Canadian Journal of Diabetes最新文献

{"title":"A Patient–Clinician Codesigned Infographic for Diabetic Ketoacidosis Education in Type 1 Diabetes","authors":"Mary Rose Waniss BSc,&nbsp;Wajeeha Cheema BSc,&nbsp;Talha Cheema BSc,&nbsp;Doug Mumford BEng,&nbsp;Natasha Verhoeff BSc,&nbsp;Hoda Gad PhD,&nbsp;Ethan Parikh BSc,&nbsp;Dalton Budhram MD,&nbsp;Priya Bapat MD,&nbsp;Yucheng Zhang MD,&nbsp;Andrej Orszag MD,&nbsp;Leif Erik Lovblom PhD,&nbsp;Anna Marshall BN,&nbsp;Krista Lamb MSc,&nbsp;Akshay Jain MD,&nbsp;Alanna Weisman MD,&nbsp;Noah Ivers MD,&nbsp;Bruce A. Perkins MD","doi":"10.1016/j.jcjd.2026.05.002","DOIUrl":"10.1016/j.jcjd.2026.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>Effective diabetic ketoacidosis (DKA) prevention tools are needed because existing protocols are often difficult to understand and are underused. Based on prior research, we identified key elements for a DKA educational tool and used design methods to cocreate a core educational infographic with individuals with type 1 diabetes (T1D) and health-care professionals.</div></div><div><h3>Methods</h3><div>A user-centred, iterative design process was conducted using a series of focus groups, with findings coanalyzed at each stage by a user advisory panel. Focus group participants and panel members included individuals with T1D and health-care professionals who were sampled purposively. At each design stage, participants reviewed alternative and progressively refined versions of the infographic. Role-play and think-aloud techniques were used to elicit feedback. Transcripts were analyzed thematically to inform iterative refinements. Recruitment continued until data saturation was reached.</div></div><div><h3>Results</h3><div>A total of 46 participants (36 focus group participants and 10 user advisory panel members) contributed across 7 iterative design refinement sessions and 12 implementation data collection sessions. The resulting infographic emphasized key barriers relevant to most individuals, substantial simplification of design elements, use of clear and accessible language, and a focus on specific behavioural actions rather than general education alone. Core design themes included flow, legibility, and the use of visuals to enhance understanding.</div></div><div><h3>Conclusion</h3><div>We codesigned a patient-centred, simplified DKA educational infographic suitable for outcome evaluation. Compared with existing resources, it features clearer messaging and more accessible visuals focused on actionable prevention steps, demonstrating the value of structured patient engagement and design methodology.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 404-414.e1"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Response to Glucose and Type 2 Diabetes and Its Impact on Cardiometabolic Disease: A Sex-stratified Mendelian Randomization Study to Assess Potential Causality","authors":"Yuchao Wu BSc,&nbsp;Habiba Hashemy MD,&nbsp;Andrew D. Paterson MD, PhD,&nbsp;Satya Dash MD, PhD, FRCPC","doi":"10.1016/j.jcjd.2026.03.001","DOIUrl":"10.1016/j.jcjd.2026.03.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Hyperinsulinemia is implicated in obesity, type 2 diabetes (T2D), and heart disease (cardiometabolic disease [CMD]). Our previous sex-combined Mendelian randomization (MR) study suggested that increased insulin response 30 minutes after oral glucose ingestion, adjusted for glycemia (corrected insulin response [CIR]), may modestly increase body mass index (BMI) but protect against T2D and dyslipidemia.</div></div><div><h3>Methods</h3><div>Given the sex differences in fat distribution, we undertook sex-stratified MR to assess the potential causal effect of CIR on adiposity and CMD using summary statistics from the largest genome-wide association studies of European ancestries. A Bonferroni-adjusted p value of ≤0.003 was considered significant and p≤0.05 nominally significant.</div></div><div><h3>Results</h3><div>Inverse variance weighted MR (IVWMR) suggested that increased CIR may increase leg fat percentage in females (females: β=0.311±0.10, p=0.002; males: β=0.253±0.12, p=0.035), reduce triglyceride levels (males: β=−0.046±0.015, p=0.002; females: β=−0.077±0.023, p=9.17×10⁻⁴), and protect against type 2 diabetes (males: odds ratio [OR] 0.471, 95% confidence interval [CI] 0.327–0.676, p=4.64×10⁻⁵; females: OR 0.511, 95% CI 0.372–0.701, p=3.31×10⁻⁵). After Bonferroni correction, we found no evidence that increased CIR modulates BMI, waist-to-hip ratio, high-density lipoprotein cholesterol, or coronary artery disease in either sex. Reverse IVWMR indicated that T2D reduced CIR only in males (OR 0.613–0.927, p=5.47×10⁻³).