Diabetes care最新文献_第2页

Beyond Glucose-Rethinking Prediabetes for Precision Prevention. 超越葡萄糖-重新思考糖尿病前期的精确预防。

IF 16.6

Diabetes care Pub Date : 2025-09-11 DOI: 10.2337/dci25-0054

Robert Wagner, Elizabeth Selvin, Ratika Sehgal, Katsiaryna Prystupa, Shivani Misra, Andreas Fritsche, Martin Heni

{"title":"Beyond Glucose-Rethinking Prediabetes for Precision Prevention.","authors":"Robert Wagner, Elizabeth Selvin, Ratika Sehgal, Katsiaryna Prystupa, Shivani Misra, Andreas Fritsche, Martin Heni","doi":"10.2337/dci25-0054","DOIUrl":"https://doi.org/10.2337/dci25-0054","url":null,"abstract":"Prediabetes affects more than one-third of U.S. adults, yet represents a biologically heterogeneous state that is only partly captured by traditional glycemic categories (impaired fasting glucose, impaired glucose tolerance, or borderline elevated HbA1c). Leveraging unsupervised clustering in comprehensively phenotyped cohorts has identified six reproducible prediabetes subtypes integrating insulin sensitivity, insulin secretion, visceral and hepatic fat, and genetic risk. Three high-risk subtypes (progressing prediabetes with fatty liver, progressing prediabetes with β-cell failure, and slow progressors with hyperinsulinemic insulin resistance) show distinct trajectories toward diabetes and unique complication patterns. For example, \"slow progressors\" develop albuminuria and face excess mortality, despite only modest glycemic deterioration over 10-15 years, showing that complications can arise before diabetes diagnosis. Recognizing these subtypes sharpens risk stratification and opens a path toward precision prevention. Intensive lifestyle modification and bariatric surgery offer the greatest glycemic benefit in the fatty liver subtype, whereas early pharmacologic β-cell protection may be required for the β-cell failure cluster. GLP-1-based therapies offer promising subtype-specific options and should be tested in randomized controlled studies. Future prediabetes intervention trials should move beyond diabetes incidence as the sole end point and systematically evaluate kidney, nerve, eye, and cardiovascular outcomes. While testing for long-term clinical end points might not be feasible in studies where individuals with prediabetes are recruited, the use of surrogate end points could facilitate the assessment of early complications. Such complication-focused, subtype-guided studies will determine whether early, tailored therapy can halt tissue damage and reduce the public health burden linked to prediabetes.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034893","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

Quantifying Barriers to Diabetic Eye Screening: A Two-Center Study at the University of California. 量化糖尿病眼筛查的障碍：加州大学的两中心研究。

IF 16.6

Diabetes care Pub Date : 2025-09-09 DOI: 10.2337/dc25-0951

Aryan Ayati, Shadera Azzam, Stella Ko, Cobi Ben-David, Michelle Wang, Nicole Bonine, David Tabano, Nina Malik, Frank Brodie, Mitul C Mehta, Vivek A Rudrapatna

{"title":"Quantifying Barriers to Diabetic Eye Screening: A Two-Center Study at the University of California.","authors":"Aryan Ayati, Shadera Azzam, Stella Ko, Cobi Ben-David, Michelle Wang, Nicole Bonine, David Tabano, Nina Malik, Frank Brodie, Mitul C Mehta, Vivek A Rudrapatna","doi":"10.2337/dc25-0951","DOIUrl":"https://doi.org/10.2337/dc25-0951","url":null,"abstract":"Objective: This study aimed to evaluate the diabetic eye disease screening continuum at two academic centers and identify its barriers.Research design and methods: We analyzed health records from the University of California, San Francisco and University of California, Irvine to identify primary care patients needing diabetic eye screening. We tracked referrals, screenings, diagnoses, and treatments to evaluate predictors and the impact of an automated referral system. We analyzed physician notes using GPT-4o to determine reasons for missed screenings.Results: Of 8,240 unscreened patients with type 2 diabetes mellitus (T2DM), 43% received a referral, and only 16% completed screening within 1 year. Demographic, provider, and socioeconomic factors predicted adherence, with referrals being the strongest predictor. An automated referral system could improve screening rates to 22-34%. Clinician notes cited comorbidities, scheduling challenges, logistical issues, coronavirus disease 2019, and personal circumstances as barriers.Conclusions: Many patients with T2DM remain unscreened after primary care visits. Although an automated referral system may partially improve adherence, additional tailored strategies are needed.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031588","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

Global and Regional Prediabetes Prevalence: Updates for 2024 and Projections for 2050. 全球和地区前驱糖尿病患病率：2024年最新情况和2050年预测。

IF 16.6

Diabetes care Pub Date : 2025-09-09 DOI: 10.2337/dc25-1640

Mary R Rooney, Jiahuan Helen He, Paraskevi Salpea, Irini Genitsaridi, Dianna J Magliano, Edward J Boyko, Amelia S Wallace, Michael Fang, Elizabeth Selvin

引用次数: 0

Goodhart's Law in Diabetes Care: The Hidden Drawbacks of Overoptimizing CGM Metrics. 糖尿病护理中的古德哈特定律：过度优化CGM指标的隐藏缺陷。

