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Differential gut microbiome profiles in diabetic retinopathy: A comparative study across continental populations 糖尿病视网膜病变的不同肠道微生物群特征:跨大陆人群的比较研究。
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-05 DOI: 10.1016/j.diabres.2025.113043
Pieu Adhikary , Ankita Maddheshiya , Brijesh Takkar , Taraparsad Das , Souvik Mukherjee
Gut dysbiosis damages gut barrier, stimulates inflammation, endotoxemia, and breakdown of blood-retina barrier, promoting diabetic retinopathy (DR). Most microbiome studies on DR relied on 16S rRNA gene sequencing, documenting altered microbial richness, diversity, and shifts in dominant phyla and genera, though these findings remain inconsistent across populations. The only shotgun metagenomic study to date identified species Eubacterium hallii, Firmicutes bacterium and Alistipes finegoldii enriched in DR, with altered metabolic pathways. The β-diversity showed distinct inter-individual variations in diseased individuals compared to healthy controls (HC). The objective of this narrative review is to highlight the key microbial biomarkers, metabolic pathways, and putative microbiota–gut–retina axis integrating both 16S rRNA and shotgun data to compare microbial alterations across HC, T2DM, and DR. The review concludes with a comprehensive understanding of dysbiotic gut taxa associated with DM and DR in different populations showing wide variability in results mostly due to small sample size, geography, antidiabetic medications, lack of demographic and clinical data and limited taxonomic classification by 16S sequencing. This emphasizes the need of a large scale, multi-ethnic shotgun metagenomic sequencing study with systematically collected medical data and dietary information to understand the contributions of gut microbiome in the progression of DR.
肠道生态失调损害肠道屏障,刺激炎症、内毒素血症和血视网膜屏障的破坏,促进糖尿病视网膜病变(DR)。大多数关于DR的微生物组研究依赖于16S rRNA基因测序,记录了微生物丰富度、多样性的改变,以及优势门和属的变化,尽管这些发现在人群中仍然不一致。迄今为止唯一的霰弹枪宏基因组研究鉴定了富含DR的哈里真杆菌(Eubacterium hallii)、厚壁菌门细菌(Firmicutes bacteria)和阿里斯提普(Alistipes finegoldii),它们的代谢途径发生了改变。与健康对照相比,患病个体的β-多样性表现出明显的个体间差异(HC)。这篇叙述性综述的目的是强调关键的微生物生物标志物、代谢途径和假定的微生物-肠道-视网膜轴,整合16S rRNA和shotgun数据,以比较HC、T2DM和DR之间的微生物变化。综述的结论是对不同人群中与DM和DR相关的益生菌肠道分类群的全面了解,结果存在很大差异,主要是由于样本量小、地理位置、抗糖尿病药物、缺乏人口学和临床资料,16S测序的分类也有限。这强调了需要进行大规模、多种族的散弹枪宏基因组测序研究,系统地收集医学数据和饮食信息,以了解肠道微生物群在DR进展中的作用。
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引用次数: 0
Comparison of efficacy of different glucose control strategies in critically ill adults: a network meta-analysis of randomized controlled trials 危重成人不同血糖控制策略的疗效比较:随机对照试验的网络荟萃分析。
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-05 DOI: 10.1016/j.diabres.2025.113034
Zhuoyang Xia , Jiahao Meng , Lidan Mei , Hui Peng , Xingui Dai , Baimei He , Pan Liu , Yumei Wu , Shuguang Gao

Aims

This network meta-analysis aimed to compare the efficacy and safety of four glucose control strategies—strict (≤110 mg/dL), intermediate strict (≤150 mg/dL), liberal (≤180 mg/dL), and very liberal (≤252 mg/dL) among critically ill adults in the intensive care unit (ICU).

Methods

PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to August 28, 2025, for randomized controlled trials (RCTs) comparing glucose control strategies in adult ICU patients. Frequentist random-effects models were used for direct and indirect comparisons, assessed risk of bias with RoB 2.0, and ranked strategies using surface under the cumulative ranking (SUCRA).

Results

Across 63 trials (N = 31,556), no statistically significant differences in all-cause mortality were observed among strategies. However, liberal control ranked highest in reducing mortality (SUCRA 0.8720) and balanced safety. Significant heterogeneity existed in adverse events (I2 = 75.8 %, p < 0.01), especially hypoglycemia risk. Surgical ICU subgroup analysis suggested potential benefit from strict control, though requiring intensified monitoring.