</div></div><div><h3>Conclusions</h3><div>Increased CIR may have beneficial effects on T2D and lipids in both sexes, with no evidence of deleterious effects on adiposity and CMD.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 373-380.e22"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Association Between Insulin Regimen and the Risk of Severe Hypoglycemia and Mortality in Adults With Type 2 Diabetes: A Large, Population-based, Retrospective Cohort Study","authors":"Noor Un Nisa Irshad MBBS,&nbsp;Syeda Sana-e-Zehra Naqvi MBBS","doi":"10.1016/j.jcjd.2025.07.001","DOIUrl":"10.1016/j.jcjd.2025.07.001","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Page 460"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life's Essential 8 and Mortality in US Adults With Diabetes: Greater Risk Reduction Compared to Those Without Diabetes","authors":"Ying Li MSc,&nbsp;Yuting Chu MSc,&nbsp;Adilan Abudukeranmu MSc,&nbsp;Zhixin Pang MSc,&nbsp;Yaxu Zhuang MSc,&nbsp;Jingdan Chang MSc,&nbsp;Hanbing Fan MSc,&nbsp;Jinnan Li MSc,&nbsp;Pengcheng Li MSc,&nbsp;Hong Zhu PhD","doi":"10.1016/j.jcjd.2026.04.004","DOIUrl":"10.1016/j.jcjd.2026.04.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Diabetes prevalence is high and increases the risk of all-cause, cardiovascular disease (CVD), and cancer-related deaths. In this study we investigated the association between Life's Essential 8 (LE8) and these mortality risks, and the potential modifying effect of diabetes.</div></div><div><h3>Methods</h3><div>We analyzed 20,231 US adults (3,497 with diabetes and 16,724 without diabetes) from the National Health and Nutrition Examination Survey 2005–2018. LE8 scores (0 to 100) were categorized by weighted tertiles. Cox proportional hazards regression models were used to assess associations with prospectively tracked mortality (through 2019).</div></div><div><h3>Results</h3><div>Over a median 7.2 years, 1,920 all-cause, 472 CVD, and 484 cancer-related deaths occurred. Mortality rates were higher in people with diabetes. Among people without diabetes, a 10-point increment in the LE8 score was linked to a significant 23% decreased risk of all-cause mortality (hazard ratio [HR] 0.77, 95% confidence interval [CI] 0.67 to 0.90) and a 21% decreased risk of CVD mortality (HR 0.79, 95% CI 0.64-0.98). However, no significant association was detected between LE8 score and cancer mortality in people with diabetes (HR 0.89, 95% CI 0.70 to 1.13). In the nondiabetes population, the HRs for LE8 score and all-cause, CVD, and cancer mortality were 0.58 (95% CI 0.44 to 0.75), 0.63 (95% CI 0.40-0.98), and 0.64 (95% CI 0.42 to 0.97), respectively. There was a synergistic additive interaction between diabetes and LE8 score for CVD death (relative excess risk due to interaction: 0.56, 95% CI 0.04 to 1.09; attributable proportion of interaction: 0.30, 95% CI 0.04 to 0.57; synergy index: 2.91, 95% CI 0.54 to 15.69).</div></div><div><h3>Conclusions</h3><div>Higher LE8 score conferred greater mortality risk reduction in people with diabetes vs those without diabetes. Diabetes and suboptimal LE8 scores may synergistically accelerate CVD death, underscoring the necessity for dual interventions addressing both glycemic management and cardiovascular health optimization in this population.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 381-393.e4"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Health Considerations and Dental Management Guidelines for Semaglutide Medications","authors":"Karina Kofman BSc,&nbsp;Aviv Ouanounou BSc, MSc, DDS","doi":"10.1016/j.jcjd.2026.03.008","DOIUrl":"10.1016/j.jcjd.2026.03.008","url":null,"abstract":"<div><div>Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated clinically meaningful weight-loss effects in individuals with type 2 diabetes and high body mass index, and dental practitioners and physicians often encounter patients who take these medications. Semaglutide is known to be associated with several systemic side effects, including delayed gastric emptying, belching, reflux and nausea, nutritional changes, and gastrointestinal discomfort. Systemic effects secondarily manifest in the oral cavity and, as a result, individuals taking semaglutide may