Diabetes care最新文献

{"title":"Developing a Computable Phenotype for Identifying Children, Adolescents, and Young Adults With Diabetes Using Electronic Health Records in the DiCAYA Network.","authors":"Hui Shao, Lorna E Thorpe, Shahidul Islam, Jiang Bian, Yi Guo, Piaopiao Li, Sarah Bost, Dana Dabelea, Rebecca Conway, Tessa Crume, Brian S Schwartz, Annemarie G Hirsch, Katie S Allen, Brian E Dixon, Shaun J Grannis, Eva Lustigova, Kristi Reynolds, Marc Rosenman, Victor W Zhong, Anthony Wong, Pedro Rivera, Thuy Le, Meredith Akerman, Sarah Conderino, Anand Rajan, Angela D Liese, Caroline Rudisill, Jihad S Obeid, Joseph A Ewing, Charles Bailey, Eneida A Mendonca, Ibrahim Zaganjor, Deborah Rolka, Giuseppina Imperatore, Meda E Pavkov, Jasmin Divers","doi":"10.2337/dc24-1972","DOIUrl":"10.2337/dc24-1972","url":null,"abstract":"<p><strong>Objective: </strong>The Diabetes in Children, Adolescents, and Young Adults (DiCAYA) network seeks to create a nationwide electronic health record (EHR)-based diabetes surveillance system. This study aimed to develop a DiCAYA-wide EHR-based computable phenotype (CP) to identify prevalent cases of diabetes.</p><p><strong>Research design and methods: </strong>We conducted network-wide chart reviews of 2,134 youth (aged <18 years) and 2,466 young adults (aged 18 to <45 years) among people with possible diabetes. Within this population, we compared the performance of three alternative CPs, using diabetes diagnoses determined by chart review as the gold standard. CPs were evaluated based on their accuracy in identifying diabetes and its subtype.</p><p><strong>Results: </strong>The final DiCAYA CP requires at least one diabetes diagnosis code from clinical encounters. Subsequently, diabetes type classification was based on the ratio of type 1 diabetes (T1D) or type 2 diabetes (T2D) diagnosis codes in the EHR. For both youth and young adults, the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) in finding diabetes cases were >90%, except for the specificity and NPV in young adults, which were slightly lower at 83.8% and 80.6%, respectively. The final DiCAYA CP achieved >90% sensitivity, specificity, PPV, and NPV in classifying T1D, and demonstrated lower but robust performance in identifying T2D, consistently maintaining >80% across metrics.</p><p><strong>Conclusions: </strong>The DiCAYA CP effectively identifies overall diabetes and T1D in youth and young adults, though T2D misclassification in youth highlights areas for refinement. The simplicity of the DiCAYA CP enables broad deployment across diverse EHR systems for diabetes surveillance.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"914-921"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756787","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":"Finding Stability for Unstable Glucose.","authors":"Robert Hilbrands, Pieter Gillard","doi":"10.2337/dci25-0016","DOIUrl":"https://doi.org/10.2337/dci25-0016","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 5","pages":"691-693"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060962","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 Christiaens et al. Diabetes Overtreatment and Hypoglycemia in Older Patients With Type 2 Diabetes on Insulin Therapy: Insights From the HYPOAGE Cohort Study. Diabetes Care 2025;48:61-66.","authors":"Antoine Christiaens, Anne-Sophie Boureau, Samy Hadjadj, Bertrand Cariou","doi":"10.2337/dc25-0418","DOIUrl":"https://doi.org/10.2337/dc25-0418","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 5","pages":"e79-e80"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047244","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":"Leveraging Historical Patient Data to Identify Undiagnosed Diabetes and Prediabetes in Routine Care.","authors":"Zhongyu Li, Mohammed K Ali, Jithin Sam Varghese","doi":"10.2337/dci25-0011","DOIUrl":"10.2337/dci25-0011","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 5","pages":"682-684"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028224","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":"Modeling Cardiovascular Protection With SGLT Inhibition in Type 1 Diabetes: A Risk-Based Approach to Guide Therapy?","authors":"Luxcia Kugathasan, Pritha Dutta, Massimo