IF 16.6

Diabetes care Pub Date : 2025-09-09 DOI: 10.2337/dc25-1985

Robert Richardson, Hood Thabit

引用次数: 0

Use of a Claims-Based Algorithm to Characterize Uptake of Continuous Glucose Monitoring Among Older Adults With Type 1 and Type 2 Diabetes Meeting Medicare Coverage Criteria From 2017 to 2019. 使用基于索赔的算法表征2017年至2019年符合医疗保险覆盖标准的老年1型和2型糖尿病患者持续血糖监测的吸收情况

IF 16.6

Diabetes care Pub Date : 2025-09-03 DOI: 10.2337/dc25-1593

Anna R Kahkoska, Virginia Pate, Richard E Pratley, Michele Jonsson-Funk, Til Stürmer

引用次数: 0

Comment on Dieguez et al. In Utero Exposure to Maternal Hyperglycemia and Offspring Type 2 Diabetes Genetic Risk Score Are Independently Associated With Risk of Impaired Glucose Tolerance in Youth. Diabetes Care 2025;48:1356-1360. 对Dieguez等人的评论。宫内暴露于母体高血糖和后代2型糖尿病遗传风险评分与青少年糖耐量受损风险独立相关糖尿病护理2025；48:1356-1360。

IF 16.6

Diabetes care Pub Date : 2025-09-01 DOI: 10.2337/dc25-1167

Masashi Hasebe, Chen-Yang Su

引用次数: 0

Cardiovascular Outcome Trials in Type 1 Diabetes: We Are Not There Yet. 1型糖尿病的心血管结局试验：我们还没有到那一步。

IF 16.6

Diabetes care Pub Date : 2025-09-01 DOI: 10.2337/dci25-0062

Irl B Hirsch, Robert H Eckel

引用次数: 0

About the Artist: Appleton. 关于艺术家：阿普尔顿。

IF 16.6

Diabetes care Pub Date : 2025-09-01 DOI: 10.2337/dci25-0087

引用次数: 0

Response to Comment on Griffin et al. Use of SGLT2i Versus DPP-4i as an Add-on Therapy and the Risk of PAD-Related Surgical Events (Amputation, Stent Placement, or Vascular Surgery): A Cohort Study in Veterans With Diabetes. Diabetes Care 2025;48:361-370. 对Griffin等人评论的回应使用SGLT2i与DPP-4i作为附加治疗和pad相关手术事件（截肢、支架置入或血管手术）的风险：一项糖尿病退伍军人的队列研究糖尿病护理2025；48:361-370。

IF 16.6

Diabetes care Pub Date : 2025-09-01 DOI: 10.2337/dci25-0061

Katherine E Griffin, Kathryn Snyder, Amir H Javid, Amber Hackstadt, Robert Greevy, Carlos G Grijalva, Christianne L Roumie

引用次数: 0

Understanding Patient Preferences Regarding Limb Salvage for Diabetic Foot Ulcers: A Discrete Choice Experiment. 了解糖尿病足溃疡患者对肢体保留的偏好：一个离散选择实验。

IF 16.6

Diabetes care Pub Date : 2025-09-01 DOI: 10.2337/dc25-0478

Lyndsay M O'Hara, Alison D Lydecker, Gwen L Robinson, Nathan N O'Hara, Justin J Kim, Alyson J Littman, Brian M Schmidt, Odessa Addison, David J Margolis, Mary-Claire Roghmann

{"title":"Understanding Patient Preferences Regarding Limb Salvage for Diabetic Foot Ulcers: A Discrete Choice Experiment.","authors":"Lyndsay M O'Hara, Alison D Lydecker, Gwen L Robinson, Nathan N O'Hara, Justin J Kim, Alyson J Littman, Brian M Schmidt, Odessa Addison, David J Margolis, Mary-Claire Roghmann","doi":"10.2337/dc25-0478","DOIUrl":"10.2337/dc25-0478","url":null,"abstract":"Objective: Diabetic foot ulcers (DFUs) often lead to amputations. Limb salvage aims to preserve the lower extremity, but the complexity of care and uncertainty of healing can delay patients' return to normal activities. This study aimed to understand military veterans' preferences regarding limb salvage for DFUs, using a discrete choice experiment (DCE).Research design and methods: A DCE was conducted with 98 veterans with diabetes at the Baltimore Veterans Affairs Medical Center. Participants were presented with 10 choice sets involving different levels of postrecovery mobility, amputation levels, and future surgery risks. These attributes were developed through literature review and interviews. Data were analyzed using a multinomial logit model to estimate the utility of each attribute level and assess preference heterogeneity.Results: The study population was older (mean age 69 years), Black (61%), and male (94%). Half (53%) had a prior foot complication. Postrecovery mobility was the most important attribute (relative importance 53%), followed by amputation level (30%) and future surgery risk (18%). Veterans valued mobility highly, with significant utility differences between walking unaided and needing a wheelchair or scooter. They were willing to accept higher amputation levels to improve mobility.Conclusions: Postrecovery mobility is a critical factor for veterans with DFUs, outweighing concerns about amputation level and future surgical risks. It should be a focus of shared decision-making. The study is limited by its single-site setting and study population. Broader research is needed. Understanding patient preferences through DCE can inform more patient-centered approaches to DFU management, potentially improving outcomes and satisfaction.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1517-1523"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556199","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