Diabetes care最新文献

{"title":"Real-Time Continuous Glucose Monitoring in Pregnancies With Gestational Diabetes Mellitus: A Randomized Controlled Trial.","authors":"Amy M Valent, Michaela Rickert, Christian Huerta Pagan, Lucy Ward, Emily Dunn, Monica Rincon","doi":"10.2337/dc25-0115","DOIUrl":"10.2337/dc25-0115","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of real-time continuous glucose monitoring (CGM; intervention) with capillary blood glucose (CBG) monitoring (control) alone to achieve greater percent glucose time in range (%TIR) among pregnant individuals diagnosed gestational diabetes mellitus (GDM).</p><p><strong>Research design and methods: </strong>This was an open-label, single-center, randomized controlled trial of pregnant individuals with GDM and ≥20 weeks' gestation. Subjects were randomly assigned (2:1) to use real-time CGM plus adjunctive CBG versus CBG alone for glucose monitoring. The intervention group was instructed on the continuous use of the Dexcom G6 CGM system from enrollment to admission for delivery. The control group used CBG monitoring four times per day underwent blinded CGM approximately every 20 days throughout the study period. The primary outcome was the CGM %TIR defined as 60-140 mg/dL (3.3-7.8 mmol/L) from study enrollment until hospital admission for delivery.</p><p><strong>Results: </strong>A total of 111 participants were enrolled between February 2021 and June 2023 (n = 74 in intervention group; n = 37 in control group) with no statistical differences in demographic characteristics between the groups. The CGM group had significantly higher %TIR ±SD (93 ± 6 min vs. 88 ± 14 min at 60-140 mg/dL; P = 0.027). Among key secondary CGM metric outcomes, the intervention group had significantly higher daytime TIR with lower 24-h and daytime mean glucose and percent time >140 mg/dL compared with the control group.</p><p><strong>Conclusions: </strong>We demonstrated a significantly higher %TIR using real-time CGM compared with CBG glucose monitoring among pregnant people with GDM. Studies are needed to determine if achieving lower CGM glucose levels can improve perinatal and neonatal outcomes.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1581-1588"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746616","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 Lee et al. Comparative Efficacy of Glucagon-Like Peptide 1 Receptor Agonists for Cardiovascular Outcomes in Asian Versus White Populations: Systematic Review and Meta-analysis of Randomized Trials of Populations With or Without Type 2 Diabetes and/or Overweight or Obesity. Diabetes Care 2025;48:489-493.","authors":"Yi-Tung Chang, Shih-Chang Lo, Edy Kornelius","doi":"10.2337/dc25-0896","DOIUrl":"https://doi.org/10.2337/dc25-0896","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 9","pages":"e107-e108"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983855","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 Lee et al. Comparative Efficacy of Glucagon-Like Peptide 1 Receptor Agonists for Cardiovascular Outcomes in Asian Versus White Populations: Systematic Review and Meta-analysis of Randomized Trials of Populations With or Without Type 2 Diabetes and/or Overweight or Obesity. Diabetes Care 2025;48:489-493.","authors":"Matthew M Y Lee, Darren K McGuire, Naveed Sattar","doi":"10.2337/dci25-0060","DOIUrl":"https://doi.org/10.2337/dci25-0060","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 9","pages":"e109-e110"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983888","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 in Pregnancy and School-Age Developmental Outcomes for Offspring: A Statewide Retrospective Cohort Study.","authors":"Hannah G Gordon, Richard J Hiscock, Alexis Shub, Jessica A Atkinson, Susan P Walker, Anna Forsythe, Amber L Kennedy, Parinaz Mehdipour, Stephen Tong, Roxanne M Hastie, Anthea C Lindquist","doi":"10.2337/dc25-0678","DOIUrl":"10.2337/dc25-0678","url":null,"abstract":"<p><strong>Objective: </strong>The impact of diabetes in pregnancy on offspring neurodevelopment is unclear. We investigate whether exposure to diabetes in utero is associated with developmental vulnerability or educational delay during primary school.</p><p><strong>Research design and methods: </strong>We used population-level pregnancy and birth data from 2009 to 2021 from Victoria, Australia, linked with standardized national assessments. Adjusting for a range of maternal and childhood covariates, we investigated whether diabetes in pregnancy was associated with an altered risk of developmental vulnerability compared with no diabetes in the first year of full-time school (ages 4-6 years), defined as below the tenth centile in two or more domains in the Australian Early Development Census (AEDC), and altered educational outcomes in grade 3 (ages 7-8 years), defined as the adjusted mean difference in overall z score in the National Assessment Program - Literacy and Numeracy test (NAPLAN).