Diabetes care最新文献_第4页

Type 1 Diabetes Driven by Residual Recipient T Cells After Hematopoietic Cell Transplantation: A Case Report. 1型糖尿病由造血细胞移植后残留受体T细胞驱动：一例报告。

IF 16.6

Diabetes care Pub Date : 2026-09-01 DOI: 10.2337/dc26-0795

Martin A Thelin, Soohee Cho, Aïsha Callebaut, Hai Nguyen, Stephen E Gitelman, Sandhya Kharbanda, Mark S Anderson, Eddie A James

{"title":"Type 1 Diabetes Driven by Residual Recipient T Cells After Hematopoietic Cell Transplantation: A Case Report.","authors":"Martin A Thelin, Soohee Cho, Aïsha Callebaut, Hai Nguyen, Stephen E Gitelman, Sandhya Kharbanda, Mark S Anderson, Eddie A James","doi":"10.2337/dc26-0795","DOIUrl":"10.2337/dc26-0795","url":null,"abstract":"Objective: Posttransplant type 1 diabetes (T1D) is typically attributed to transferred donor autoimmunity. We investigated a distinct etiology in a patient who developed diabetes following haploidentical hematopoietic cell transplantation, assessing whether autoimmunity originated from donor or residual host cells.Research design and methods: Leveraging HLA disparity between the haploidentical donor and recipient, we used HLA class II tetramers to enumerate islet-specific CD4+ T cells in peripheral blood restricted by shared versus recipient-only HLA alleles.Results: Tetramer analysis revealed an expanded population of islet-specific T cells in the recipient. The donor showed no such expansion. Despite 99% donor T-cell chimerism, >80% of the islet-specific T cells were restricted by recipient-unique HLA alleles, suggesting they originated from the residual host fraction.Conclusions: T1D in this patient was most likely driven by residual recipient-derived T cells. Their survival despite myeloablative conditioning and repeated immunotherapy underscores the remarkable durability of established islet autoimmunity.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1694-1699"},"PeriodicalIF":16.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400361","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

Clinical and Biochemical Recovery From Immune Checkpoint Inhibitor-Induced Diabetes With Seroconversion of GAD Antibodies. 免疫检查点抑制剂诱导糖尿病的临床和生化恢复与GAD抗体的血清转化。

IF 16.6

Diabetes care Pub Date : 2026-09-01 DOI: 10.2337/dc26-0700

Lillian Ruiheng Chen, Tim Cooksley, Rupinder Kochhar, Ezhil Jothi Titus Raj, Paul Lorigan, Safwaan Adam

{"title":"Clinical and Biochemical Recovery From Immune Checkpoint Inhibitor-Induced Diabetes With Seroconversion of GAD Antibodies.","authors":"Lillian Ruiheng Chen, Tim Cooksley, Rupinder Kochhar, Ezhil Jothi Titus Raj, Paul Lorigan, Safwaan Adam","doi":"10.2337/dc26-0700","DOIUrl":"10.2337/dc26-0700","url":null,"abstract":"Objective: Immune checkpoint inhibitors (ICIs) improve outcomes across multiple cancers but may cause immune-related adverse events, including ICI-induced diabetes (ICI-D). ICI-D typically presents abruptly with severe insulin deficiency, and published cases have largely described irreversible loss of endogenous insulin secretion.Research design and methods: We report a novel case of clinical and biochemical recovery of ICI-D.Results: Following melanoma treatment with ipilimumab plus nivolumab, then nivolumab monotherapy, the patient developed abrupt-onset symptomatic hyperglycemia with mild ketosis and positive GAD and insulin autoantibodies, consistent with ICI-D. The patient subsequently received infliximab for ICI-related arthritis. Insulin requirements progressively declined, allowing discontinuation of insulin therapy. GAD antibodies normalized within ∼2 months and later became undetectable. Urine C-peptide-to-creatinine ratios increased over time, consistent with endogenous insulin secretion.Conclusions: Recovery from ICI-D may occur. The temporal association suggests infliximab may have contributed, warranting further study as a potential disease-modifying therapy.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1669-1672"},"PeriodicalIF":16.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364512","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