Conclusion

Liberal glucose control is the optimal strategy for most ICU patients, balancing mortality reduction and safety. In surgical ICUs, strict control may be considered but requires vigilant hypoglycemia monitoring.
目的:本网络meta分析旨在比较重症监护病房(ICU)危重成人中严格(≤110 mg/dL)、中等严格(≤150 mg/dL)、自由(≤180 mg/dL)和非常自由(≤252 mg/dL)四种血糖控制策略的疗效和安全性。方法:检索PubMed、Embase、Cochrane Library和Web of Science,检索自成立以来至2025年8月28日的比较成人ICU患者血糖控制策略的随机对照试验(RCTs)。使用频率随机效应模型进行直接和间接比较,使用RoB 2.0评估偏倚风险,并使用累积排名(SUCRA)下的表面对策略进行排名。结果:在63项试验中(N = 31,556),不同策略的全因死亡率没有统计学上的显著差异。然而,自由对照在降低死亡率(SUCRA 0.8720)和平衡安全性方面排名最高。不良事件发生率存在显著的异质性(I2 = 75.8 %,p )结论:自由血糖控制是大多数ICU患者的最佳策略,可以平衡降低死亡率和安全性。在外科icu中,可以考虑严格控制,但需要警惕低血糖监测。
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引用次数: 0
Limb Salvage: A review of stem cell and growth factor therapies for diabetic foot ulcers 残肢修复:干细胞和生长因子治疗糖尿病足溃疡的综述。
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-04 DOI: 10.1016/j.diabres.2025.113036
Arwa Metwaly , Shimaa Ismail , Yousef M. Nagy , Amany Abdallah , Shahd M Hassanin , Karim Ramadan , Ahmed Nady , Lydia Melad , Maryam Mahmoud , Menna ullah Abdullah , Abdulla Tantawi Alkarni , Yasser M. Nagy
Diabetic foot ulcers (DFUs) remain a major cause of morbidity, hospitalization, and lower-limb amputation among individuals with diabetes, despite advancements in conventional wound care. Increasing evidence highlights the therapeutic potential of stem cell–based and growth factor–based interventions in correcting impaired angiogenesis, chronic inflammation, and defective extracellular matrix remodeling characteristic of diabetic wounds. This review synthesizes current mechanistic and clinical insights into mesenchymal stem cells, mononuclear cells, pluripotent stem cells, and key growth factors—including EGF, PDGF, VEGF, and PRP—and evaluates their comparative efficacy based on recent randomized trials and network meta-analyses. Findings demonstrate significant improvements in ulcer healing, perfusion indices, and amputation reduction in selected modalities; however, clinical translation remains limited by small sample sizes, methodological heterogeneity, variable delivery techniques, and short-term follow-up. Emerging approaches such as exosome therapy, bioengineered matrices, and combined biologic platforms represent promising future directions. This review underscores the need for standardized protocols and robust multicenter trials to integrate regenerative therapies effectively into DFU management.
尽管传统伤口护理有所进步,但糖尿病足溃疡(DFUs)仍然是糖尿病患者发病、住院和下肢截肢的主要原因。越来越多的证据表明,基于干细胞和生长因子的干预在纠正糖尿病伤口的血管生成障碍、慢性炎症和细胞外基质重塑缺陷方面具有治疗潜力。本综述综合了目前间充质干细胞、单核细胞、多能干细胞和关键生长因子(包括EGF、PDGF、VEGF和prp)的机制和临床见解,并基于最近的随机试验和网络荟萃分析评估了它们的比较疗效。研究结果表明,在选择的模式显著改善溃疡愈合,灌注指数和截肢减少;然而,临床翻译仍然受到样本量小、方法异质性、不同的递送技术和短期随访的限制。新兴的方法,如外泌体治疗、生物工程基质和联合生物平台代表了未来有希望的方向。本综述强调需要标准化的方案和强大的多中心试验,将再生疗法有效地整合到DFU管理中。
