Xinyi Li, Jinhee Hur, Stephanie A. Smith-Warner, Mingyang Song, Liming Liang, Kenneth J. Mukamal, Eric B. Rimm, Edward L. Giovannucci
OBJECTIVE Although the adverse effects of excessive alcohol consumption are well established, the association between light to moderate alcohol consumption (≤30 g ethanol per day) and risk of type 2 diabetes (T2D) remains controversial and holds substantial public health implications. We aimed to examine the association of total alcohol intake and drinking pattern with T2D among three cohorts, Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII), and Health Professionals Follow-up Study (HPFS). RESEARCH DESIGN AND METHODS Former regular drinkers were excluded from baseline nondrinkers. Hazard ratios (HRs) and 95% CIs were estimated by Cox models. RESULTS Over 3 decades of follow-up, 20,551 T2D cases were documented among 200,969 participants. Total alcohol intake was associated with a lower risk of T2D, either using nondrinkers or 0.1–4.9 g/day as the reference. The association was robust to extended latency periods and alternative modeling of exposure. Drinking frequency was associated with a lower T2D risk. For example, compared with drinking 1–2 days per week, the HRs (95% CIs) for drinking 5–6 days were 0.73 (0.65, 0.83), 0.73 (0.62, 0.86), and 0.76 (0.67, 0.86) in the NHS, NHSII, and HPFS cohorts, respectively. When modeled jointly, the lower risk of T2D among drinkers was primarily driven by the drinking frequency. The inverse association began at drinking 1–2 days per week in women and 3–4 days per week in men and was strongest for ≥5 days per week, regardless of drinking <10 g or ≥30 g per drinking day. CONCLUSIONS Light to moderate alcohol consumption, especially regular light drinking, was associated with a lower risk of T2D in both men and women.
{"title":"Alcohol Intake, Drinking Pattern, and Risk of Type 2 Diabetes in Three Prospective Cohorts of U.S. Women and Men","authors":"Xinyi Li, Jinhee Hur, Stephanie A. Smith-Warner, Mingyang Song, Liming Liang, Kenneth J. Mukamal, Eric B. Rimm, Edward L. Giovannucci","doi":"10.2337/dc24-1902","DOIUrl":"https://doi.org/10.2337/dc24-1902","url":null,"abstract":"OBJECTIVE Although the adverse effects of excessive alcohol consumption are well established, the association between light to moderate alcohol consumption (≤30 g ethanol per day) and risk of type 2 diabetes (T2D) remains controversial and holds substantial public health implications. We aimed to examine the association of total alcohol intake and drinking pattern with T2D among three cohorts, Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII), and Health Professionals Follow-up Study (HPFS). RESEARCH DESIGN AND METHODS Former regular drinkers were excluded from baseline nondrinkers. Hazard ratios (HRs) and 95% CIs were estimated by Cox models. RESULTS Over 3 decades of follow-up, 20,551 T2D cases were documented among 200,969 participants. Total alcohol intake was associated with a lower risk of T2D, either using nondrinkers or 0.1–4.9 g/day as the reference. The association was robust to extended latency periods and alternative modeling of exposure. Drinking frequency was associated with a lower T2D risk. For example, compared with drinking 1–2 days per week, the HRs (95% CIs) for drinking 5–6 days were 0.73 (0.65, 0.83), 0.73 (0.62, 0.86), and 0.76 (0.67, 0.86) in the NHS, NHSII, and HPFS cohorts, respectively. When modeled jointly, the lower risk of T2D among drinkers was primarily driven by the drinking frequency. The inverse association began at drinking 1–2 days per week in women and 3–4 days per week in men and was strongest for ≥5 days per week, regardless of drinking &lt;10 g or ≥30 g per drinking day. CONCLUSIONS Light to moderate alcohol consumption, especially regular light drinking, was associated with a lower risk of T2D in both men and women.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"1 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Klemen Dovc, Vit Neuman, Gemulla Gita, Valentino Cherubini, G. Todd Alonso, Maria Fritsch, Claudia Boettcher, Carine de Beaufort, Reinhard W. Holl, Martin de Bock
OBJECTIVE This study examined the association between diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis and long-term glycemic outcomes, insulin requirements, BMI SDS, and diabetes technology uptake in youth. RESEARCH DESIGN AND METHODS Data were from nine countries (Austria, Czechia, Germany, Italy, Luxembourg, New Zealand, Slovenia, Switzerland, and U.S. [Colorado]), including youth (0.5–15.9 years) diagnosed with type 1 diabetes in 2019–2020 and followed for 2 years thereafter. Participants were divided into three groups: no DKA, nonsevere, and severe DKA at diagnosis. HbA1c, insulin requirements, BMI SDS, and use of technology, including automated insulin delivery (AID), were assessed. RESULTS The analysis included 9,269 individuals (54.8% males, mean age 9.0 years). DKA at diagnosis was observed in 34.2% of participants and severe DKA in 12.8%. After 1 year, adjusted mean HbA1c was higher in the severe DKA group (7.41%) compared with nonsevere DKA (7.23%, P = 0.001) and no DKA groups (7.14, P < 0.001), and this difference persisted after 2 years (7.58% vs. 7.38% [P < 0.001] and vs. 7.32% [P < 0.001]). Higher BMI SDS was observed in both DKA groups compared with no DKA. The use of AID was associated with lower HbA1c levels compared with other treatment modalities and moderated differences between DKA groups after 2 years of follow-up (P = 0.072). CONCLUSIONS Severe and nonsevere DKA at type 1 diabetes diagnosis were both associated with persistently higher HbA1c and higher BMI SDS. AID use diminishes the association of DKA at diagnosis and higher HbA1c over time.
