Diabetes research and clinical practice最新文献

Aims: Evidence suggests sodium glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists reduce the dementia onset/progression. The dual GLP1/GIP receptor agonist, tirzepatide's effect on dementia outcomes remains unknown. We compared tirzepatide, semaglutide and SGLT2-i head-to-head in relation to incident dementia in type 2 diabetes patients METHODS: Three target trial emulations (TTE) were conducted using real-world data from the TriNetX global federated network: TTE1: tirzepatide vs. SGLT2-i, TTE2: semaglutide vs. SGLT2-i and TTE3: tirzepatide vs. semaglutide. Eligible adults with type 2 diabetes and no baseline dementia were included. Follow-up was two years. First diagnosis of dementia, MACE, and all-cause mortality were analysed using survival analysis after propensity score matching.

Results: After matching, TTE1 included 14,462 patients; TTE2, 57,959; TTE3 12,246. Tirzepatide was associated with lower risk of dementia versus semaglutide (HR 0.69, 95% CI 0.48-0.99, p = 0.04) and SGLT2-i (HR 0.66, 95% CI 0.47-0.93, p = 0.02), and lower mortality (HR 0.72, 95% CI 0.58-0.90, p < 0.01; HR 0.29, 95% CI 0.23-0.37, p < 0.01). Tirzepatide and semaglutide reduced MACE vs SGLT2-i.

Conclusions: Tirzepatide is associated with a lower risk of dementia versus semaglutide and SGLT2-I in type 2 diabetes. Findings are hypothesis generating, requiring confirmation in randomised controlled trials.

Aims: We evaluated the effectiveness of a lifestyle modification (LSM) intervention in prediabetes remission among women with isolated impaired fasting glucose (i-IFG).

Methods: We conducted a community-based, parallel-group, open-label, randomised controlled trial in Kerala, India. Women aged 30-60 years with i-IFG were randomly assigned (1:1) to receive either a 12-month LSM program or standard care (diabetes information booklet). Randomization was computer-generated with allocation concealed until assignment. The primary outcome was prediabetes remission based on oral glucose tolerance testing at 12 months. Secondary outcomes included progression to type 2 diabetes and changes in glycaemic markers, anthropometric measures, body composition, and blood pressure. Analyses followed the intention-to-treat approach.

Results: Of 1092 participants randomised, 1080 (98.9 %) completed the 12-month follow-up. Prediabetes remission was significantly higher in the LSM group than in controls (45.9 % vs 6.3 %; RR 7.04, 95 % CI 5.12-10.06). LSM also produced greater improvements in fasting plasma glucose (-5.2 mg/dL), HbA1c (-0.09 %), HOMA2-IR (log) (-0.38), weight (-3.7 kg), waist circumference (-1.4 cm), fat mass (-2.9 kg), and fat-free mass (+0.86 kg). The number needed to treat for prediabetes remission was 2.8 (1.8-4.0).

Conclusion: A structured LSM intervention effectively promotes prediabetes remission in women with i-IFG and improves cardio metabolic health.

Diabetic peripheral neuropathy (DPN) and peripheral artery disease (PAD) are common neurovascular complications of diabetes; however, evidence on their pooled prevalences remains unclear. We estimate the pooled prevalences of DPN and PAD in people with diabetes, and to ascertain related risk factors. A systematic review and meta-analysis was conducted using PubMed, Embase, Scopus, Web of Science, and gray literature sources (Google Scholar and Garuda), with searches completed up to December 10, 2025. Across 155 studies, the pooled prevalence was 36 % for DPN and 19 % for PAD. Compared to developed countries, developing countries had higher prevalences of DPN (25 % vs. 39 %) and PAD (10 % vs. 24 %). A meta-regression indicated that chronic kidney disease (CKD) comorbidity was associated with a higher DPN prevalence (β = 0.024; 95 % CI 0.004-0.042). The prevalence of DPN was higher in the combination method (39 %) than in symptom assessment (36 %) or symptoms alone (30 %). Clinical practice should emphasize regular foot examinations, early vascular assessment, and patient education, particularly in developing countries and among people with CKD, to ensure timely detection and effective prevention of diabetes-related complications.

Aim: This study aims to identify oral microbial signatures associated with prediabetes in young adults and to investigate potential oral risk factors for early-onset diabetes, as well as to pinpoint targets for monitoring and intervention.

Methods: The study involved a large cross-sectional analysis of 3,142 participants from two independent cohorts. The discovery cohort consisted of 334 prediabetes cases and 1,266 controls, while the validation cohort had 325 prediabetes cases and 1,217 controls. We compared the basic and clinical characteristics of the different groups. Additionally, 16S rRNA gene sequencing was conducted on oral rinse samples.

Results: Prediabetes-enriched taxa comprised Bacteroidetes, Prevotella_7, and Veillonella. In contrast, normoglycemic controls showed a higher presence of Firmicutes and Streptococcus. The combined models, constructed from indicators identified by LASSO regression, including BMI, HOMA-IR, and specific microbiota (Prevotella_7 or Veillonella), demonstrated discriminatory performance. In the discovery set, the AUC values were 0.761 and 0.758, respectively, whereas in the validation set, the AUC values were 0.693 and 0.696, respectively.

Conclusion: Reproducible alterations and enrichment of Prevotella_7 and Veillonella are linked to prediabetes in young adults. Furthermore, the combined interaction between specific bacterial genera and core clinical indicators may be crucial in the development of prediabetes in young individuals.