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引用次数: 0
Perspectives on antibiotic management of diabetic foot osteomyelitis: A scoping review on routes of administration 糖尿病足骨髓炎抗生素治疗的前景:对给药途径的综述。
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-04 DOI: 10.1016/j.diabres.2025.113035
Narimane Meddas , Benoit Gachet , Arthur Piraux , Eric Senneville , Laura M. Drudi , Magali Brousseau-Foley , Virginie Blanchette
Diabetic foot ulcers can progress to diabetic foot osteomyelitis (DFO). Intravenous (IV) antibiotics are traditionally the standard treatment for DFO, but it might reduce quality of life, increase adverse events and costs. Our objective was to examine the potential advantages and disadvantages of antibiotic administration routes for DFO to support a future patient decision aid tool. We conducted a scoping review using the Joanna Briggs Institute methodological framework to map evidence on antibiotic administration routes for DFO using the quintuple aim for quality of care. Records from databases, reference lists, and grey literature were deduplication in EndNote, screened in Rayyan, and assessed independently by two interdisciplinary reviewers. Of 6814, 25 studies were included, all quantitative and mainly retrospective observational (76 %). The majority (68 %) included adult patients with diabetic foot infection or DFO. Oral and IV antibiotics demonstrated comparable clinical outcomes across studies. Data on patient-reported outcomes and experience, team management, equity factors, and standardized definitions of clinical endpoints were largely scarce across studies. Current data suggest that oral antibiotic therapy may be a safe and effective alternative to IV therapy in selected patients with DFO, though substantial evidence gaps remain beyond infection management.
糖尿病足溃疡可发展为糖尿病足骨髓炎(DFO)。静脉注射(IV)抗生素是DFO的传统标准治疗方法,但它可能降低生活质量,增加不良事件和成本。我们的目的是研究DFO抗生素给药途径的潜在优点和缺点,以支持未来患者决策辅助工具。我们使用乔安娜布里格斯研究所的方法学框架进行了范围审查,以利用护理质量的五项目标绘制DFO抗生素给药途径的证据。EndNote中删除数据库、参考文献列表和灰色文献中的记录,在Rayyan中进行筛选,并由两名跨学科审稿人独立评估。6814项研究共纳入25项,均为定量研究,主要为回顾性观察性研究(76%)。大多数(68%)包括糖尿病足感染或DFO的成年患者。口服和静脉注射抗生素在所有研究中显示出相似的临床结果。关于患者报告的结果和经验、团队管理、公平因素和临床终点的标准化定义的数据在研究中基本上是稀缺的。目前的数据表明,对于某些DFO患者,口服抗生素治疗可能是一种安全有效的静脉治疗替代方案,尽管在感染管理方面仍存在大量证据空白。
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引用次数: 0
Prediction of gestational diabetes mellitus using continuous glucose monitoring metrics 使用连续血糖监测指标预测妊娠期糖尿病。
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-04 DOI: 10.1016/j.diabres.2025.113044
Ling-Wei Chen , Chee Wai Ku , Ruther Teo Zheng , Jerry Kok Yen Chan , Fabian Yap , See Ling Loy