{"title":"Association of Diabetic Ketoacidosis at Onset, Diabetes Technology Uptake, and Clinical Outcomes After 1 and 2 Years of Follow-up: A Collaborative Analysis of Pediatric Registries Involving 9,269 Children With Type 1 Diabetes From Nine Countries","authors":"Klemen Dovc, Vit Neuman, Gemulla Gita, Valentino Cherubini, G. Todd Alonso, Maria Fritsch, Claudia Boettcher, Carine de Beaufort, Reinhard W. Holl, Martin de Bock","doi":"10.2337/dc24-2483","DOIUrl":"https://doi.org/10.2337/dc24-2483","url":null,"abstract":"OBJECTIVE This study examined the association between diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis and long-term glycemic outcomes, insulin requirements, BMI SDS, and diabetes technology uptake in youth. RESEARCH DESIGN AND METHODS Data were from nine countries (Austria, Czechia, Germany, Italy, Luxembourg, New Zealand, Slovenia, Switzerland, and U.S. [Colorado]), including youth (0.5–15.9 years) diagnosed with type 1 diabetes in 2019–2020 and followed for 2 years thereafter. Participants were divided into three groups: no DKA, nonsevere, and severe DKA at diagnosis. HbA1c, insulin requirements, BMI SDS, and use of technology, including automated insulin delivery (AID), were assessed. RESULTS The analysis included 9,269 individuals (54.8% males, mean age 9.0 years). DKA at diagnosis was observed in 34.2% of participants and severe DKA in 12.8%. After 1 year, adjusted mean HbA1c was higher in the severe DKA group (7.41%) compared with nonsevere DKA (7.23%, P = 0.001) and no DKA groups (7.14, P &lt; 0.001), and this difference persisted after 2 years (7.58% vs. 7.38% [P &lt; 0.001] and vs. 7.32% [P &lt; 0.001]). Higher BMI SDS was observed in both DKA groups compared with no DKA. The use of AID was associated with lower HbA1c levels compared with other treatment modalities and moderated differences between DKA groups after 2 years of follow-up (P = 0.072). CONCLUSIONS Severe and nonsevere DKA at type 1 diabetes diagnosis were both associated with persistently higher HbA1c and higher BMI SDS. AID use diminishes the association of DKA at diagnosis and higher HbA1c over time.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"13 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chaolei Chen, Zehan Huang, Lin Liu, Bingbing Su, Yingqing Feng, Yuqing Huang
OBJECTIVE Individuals with type 2 diabetes (T2D) frequently exhibit impaired lung function, potentially accelerating the onset of cardiovascular disease (CVD), although prospective studies remain limited. We aimed to explore the relationship between lung function impairment and risk of CVD and mortality within this high-risk population. RESEARCH DESIGN AND METHODS This prospective study included 16,242 participants with T2D and free of CVD from the UK Biobank. Obstructive physiology (OP), restrictive physiology (RP), and preserved ratio impaired spirometry (PRISm) were defined using spirometry, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Fine-Gray subdistribution hazards models and Cox proportional hazards models were used to estimate risks of CVD and all-cause mortality, respectively. RESULTS During a median follow-up of 13.9 years, 2,825 incident cases of CVD and 2,811 deaths were documented. Lower FEV1, FVC, FEV1/FVC ratio, FEV1 percent predicted, and FVC percent predicted were related to higher risks of CVD and all-cause mortality. Compared with preserved lung function, the adjusted subdistribution hazard ratios (HRs) for CVD were 1.19 (95% CI 1.05–1.35) for OP and 1.47 (95% CI 1.33–1.65) for RP. Compared with the control group, the subdistribution HRs for CVD were 1.20 (95% CI 1.06–1.36) for OP and 1.43 (95% CI 1.29–1.59) for PRISm. These associations were consistent across subgroups and sensitivity analyses. Adding lung function measurements significantly enhanced the performance of CVD prediction beyond the SCORE2-Diabetes model. CONCLUSIONS Lung function impairment was associated with increased risks of CVD and all-cause mortality among individuals with T2D.