Nardone, Vikas S Sridhar, David J T Campbell, Anita T Layton, Bruce A Perkins, Sean Barbour, Tony K T Lam, Adeera Levin, Leif Erik Lovblom, Istvan Mucsi, Remi Rabasa-Lhoret, Valeria E Rac, Peter Senior, Ronald J Sigal, Aleksandra Vukobradovic, Frederik Persson, Elisabeth B Stougaard, Alessandro Doria, David Z I Cherney","doi":"10.2337/dc24-2840","DOIUrl":"10.2337/dc24-2840","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"e74-e76"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660044","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":"Metformin for Glucocorticoid-Induced Toxicity: Why Not?","authors":"Klara R Klein","doi":"10.2337/dci25-0010","DOIUrl":"https://doi.org/10.2337/dci25-0010","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 5","pages":"688-690"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001761","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":"Cardiovascular and Kidney Outcomes and Mortality With Long-Acting Injectable and Oral Glucagon-Like Peptide 1 Receptor Agonists in Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Trials.","authors":"Matthew M Y Lee, Naveed Sattar, Rodica Pop-Busui, John Deanfield, Scott S Emerson, Silvio E Inzucchi, Johannes F E Mann, Nikolaus Marx, Sharon L Mulvagh, Neil R Poulter, Sunil V Badve, Richard E Pratley, Vlado Perkovic, John B Buse, Darren K McGuire","doi":"10.2337/dc25-0241","DOIUrl":"10.2337/dc25-0241","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide 1 receptor agonists (GLP-1RA) reduce the incidence of major adverse cardiovascular events (MACE) in type 2 diabetes (T2D), although whether benefits extend to both subcutaneous and oral formulations remains unclear.</p><p><strong>Purpose: </strong>In these meta-analyses, including new data from the Semaglutide cardiOvascular oUtcomes triaL (SOUL) (oral semaglutide) and Evaluate Renal Function with Semaglutide Once Weekly (FLOW) trial, we examined cardiovascular (CV) and kidney benefits and risks of long-acting (defined as having pharmacokinetics sufficient to provide 24-h activity) GLP-1RA in T2D.</p><p><strong>Data sources: </strong>A systematic review of PubMed was conducted (to 7 February 2025).</p><p><strong>Study selection: </strong>Randomized placebo-controlled CV and kidney outcomes trials of GLP-1RA with ≥500 individuals with T2D were included.</p><p><strong>Data extraction: </strong>A random-effects model was used to estimate hazard ratios (HRs) for MACE, its components, all-cause mortality, hospitalization for heart failure (HHF), a composite kidney outcome (kidney failure [kidney replacement therapy or persistent estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2], sustained ≥50% eGFR decline or nearest equivalent, or kidney-related death), worsening kidney function, and safety outcomes.</p><p><strong>Data synthesis: </strong>Across 10 trials (n = 71,351), long-acting GLP-1RA reduced incidence rate of MACE by 14% (HR 0.86 [95% CI 0.81, 0.90]; I2 = 27.6%), HHF by 14% (0.86 [0.79, 0.93]; I2 = 2.1%), and the composite kidney outcome by 17% (0.83 [0.75, 0.92]; I2 = 20.4%) and all-cause mortality by 12% (0.88 [0.82, 0.93]; I2 = 17.5%). A consistent 14% reduction was seen for all MACE components. There was no significant heterogeneity by GLP-1RA administration route (subcutaneous vs. oral). There were no increased risks of severe hypoglycemia, retinopathy, or pancreatic events.</p><p><strong>Limitations: </strong>Trial-level meta-analyses preclude detailed subgroup analyses and may introduce ecological bias.</p><p><strong>Conclusions: </strong>As a group, long-acting GLP-1RA, including both injectable and oral formulations, reduce incidence of MACE, HHF, and kidney events and all-cause mortality in T2D.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"846-859"},"PeriodicalIF":16.