Predicting the Path to Attrition: Multidomain Risk Assessment in Diabetic Foot Ulcer Offloading Randomized Controlled Trials. 预测损耗的路径：糖尿病足溃疡卸载随机对照试验中的多域风险评估。

IF 16.6

Diabetes care Pub Date : 2026-09-01 DOI: 10.2337/dc26-0658

Aminreza Khandan, Mohammad Dehghan Rouzi, David G Armstrong, Bijan Najafi

{"title":"Predicting the Path to Attrition: Multidomain Risk Assessment in Diabetic Foot Ulcer Offloading Randomized Controlled Trials.","authors":"Aminreza Khandan, Mohammad Dehghan Rouzi, David G Armstrong, Bijan Najafi","doi":"10.2337/dc26-0658","DOIUrl":"10.2337/dc26-0658","url":null,"abstract":"Objective: To test whether measured baseline wound, functional, and psychosocial metrics predict attrition from a diabetic foot ulcer randomized controlled trial (RCT) using an offloading device.Research design and methods: In a 12-week RCT, participants were randomized to removable, removable plus education, or smart removable (feedback-enabled) boots. A secondary analysis projected baseline variables onto a unified attrition-risk scale using a normalization framework and radar visualization, with higher values indicating greater risk. Multivariable logistic regression estimated predictors; discrimination was assessed using the receiver operating characteristic area under the curve (AUC).Results: Of 210 participants, 76 (36%) withdrew or were lost to follow-up. Slower gait (odds ratio [OR] 1.16) and higher depressive symptoms (OR 1.52) independently predicted attrition. Integrated smart boot metrics demonstrated strong discrimination (AUC 0.81).Conclusions: Baseline clinical, functional, and psychosocial variables, integrated through risk-normalized radar visualization, may guide retention strategies. Lower withdrawal in the smart boot group may reflect reinforcement through real-time adherence reminders.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"1681-1685"},"PeriodicalIF":16.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400392","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

Effects of the DASH4D Diet on Biomarkers of Glycemia in Adults With Type 2 Diabetes: A Secondary Analysis of the DASH4D Randomized Clinical Trial. DASH4D饮食对成人2型糖尿病患者血糖生物标志物的影响：DASH4D随机临床试验的二次分析

IF 16.6

Diabetes care Pub Date : 2026-08-28 DOI: 10.2337/dc26-1062

Michael Fang, Dan Wang, Casey M Rebholz, Justin B Echouffo-Tcheugui, Christopher Farnsworth, Jennifer Powers Carson, Christine M Mitchell, Scott J Pilla, Lawrence J Appel, Elizabeth Selvin

{"title":"Effects of the DASH4D Diet on Biomarkers of Glycemia in Adults With Type 2 Diabetes: A Secondary Analysis of the DASH4D Randomized Clinical Trial.","authors":"Michael Fang, Dan Wang, Casey M Rebholz, Justin B Echouffo-Tcheugui, Christopher Farnsworth, Jennifer Powers Carson, Christine M Mitchell, Scott J Pilla, Lawrence J Appel, Elizabeth Selvin","doi":"10.2337/dc26-1062","DOIUrl":"10.2337/dc26-1062","url":null,"abstract":"Objective: To examine the effect of the Dietary Approaches to Stop Hypertension for Diabetes (DASH4D) diet (a DASH-style diet tailored for diabetes) on biomarkers of glycemia.Research design and methods: In this controlled feeding trial, adults with type 2 diabetes were fed four diets in a random order: DASH4D diet and comparison diet (representative of a typical American diet), each with higher and lower sodium. Each feeding period lasted 5 weeks. Using a modified intention-to-treat approach, we estimated the effect of the DASH4D (versus comparison) diet on fructosamine, fasting glucose, and HbA1c with linear mixed-effects models.Results: Among 101 participants (mean age 67 years, 65% female, 87% Black adults), compared with the comparison diet, the DASH4D diet significantly reduced end-of-period fructosamine (adjusted difference: -5.6 μmol/L, P = 0.002), fasting glucose (adjusted difference: -4.5 mg/dL; P = 0.02), and HbA1c (adjusted difference: -0.09 percentage points; P = 0.04).Conclusions: Our results support recommending the DASH4D diet for glycemic management in type 2 diabetes.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842430","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