Aims

We evaluated continuous glucose monitoring (CGM)-derived metrics for predicting gestational diabetes mellitus (GDM).

Methods

We analyzed data from 167 pregnant participants who had ≥ 3 days of CGM data at 18–24 weeks’ gestation and who underwent 75-gram oral-glucose-tolerance-tests at 24–28 weeks in a multi-ethnic prospective cohort. Predictive performance of CGM metrics was assessed using the area-under-the-receiver-operating-characteristic-curve (AUROC) with 20 repetitions of 5-fold cross-validation; optimal cut-points were determined using Youden’s index.

Results

There were 30 (18 %) GDM cases. The strongest predictors were %time-above-7.8-mmol/L (%TA7.8) [AUROC (95 % CI): 0.862 (0.780, 0.945); cut-point: 1.23 %; sensitivity: 0.800; specificity: 0.847] and the hyperglycemia-component-of-the-Glycemic-Risk-Index (Hyper-GRI) [0.862 (0.779, 0.945); cut-point: 0.79; sensitivity: 0.767; specificity: 0.883]. J-index, standard deviation (SD), and mean-amplitude-of-glucose-excursions(MAGE) also achieved AUROCs > 0.80. The predictive performance of these metrics was stronger in women with BMI < 23 kg/m2 (n = 89; AUROC range: 0.813–0.882) than in those with BMI ≥ 23 kg/m2 (n = 78; AUROC range: 0.657–0.756). Among Chinese participants (n = 142), %TA7.8 and J-index had AUROC > 0.80; in non-Chinese participants (n = 25), SD performed best (AUROC: 0.845). Adding individual CGM metrics to a model including maternal age, pre-pregnancy BMI, job status, ethnicity, history of GDM, and family history of diabetes improved the AUROC from 0.642 to 0.895 (%TA7.8), 0.867 (Hyper-GRI), 0.877 (J-index), 0.868 (SD), and 0.848 (MAGE).

