infusions) and glycemic control (assessed by 24-h serial plasma glucose and insulin concentrations during wakefulness) were determined.Results: Time in bed and sleep duration increased more in the ES group (1.3 ± 0.6 and 1.1 ± 0.5 h/night) than in the HS group (0.3 ± 0.8 and 0.0 ± 0.4 h/night). Day-to-day variability in sleep and subjective measures of sleep health improved more in the ES than HS group, without differences in multiorgan insulin sensitivity or glycemic control between groups.Conclusions: Extending sleep by ∼1 h/night for ∼6 weeks in people with overweight or obesity and short sleep schedules improves sleep health but not insulin sensitivity or glycemic control.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"740-745"},"PeriodicalIF":16.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021053","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}

引用次数: 0

Association Between GLP-1 Receptor Agonists and Ischemic Optic Neuropathy: A Meta-analysis. GLP-1受体激动剂与缺血性视神经病变之间的关系：一项荟萃分析。

IF 16.6

Diabetes care Pub Date : 2026-05-01 DOI: 10.2337/dc25-1238

Alleh Nogueira, Tiago N O Rassi, Asad Iqbal, Nicole Felix, Omar Alghaith, Asad Khan, Nelson Rassi, Mauricio Maia, Filipe A Moura

{"title":"Association Between GLP-1 Receptor Agonists and Ischemic Optic Neuropathy: A Meta-analysis.","authors":"Alleh Nogueira, Tiago N O Rassi, Asad Iqbal, Nicole Felix, Omar Alghaith, Asad Khan, Nelson Rassi, Mauricio Maia, Filipe A Moura","doi":"10.2337/dc25-1238","DOIUrl":"10.2337/dc25-1238","url":null,"abstract":"Objective: To investigate the association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and nonarteritic ischemic optic neuropathy (NAION).Research design and methods: The PubMed, Embase, and Cochrane Library databases were searched during August 2025. Odds ratios (ORs) and absolute risk for NAION values were pooled using random-effects Peto and inverse-variance models. Any ocular event was a secondary outcome.Results: Fifteen longitudinal studies (8 trials; >1.5 million patients) were included. GLP-1 RA use was associated with higher NAION risk (OR 1.70; 95% CI 1.23-2.36), consistent across randomized (2.36; 0.85-6.53) and nonrandomized studies (1.64; 1.15-2.35) (P = 0.51, for heterogeneity). Absolute NAION risk in the GLP-1 RA group was 0.09%, corresponding to a 0.037% risk difference (number needed to harm ∼2,700). There was no association with overall ocular events (OR 0.95; 95% CI 0.86-1.05).Conclusions: GLP-1 RA use was associated with a modest increase in NAION risk but not overall ocular adverse events. Findings underscore the need for long-term postmarketing safety studies and should be interpreted against their well-established mortality and cardio-kidney-metabolic benefits.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"724-729"},"PeriodicalIF":16.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914274","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}

引用次数: 0

GLP-1 Receptor Agonists Are Associated With Reduced Mortality Following Diabetic Foot Ulcers: A Nationwide Observational Study. GLP-1受体激动剂与糖尿病足溃疡后死亡率降低相关：一项全国性的观察性研究

IF 16.6

Diabetes care Pub Date : 2026-05-01 DOI: 10.2337/dc25-2120

Jean-Baptiste Bonnet, Helena Huguet, Antoine Avignon, Claire Duflos, Ariane Sultan

