Pub Date : 2026-01-18DOI: 10.1016/j.diabres.2026.113110
Sayali S. Deshpande-Joshi , Sonali S. Wagle-Patki , Madhura K. Deshmukh , Himangi G. Lubree , Hemant S. Damle , Suhas R. Otiv , Sanat B. Phatak , Rucha H. Wagh , Shrreya S. Sudade , K. Meenakumari , Smita N. Dhadge , Rajashree P. Kamat , Sayali G. Wadke , Deepa A. Raut , Dattatray S. Bhat , Souvik Bandyopadhyay , Chittaranjan S. Yajnik
Aim
To examine relative influence of maternal diabetes and obesity on neonatal size and adiposity in lean Indian population.
Methods
We analyzed routine clinical data collected in one diabetes clinic. Using ANCOVA (Analysis of Covariance), we examined the association of maternal diabetes and overweight-obesity with neonatal weight, abdominal circumference, and skinfold thickness.
Results
We included 772 pregnancies with diabetes (61-type 1, 79-type 2, 632-gestational diabetes mellites (GDM)) and 349 with normal glucose tolerance (NGT). Maternal type of diabetes and overweight-obesity were independently associated with larger neonatal size and adiposity, with a stronger influence of diabetes. Mothers with type 1 diabetes had lowest Body Mass Index (BMI) and highest Glycated hemoglobin (HbA1c) however, their neonates had highest weight, abdominal circumferences, and skinfolds. Compared to neonates of NGT mothers, those of type 1 diabetes were 300 g heavier, of type 2 diabetes 174 g, and of GDM by 111 g. Neonates of overweight-obese mothers were 128 g heavier than those of non-overweight mothers. Gestational weight gain (GWG) was not associated. Similar findings were seen for abdominal circumference and skinfolds.
Conclusion
In an Indian clinic, maternal glycaemia had a much stronger effect on neonatal adiposity compared to her overweight-obesity. Adequate control of maternal hyperglycemia will help control neonatal adiposity.
{"title":"Neonatal adiposity is predominantly influenced by maternal hyperglycemia than obesity: Evidence from India","authors":"Sayali S. Deshpande-Joshi , Sonali S. Wagle-Patki , Madhura K. Deshmukh , Himangi G. Lubree , Hemant S. Damle , Suhas R. Otiv , Sanat B. Phatak , Rucha H. Wagh , Shrreya S. Sudade , K. Meenakumari , Smita N. Dhadge , Rajashree P. Kamat , Sayali G. Wadke , Deepa A. Raut , Dattatray S. Bhat , Souvik Bandyopadhyay , Chittaranjan S. Yajnik","doi":"10.1016/j.diabres.2026.113110","DOIUrl":"10.1016/j.diabres.2026.113110","url":null,"abstract":"<div><h3>Aim</h3><div>To examine relative influence of maternal diabetes and obesity on neonatal size and adiposity in lean Indian population.</div></div><div><h3>Methods</h3><div>We analyzed routine clinical data collected in one diabetes clinic. Using ANCOVA (Analysis of Covariance), we examined the association of maternal diabetes and overweight-obesity with neonatal weight, abdominal circumference, and skinfold thickness.</div></div><div><h3>Results</h3><div>We included 772 pregnancies with diabetes (61-type 1, 79-type 2, 632-gestational diabetes mellites (GDM)) and 349 with normal glucose tolerance (NGT). Maternal type of diabetes and overweight-obesity were independently associated with larger neonatal size and adiposity, with a stronger influence of diabetes. Mothers with type 1 diabetes had lowest Body Mass Index (BMI) and highest Glycated hemoglobin (HbA1c) however, their neonates had highest weight, abdominal circumferences, and skinfolds. Compared to neonates of NGT mothers, those of type 1 diabetes were 300 g heavier, of type 2 diabetes 174 g, and of GDM by 111 g. Neonates of overweight-obese mothers were 128 g heavier than those of non-overweight mothers. Gestational weight gain (GWG) was not associated. Similar findings were seen for abdominal circumference and skinfolds.</div></div><div><h3>Conclusion</h3><div>In an Indian clinic, maternal glycaemia had a much stronger effect on neonatal adiposity compared to her overweight-obesity. Adequate control of maternal hyperglycemia will help control neonatal adiposity.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113110"},"PeriodicalIF":7.4,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009206","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}
Pub Date : 2026-01-15DOI: 10.1016/j.diabres.2026.113108
Nick S.R. Lan , Jonathan Hiew , Pamela Chen , Mahalia McEvoy , Priyal Shah , Ivana Ferreira , J. Carsten Ritter , Laurens Manning , Bu B. Yeap , P. Gerry Fegan , Girish Dwivedi , Emma J. Hamilton
Aims
Pedal medial arterial calcification (pMAC) is a marker of vascular pathology incidentally detected on foot x-ray. We assessed the association between pMAC and major adverse cardiovascular events (MACE) and mortality in patients with diabetes-related foot ulceration (DFU).