{"title":"Lung Function Impairment and Risks of Incident Cardiovascular Diseases and Mortality Among People With Type 2 Diabetes: A Prospective Cohort Study","authors":"Chaolei Chen, Zehan Huang, Lin Liu, Bingbing Su, Yingqing Feng, Yuqing Huang","doi":"10.2337/dc24-2188","DOIUrl":"https://doi.org/10.2337/dc24-2188","url":null,"abstract":"OBJECTIVE Individuals with type 2 diabetes (T2D) frequently exhibit impaired lung function, potentially accelerating the onset of cardiovascular disease (CVD), although prospective studies remain limited. We aimed to explore the relationship between lung function impairment and risk of CVD and mortality within this high-risk population. RESEARCH DESIGN AND METHODS This prospective study included 16,242 participants with T2D and free of CVD from the UK Biobank. Obstructive physiology (OP), restrictive physiology (RP), and preserved ratio impaired spirometry (PRISm) were defined using spirometry, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Fine-Gray subdistribution hazards models and Cox proportional hazards models were used to estimate risks of CVD and all-cause mortality, respectively. RESULTS During a median follow-up of 13.9 years, 2,825 incident cases of CVD and 2,811 deaths were documented. Lower FEV1, FVC, FEV1/FVC ratio, FEV1 percent predicted, and FVC percent predicted were related to higher risks of CVD and all-cause mortality. Compared with preserved lung function, the adjusted subdistribution hazard ratios (HRs) for CVD were 1.19 (95% CI 1.05–1.35) for OP and 1.47 (95% CI 1.33–1.65) for RP. Compared with the control group, the subdistribution HRs for CVD were 1.20 (95% CI 1.06–1.36) for OP and 1.43 (95% CI 1.29–1.59) for PRISm. These associations were consistent across subgroups and sensitivity analyses. Adding lung function measurements significantly enhanced the performance of CVD prediction beyond the SCORE2-Diabetes model. CONCLUSIONS Lung function impairment was associated with increased risks of CVD and all-cause mortality among individuals with T2D.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"15 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143393333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hasan Nassereldine, Zhuochen Li, Kelly Compton, Parkes Kendrick, Ethan Kahn, Yekaterina O. Kelly, Mathew M. Baumann, Chris A. Schmidt, Dillon O. Sylte, Kanyin Liane Ong, Wichada La Motte-Kerr, Farah Daoud, Susan A. McLaughlin, Simon I. Hay, Erik J. Rodriquez, Anna M. Nápoles, George A. Mensah, Eliseo J. Pérez-Stable, Ali H. Mokdad, Laura Dwyer-Lindgren
OBJECTIVE Diabetes is a leading cause of death in the U.S. Previous studies have found substantial racial, ethnic, and geographical disparities in diabetes mortality; however, research considering racial, ethnic, and geographical disparities simultaneously has been limited. To fill this gap, we estimated trends in diabetes mortality rates from 2000 to 2019 at the county level for five racial and ethnic populations. RESEARCH DESIGN AND METHODS We applied small-area estimation methods to death registration data from the U.S. National Vital Statistics System and population data from the U.S. National Center for Health Statistics and corrected for misclassification of race and ethnicity on death certificates. RESULTS Age-standardized diabetes mortality rates decreased in the U.S. from 28.1 deaths per 100,000 (95% uncertainty interval 27.9–28.2) in 2000 to 19.1 deaths per 100,000 (19.0–19.2) in 2019. In 2019, national-level rates were highest for the American Indian or Alaska Native (AIAN) population (35.6 [32.1–39.4]), followed by the Black (31.9 [31.5–32.3]), Latino (19.7 [19.3–20.2]), White (17.6 [17.5–17.8]), and Asian (12.6 [12.1–13.1]) populations. There was substantial heterogeneity in diabetes mortality rates across counties within each racial and ethnic population, with the AIAN population experiencing the greatest heterogeneity in 2019 (interquartile range 18.7–50.3 [median 31.9]). For each racial and ethnic population, mortality rates declined in most counties from 2000 to 2019. CONCLUSIONS Since 2000, progress has been made in reducing diabetes mortality rates. Nonetheless, diabetes mortality remains too high for many Americans. Interventions focusing on communities at highest risk are vital to resolving persistent health inequities.
{"title":"The Burden of Diabetes Mortality by County, Race, and Ethnicity in the U.S., 2000–2019","authors":"Hasan Nassereldine, Zhuochen Li, Kelly Compton, Parkes Kendrick, Ethan Kahn, Yekaterina O. Kelly, Mathew M. Baumann, Chris A. Schmidt, Dillon O. Sylte, Kanyin Liane Ong, Wichada La Motte-Kerr, Farah Daoud, Susan A. McLaughlin, Simon I. Hay, Erik J. Rodriquez, Anna M. Nápoles, George A. Mensah, Eliseo J. Pérez-Stable, Ali H. Mokdad, Laura Dwyer-Lindgren","doi":"10.2337/dc24-2259","DOIUrl":"https://doi.org/10.2337/dc24-2259","url":null,"abstract":"OBJECTIVE Diabetes is a leading cause of death in the U.S. Previous studies have found substantial racial, ethnic, and geographical disparities in diabetes mortality; however, research considering racial, ethnic, and geographical disparities simultaneously has been limited. To fill this gap, we estimated trends in diabetes mortality rates from 2000 to 2019 at the county level for five racial and ethnic populations. RESEARCH DESIGN AND METHODS We applied small-area estimation methods to death registration data from the U.S. National Vital Statistics System and population data from the U.S. National Center for Health Statistics and corrected for misclassification of race and ethnicity on death certificates. RESULTS Age-standardized diabetes mortality rates decreased in the U.S. from 28.1 deaths per 100,000 (95% uncertainty interval 27.9–28.2) in 2000 to 19.1 deaths per 100,000 (19.0–19.2) in 2019. In 2019, national-level rates were highest for the American Indian or Alaska Native (AIAN) population (35.6 [32.1–39.4]), followed by the Black (31.9 [31.5–32.3]), Latino (19.7 [19.3–20.2]), White (17.6 [17.5–17.8]), and Asian (12.6 [12.1–13.1]) populations. There was substantial heterogeneity in diabetes mortality rates across counties within each racial and ethnic population, with the AIAN population experiencing the greatest heterogeneity in 2019 (interquartile range 18.7–50.3 [median 31.9]). For each racial and ethnic population, mortality rates declined in most counties from 2000 to 2019. CONCLUSIONS Since 2000, progress has been made in reducing diabetes mortality rates. Nonetheless, diabetes mortality remains too high for many Americans. Interventions focusing on communities at highest risk are vital to resolving persistent health inequities.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"16 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gregory G. Schwartz, Michael Szarek, J. Wouter Jukema, Christa M. Cobbaert, Esther Reijnders, Vera A. Bittner, Markus Schwertfeger, Deepak L. Bhatt, Sergio Fazio, Genevieve Garon, Shaun G. Goodman, Robert A. Harrington, Harvey D. White, Philippe Gabriel Steg