{"title":"GLP-1 Receptor Agonists Are Associated With Reduced Mortality Following Diabetic Foot Ulcers: A Nationwide Observational Study.","authors":"Jean-Baptiste Bonnet, Helena Huguet, Antoine Avignon, Claire Duflos, Ariane Sultan","doi":"10.2337/dc25-2120","DOIUrl":"10.2337/dc25-2120","url":null,"abstract":"Objective: This nationwide study aimed to identify factors associated with 1-year mortality following a first diabetic foot ulcer (DFU) using the French National Health Data System (SNDS). A secondary objective was to analyze mortality after major lower-limb amputation within the same time frame.Research design and methods: A retrospective cohort analysis was conducted using SNDS data to identify adults with incident DFUs between January 2017 and December 2018, with 12 months of follow-up. Inclusion criteria combined hospitalization records and community care data. Cox proportional hazards models were used to estimate associations with mortality, adjusting for demographic, clinical, treatment, and care access variables.Results: Among 133,791 individuals with incident DFU, 14.6% died within 1 year, and 3.5% underwent a major amputation. Of those amputated, 28.8% died within a year. Independent predictors of 1-year mortality included male sex, older age, hospital-acquired DFU, insulin, major amputation, cardiovascular disease, cancer, dementia, ESKD, and liver disease. Protective factors included lipid-lowering therapy, glucagon-like peptide 1 (GLP-1) receptor agonists, and prior consultations with diabetologists, ophthalmologists, and podiatrists. Similar patterns were observed for postamputation mortality, with GLP-1 receptor agonists showing a consistent survival benefit.Conclusions: One-year mortality after DFU remains high and is strongly linked to age and comorbidities. Community-based identification highlights the vulnerability of these patients, even outside hospital settings. Glucagon-like peptide 1 receptor agonists and structured, multidisciplinary follow-up are associated with better survival and should be prioritized. These findings underline the urgent need to reinforce preventive care and optimize care pathways for high-risk diabetic populations.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"730-739"},"PeriodicalIF":16.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088534","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}

引用次数: 0

Racial and Ethnic Differences Between Waist Circumference and BMI in Identifying Obesity. 腰围和BMI在肥胖识别中的种族和民族差异

IF 16.6

Diabetes care Pub Date : 2026-05-01 DOI: 10.2337/dc25-2214

Simar S Bajaj, John C Lin, Clara E Tandar, Fatima C Stanford

引用次数: 0

C-Peptide Provides Critical Contextual Insight Into Elevated Glucose Values During Progression to Type 1 Diabetes. c肽为1型糖尿病进展过程中血糖升高提供了关键的背景信息。

IF 16.6

Diabetes care Pub Date : 2026-04-30 DOI: 10.2337/dci26-0022

Emily K Sims, Jay S Skyler, Laura M Jacobsen, Heba M Ismail, Maria J Redondo, Brandon M Nathan, David Cuthbertson, Jay M Sosenko

引用次数: 0

Associations of General Adiposity, Abdominal Adiposity and Their Changes With Fracture Risk in Chinese Individuals With Type 2 Diabetes: A Population-Based Cohort Study in Hong Kong. 中国2型糖尿病患者全身肥胖、腹部肥胖及其变化与骨折风险的关系：香港一项基于人群的队列研究

IF 16.6

Diabetes care Pub Date : 2026-04-30 DOI: 10.2337/dc26-0261

Yingnan Fan, Hongjiang Wu, Eric S H Lau, Mai Shi, Baoqi Fan, Aimin Yang, Edith W K Chow, Alice P S Kong, Elaine Chow, Ronald C W Ma, Juliana C N Chan, Andrea O Y Luk

{"title":"Associations of General Adiposity, Abdominal Adiposity and Their Changes With Fracture Risk in Chinese Individuals With Type 2 Diabetes: A Population-Based Cohort Study in Hong Kong.","authors":"Yingnan Fan, Hongjiang Wu, Eric S H Lau, Mai Shi, Baoqi Fan, Aimin Yang, Edith W K Chow, Alice P S Kong, Elaine Chow, Ronald C W Ma, Juliana C N Chan, Andrea O Y Luk","doi":"10.2337/dc26-0261","DOIUrl":"https://doi.org/10.2337/dc26-0261","url":null,"abstract":"Objective: To investigate the associations of baseline general and abdominal adiposity, as well as their longitudinal changes, with risks of any-site, major osteoporotic, and site-specific fractures in individuals with type 2 diabetes.Research design and methods: Individuals with type 2 diabetes who underwent structured assessments in the Hong Kong Hospital Authority between August 2001 and February 2022 were followed for incident fractures until June 2024. Multivariable Cox regression and restricted cubic spline analyses were used to evaluate the associations of baseline BMI, waist circumference, and their 2-year percentage changes with fracture risk.Results: Among 436,929 individuals (mean ± SD age 61.9 ± 11.8 years, median [interquartile range] diabetes duration 1 [0-6] years, 53.1% men) followed for a median of 8.3 years, underweight was associated with 30-77% higher risks of any-site, major osteoporotic, hip, and pelvis fractures, whereas class II obesity was associated with 21-36% higher risks of humerus, upper leg, and ankle fractures. Waist circumference residuals from BMI were positively associated with fracture risk. Among 247,540 individuals with 2-year adiposity measurements, weight change showed U-shaped associations with any-site, major osteoporotic, hip, and humerus fractures, with the lowest risks at -1.5 to 2.3% weight change. Increases in waist circumference were positively associated with risks of any-site, major osteoporotic, hip, rib, humerus, and elbow fractures.Conclusions: In individuals with type 2 diabetes, general adiposity showed site-specific associations with fracture risk, with its longitudinal changes demonstrating U-shaped relationships, whereas abdominal adiposity and its increases were independently associated with higher fracture risk.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824840","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}