Methods
A retrospective study of adults with DFU was performed. pMAC was assessed at five sites on foot x-ray and graded as no/low, moderate or severe. Incident MACE was defined as hospitalisation for myocardial infarction, heart failure, stroke or transient ischaemic attack.
Results
Of 509 patients, 55.2%, 23.4% and 21.4% had no/low, moderate and severe pMAC, respectively. Median follow-up was 531 days (interquartile range 288–793). pMAC was associated with higher MACE or all-cause mortality (no/low 18.1% versus moderate 26.9% versus severe 42.2%; log-rank p < 0.001) and MACE (no/low 11.4% versus moderate 19.3% versus severe 19.3%; log-rank p = 0.020). In multivariable analysis, pMAC was associated with MACE or all-cause mortality (p = 0.009), but not MACE (p = 0.299). MACE was highest in patients with both pMAC and infected ulcers (25.0%), compared with pMAC only (12.5%), infection only (14.0%) and neither (9.0%) (log-rank p < 0.001), remaining significant after adjustment (p = 0.017).
Conclusions
pMAC is associated with MACE or all-cause mortality in patients with DFU, with infected ulcers heightening the risk of MACE.
{"title":"Medial arterial calcification of the foot arteries is associated with incident cardiovascular events or all-cause mortality in patients with diabetes-related foot ulceration","authors":"Nick S.R. Lan , Jonathan Hiew , Pamela Chen , Mahalia McEvoy , Priyal Shah , Ivana Ferreira , J. Carsten Ritter , Laurens Manning , Bu B. Yeap , P. Gerry Fegan , Girish Dwivedi , Emma J. Hamilton","doi":"10.1016/j.diabres.2026.113108","DOIUrl":"10.1016/j.diabres.2026.113108","url":null,"abstract":"<div><h3>Aims</h3><div>Pedal medial arterial calcification (pMAC) is a marker of vascular pathology incidentally detected on foot x-ray. We assessed the association between pMAC and major adverse cardiovascular events (MACE) and mortality in patients with diabetes-related foot ulceration (DFU).</div></div><div><h3>Methods</h3><div>A retrospective study of adults with DFU was performed. pMAC was assessed at five sites on foot x-ray and graded as no/low, moderate or severe. Incident MACE was defined as hospitalisation for myocardial infarction, heart failure, stroke or transient ischaemic attack.</div></div><div><h3>Results</h3><div>Of 509 patients, 55.2%, 23.4% and 21.4% had no/low, moderate and severe pMAC, respectively. Median follow-up was 531 days (interquartile range 288–793). pMAC was associated with higher MACE or all-cause mortality (no/low 18.1% versus moderate 26.9% versus severe 42.2%; log-rank p < 0.001) and MACE (no/low 11.4% versus moderate 19.3% versus severe 19.3%; log-rank p = 0.020). In multivariable analysis, pMAC was associated with MACE or all-cause mortality (p = 0.009), but not MACE (p = 0.299). MACE was highest in patients with both pMAC and infected ulcers (25.0%), compared with pMAC only (12.5%), infection only (14.0%) and neither (9.0%) (log-rank p < 0.001), remaining significant after adjustment (p = 0.017).</div></div><div><h3>Conclusions</h3><div>pMAC is associated with MACE or all-cause mortality in patients with DFU, with infected ulcers heightening the risk of MACE.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113108"},"PeriodicalIF":7.4,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994209","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}
Pub Date : 2026-01-14DOI: 10.1016/j.diabres.2026.113083
Alhena Younis, Alex E Henney, David R Riley, Matthew Anson, Sizheng S Zhao, Gema H Ibarburu, Rayaz A Malik, Li Su, Gregory Y H Lip, Daniel J Cuthbertson, Uazman Alam
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.