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744562","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":"Islet Transplantation Versus Standard of Care for Type 1 Diabetes Complicated by Severe Hypoglycemia From the Collaborative Islet Transplant Registry and the T1D Exchange Registry.","authors":"Michael R Rickels, Cassandra M Ballou, Nicole C Foster, Rodolfo Alejandro, David A Baidal, Melena D Bellin, Thomas L Eggerman, Bernhard J Hering, Fouad Kandeel, Adam Brand, Kellee M Miller, Franca B Barton, Elizabeth H Payne","doi":"10.2337/dc24-1915","DOIUrl":"10.2337/dc24-1915","url":null,"abstract":"<p><strong>Objective: </strong>Islet transplantation was recently approved by the U.S. Food and Drug Administration for adults with type 1 diabetes complicated by recurrent severe hypoglycemia events (SHEs). We sought to understand the long-term benefit for glycemic control and risk of immunosuppression to kidney function associated with islet transplantation compared with ongoing standard of care.</p><p><strong>Research design and methods: </strong>We performed a case-control analysis of prospectively collected data from patients in the Collaborative Islet Transplant Registry (CITR) with at least one SHE in the year (2000-2014) before transplantation (case subjects) and compared them with data from patients in the T1D Exchange (T1DX) Registry with at least one SHE in the year (2010-2012) before enrollment (control subjects), with both cohorts observed over 5 years. SHEs were restricted to those resulting in seizure or loss of consciousness.</p><p><strong>Results: </strong>Case subjects from CITR (n = 71) compared with control subjects from T1DX (n = 213) more often achieved the primary outcome of HbA1c <7.0% and absence of an SHE (71-80% vs. 21-33% over 5 years; P < 0.001) and the outcome of HbA1c ≤6.5% and absence of an SHE (60-75% vs. 10-20%; P < 0.001) while requiring significantly less insulin (majority in CITR were insulin independent). Kidney function, measured by estimated glomerular filtration rate, declined from baseline to a greater extent in CITR than in T1DX (-8.8 to -20 vs. -1.3 to -6.5 mL ⋅ min-1 ⋅ 1.73 m-2 over 5 years; P < 0.001).</p><p><strong>Conclusions: </strong>Islet transplantation for adults with type 1 diabetes complicated by SHEs results in near-normal glycemic control in the absence of SHEs more often than observed with standard of care, but at the cost of greater reduction in kidney function.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"737-744"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416558","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":"Progression of Cerebral Small Vessel Disease Among Neurologically Asymptomatic Middle-Aged Individuals With Type 1 Diabetes.","authors":"Aleksi Tarkkonen, Iiris Kyläheiko, Jussi Inkeri, Marika I Eriksson, Lena M Thorn, Paula A Summanen, Turgut Tatlisumak, Per-Henrik Groop, Jukka Putaala, Daniel Gordin, Juha Martola","doi":"10.2337/dc24-1825","DOIUrl":"10.2337/dc24-1825","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential progression rate of cerebral small vessel disease (CSVD) in brain MRI among neurologically asymptomatic middle-aged individuals with type 1 diabetes.</p><p><strong>Research design and methods: </strong>A total of 172 individuals with type 1 diabetes were re-examined with brain MRI 7.5 years after their initial visit. Baseline predictors of changes in CSVD, particularly cerebral microbleeds (CMBs) and white matter hyperintensities (WMHs) were analyzed.</p><p><strong>Results: </strong>The proportion of individuals with type 1 diabetes with CSVD increased from 36% to 70% (P < 0.001), CMBs increased from 17% to 33% (P < 0.001), and WMHs from 23% to 63% (P < 0.001) at follow-up. The increase in CMBs was associated with baseline systolic blood pressure, HbA1c, and preexisting CMBs. The increases in CSVD and WMHs were associated only with age.</p><p><strong>Conclusions: </strong>The prevalence of CSVD doubled over a 7.5-year period in middle-aged individuals with type 1 diabetes.</p>","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":" ","pages":"776-780"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652735","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":"Historic Residential Redlining and Diabetes: Mediating Pathways and Policy Solutions.","authors":"Sebastian Linde, Leonard E Egede","doi":"10.2337/dci25-0017","DOIUrl":"10.2337/dci25-0017","url":null,"abstract":"","PeriodicalId":93979,"journal":{"name":"Diabetes care","volume":"48 5","pages":"685-687"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065248","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}