OBJECTIVE Previous genetic and clinical analyses have associated lower lipoprotein(a) and LDL cholesterol (LDL-C) with greater risk of new-onset type 2 diabetes (NOD). However, PCSK9 inhibitors such as alirocumab lower both lipoprotein(a) and LDL-C without effect on NOD. RESEARCH DESIGN AND METHODS In a post hoc analysis of the ODYSSEY OUTCOMES trial (NCT01663402), we examined the joint prediction of NOD by baseline lipoprotein(a), LDL-C, and insulin (or HOMA–insulin resistance [HOMA-IR]) and their changes with alirocumab treatment. Analyses included 8,107 patients with recent acute coronary syndrome on optimized statin therapy, without diabetes at baseline, assigned to alirocumab or placebo with median follow-up 2.4 years. Splines were estimated from logistic regression models. RESULTS Lower baseline lipoprotein(a) and higher baseline insulin or HOMA-IR independently predicted 782 cases of NOD; baseline LDL-C did not predict NOD. Alirocumab reduced lipoprotein(a) and LDL-C without affecting insulin or NOD risk (odds ratio [OR] vs. placebo 0.998; 95% CI 0.860–1.158). However, in logistic regression, decreased lipoprotein(a) and LDL-C on alirocumab were independent, opposite predictors of NOD. OR for NOD for 25% and 50% lipoprotein(a) reductions on alirocumab were 1.12 (95% CI 1.01–1.23) and 1.24 (1.02–1.52). OR for NOD for 25% and 50% LDL-C reductions on alirocumab were 0.88 (95% CI 0.80–0.97) and 0.77 (0.64–0.94). CONCLUSIONS Baseline lipoprotein(a) was inversely associated with risk of NOD. Alirocumab-induced reductions of lipoprotein(a) and LDL-C were associated with increased and decreased risk of NOD, respectively, without net effect on NOD. Ongoing trials will determine the impact of larger and longer lipoprotein(a) reductions on NOD.
{"title":"Risk of Incident Diabetes Related to Lipoprotein(a), LDL Cholesterol, and Their Changes With Alirocumab: Post Hoc Analyses of the ODYSSEY OUTCOMES Randomized Trial","authors":"Gregory G. Schwartz, Michael Szarek, J. Wouter Jukema, Christa M. Cobbaert, Esther Reijnders, Vera A. Bittner, Markus Schwertfeger, Deepak L. Bhatt, Sergio Fazio, Genevieve Garon, Shaun G. Goodman, Robert A. Harrington, Harvey D. White, Philippe Gabriel Steg","doi":"10.2337/dc24-2110","DOIUrl":"https://doi.org/10.2337/dc24-2110","url":null,"abstract":"OBJECTIVE Previous genetic and clinical analyses have associated lower lipoprotein(a) and LDL cholesterol (LDL-C) with greater risk of new-onset type 2 diabetes (NOD). However, PCSK9 inhibitors such as alirocumab lower both lipoprotein(a) and LDL-C without effect on NOD. RESEARCH DESIGN AND METHODS In a post hoc analysis of the ODYSSEY OUTCOMES trial (NCT01663402), we examined the joint prediction of NOD by baseline lipoprotein(a), LDL-C, and insulin (or HOMA–insulin resistance [HOMA-IR]) and their changes with alirocumab treatment. Analyses included 8,107 patients with recent acute coronary syndrome on optimized statin therapy, without diabetes at baseline, assigned to alirocumab or placebo with median follow-up 2.4 years. Splines were estimated from logistic regression models. RESULTS Lower baseline lipoprotein(a) and higher baseline insulin or HOMA-IR independently predicted 782 cases of NOD; baseline LDL-C did not predict NOD. Alirocumab reduced lipoprotein(a) and LDL-C without affecting insulin or NOD risk (odds ratio [OR] vs. placebo 0.998; 95% CI 0.860–1.158). However, in logistic regression, decreased lipoprotein(a) and LDL-C on alirocumab were independent, opposite predictors of NOD. OR for NOD for 25% and 50% lipoprotein(a) reductions on alirocumab were 1.12 (95% CI 1.01–1.23) and 1.24 (1.02–1.52). OR for NOD for 25% and 50% LDL-C reductions on alirocumab were 0.88 (95% CI 0.80–0.97) and 0.77 (0.64–0.94). CONCLUSIONS Baseline lipoprotein(a) was inversely associated with risk of NOD. Alirocumab-induced reductions of lipoprotein(a) and LDL-C were associated with increased and decreased risk of NOD, respectively, without net effect on NOD. Ongoing trials will determine the impact of larger and longer lipoprotein(a) reductions on NOD.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"85 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Donald C. Simonson, William F. Gourash, David E. Arterburn, Bo Hu, Sangeeta R. Kashyap, David E. Cummings, Mary-Elizabeth Patti, Anita P. Courcoulas, Ashley H. Vernon, John M. Jakicic, Sarah Kirschling, Ali Aminian, Philip R. Schauer, John P. Kirwan
OBJECTIVE Type 2 diabetes and obesity are associated with reduced health-related quality of life (HRQoL) and health utility (HU), but long-term effects of metabolic/bariatric surgery (MBS) compared with those of medical/lifestyle intervention (MLI) on these outcomes are unclear. RESEARCH DESIGN AND METHODS We studied 228 individuals with type 2 diabetes and obesity randomly assigned to MBS (Roux-en-Y gastric bypass, sleeve gastrectomy, or gastric band; n = 152) or MLI (n = 76) in the ARMMS-T2D study. HRQoL (36-Item Short-Form Health Survey [SF-36], including Physical Component Score [PCS] and Mental Component Score [MCS]) and HU (Short Form 6 Dimensions [SF-6D]) were measured annually up to 12 years. RESULTS At baseline, participants’ mean ± SD age was 49.2 ± 8.0 years, 68.4% were female, BMI was 36.3 ± 3.4 kg/m2, and HbA1c was 8.7 ± 1.6%. PCS improved significantly more in the MBS versus MLI group over 12 years (+2.37 ± 0.53 vs. −0.95 ± 0.73; difference 3.32 ± 0.85; P < 0.001). MBS was associated with better general health (P < 0.001), physical functioning (P = 0.001), and vitality (P = 0.003). Reduction in BMI was greater after MBS versus MLI (P < 0.001) and correlated with improved PCS (r = −0.43; P < 0.001). Change in PCS was not associated with change in HbA1c. MCS changed minimally from baseline and was similar between MBS and MLI groups during follow-up (−0.21 ± 0.61 vs. −0.89 ± 0.84; difference 0.68 ± 0.97; P = 0.48). Improvements in HU were greater in the MBS versus MLI group over 12 years (+0.02 ± 0.01 vs. −0.01 ± 0.01; difference 0.03 ± 0.01; P = 0.003). CONCLUSIONS Metabolic surgery produces sustained weight loss and improves PCS, general health, physical functioning, vitality, and HU in individuals with type 2 diabetes and obesity compared with medical therapy up to 12 years after intervention.