</p><p><strong>Results: </strong>Our study comprised 177,898 children who had linked birth and AEDC data, and 115,231 with linked birth and NAPLAN data, including, respectively, 16,363 (9.2%) and 7,532 (6.5%) exposed to diabetes in pregnancy. Following adjusted analysis, diabetes in pregnancy was not associated with an altered risk of overall developmental vulnerability compared with no diabetes (adjusted relative risk 1.02 [95% CI 0.98, 1.07]). Diabetes was associated with a marginally higher overall NAPLAN z score, but below the prespecified threshold for clinical significance (adjusted mean difference 0.04 [95% CI 0.01, 0.07]).</p><p><strong>Conclusions: </strong>Diabetes in pregnancy was not associated with overall developmental vulnerability or a clinically meaningful difference in educational outcomes. This should provide reassurance for patients and their treating clinicians.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1612-1621"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683840","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":"Connecting the Spots: Serial Home C-peptide Measurements Paint an Accurate Picture of Change in β-Cell Function.","authors":"Brittany S Bruggeman, Timothy P Foster, Michael J Haller","doi":"10.2337/dci25-0059","DOIUrl":"https://doi.org/10.2337/dci25-0059","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 9","pages":"1472-1474"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983918","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":"A New Simulation Model to Estimate the Long-term Health and Cost Outcomes of Interventions for People With Type 1 Diabetes.","authors":"Carolina Barbosa, Thomas J Hoerger, Nicole A Mack, Georgiy V Bobashev, Simon Neuwahl, Rainer Hilscher, Trevor Orchard, Tina Costacou, Rachel G Miller, Ralph D'Agostino, Ping Zhang","doi":"10.2337/dc25-0124","DOIUrl":"10.2337/dc25-0124","url":null,"abstract":"<p><strong>Objective: </strong>To develop a U.S.-based microsimulation model for assessing the cost-effectiveness of interventions to manage type 1 diabetes.</p><p><strong>Research design and methods: </strong>We developed risk equations for 14 diabetes-related complications and mortality, 12 risk factor progression equations, and one equation for utilities associated with 14 complications using data from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) studies and the Epidemiology of Diabetes Complications (EDC) study. We integrated all equations into a simulation model. We conducted internal and external validation and demonstrated the utility of the model using a real-world example. Main model-generated outcomes included cumulative incidence of diabetes-related complications, life years, quality-adjusted life years, medical costs, and incremental cost-effectiveness ratios.</p><p><strong>Results: </strong>The model generates long-term clinical and economic outcomes from changes in risk factors of type 1 diabetes complications. Internal validation comparing modeled outcomes to observed data used to develop the model yielded good prediction accuracy, with mean absolute percentage error across all complications of 9% and correlation of cumulative failure rates above 0.9. External validation results were mixed, with occurrence of slight under- or overprediction across complications and studies. We illustrated the model with a case study estimating the effects of expanding the use of an insulin pump with continuous glucose monitoring to all people with type 1 diabetes.</p><p><strong>Conclusions: </strong>Our new comprehensive type 1 diabetes simulation model can generate valid and accurate results for assessing the long-term cost-effectiveness of interventions to manage type 1 diabetes in the U.S.