A Randomized Placebo-Controlled Trial of HTD1801 Monotherapy in Participants With Type 2 Diabetes. HTD1801单药治疗2型糖尿病患者的随机安慰剂对照试验

IF 16.6

Diabetes care Pub Date : 2026-08-24 DOI: 10.2337/dc26-0739

Linong Ji, Jianhua Ma, Zhifeng Cheng, Dexue Liu, Hanqing Cai, Sihong Wang, Xiaomei Wang, Yujin Ma, Xiaojing Wang, Jie Han, Guoyue Yuan, Yawei Zhang, Fang Yu, Kui Liu, Leigh MacConell, Meng Yu, Liping Liu

{"title":"A Randomized Placebo-Controlled Trial of HTD1801 Monotherapy in Participants With Type 2 Diabetes.","authors":"Linong Ji, Jianhua Ma, Zhifeng Cheng, Dexue Liu, Hanqing Cai, Sihong Wang, Xiaomei Wang, Yujin Ma, Xiaojing Wang, Jie Han, Guoyue Yuan, Yawei Zhang, Fang Yu, Kui Liu, Leigh MacConell, Meng Yu, Liping Liu","doi":"10.2337/dc26-0739","DOIUrl":"https://doi.org/10.2337/dc26-0739","url":null,"abstract":"Objective: The safety and efficacy of HTD1801 versus placebo were evaluated in participants with type 2 diabetes inadequately controlled with diet and exercise.Research design and methods: Key entry criteria of this phase 3, randomized, placebo-controlled trial included type 2 diabetes (per World Health Organization guidelines), HbA1c 7.0-10.5% (53-91 mmol/mol), fasting plasma glucose ≤13.9 mmol/L, and ≥8 weeks of diet and exercise. Participants were randomized and treated 2:1 to HTD1801 1,000 mg twice daily (BID) (n = 271) or placebo (n = 136). The primary end point was the change from baseline in HbA1c at week 24. After completion of a 24-week, double-blind trial, participants could enter a 28-week open-label extension during which everyone received HTD1801 1,000 mg BID. Safety was assessed for 56 weeks.Results: Baseline HbA1c was 8.5% (69 mmol/mol) in both groups. The primary end point was achieved: HTD1801-treated participants achieved a change in HbA1c of -1.3% versus -0.6% with placebo (least squares mean difference -0.7%; 95% CI -0.8, -0.5; P < 0.0001). After 24 weeks of HTD1801 treatment, significant improvements were observed in key cardiometabolic and inflammatory markers. HbA1c reductions were durable through 52 weeks. The most common adverse events were mild to moderate diarrhea (HTD1801: n = 26 participants [9.6%]; placebo: n = 1 participant [0.7%]); most of which occurred at treatment initiation. Longer-term safety (56 weeks) was consistent with safety findings of the double-blind trial.Conclusions: HTD1801 treatment produced sustained improvements in glycemic, cardiometabolic, and inflammatory parameters, supporting further evaluation as a well-tolerated oral therapy for patients with type 2 diabetes.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809673","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

β-Cell Function and Diabetes Outcomes 1 Year After Stopping Oral Baricitinib Immunotherapy for Type 1 Diabetes. 1型糖尿病患者停止口服Baricitinib免疫治疗1年后β-细胞功能和糖尿病结局

IF 16.6

Diabetes care Pub Date : 2026-08-21 DOI: 10.2337/dc26-1072

Michelle So, Michaela Waibel, Jennifer J Couper, Fergus J Cameron, Richard J MacIsaac, Gabby Atlas, Alexandra Gorelik, Sara Vogrin, Sara Litwak, Laura Sanz-Villanueva, Prerak Trivedi, Jessica E Harbison, Candice Hall, Balasubramanian Krishnamurthy, Peter G Colman, Leonard C Harrison, Helen E Thomas, Thomas W H Kay, John M Wentworth