引用次数: 0

Misguided Brushes of a Pen Continue to Dismantle and Destroy Biomedical Research in the United States: We Can No Longer Afford Complacency and Fear. We Must All Act Now! 被误导的笔刷继续拆除和破坏美国的生物医学研究：我们再也不能自满和恐惧。我们必须立即行动起来！

IF 16.6

Diabetes care Pub Date : 2026-04-29 DOI: 10.2337/dci26-0068

Steven E Kahn, Cheryl A M Anderson, John B Buse, Elizabeth Selvin

引用次数: 0

Dose-Response Associations of Intermittent Lifestyle Physical Activity Micropatterns and Incident Type 2 Diabetes. 间歇性生活方式体力活动微模式与2型糖尿病发病的剂量-反应关系

IF 16.6

Diabetes care Pub Date : 2026-04-28 DOI: 10.2337/dc25-3018

Kar Hau Chong, Matthew N Ahmadi, Raaj K Biswas, Monique E Francois, Nicholas A Koemel, Angelo Sabag, Martin J Gibala, Shelley E Keating, Jonathan Little, Cecilie Thøgersen-Ntoumani, Emmanuel Stamatakis

{"title":"Dose-Response Associations of Intermittent Lifestyle Physical Activity Micropatterns and Incident Type 2 Diabetes.","authors":"Kar Hau Chong, Matthew N Ahmadi, Raaj K Biswas, Monique E Francois, Nicholas A Koemel, Angelo Sabag, Martin J Gibala, Shelley E Keating, Jonathan Little, Cecilie Thøgersen-Ntoumani, Emmanuel Stamatakis","doi":"10.2337/dc25-3018","DOIUrl":"https://doi.org/10.2337/dc25-3018","url":null,"abstract":"Objective: To examine dose-response associations of vigorous intermittent lifestyle physical activity (VILPA; bouts ≤1 min) and its moderate- to vigorous-intensity equivalent (MV-ILPA; bouts ≤3 min) with incident type 2 diabetes.Research design and methods: Prospective data from UK Biobank accelerometry substudy participants who reported no leisure-time exercise and had no type 2 diabetes at baseline were analyzed. Daily duration and frequency of VILPA and MV-ILPA were derived from wrist-worn accelerometers. Incident type 2 diabetes was ascertained through linked primary care, hospital, and death records. Dose-response associations were examined using multivariable-adjusted Fine-Gray subdistribution hazard models accounting for competing risks.Results: Among 22,706 participants (mean age 62.3 years; 56.4% female), 665 developed type 2 diabetes over an average follow-up of 7.9 years. Daily durations of VILPA and MV-ILPA showed inverse, nonlinear L-shaped associations with incident type 2 diabetes. Median durations of 3.9 min/day of VILPA and 25.3 min/day of MV-ILPA were associated with 36% and 46% lower risks of type 2 diabetes, respectively, compared with no VILPA or 3.9 min/day of MV-ILPA. Daily VILPA frequency showed a near-linear inverse association, with 10.4 bouts/day (median) corresponding to a hazard ratio (HR) of 0.64 (95% CI 0.51-0.81) compared with 0 bouts/day. Daily MV-ILPA frequency showed a U-shaped pattern, with risk reductions plateauing at approximately 56 bouts/day (HR 0.54; 95% CI 0.39-0.76).Conclusions: Among adults who do not engage in leisure-time exercise, accruing brief, intermittent bouts of moderate- to vigorous-intensity physical activity during day-to-day routines may be a promising strategy for prevention of type 2 diabetes.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792943","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}

引用次数: 0

The Importance of C-Peptide for Developing T1D Disease-Modifying Therapies. c肽对发展T1D疾病改善疗法的重要性

IF 16.6

Diabetes care Pub Date : 2026-04-20 DOI: 10.2337/dci26-0015

G Alexander Fleming, Chantal Mathieu, Jay S Skyler

引用次数: 0