{"title":"Health-Related Quality of Life and Health Utility After Metabolic/Bariatric Surgery Versus Medical/Lifestyle Intervention in Individuals With Type 2 Diabetes and Obesity: The ARMMS-T2D Study","authors":"Donald C. Simonson, William F. Gourash, David E. Arterburn, Bo Hu, Sangeeta R. Kashyap, David E. Cummings, Mary-Elizabeth Patti, Anita P. Courcoulas, Ashley H. Vernon, John M. Jakicic, Sarah Kirschling, Ali Aminian, Philip R. Schauer, John P. Kirwan","doi":"10.2337/dc24-2046","DOIUrl":"https://doi.org/10.2337/dc24-2046","url":null,"abstract":"OBJECTIVE Type 2 diabetes and obesity are associated with reduced health-related quality of life (HRQoL) and health utility (HU), but long-term effects of metabolic/bariatric surgery (MBS) compared with those of medical/lifestyle intervention (MLI) on these outcomes are unclear. RESEARCH DESIGN AND METHODS We studied 228 individuals with type 2 diabetes and obesity randomly assigned to MBS (Roux-en-Y gastric bypass, sleeve gastrectomy, or gastric band; n = 152) or MLI (n = 76) in the ARMMS-T2D study. HRQoL (36-Item Short-Form Health Survey [SF-36], including Physical Component Score [PCS] and Mental Component Score [MCS]) and HU (Short Form 6 Dimensions [SF-6D]) were measured annually up to 12 years. RESULTS At baseline, participants’ mean ± SD age was 49.2 ± 8.0 years, 68.4% were female, BMI was 36.3 ± 3.4 kg/m2, and HbA1c was 8.7 ± 1.6%. PCS improved significantly more in the MBS versus MLI group over 12 years (+2.37 ± 0.53 vs. −0.95 ± 0.73; difference 3.32 ± 0.85; P &lt; 0.001). MBS was associated with better general health (P &lt; 0.001), physical functioning (P = 0.001), and vitality (P = 0.003). Reduction in BMI was greater after MBS versus MLI (P &lt; 0.001) and correlated with improved PCS (r = −0.43; P &lt; 0.001). Change in PCS was not associated with change in HbA1c. MCS changed minimally from baseline and was similar between MBS and MLI groups during follow-up (−0.21 ± 0.61 vs. −0.89 ± 0.84; difference 0.68 ± 0.97; P = 0.48). Improvements in HU were greater in the MBS versus MLI group over 12 years (+0.02 ± 0.01 vs. −0.01 ± 0.01; difference 0.03 ± 0.01; P = 0.003). CONCLUSIONS Metabolic surgery produces sustained weight loss and improves PCS, general health, physical functioning, vitality, and HU in individuals with type 2 diabetes and obesity compared with medical therapy up to 12 years after intervention.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"164 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susanne Thierry, Caspar Joyce Peterson, Stéphanie Pfammatter, Patricia Arroyo Tardio, Christian Meier, Tarik Delko, Vasco Iten, Christine S. Zuern, Michael Kühne, Michael Epstein, Alaa Othman, Nicola Zamboni, Isabel Reinisch, Adhideb Ghosh, Christian Wolfrum, Eleonora Seelig
OBJECTIVE Glucocorticoids (GCs) are potent anti-inflammatory drugs, but strategies to prevent side effects are lacking. We investigated whether metformin could prevent GC-related toxicity and explored the underlying mechanisms. RESEARCH DESIGN AND METHODS This single-center, randomized, placebo-controlled, double-blind, crossover trial compared metformin with placebo during high-dose GC treatment in 18 lean, healthy, male study participants. The trial was conducted at the University Hospital Basel, Switzerland. Participants received prednisone 30 mg/d in combination with metformin or placebo for two 7-day periods (1:1 randomization). The primary outcome, change in insulin sensitivity, was assessed using a two-sided paired t test. Before and after each study period, we conducted a mixed-meal tolerance test, blood metabolomics, and RNA sequencing of subcutaneous adipose tissue biopsy specimens. RESULTS Metformin improved insulin sensitivity as assessed by the Matsuda index (n = 17; mean change: −2.73 ± 3.55 SD for placebo, 2.21 ± 3.95 for metformin; mean difference of change −4.94 [95% CI, −7.24, −2.65)]; P < 0.001). Metabolomic and transcriptomic analyses revealed that metformin altered fatty acid flux in the blood and downregulated genes involved in fatty acid synthesis in adipose tissue. Metformin reduced markers of protein breakdown and bone resorption. Furthermore, metformin downregulated genes responsible for AMPK inhibition and affected GLP1 and bile acid metabolism. CONCLUSIONS Metformin prevents GC-induced insulin resistance and reduces markers of dyslipidemia, myopathy, and, possibly, bone resorption through AMPK-dependent and -independent pathways.