present with xerostomia (dry mouth), halitosis (bad breath), enamel erosion tied to vomiting, and altered taste, among other oral signs and symptoms. It is important for dental professionals and physicians to become informed of possible symptoms and corresponding management strategies, given the multiple potential indirect effects on the oral cavity and relevance to dental treatment planning. In this article, we review the pharmacodynamics of semaglutide and present the current evidence on oral manifestations of the drug family and implications for dental and oral health. Practical management recommendations for dentists and the broader interdisciplinary health-care team are outlined.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 440-447"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferred Glucagon-like Peptide-1 Receptor Agonists in Adults With Type 2 Diabetes and Established Cardiovascular Disease or High Cardiovascular Risk: A Network Meta-analysis of Randomized Trials","authors":"Mustafa Abomohsen MD,&nbsp;Mohamed Rifai MD,&nbsp;Ahmed Farid Gadelmawla MD,&nbsp;Hamzah M. Alghzawi MD,&nbsp;Mohamed S. Elgendy MBBCh,&nbsp;Hager Mohamed Bakr MBBCh,&nbsp;Adam Friedman MD,&nbsp;Iyad Y. Idries MD","doi":"10.1016/j.jcjd.2026.04.001","DOIUrl":"10.1016/j.jcjd.2026.04.001","url":null,"abstract":"<div><div>The comparative cardiovascular (CV) efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D) and established cardiovascular disease (CVD) or high CV risk remain uncertain. PubMed, Embase, Web of Science, Scopus, and CENTRAL were searched from inception to December 20, 2025, for randomized controlled trials. We conducted a frequentist random-effects network meta-analysis and reported risk ratios (RRs) with 95% confidence intervals (CIs). Treatments were ranked using P-scores. Regimens were analyzed as individual agents, including albiglutide, dulaglutide, efpeglenatide, exenatide extended release, ITCA 650, liraglutide, lixisenatide, subcutaneous semaglutide, oral semaglutide, tirzepatide, and placebo. Eleven trials (n=83,215) were included. In the 3-point major adverse CV events (MACE) network (11 trials, 11 regimens), heterogeneity and inconsistency were absent (<em>I</em>²=0%, τ<strong>²</strong>=0). MACE rate was reduced with subcutaneous semaglutide (RR 0.74, 95% CI 0.58 to 0.94), efpeglenatide (RR 0.76, 95% CI 0.61 to 0.94), and albiglutide (RR 0.79, 95% CI 0.69 to 0.91); tirzepatide, oral semaglutide, liraglutide, and dulaglutide were also significantly reduced compared with placebo. Top ranked were subcutaneous semaglutide (P-score 0.87), efpeglenatide (0.84), and albiglutide (0.80). No regimen significantly reduced all-cause or CV death compared with placebo. Stroke was reduced with tirzepatide (RR 0.71, 95% CI 0.54 to 0.93) and dulaglutide (RR 0.77, 95% CI 0.63 to 0.95) vs placebo. Discontinuation and gastrointestinal discontinuation were higher with subcutaneous semaglutide, oral semaglutide, lixisenatide, and ITCA 650. Several GLP-1–based therapies reduced MACE vs placebo, with 3-point MACE emerging as the most consistent efficacy signal. Overall, these findings support guideline-based use of GLP-1 RAs in high-risk T2D while highlighting the need for individualized treatment selection.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 429-439.e26"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of Ecological Momentary Assessment of Psychosocial Functioning in Adults With Complications Related to Type 1 Diabetes","authors":"Hayley Centola PhD,&nbsp;Melissa Plegue MA,&nbsp;Dana Albright PhD,&nbsp;Kara Mizokami-Stout MD,&nbsp;Lynn Ang MD,&nbsp;Jennifer Iyengar MD,&nbsp;Emily Hirschfeld BA,&nbsp;Anna Kratz PhD,&nbsp;Evan L. Reynolds PhD,&nbsp;Brian C. Callaghan MD,&nbsp;Rodica Pop-Busui MD, PhD,&nbsp;Joyce M. Lee MD, MPH","doi":"10.1016/j.jcjd.2026.04.005","DOIUrl":"10.1016/j.jcjd.2026.04.005","url":null,"abstract":"<div><h3>Objectives</h3><div>Ecological momentary assessment (EMA) is a promising methodology for examining the contextual impact of psychosocial functioning on chronic disease management in individuals with type 1 diabetes (T1D). Little is known regarding psychometric properties of EMA of psychosocial functioning in adults with complications related to T1D. The aim of this study is to explore the feasibility, reliability, and validity of EMA psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia in a sample of adult individuals with complications related to T1D.