{"title":"β-Cell Function and Diabetes Outcomes 1 Year After Stopping Oral Baricitinib Immunotherapy for Type 1 Diabetes.","authors":"Michelle So, Michaela Waibel, Jennifer J Couper, Fergus J Cameron, Richard J MacIsaac, Gabby Atlas, Alexandra Gorelik, Sara Vogrin, Sara Litwak, Laura Sanz-Villanueva, Prerak Trivedi, Jessica E Harbison, Candice Hall, Balasubramanian Krishnamurthy, Peter G Colman, Leonard C Harrison, Helen E Thomas, Thomas W H Kay, John M Wentworth","doi":"10.2337/dc26-1072","DOIUrl":"https://doi.org/10.2337/dc26-1072","url":null,"abstract":"Objective: The Baricitinib in New-Onset Type 1 Diabetes (BANDIT) trial showed that baricitinib treatment for 48 weeks preserved β-cell function and lowered insulin requirements and glucose in recent-onset type 1 diabetes. We aimed to determine the durability of these effects following treatment cessation.Research design and methods: The following posttreatment outcomes of the randomized, double-blind, placebo-controlled BANDIT trial were analyzed: C-peptide and glucagon responses to a mixed meal, HbA1c, continuous glucose monitoring (CGM) measures, CD8+ T-cell phenotype and function, and adverse events.Results: Of 91 randomized participants, 88 (58 baricitinib and 30 placebo) completed the week 96 follow-up. Mean ± SEM C-peptide was significantly greater in baricitinib-treated participants at week 72 (0.54 ± 0.05 vs. 0.38 ± 0.06 pmol/mL; P = 0.015) but not at week 96 (0.43 ± 0.05 vs. 0.35 ± 0.06 nmol/L; P = 0.336). No significant between-group differences in insulin dose, HbA1c, or CGM measures were observed during follow-up. Post hoc comparisons showed that when the study drug was ceased at week 48, baricitinib-treated adults (n = 28) experienced full preservation of β-cell function whereas C-peptide decreased relative to baseline by 0.09 pmol/mL in baricitinib-treated children (n = 32; P = 0.022). Baricitinib did not resolve paradoxical glucagon increase after a mixed meal. Decreased frequency and cytokine signaling of effector memory CD8+ T cells observed at week 48 resolved by week 96.Conclusions: The benefits of oral baricitinib in type 1 diabetes wane over 48 weeks following treatment cessation. Durable benefit is likely to require continuous treatment.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803502","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

Glucose in Motion: Characterizing Temporal Patterns in Real-World Glycemic Control in a Large Observational Cohort. 运动中的葡萄糖：在一个大型观察队列中表征真实世界血糖控制的时间模式。

IF 16.6

Diabetes care Pub Date : 2026-08-17 DOI: 10.2337/dc26-0886

Iben E Giese, Stine Hangaard, Niels V Hartvig, Irl B Hirsch, Morten H Jensen, Simon L Cichosz

{"title":"Glucose in Motion: Characterizing Temporal Patterns in Real-World Glycemic Control in a Large Observational Cohort.","authors":"Iben E Giese, Stine Hangaard, Niels V Hartvig, Irl B Hirsch, Morten H Jensen, Simon L Cichosz","doi":"10.2337/dc26-0886","DOIUrl":"https://doi.org/10.2337/dc26-0886","url":null,"abstract":"Objective: To identify and characterize daily and weekly patterns in glycemic management in longitudinal real-world continuous glucose monitoring (CGM) data from people with diabetes to enhance clinical interpretation and support more effective personalized diabetes management.Research design and methods: This observational, retrospective study used two independent, multiyear, real-world CGM cohorts (T1DiabetesGranada and Connected Pen), comprising 86,779 participants with diabetes. Their mean age (SD) was 40.3 (15.8) and 44.0 (15.9), respectively, and there was a total of 21,011,021 measurement days. Weekly variations in CGM metrics and bolus insulin dose were examined using linear mixed-effects models, and daily temporal patterns were assessed.Results: Weekly and daily glycemic patterns emerged. Mid-week time in range was consistently higher (e.g., Wednesday: +0.96 percentage points [%-points]; 95% CI 0.93-0.99; P < 0.001), with deterioration during weekends and Mondays (e.g., Sunday: -1.74%-points; 95% CI -1.77, -1.72; P < 0.001), mirrored by shifts in other CGM metrics. Bolus insulin dose increased on weekend days (e.g., Sunday: +0.69 units; 95% CI 0.64-0.74; P < 0.001). Daily analyses revealed distinct diurnal profiles, with the most favorable glycemic control during morning and midday hours on weekdays and consistently poorer control during evening and nighttime periods, particularly on weekends.Conclusions: Daily and weekly glycemic patterns revealed statistically robust and consistent temporal variations in glycemic control across two large real-world cohorts. Although the magnitude of these differences was small, the findings provide novel population-level evidence and underscore the value of longer-term CGM perspectives in routine care.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762695","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