Conclusions

CGM-derived metrics show good performance in predicting GDM and potential for earlier detection of adverse pregnancy glycemic profiles.
目的:我们评估连续血糖监测(CGM)衍生指标预测妊娠糖尿病(GDM)。方法:我们分析了167名妊娠参与者的数据,这些孕妇在妊娠18-24 周时CGM数据≥3 天,并在妊娠24-28 周时进行了75克口服葡萄糖耐量试验。采用受试者工作特征曲线下面积(AUROC)评估CGM指标的预测性能,并进行20次5重交叉验证;利用约登指数确定最佳切点。结果:GDM患者30例(18 %)。最强的预测因子为时间≥7.8 mmol/L (%TA7.8) [AUROC(95 % CI): 0.862(0.780, 0.945);切割点:1.23 %;灵敏度:0.800;特异性:0.847],高血糖成分-血糖风险指数(Hyper-GRI) [0.862(0.779, 0.945);切割点:0.79;灵敏度:0.767;特异性:0.883)。j指数、标准差(SD)和葡萄糖漂移平均振幅(MAGE)也达到了auroc > 0.80。这些指标对BMI为 2 (n = 89;AUROC范围:0.813-0.882)的女性的预测效果强于BMI为 ≥ 23 kg/m2 (n = 78;AUROC范围:0.657-0.756)的女性。在中国参与者中(n = 142),%TA7.8和J-index为AUROC > 0.80;在非华裔参与者中(n = 25),SD表现最佳(AUROC:0.845)。将个体CGM指标加入到包括母亲年龄、孕前BMI、工作状态、种族、GDM史和糖尿病家族史的模型中,AUROC从0.642提高到0.895(%TA7.8)、0.867(super - gri)、0.877(J-index)、0.868(SD)和0.848(MAGE)。结论:cgm衍生的指标在预测GDM和早期发现不良妊娠血糖谱方面表现良好。
{"title":"Prediction of gestational diabetes mellitus using continuous glucose monitoring metrics","authors":"Ling-Wei Chen ,&nbsp;Chee Wai Ku ,&nbsp;Ruther Teo Zheng ,&nbsp;Jerry Kok Yen Chan ,&nbsp;Fabian Yap ,&nbsp;See Ling Loy","doi":"10.1016/j.diabres.2025.113044","DOIUrl":"10.1016/j.diabres.2025.113044","url":null,"abstract":"<div><h3>Aims</h3><div>We evaluated continuous glucose monitoring (CGM)-derived metrics for predicting gestational diabetes mellitus (GDM).</div></div><div><h3>Methods</h3><div>We analyzed data from 167 pregnant participants who had ≥ 3 days of CGM data at 18–24 weeks’ gestation and who underwent 75-gram oral-glucose-tolerance-tests at 24–28 weeks in a multi-ethnic prospective cohort. Predictive performance of CGM metrics was assessed using the area-under-the-receiver-operating-characteristic-curve (AUROC) with 20 repetitions of 5-fold cross-validation; optimal cut-points were determined using Youden’s index.</div></div><div><h3>Results</h3><div>There were 30 (18 %) GDM cases. The strongest predictors were %time-above-7.8-mmol/L (%TA7.8) [AUROC (95 % CI): 0.862 (0.780, 0.945); cut-point: 1.23 %; sensitivity: 0.800; specificity: 0.847] and the hyperglycemia-component-of-the-Glycemic-Risk-Index (Hyper-GRI) [0.862 (0.779, 0.945); cut-point: 0.79; sensitivity: 0.767; specificity: 0.883]. J-index, standard deviation (SD), and mean-amplitude-of-glucose-excursions(MAGE) also achieved AUROCs &gt; 0.80. The predictive performance of these metrics was stronger in women with BMI &lt; 23 kg/m<sup>2</sup> (n = 89; AUROC range: 0.813–0.882) than in those with BMI ≥ 23 kg/m<sup>2</sup> (n = 78; AUROC range: 0.657–0.756). Among Chinese participants (n = 142), %TA7.8 and J-index had AUROC &gt; 0.80; in non-Chinese participants (n = 25), SD performed best (AUROC: 0.845). Adding individual CGM metrics to a model including maternal age, pre-pregnancy BMI, job status, ethnicity, history of GDM, and family history of diabetes improved the AUROC from 0.642 to 0.895 (%TA7.8), 0.867 (Hyper-GRI), 0.877 (J-index), 0.868 (SD), and 0.848 (MAGE).</div></div><div><h3>Conclusions</h3><div>CGM-derived metrics show good performance in predicting GDM and potential for earlier detection of adverse pregnancy glycemic profiles.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"231 ","pages":"Article 113044"},"PeriodicalIF":7.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Emerging role of lipoprotein(a) in diabetic kidney disease: possible pathophysiological links and unresolved mechanisms 脂蛋白(a)在糖尿病肾病中的新作用:可能的病理生理联系和尚未解决的机制
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-03 DOI: 10.1016/j.diabres.2025.113040
Habib Yaribeygi , Mina Maleki , Sercan Karav , Prashant Kesharwani , Amirhossein Sahebkar