</div></div><div><h3>Methods</h3><div>Fifty-one participants with T1D completed a 14-day EMA of symptoms of depression, anxiety, diabetes-related distress, and fear of hypoglycemia. Multilevel linear models were used to evaluate the association of EMA psychosocial questions with standard psychosocial measures.</div></div><div><h3>Results</h3><div>Feasibility was demonstrated via high response rates across the 14-day EMA response period (3 times daily). All 4 EMA measures (depression, anxiety, diabetes-related distress, and fear of hypoglycemia) showed meaningful (i.e. ≥25%) within-person variability (from 28.7% in diabetes-related distress to 46.5% in fear of hypoglycemia). All measures exceeded between-person reliability of 0.8 within 1 to 3 days. None of the measures demonstrated significant diurnal patterns. Convergent validity was established via significant correlations between all aggregate EMA measures with corresponding “gold standard” surveys.</div></div><div><h3>Conclusions</h3><div>Overall, findings support the psychometric properties (feasibility, reliability, and validity) of EMA of psychosocial measures in an adult cohort with complications related to T1D. This is the first study to date to examine psychometric properties of EMA of psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia simultaneously in an adult population with complications related to T1D.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 394-403.e1"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of Glucose Measurement Methods During Surgery: A Systematic Review","authors":"Lambert Heatlie MSc,&nbsp;Maede Ejaredar PhD,&nbsp;Kirstie C. Lithgow MD,&nbsp;Derek Dillane MD,&nbsp;Rupali Manek BSc,&nbsp;Simran Gill BSc,&nbsp;Anna Cameron MD, MSc, Epi,&nbsp;Anna K. Füzéry PhD,&nbsp;Michelle Pham MSc,&nbsp;Abinaya Subramanian BSc,&nbsp;Shannon M. Ruzycki MD, MPH","doi":"10.1016/j.jcjd.2026.04.002","DOIUrl":"10.1016/j.jcjd.2026.04.002","url":null,"abstract":"<div><div>Intraoperative hyperglycemia is associated with adverse patient outcomes and there are major quality gaps in intraoperative glucose measurement and management. It is unclear how anesthesiologists can accurately and feasibly measure glucose values during surgery. Our purpose in this systematic review was to describe the current literature describing the precision and accuracy of intraoperative glucose measurement to inform clinical decision-making for anaesthesiologists. A systematic search strategy identified English-language studies that compared 2 or more methods to measure a blood glucose value during surgery for adult, nonpregnant patients. MEDLINE, PubMed, Embase, and CINAHL were searched from inception until 2024. A grey literature search and hand searching of reference lists for included articles was also completed. Abstracts and full text were screened and then extracted in duplicate by study team members. Of 8,691 unique studies identified, 23 studies were included in the analysis (1,258 total patients, 4,071 pairs of glucose measurements). There was important heterogeneity between these studies with respect to the blood source, blood fraction, comparator measurement method, reference measurement method, and statistical analysis used. This heterogeneity precluded meta-analysis of results. Hypoglycemia was rare (9 of 1,992 measurements, 0.45%). Most studies did not use international accuracy standards to determine whether differences between their comparator measurement method and reference measurement method were clinically acceptable. The optimal method to measure intraoperative glucose is not known. In the meantime, anesthesiologists should consider the characteristics of existing glucose measurement methods when selecting a method for their settings and patients.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 448-455.e5"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world Glycemic Outcomes of a Tubeless Automated Insulin Delivery System (Medtrum A8 TouchCare) in Adults With Type 1 Diabetes","authors":"Michele Roberto Modestino MD,&nbsp;Mariarosaria De Luca MD,&nbsp;Umberto De Fortuna MD,&nbsp;Laura Ferrentino MD,&nbsp;Olimpia Iacono MD,&nbsp;Rita Verdoliva MD,&nbsp;Angelo Foglia MD,&nbsp;Vincenzo Guardasole MD","doi":"10.1016/j.jcjd.2026.05.004","DOIUrl":"10.1016/j.jcjd.2026.05.