Efficacy and Safety of Time-Restricted Eating in Adults With Type 1 Diabetes: A Randomized Controlled Trial. 成人1型糖尿病患者限时饮食的有效性和安全性：一项随机对照试验。

IF 16.6

Diabetes care Pub Date : 2026-08-17 DOI: 10.2337/dc26-1093

Mary-Claire Runchey, Sarah Corapi, Vasiliki Pavlou, Sofia Cienfuegos, Shuhao Lin, Mark Ezpeleta, Kelsey Gabel, Lisa Tussing-Humphreys, Vanessa M Oddo, Shaina J Alexandria, Julienne Sanchez, Terry Unterman, Lisa S Chow, Alaina P Vidmar, Sirimon Reutrakul, Krista A Varady

{"title":"Efficacy and Safety of Time-Restricted Eating in Adults With Type 1 Diabetes: A Randomized Controlled Trial.","authors":"Mary-Claire Runchey, Sarah Corapi, Vasiliki Pavlou, Sofia Cienfuegos, Shuhao Lin, Mark Ezpeleta, Kelsey Gabel, Lisa Tussing-Humphreys, Vanessa M Oddo, Shaina J Alexandria, Julienne Sanchez, Terry Unterman, Lisa S Chow, Alaina P Vidmar, Sirimon Reutrakul, Krista A Varady","doi":"10.2337/dc26-1093","DOIUrl":"https://doi.org/10.2337/dc26-1093","url":null,"abstract":"Objective: Many adults with type 1 diabetes (T1D) have overweight or obesity, underscoring the need for effective dietary weight loss strategies in this population. Time-restricted eating (TRE) has emerged as a popular approach for weight loss; however, its efficacy and safety in T1D have not been evaluated. We examined whether TRE is more effective for reducing body weight than standard care (daily calorie restriction [CR]), or compared with a control group, in adults with T1D and overweight or obesity.Research design and methods: Participants were randomized to one of three groups for 6 months: 8-h TRE (eating only between 12:00 p.m. and 8:00 p.m., without calorie counting) versus CR (25% energy restriction daily), and compared with a no-intervention control group. The primary outcome was percent change in body weight by month 6.Results: Thirty-two participants were randomized. By month 6, body weight did not change significantly in the TRE group (-2.19% [95% CI -5.70, -1.31]) or CR group (-0.47% [95% CI -4.72, 3.78]) relative to a control group, or between TRE and CR groups (-1.73% [95% CI -5.37, 1.92]). HbA1c levels were significantly reduced by the TRE group when compared with the CR group (-0.46% [95% CI -0.80, -0.12]). There were no significant differences in total insulin dose or mean glucose levels across groups. TRE did not increase the risk for diabetic ketoacidosis, severe hypoglycemia, or severe hyperglycemia.Conclusions: These findings suggest that TRE may be a safe approach for reducing HbA1c levels in T1D, although not more effective for weight loss compared with CR or a control group.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764078","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

Adult Complications of Childhood-Onset Type 1 Diabetes Vary With Age at Diagnosis: A Population-Based Study. 儿童期发病1型糖尿病的成人并发症随诊断年龄的变化而变化：一项基于人群的研究

IF 16.6

Diabetes care Pub Date : 2026-08-13 DOI: 10.2337/dc26-0964

Timothy C Nielsen, Samantha J Lain, Maria E Craig, Kirstine J Bell, Heather Baldwin, Alicia J Jenkins, Gerald Liew, Kim C Donaghue, Natasha Nassar