{"title":"Short-Term Metformin Protects Against Glucocorticoid-Induced Toxicity in Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial","authors":"Susanne Thierry, Caspar Joyce Peterson, Stéphanie Pfammatter, Patricia Arroyo Tardio, Christian Meier, Tarik Delko, Vasco Iten, Christine S. Zuern, Michael Kühne, Michael Epstein, Alaa Othman, Nicola Zamboni, Isabel Reinisch, Adhideb Ghosh, Christian Wolfrum, Eleonora Seelig","doi":"10.2337/dc24-2039","DOIUrl":"https://doi.org/10.2337/dc24-2039","url":null,"abstract":"OBJECTIVE Glucocorticoids (GCs) are potent anti-inflammatory drugs, but strategies to prevent side effects are lacking. We investigated whether metformin could prevent GC-related toxicity and explored the underlying mechanisms. RESEARCH DESIGN AND METHODS This single-center, randomized, placebo-controlled, double-blind, crossover trial compared metformin with placebo during high-dose GC treatment in 18 lean, healthy, male study participants. The trial was conducted at the University Hospital Basel, Switzerland. Participants received prednisone 30 mg/d in combination with metformin or placebo for two 7-day periods (1:1 randomization). The primary outcome, change in insulin sensitivity, was assessed using a two-sided paired t test. Before and after each study period, we conducted a mixed-meal tolerance test, blood metabolomics, and RNA sequencing of subcutaneous adipose tissue biopsy specimens. RESULTS Metformin improved insulin sensitivity as assessed by the Matsuda index (n = 17; mean change: −2.73 ± 3.55 SD for placebo, 2.21 ± 3.95 for metformin; mean difference of change −4.94 [95% CI, −7.24, −2.65)]; P &lt; 0.001). Metabolomic and transcriptomic analyses revealed that metformin altered fatty acid flux in the blood and downregulated genes involved in fatty acid synthesis in adipose tissue. Metformin reduced markers of protein breakdown and bone resorption. Furthermore, metformin downregulated genes responsible for AMPK inhibition and affected GLP1 and bile acid metabolism. CONCLUSIONS Metformin prevents GC-induced insulin resistance and reduces markers of dyslipidemia, myopathy, and, possibly, bone resorption through AMPK-dependent and -independent pathways.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"20 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John M. Wentworth, Anna B. E. Sing, Gaetano Naselli, Dexing Huang, Elizabeth Azidis-Yates, Batsho Mandlebe, James D. Brown, Kelly McGorm, Candice Hall, Leanne Redl, Renee Kludas, Aniruddh Haldar, Felicity Healy, Abbey Gilbert, Kelly Watson, Cherie Chiang, Jennifer J. Couper, Tony Huynh, Elizabeth A. Davis, Maria E. Craig, Fergus J. Cameron, Thomas W. Kay, Leonard C. Harrison, Peter G. Colman
OBJECTIVE Type1Screen offers islet autoantibody testing to Australians with a family history of type 1 diabetes (T1D) with the dual aims of preventing diabetic ketoacidosis (DKA) and enabling use of disease-modifying therapy. We describe screening and monitoring outcomes 2 years after implementing in-home capillary blood spot sampling. RESEARCH DESIGN AND METHODS Data from 2,064 participants who registered between July 2022 and June 2024 were analyzed: 1,507 and 557 chose blood spot and venipuncture screening respectively. We compared baseline characteristics and outcomes for 1,243 participants (967 blood spot and 276 venipuncture) whose samples were tested by June 2024. RESULTS One blood spot and five venous participants reported unsuccessful sample collections. The median (quartile 1, quartile 3) age of blood spot registrants was lower (12.1 [7.1, 27.1] vs. 17.2 [9, 38.4] years; P < 0.0001), and a higher proportion lived in regional Australia (39% vs. 29%; P = 0.0037). Among 72 participants (5.9%) with a positive screening test, 5 screened by blood spot and 2 by venipuncture had no autoantibodies on confirmatory testing. Blood spot screening identified the expected 2.1% prevalence of multiple autoantibodies and a 2.5% prevalence of a single autoantibody compared with 1.5% and 4.1%, respectively, for venipuncture screening. Clinical diabetes developed in 12 participants. All had screened positive and none had DKA. CONCLUSIONS Type1Screen has national reach. In-home blood spot screening is feasible, particularly for younger participants living regionally, and identifies the expected prevalence of preclinical T1D. The lower cost, increased convenience, and greater reach of blood spot screening could help meet increasing demand for early T1D diagnosis.