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Automated insulin delivery (AID) systems are recommended as a first-line therapy for type 1 diabetes. The Medtrum A8 TouchCare is a tubeless AID system powered by the APGO algorithm, which modulates basal insulin and delivers automatic correction microboluses. Real-world evidence on this system remains extremely limited. In this study, we aimed to evaluate the efficacy of the Medtrum A8 TouchCare in AID mode in a real-world cohort of adults with type 1 diabetes.</div></div><div><h3>Methods</h3><div>We conducted a single-centre, observational retrospective study at Federico II University Hospital, Naples, Italy (January to October 2025). Adults with type 1 diabetes of ≥6 months’ duration who were using the Medtrum A8 TouchCare in AID mode were included. Continuous glucose monitoring metrics and clinical parameters were compared at baseline and after 3 months. The primary endpoint was the change in time in range.</div></div><div><h3>Results</h3><div>A total of 20 patients were included (mean age: 39±6 years; diabetes duration: 18±6 years). After 3 months, time in range increased by 12.51% (p&lt;0.05); time above range 1 and time above range 2 decreased by 7.2% (p&lt;0.05) and 5.97% (p&lt;0.05), respectively. Glucose monitoring index improved by 0.46% (p&lt;0.05) and glycemia risk index by 13.75 points (p&lt;0.05), and glycated hemoglobin decreased by 0.52% (p&lt;0.05). No significant changes were observed in time below range 1, time below range 2, or coefficient variability, and no severe hypoglycemia episodes occurred.</div></div><div><h3>Conclusions</h3><div>The Medtrum A8 TouchCare in AID mode significantly improved glycemic management without increasing hypoglycemia. These findings support the efficacy of this tubeless AID system and warrant confirmation in larger prospective studies.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 423-428"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity Self-reflections: A Year-Long Analysis of Barriers and Facilitators in a Diabetes Prevention Program","authors":"Blanca Gala MSc,&nbsp;Megan M. MacPherson PhD,&nbsp;Kyra Braaten MSc,&nbsp;Sarah Craven MSc,&nbsp;Mary Jung PhD","doi":"10.1016/j.jcjd.2026.05.003","DOIUrl":"10.1016/j.jcjd.2026.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>Type 2 diabetes (T2D) is a public health issue. Diabetes prevention programs (DPPs) reduce T2D risk by encouraging changes in diet and physical activity (PA) behaviours; however, long-term PA adherence is challenging. Sustaining regular PA not only is crucial for reducing T2D risk but also plays an important role in maintaining weight loss achieved during DPPs, which further reinforces long-term metabolic health. This study examines the barriers to and facilitators of sustained PA after DPP participation and the role of self-reflection in promoting PA adherence.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of 6,684 self-reflections collected via a mobile application from Small Steps for Big Changes DPP participants. Participants (n=86) logged daily PA and optionally recorded reflections on their exercise experiences for 1 year. Reflections were coded using the theoretical domains framework and classified by PA engagement (exercise/rest day/nonexercise day).</div></div><div><h3>Results</h3><div>Participants engaged in PA on an average of 143 days, with higher self-reflection frequencies correlating with increased PA engagement (<em>r</em>₈₄=0.42, p=0.01). Self-monitoring appeared in 73% of reflections and remained present across the year. Facilitators were mentioned in 48% of reflections, peaking in the fourth quarter, whereas barriers (23%) declined over time. Commonly cited theoretical domains framework domains included behavioural regulation (75%) and environmental context and resources (68%).</div></div><div><h3>Conclusions</h3><div>Self-reflections were positively associated with PA engagement, with participants primarily focusing on tracking specific PA behaviours and environmental contexts. The integration of self-reflection and monitoring tools in DPPs could offer valuable support for behaviour change by enabling participants to be aware and to document and respond to real-time barriers and facilitators. Future DPPs may benefit from embedding flexible self-reflection tools that encourage sustained engagement and promote PA behaviour.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 6","pages":"Pages 415-422"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}