{"title":"Adult Complications of Childhood-Onset Type 1 Diabetes Vary With Age at Diagnosis: A Population-Based Study.","authors":"Timothy C Nielsen, Samantha J Lain, Maria E Craig, Kirstine J Bell, Heather Baldwin, Alicia J Jenkins, Gerald Liew, Kim C Donaghue, Natasha Nassar","doi":"10.2337/dc26-0964","DOIUrl":"https://doi.org/10.2337/dc26-0964","url":null,"abstract":"Objective: To examine incidence of long-term complications among people with childhood-onset type 1 diabetes, focusing on age at diabetes onset.Research design and methods: A registry of children diagnosed with type 1 diabetes aged <16 years in New South Wales, Australia, between 1990 and 2009 linked to hospital, emergency department, public insurance, and death data from 2001 to 2019 to identify complications. Age at onset was categorized as <7 years, 7 to <13 years, and 13 to <16 years. Incidence rates and hazard ratios (HR), with 95% CI, for the risk of complications, were calculated from multivariable Cox regression models by 1) duration of diabetes 0 to <20 years and 2) attained age of 16-34 years, with HR adjusted for diagnosis year, sociodemographics, and acute diabetes complications.Results: Of 5,202 people identified, 1,694 (32.6%) were diagnosed at age <7 years, 2,538 (48.8%) age 7 to <13 years, and 970 (18.6%) age 13 to <16 years. Within 20 years of onset, incidence ranged from 9.2 per 10,000 person-years (95% CI 7.2, 11.7) for cardiac complications to 53.4 per 10,000 person-years (95% CI 48.2, 59.0) for kidney complications. Diabetes onset at age <7 years (vs. 13 to <16 years) was associated with lower 20-year risk of complications, except lower-limb infections; cardiac adjusted HR (aHR) was 0.32 (95% CI 0.15, 0.66), severe retinopathy aHR was 0.25 (0.17, 0.36), lower-limb vascular complications aHR was 0.41 (0.24, 0.69), peripheral neuropathy aHR was 0.16 (0.08, 0.32), and kidney complications aHR was 0.40 (0.30, 0.53). Risk of complications did not differ by attained age.Conclusions: Children with type 1 diabetes onset at age <7 years had lower chronic complication risk in the first 20 years postdiagnosis, supporting a slower time to develop complications with prepubertal onset.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763220","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

Housing Instability Associated With Cost-Related Nonadherence and Financial Toxicity in People With Uncontrolled Diabetes. 未控制糖尿病患者的住房不稳定与费用相关的不依从和财务毒性相关。

IF 16.6

Diabetes care Pub Date : 2026-08-13 DOI: 10.2337/dc26-1152

Victoria H Davis, Roshanak Mehdipanah, Minal R Patel

{"title":"Housing Instability Associated With Cost-Related Nonadherence and Financial Toxicity in People With Uncontrolled Diabetes.","authors":"Victoria H Davis, Roshanak Mehdipanah, Minal R Patel","doi":"10.2337/dc26-1152","DOIUrl":"https://doi.org/10.2337/dc26-1152","url":null,"abstract":"Objective: To assess the prevalence of housing instability and its associations with cost-related nonadherence and financial toxicity among adults with uncontrolled diabetes.Research design and methods: We analyzed baseline randomized controlled trial data from 600 adults with uncontrolled diabetes and cost-related barriers to care. Logistic and linear regression assessed associations of housing instability with cost-related nonadherence and financial toxicity.Results: Half (n = 298) reported housing instability, which was associated with greater odds of cost-related nonadherence (adjusted odds ratio 1.64; 95% CI 1.05, 2.56) and worse financial toxicity (B = -4.64; 95% CI -6.20, -3.09). Cost-related nonadherence was not significant after adjusting for diabetes distress and symptoms of depression and anxiety; financial toxicity remained significant. In sensitivity analyses, worry about housing costs, not housing or utility needs, was associated with financial toxicity.Conclusions: Housing instability was associated with financial toxicity and, in primary models, with cost-related nonadherence. Findings should be validated in longitudinal, nationally representative samples.","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763125","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