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1553-1561"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556241","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":"Setting Expectations for Metabolic Outcomes of Total Pancreatectomy With Islet Autotransplantation: Validation From a Multicenter Cohort Study.","authors":"Michael R Rickels","doi":"10.2337/dci25-0064","DOIUrl":"https://doi.org/10.2337/dci25-0064","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 9","pages":"1475-1477"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983875","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":"Gradual Titration of Semaglutide Results in Better Treatment Adherence and Fewer Adverse Events: A Randomized Controlled Open-Label Pilot Study Examining a 16-Week Flexible Titration Regimen Versus Label-Recommended 8-Week Semaglutide Titration Regimen.","authors":"Roy Eldor, Noa Avraham, Orit Rosenberg, Miriam Shpigelman, Avivit Golan-Cohen, Tali Cukierman-Yaffe, Eugene Merzon, Assaf Buch","doi":"10.2337/dc25-0690","DOIUrl":"10.2337/dc25-0690","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether a slower, flexible titration regimen of semaglutide would improve adherence and reduce gastrointestinal adverse events (GI-AEs) compared with the label-recommended regimen in patients with type 2 diabetes (T2D).</p><p><strong>Research design and methods: </strong>A total of 104 patients with T2D were randomized to label-recommended titration (0.25 mg, 0.5 mg, 1 mg at 4-week intervals) or flexible titration (starting at 0.0675 mg [measured as five clicks made by the dose selector dial], with gradual increases by 0.0675 mg/week and delays for GI-AEs) for 26 weeks.</p><p><strong>Results: </strong>While final doses were similar between groups, only 2% of patients in the flexible arm withdrew due to GI-AEs vs. 19% in the label arm (P = 0.005). The flexible arm reported less nausea (45.1% vs. 64.2%; P = 0.051) and asthenia (9.8% vs. 24.5%; P = 0.047), with fewer days experiencing nausea (2.88 vs. 6.3 days; P = 0.017). HbA1c and BMI changes were similar between groups.</p><p><strong>Conclusions: </strong>Slower, flexible titration improved adherence and reduced adverse events without compromising efficacy.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1607-1611"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651644","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 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.","authors":"Abigayil C Dieguez, Alan Kuang, Jami L Josefson, Denise M Scholtens, William L Lowe, M Geoffrey Hayes, Marie-France Hivert","doi":"10.2337/dci25-0074","DOIUrl":"https://doi.org/10.2337/dci25-0074","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 9","pages":"e117-e118"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983850","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":"Early Detection of β-Cell Decline Using Home Dried Blood Spot C-Peptide Levels in New-Onset Type 1 Diabetes.","authors":"A Emile J Hendriks, M Loredana Marcovecchio, Mark L Evans, Peter Barker, Keith Burling, Lut Overbergh, Chantal Mathieu","doi":"10.2337/dc25-0214","DOIUrl":"10.2337/dc25-0214","url":null,"abstract":"<p><strong>Objective: </strong>There is a need for early detection of β-cell decline in people with newly diagnosed (ND) type 1 diabetes. The gold standard mixed-meal tolerance test (MMTT) is an invasive and time-consuming procedure that requires participants to travel to clinical sites. We assessed the feasibility of measuring dried blood spot (DBS) C-peptide levels collected at home as an alternative to the MMTT to detect early β-cell decline.</p><p><strong>Research design and methods: </strong>Individuals with ND type 1 diabetes were recruited within 6 weeks of diagnosis as part of the INNODIA cohort. They collected finger-prick DBS C-peptide data at home, both while fasting and 60 min after a liquid meal. At 12 months, an MMTT was conducted to measure the area under the curve (AUC) of venous C-peptide.</p><p><strong>Results: </strong>Data of 292 people were analyzed (mean age 12.7 years; range 1.2-43.8 years). The median number of DBS card pairs per participant was 6.5 (interquartile range = 2, 9) over 12 months. The slopes of stimulated DBS C-peptide levels in the first 6 months significantly predicted venous MMTT AUC C-peptide and peak C-peptide levels at 12 months (P < 0.01). The models were adjusted for simultaneous glucose levels, age, and baseline fasting C-peptide level. However, the 6-month fasting DBS C-peptide slope did not predict 12-month MMTT AUC C-peptide.</p><p><strong>Conclusions: </strong>Home DBS C-peptide assessment is a feasible method to monitor β-cell function in ND type 1 diabetes. The early prognostic utility of stimulated DBS C-peptide highlights its potential for optimizing trial design. However, further validation is needed to confirm its reliability and broader applicability.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1484-1492"},"PeriodicalIF":16.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121729","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}