Diabetic kidney disease (DKD) is one of the most serious microvascular complications of diabetes mellitus and a leading cause of end-stage renal disease worldwide. Although hyperglycemia and hypertension are well-established drivers of DKD, accumulating evidence suggests that additional factors, such as lipoprotein(a) [Lp(a)], may contribute to its pathogenesis. Lp(a) is a genetically determined lipoprotein with pro-atherogenic, pro-inflammatory, and pro-thrombotic properties, and elevated circulating levels have been associated with increased cardiovascular and renal risk in diabetic individuals. In this review, we summarize the current understanding of the relationship between Lp(a) and DKD, with a focus on the proposed molecular mechanisms. These include activation of TGF-β/Smad signaling leading to fibrosis, induction of oxidative stress, chronic inflammation, endothelial dysfunction, impaired fibrinolysis, and direct injury to podocytes resulting in proteinuria. While several clinical and experimental studies support the involvement of Lp(a) in these pathways, the precise molecular mediators remain largely undefined. Understanding these mechanisms may offer novel insights into the pathophysiology of DKD and identify new therapeutic targets. This article aims to provide a comprehensive overview of the potential role of Lp(a) in DKD and to highlight areas requiring further investigation.
糖尿病肾病(DKD)是糖尿病最严重的微血管并发症之一,也是世界范围内终末期肾脏疾病的主要原因。虽然高血糖和高血压是公认的DKD的驱动因素,但越来越多的证据表明,脂蛋白(a) [Lp(a)]等其他因素可能有助于其发病机制。Lp(a)是一种基因决定的脂蛋白,具有促动脉粥样硬化、促炎症和促血栓形成的特性,在糖尿病患者中,循环水平升高与心血管和肾脏风险增加有关。在这篇综述中,我们总结了目前对Lp(a)和DKD之间关系的理解,并重点讨论了可能的分子机制。这些包括导致纤维化的TGF-β/Smad信号的激活、氧化应激的诱导、慢性炎症、内皮功能障碍、纤维蛋白溶解受损以及导致蛋白尿的足细胞直接损伤。虽然一些临床和实验研究支持Lp(a)参与这些途径,但精确的分子介质在很大程度上仍未确定。了解这些机制可以为DKD的病理生理学提供新的见解,并确定新的治疗靶点。本文旨在全面概述Lp(a)在DKD中的潜在作用,并强调需要进一步研究的领域。
{"title":"The Emerging role of lipoprotein(a) in diabetic kidney disease: possible pathophysiological links and unresolved mechanisms","authors":"Habib Yaribeygi ,&nbsp;Mina Maleki ,&nbsp;Sercan Karav ,&nbsp;Prashant Kesharwani ,&nbsp;Amirhossein Sahebkar","doi":"10.1016/j.diabres.2025.113040","DOIUrl":"10.1016/j.diabres.2025.113040","url":null,"abstract":"<div><div>Diabetic kidney disease (DKD) is one of the most serious microvascular complications of diabetes mellitus and a leading cause of end-stage renal disease worldwide. Although hyperglycemia and hypertension are well-established drivers of DKD, accumulating evidence suggests that additional factors, such as lipoprotein(a) [Lp(a)], may contribute to its pathogenesis. Lp(a) is a genetically determined lipoprotein with pro-atherogenic, pro-inflammatory, and pro-thrombotic properties, and elevated circulating levels have been associated with increased cardiovascular and renal risk in diabetic individuals. In this review, we summarize the current understanding of the relationship between Lp(a) and DKD, with a focus on the proposed molecular mechanisms. These include activation of TGF-β/Smad signaling leading to fibrosis, induction of oxidative stress, chronic inflammation, endothelial dysfunction, impaired fibrinolysis, and direct injury to podocytes resulting in proteinuria. While several clinical and experimental studies support the involvement of Lp(a) in these pathways, the precise molecular mediators remain largely undefined. Understanding these mechanisms may offer novel insights into the pathophysiology of DKD and identify new therapeutic targets. This article aims to provide a comprehensive overview of the potential role of Lp(a) in DKD and to highlight areas requiring further investigation.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"231 ","pages":"Article 113040"},"PeriodicalIF":7.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Weight loss from glucagon-like peptide-1 receptor agonists by genetic factors in adults with type 2 diabetes 2型糖尿病成人患者胰高血糖素样肽-1受体激动剂所致体重减轻的遗传因素
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-03 DOI: 10.1016/j.diabres.2025.113041
Yulu Zheng , Zheng Guo , Eugene Jeong , Shuai Xu , Jason M. Samuels , Ghadeer K Dawwas , Ran Tao , Gitanjali Srivastava , You Chen , Danxia Yu