{"title":"Islet Autoantibody Screening Throughout Australia Using In-Home Blood Spot Sampling: 2-Year Outcomes of Type1Screen","authors":"John M. Wentworth, Anna B. E. Sing, Gaetano Naselli, Dexing Huang, Elizabeth Azidis-Yates, Batsho Mandlebe, James D. Brown, Kelly McGorm, Candice Hall, Leanne Redl, Renee Kludas, Aniruddh Haldar, Felicity Healy, Abbey Gilbert, Kelly Watson, Cherie Chiang, Jennifer J. Couper, Tony Huynh, Elizabeth A. Davis, Maria E. Craig, Fergus J. Cameron, Thomas W. Kay, Leonard C. Harrison, Peter G. Colman","doi":"10.2337/dc24-2443","DOIUrl":"https://doi.org/10.2337/dc24-2443","url":null,"abstract":"OBJECTIVE Type1Screen offers islet autoantibody testing to Australians with a family history of type 1 diabetes (T1D) with the dual aims of preventing diabetic ketoacidosis (DKA) and enabling use of disease-modifying therapy. We describe screening and monitoring outcomes 2 years after implementing in-home capillary blood spot sampling. RESEARCH DESIGN AND METHODS Data from 2,064 participants who registered between July 2022 and June 2024 were analyzed: 1,507 and 557 chose blood spot and venipuncture screening respectively. We compared baseline characteristics and outcomes for 1,243 participants (967 blood spot and 276 venipuncture) whose samples were tested by June 2024. RESULTS One blood spot and five venous participants reported unsuccessful sample collections. The median (quartile 1, quartile 3) age of blood spot registrants was lower (12.1 [7.1, 27.1] vs. 17.2 [9, 38.4] years; P &lt; 0.0001), and a higher proportion lived in regional Australia (39% vs. 29%; P = 0.0037). Among 72 participants (5.9%) with a positive screening test, 5 screened by blood spot and 2 by venipuncture had no autoantibodies on confirmatory testing. Blood spot screening identified the expected 2.1% prevalence of multiple autoantibodies and a 2.5% prevalence of a single autoantibody compared with 1.5% and 4.1%, respectively, for venipuncture screening. Clinical diabetes developed in 12 participants. All had screened positive and none had DKA. CONCLUSIONS Type1Screen has national reach. In-home blood spot screening is feasible, particularly for younger participants living regionally, and identifies the expected prevalence of preclinical T1D. The lower cost, increased convenience, and greater reach of blood spot screening could help meet increasing demand for early T1D diagnosis.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"74 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kirsten J. Cromie, Robert D. Murray, Ramzi A. Ajjan, Nicola F. Hughes, Richard G. Feltbower, Adam W. Glaser
OBJECTIVE Diabetes is a potential late consequence of childhood and young adult cancer (CYAC) treatment. Causative treatments associated with diabetes have been identified in retrospective cohort studies but have not been validated in population-based cohorts. Our aim was to define the extent of diabetes risk and explore contributory factors for its development in survivors of CYAC in the United Kingdom. RESEARCH DESIGN AND METHODS Cancer registration data (n = 4,238) were linked to electronic health care databases to identify cases of diabetes through clinical coding or HbA1c values. Total effect of prespecified treatment exposures on diabetes risk was estimated using flexible parametric modeling and standardized cause-specific cumulative incidence functions (CIFs). RESULTS After median follow-up of 14.4 years, 163 individuals (3.8%) were identified with diabetes. Total body irradiation (TBI) increases diabetes risk over time, with a 40-year CIF reaching 21.0% (95% CI 13.8–31.9) compared with 8.4% (95% CI 6.1–11.5) without TBI. Survivors treated with corticosteroids had a 7.7% increased risk at 40 years after cancer diagnosis. Hematopoietic stem cell transplant (HSCT) survivors had markedly higher risk, with a 40-year CIF of 19.6% (95% CI 13.4–28.6) versus 8.2% (95% CI 6.0–11.3) for patients who had not undergone HSCT. Among patients who received allogeneic HSCT, the 40-year CIF of diabetes was 25.7% (95% CI 17.4–38.0), compared with 7.9% (95% CI 3.3–19.1) in patients who received autologous transplants. CONCLUSIONS This evaluation of a hospital-based cohort of patients with CYAC identifies these patients’ increased long-term risk of developing diabetes and how this varies temporally according to treatment modalities. Notable contrasts in risk by treatment were detected as early as 10 years after cancer diagnosis. Findings should inform the development of risk-stratified evidence-based screening.