Aims

To identify whether genetic predisposition to obesity influences the weight loss effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) among adults with type 2 diabetes (T2D).

Methods

This study evaluated 52-week weight loss trajectories. Genetic exposures comprised: 1) a BMI polygenic risk score (PRS) incorporating 935,416 single-nucleotide polymorphisms (SNPs) and stratified into low (bottom 20 %), intermediate (middle 60 %), and high (top 20 %) categories; and 2) five major genetic variants for BMI PRS. Linear mixed models were applied to assess the associations between genetic factors and weight loss percentage, and the interaction effect between genetic factors and follow-up time was further considered.

Results

Among the 1,055 included adults (mean age 59 ± 11 years, 55 % female), intermediate and high BMI PRS groups were modestly associated with less weight loss over 52 weeks (0.7 % and 1.5 %, P = 0.0017 and 0.0023, respectively) than the low BMI PRS group. Individual SNPs showed no significant association with weight loss. BMI PRS modified response over time—intermediate PRS showed less early weight loss, whereas high PRS showed less late weight loss; several genotypes also showed significant time-varying effects.

Conclusions

BMI PRS could potentially be used to personalize obesity management with GLP-1RAs. Large-scale, multi-ancestry studies are needed to validate the application.
目的探讨肥胖遗传易感性是否会影响2型糖尿病(T2D)患者使用胰高血糖素样肽-1受体激动剂(GLP-1RAs)的减肥效果。方法本研究评估了52周的减肥轨迹。遗传暴露包括:1)BMI多基因风险评分(PRS),包含935,416个单核苷酸多态性(snp),并分为低(最低20%)、中(中间60%)和高(最高20%)三类;2) BMI PRS的5个主要基因变异。采用线性混合模型评估遗传因素与减重率之间的关系,并进一步考虑遗传因素与随访时间之间的交互作用。结果在1055名纳入的成年人(平均年龄59±11岁,55%为女性)中,与低BMI PRS组相比,中等和高BMI PRS组在52周内的体重减轻较少(分别为0.7%和1.5%,P分别= 0.0017和0.0023)。单个snp与体重减轻没有显著关联。随着时间的推移,BMI - PRS改善了反应-中间PRS显示较低的早期体重减轻,而高PRS显示较低的晚期体重减轻;几个基因型也表现出显著的时变效应。结论bmi PRS可用于GLP-1RAs的个体化肥胖管理。需要大规模、多祖先的研究来验证这一应用。
{"title":"Weight loss from glucagon-like peptide-1 receptor agonists by genetic factors in adults with type 2 diabetes","authors":"Yulu Zheng ,&nbsp;Zheng Guo ,&nbsp;Eugene Jeong ,&nbsp;Shuai Xu ,&nbsp;Jason M. Samuels ,&nbsp;Ghadeer K Dawwas ,&nbsp;Ran Tao ,&nbsp;Gitanjali Srivastava ,&nbsp;You Chen ,&nbsp;Danxia Yu","doi":"10.1016/j.diabres.2025.113041","DOIUrl":"10.1016/j.diabres.2025.113041","url":null,"abstract":"<div><h3>Aims</h3><div>To identify whether genetic predisposition to obesity influences the weight loss effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) among adults with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This study evaluated 52-week weight loss trajectories. Genetic exposures comprised: 1) a BMI polygenic risk score (PRS) incorporating 935,416 single-nucleotide polymorphisms (SNPs) and stratified into low (bottom 20 %), intermediate (middle 60 %), and high (top 20 %) categories; and 2) five major genetic variants for BMI PRS. Linear mixed models were applied to assess the associations between genetic factors and weight loss percentage, and the interaction effect between genetic factors and follow-up time was further considered.</div></div><div><h3>Results</h3><div>Among the 1,055 included adults (mean age 59 ± 11 years, 55 % female), intermediate and high BMI PRS groups were modestly associated with less weight loss over 52 weeks (0.7 % and 1.5 %, <em>P</em> = 0.0017 and 0.0023, respectively) than the low BMI PRS group. Individual SNPs showed no significant association with weight loss. BMI PRS modified response over time—intermediate PRS showed less early weight loss, whereas high PRS showed less late weight loss; several genotypes also showed significant time-varying effects.</div></div><div><h3>Conclusions</h3><div>BMI PRS could potentially be used to personalize obesity management with GLP-1RAs. Large-scale, multi-ancestry studies are needed to validate the application.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"231 ","pages":"Article 113041"},"PeriodicalIF":7.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When the summer camp ends: Short-term, post-camp deterioration of glycemic control in youth with type 1 diabetes 夏令营结束时:1型糖尿病青少年短期后血糖控制恶化。
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-03 DOI: 10.1016/j.diabres.2025.113039
Georgia Sotiriou, Meropi Dimitriadou, Aggeliki Nemtsa, Evgenia Kavoura, Konstantina Pappa, Athanasios Christoforidis