{"title":"Diabetes Risk After Treatment for Childhood and Young Adult Cancer","authors":"Kirsten J. Cromie, Robert D. Murray, Ramzi A. Ajjan, Nicola F. Hughes, Richard G. Feltbower, Adam W. Glaser","doi":"10.2337/dc24-2171","DOIUrl":"https://doi.org/10.2337/dc24-2171","url":null,"abstract":"OBJECTIVE Diabetes is a potential late consequence of childhood and young adult cancer (CYAC) treatment. Causative treatments associated with diabetes have been identified in retrospective cohort studies but have not been validated in population-based cohorts. Our aim was to define the extent of diabetes risk and explore contributory factors for its development in survivors of CYAC in the United Kingdom. RESEARCH DESIGN AND METHODS Cancer registration data (n = 4,238) were linked to electronic health care databases to identify cases of diabetes through clinical coding or HbA1c values. Total effect of prespecified treatment exposures on diabetes risk was estimated using flexible parametric modeling and standardized cause-specific cumulative incidence functions (CIFs). RESULTS After median follow-up of 14.4 years, 163 individuals (3.8%) were identified with diabetes. Total body irradiation (TBI) increases diabetes risk over time, with a 40-year CIF reaching 21.0% (95% CI 13.8–31.9) compared with 8.4% (95% CI 6.1–11.5) without TBI. Survivors treated with corticosteroids had a 7.7% increased risk at 40 years after cancer diagnosis. Hematopoietic stem cell transplant (HSCT) survivors had markedly higher risk, with a 40-year CIF of 19.6% (95% CI 13.4–28.6) versus 8.2% (95% CI 6.0–11.3) for patients who had not undergone HSCT. Among patients who received allogeneic HSCT, the 40-year CIF of diabetes was 25.7% (95% CI 17.4–38.0), compared with 7.9% (95% CI 3.3–19.1) in patients who received autologous transplants. CONCLUSIONS This evaluation of a hospital-based cohort of patients with CYAC identifies these patients’ increased long-term risk of developing diabetes and how this varies temporally according to treatment modalities. Notable contrasts in risk by treatment were detected as early as 10 years after cancer diagnosis. Findings should inform the development of risk-stratified evidence-based screening.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"35 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily Drzymalla, Laura Raffield, Katherine Kolor, Alain Koyama, Ramal Moonesinghe, Meda E. Pavkov, Cassandra N. Spracklen, Muin J. Khoury
OBJECTIVE The goal of this study was to assess the additive value of considering type 2 diabetes (T2D) polygenic risk score (PRS) in addition to family history for T2D prediction. RESEARCH DESIGN AND METHODS Data were obtained from the All of Us (AoU) research database. First-degree T2D family history was self-reported on the personal family history health questionnaire. A PRS was constructed from 1,289 variants identified from a large multiancestry genome-wide association study meta-analysis for T2D. Logistic regression models were run to generate odds ratios (ORs) and 95% CIs for T2D. All models were adjusted for age, sex, and BMI. RESULTS A total of 109,958 AoU research participants were included in the analysis. The odds of T2D increased with 1 SD PRS (OR 1.75; 95% CI 1.71–1.79) and positive T2D family history (OR 2.32; 95% CI 2.20–2.43). In the joint model, both 1 SD PRS (OR 1.69; 95% CI 1.65–1.72) and family history (OR 2.06; 95% CI 1.98–2.15) were significantly associated with T2D, although the ORs were slightly attenuated. Predictive models that included both the PRS and family history (area under the curve [AUC] 0.794) performed better than models including only family history (AUC 0.763) or the PRS (AUC 0.785). CONCLUSIONS In predicting T2D, inclusion of a T2D PRS in addition to family history of T2D (first-degree relatives) added statistical value. Further study is needed to determine whether consideration of both family history and a PRS would be useful for clinical T2D prediction.
目的：本研究的目的是评估除家族史外考虑2型糖尿病（T2D）多基因风险评分（PRS）对T2D预测的附加价值。研究设计与方法数据来源于All of Us （AoU）研究数据库。在个人家族史健康问卷中自述一级T2D家族史。从一项大型多祖先全基因组关联研究荟萃分析中鉴定出1289个T2D变异，构建了一个PRS。运行逻辑回归模型以生成T2D的优势比（ORs）和95% ci。所有模型都根据年龄、性别和BMI进行了调整。结果共纳入109,958名AoU研究参与者。T2D的几率随着1 SD PRS的增加而增加(OR 1.75；95% CI 1.71-1.79)和T2D家族史阳性(OR 2.32；95% ci 2.20-2.43)。在联合模型中，1 SD PRS (OR 1.69；95% CI 1.65-1.72)和家族史(OR 2.06；95% CI 1.98-2.15)与T2D显著相关，尽管ORs略有减弱。同时包含PRS和家族史（曲线下面积[AUC] 0.794）的预测模型优于仅包含家族史（AUC 0.763）或PRS （AUC 0.785）的模型。结论：在预测T2D时，纳入T2D PRS和T2D家族史（一级亲属）增加了统计价值。需要进一步的研究来确定考虑家族史和PRS是否对临床T2D预测有用。
{"title":"Additive Value of Polygenic Risk Score to Family History for Type 2 Diabetes Prediction: Results From the All of Us Research Database","authors":"Emily Drzymalla, Laura Raffield, Katherine Kolor, Alain Koyama, Ramal Moonesinghe, Meda E. Pavkov, Cassandra N. Spracklen, Muin J. Khoury","doi":"10.2337/dc24-1537","DOIUrl":"https://doi.org/10.2337/dc24-1537","url":null,"abstract":"OBJECTIVE The goal of this study was to assess the additive value of considering type 2 diabetes (T2D) polygenic risk score (PRS) in addition to family history for T2D prediction. RESEARCH DESIGN AND METHODS Data were obtained from the All of Us (AoU) research database. First-degree T2D family history was self-reported on the personal family history health questionnaire. A PRS was constructed from 1,289 variants identified from a large multiancestry genome-wide association study meta-analysis for T2D. Logistic regression models were run to generate odds ratios (ORs) and 95% CIs for T2D. All models were adjusted for age, sex, and BMI. RESULTS A total of 109,958 AoU research participants were included in the analysis. The odds of T2D increased with 1 SD PRS (OR 1.75; 95% CI 1.71–1.79) and positive T2D family history (OR 2.32; 95% CI 2.20–2.43). In the joint model, both 1 SD PRS (OR 1.69; 95% CI 1.65–1.72) and family history (OR 2.06; 95% CI 1.98–2.15) were significantly associated with T2D, although the ORs were slightly attenuated. Predictive models that included both the PRS and family history (area under the curve [AUC] 0.794) performed better than models including only family history (AUC 0.763) or the PRS (AUC 0.785). CONCLUSIONS In predicting T2D, inclusion of a T2D PRS in addition to family history of T2D (first-degree relatives) added statistical value. Further study is needed to determine whether consideration of both family history and a PRS would be useful for clinical T2D prediction.","PeriodicalId":11140,"journal":{"name":"Diabetes Care","volume":"27 1","pages":""},"PeriodicalIF":16.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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