Aims

To investigate short-term post-camp glycemic deterioration in youth with T1D using sensor-augmented or automated insulin delivery systems and to identify contributing factors.

Methods

This retrospective analysis included 93 children and adolescents with T1D using MiniMed™ CSII systems, attending a seven-day summer diabetes camp in Greece (2019–2025). Glycemic metrics, insulin dosing, carbohydrate intake, infusion set changes were assessed for the pre-camp week, the camp week, and the post-camp week.

Results

Glycemic control during camp was satisfactory and superior to pre-camp values. Post-camp, time in range (70–180 mg/dL) declined (64.53 %) compared with camp (71.27 %) and pre-camp (69.95 %), while time above range (>180 mg/dL and >250 mg/dL) increased. This short-term deterioration was consistent across all six years. Glucose variability peaked during camp (CV 35.21 %). MiniMed™780G users maintained better post-camp control than MiniMed™640G users (TIR 70.02 % vs. 55.43 %, p < 0.001). Post-camp, participants consumed more meals and carbohydrates and required higher total daily insulin (41.13 units/day, 0.84 U/kg). The TDD/Carbs ratio remained stable, and infusion set changes were less frequent during camp.

Conclusions

Children and adolescents with T1D maintain adequate glycemic control during camp, but experience a transient post-camp deterioration, underscoring the need for monitoring and individualized support during the week following camp.
目的:利用传感器增强或自动胰岛素输送系统研究青年T1D患者营后短期血糖恶化,并确定影响因素。方法:本回顾性分析包括93名使用MiniMed™CSII系统的T1D儿童和青少年,他们参加了希腊为期7天的糖尿病夏令营(2019-2025)。血糖指标、胰岛素剂量、碳水化合物摄入量、输液器变化在训练营前一周、训练营周和训练营后一周进行评估。结果:训练营期间血糖控制良好,优于训练营前。与营地(71.27 %)和营地前(69.95 %)相比,营地后在70 ~ 180 mg/dL范围内停留的时间(64.53 %)减少,而在180 ~ 180 mg/dL和250 mg/dL范围内停留的时间(> ~ 250 mg/dL)增加。这种短期恶化在所有六年中都是一致的。葡萄糖变异在营地期间达到峰值(CV 35.21 %)。与MiniMed™640G使用者相比,MiniMed™780G使用者在营地后保持了更好的控制(TIR为70.02 % vs. 55.43 %,p )。结论:T1D儿童和青少年在营地期间维持了适当的血糖控制,但经历了短暂的营地后恶化,强调了在营地后一周进行监测和个性化支持的必要性。
{"title":"When the summer camp ends: Short-term, post-camp deterioration of glycemic control in youth with type 1 diabetes","authors":"Georgia Sotiriou,&nbsp;Meropi Dimitriadou,&nbsp;Aggeliki Nemtsa,&nbsp;Evgenia Kavoura,&nbsp;Konstantina Pappa,&nbsp;Athanasios Christoforidis","doi":"10.1016/j.diabres.2025.113039","DOIUrl":"10.1016/j.diabres.2025.113039","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate short-term post-camp glycemic deterioration in youth with T1D using sensor-augmented or automated insulin delivery systems and to identify contributing factors.</div></div><div><h3>Methods</h3><div>This retrospective analysis included 93 children and adolescents with T1D using MiniMed™ CSII systems, attending a seven-day summer diabetes camp in Greece (2019–2025). Glycemic metrics, insulin dosing, carbohydrate intake, infusion set changes were assessed for the pre-camp week, the camp week, and the post-camp week.</div></div><div><h3>Results</h3><div>Glycemic control during camp was satisfactory and superior to pre-camp values. Post-camp, time in range (70–180 mg/dL) declined (64.53 %) compared with camp (71.27 %) and pre-camp (69.95 %), while time above range (&gt;180 mg/dL and &gt;250 mg/dL) increased. This short-term deterioration was consistent across all six years. Glucose variability peaked during camp (CV 35.21 %). MiniMed™780G users maintained better post-camp control than MiniMed™640G users (TIR 70.02 % vs. 55.43 %, p &lt; 0.001). Post-camp, participants consumed more meals and carbohydrates and required higher total daily insulin (41.13 units/day, 0.84 U/kg). The TDD/Carbs ratio remained stable, and infusion set changes were less frequent during camp.</div></div><div><h3>Conclusions</h3><div>Children and adolescents with T1D maintain adequate glycemic control during camp, but experience a transient post-camp deterioration, underscoring the need for monitoring and individualized support during the week following camp.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"231 ","pages":"Article 113039"},"PeriodicalIF":7.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Integrated metabolomics and metagenomics analysis defines a unique signature of metabolic syndrome in a Thai population 综合代谢组学和宏基因组学分析定义了泰国人群中代谢综合征的独特特征
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-01 DOI: 10.1016/j.diabres.2025.112491
G. Sweeney , S. Wannaiampikul , B. Lee , K. Prentice , J. Chen , R. Ayansola , A. Xu , K. Pantopoulos
{"title":"Integrated metabolomics and metagenomics analysis defines a unique signature of metabolic syndrome in a Thai population","authors":"G. Sweeney ,&nbsp;S. Wannaiampikul ,&nbsp;B. Lee ,&nbsp;K. Prentice ,&nbsp;J. Chen ,&nbsp;R. Ayansola ,&nbsp;A. Xu ,&nbsp;K. Pantopoulos","doi":"10.1016/j.diabres.2025.112491","DOIUrl":"10.1016/j.diabres.2025.112491","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"230 ","pages":"Article 112491"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global and mitochondrial epigenetic profiles in type 2 diabetes: Findings from the RICH study 2型糖尿病的整体和线粒体表观遗传谱:来自RICH研究的发现
IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-01 DOI: 10.1016/j.diabres.2025.112508
H.C. Low , H.L. Cheah , J.H. Lim , C.K.Y. Ong , Y.Q. Chin , C.K.M. Lim , Q. Ayub , W. Ratnam , T. Karupaiah , F. Daud , Z.A.M. Daud , Y.F. Pung
{"title":"Global and mitochondrial epigenetic profiles in type 2 diabetes: Findings from the RICH study","authors":"H.C. Low ,&nbsp;H.L. Cheah ,&nbsp;J.H. Lim ,&nbsp;C.K.Y. Ong ,&nbsp;Y.Q. Chin ,&nbsp;C.K.M. Lim ,&nbsp;Q. Ayub ,&nbsp;W. Ratnam ,&nbsp;T. Karupaiah ,&nbsp;F. Daud ,&nbsp;Z.A.M. Daud ,&nbsp;Y.F. Pung","doi":"10.1016/j.diabres.2025.112508","DOIUrl":"10.1016/j.diabres.2025.112508","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"230 ","pages":"Article 112508"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Diabetes research and clinical practice
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