目的：有证据表明，钠葡萄糖共转运蛋白2抑制剂和胰高血糖素样肽-1受体激动剂可减少痴呆的发病/进展。作为GLP1/GIP受体双激动剂，替西帕肽对痴呆预后的影响尚不清楚。方法：使用TriNetX全球联合网络的真实数据进行了三个目标试验模拟（TTE）： TTE1：替西肽vs. SGLT2-i, TTE2: semaglutide vs. SGLT2-i， TTE3：替西肽vs. semaglutide。纳入了符合条件的2型糖尿病成人，无基线痴呆。随访时间为两年。采用倾向评分匹配后的生存分析分析首次诊断的痴呆、MACE和全因死亡率。结果：匹配后，TTE1纳入14462例患者；TTE2, 57959;TTE3 12246。与塞马鲁肽和SGLT2-i相比，替泽帕肽的痴呆风险更低（HR 0.69, 95% CI 0.48-0.99, p = 0.04）和SGLT2-i (HR 0.66, 95% CI 0.47-0.93, p = 0.02)，死亡率更低（HR 0.72, 95% CI 0.58-0.90, p ）。结论：在2型糖尿病患者中，替泽帕肽与塞马鲁肽和SGLT2-i相比，痴呆风险更低。研究结果是假设生成的，需要在随机对照试验中得到证实。
{"title":"Target trial emulations for tirzepatide, semaglutide and SGLT2-inhibitors for dementia in patients with type 2 diabetes: Real world evidence from a retrospective cohort study.","authors":"Alhena Younis, Alex E Henney, David R Riley, Matthew Anson, Sizheng S Zhao, Gema H Ibarburu, Rayaz A Malik, Li Su, Gregory Y H Lip, Daniel J Cuthbertson, Uazman Alam","doi":"10.1016/j.diabres.2026.113083","DOIUrl":"https://doi.org/10.1016/j.diabres.2026.113083","url":null,"abstract":"<p><strong>Aims: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":" ","pages":"113083"},"PeriodicalIF":7.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988813","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}
Pub Date : 2026-01-14DOI: 10.1016/j.diabres.2026.113107
Xiaoqin Zhou , Weiqiang Ruan , Jianfeng Pu , Jinmei Zhang , Chuanya Pang , Shuhua Luo , Jing Li
Aims
To analyze 25-year trends (1999–2023) in cardiovascular mortality among U.S. adults ≥ 65 years with type 2 diabetes.
Methods
Using CDC WONDER data, we assessed age-adjusted mortality rates (AAMR) for cardiovascular deaths with type 2 diabetes as a contributing cause, stratified by sex, age group, race/ethnicity, and geographic region.
Results
Between 1999–2023, 529,472 cardiovascular deaths occurred among older adults with type 2 diabetes. AAMR increased significantly from 40.58 to 66.93 per 100,000 population. A dramatic acceleration occurred during 2019–2021 with a 26.2% mortality increase, coinciding with the COVID-19 pandemic. Men consistently demonstrated higher AAMR and steeper increases. Hispanic older adults shifted from third-highest to the highest AAMR by 2023. States with elevated mortality concentrated in the West and Midwest regions. Atherosclerotic heart disease remained the leading cause, while atrial fibrillation emerged as the 5th leading cause with a 624.7% increase in AAMR.
Conclusions
Cardiovascular mortality among older adults with type 2 diabetes increased over 25 years, with a devastating acceleration during 2019–2021 that temporally coincided with the COVID-19 pandemic. Persistent sex-, racial-, and geographic-based disparities, combined with evolving cardiovascular mortality patterns, underscore the imperative for targeted interventions addressing the fundamental social determinants of health underlying these inequities.
{"title":"Cardiovascular mortality trends and disparities among older adults (≥65 years) with type 2 diabetes in the United States: a CDC WONDER database analysis, 1999–2023","authors":"Xiaoqin Zhou , Weiqiang Ruan , Jianfeng Pu , Jinmei Zhang , Chuanya Pang , Shuhua Luo , Jing Li","doi":"10.1016/j.diabres.2026.113107","DOIUrl":"10.1016/j.diabres.2026.113107","url":null,"abstract":"<div><h3>Aims</h3><div>To analyze 25-year trends (1999–2023) in cardiovascular mortality among U.S. adults ≥ 65 years with type 2 diabetes.</div></div><div><h3>Methods</h3><div>Using CDC WONDER data, we assessed age-adjusted mortality rates (AAMR) for cardiovascular deaths with type 2 diabetes as a contributing cause, stratified by sex, age group, race/ethnicity, and geographic region.</div></div><div><h3>Results</h3><div>Between 1999–2023, 529,472 cardiovascular deaths occurred among older adults with type 2 diabetes. AAMR increased significantly from 40.58 to 66.93 per 100,000 population. A dramatic acceleration occurred during 2019–2021 with a 26.2% mortality increase, coinciding with the COVID-19 pandemic. Men consistently demonstrated higher AAMR and steeper increases. Hispanic older adults shifted from third-highest to the highest AAMR by 2023. States with elevated mortality concentrated in the West and Midwest regions. Atherosclerotic heart disease remained the leading cause, while atrial fibrillation emerged as the 5th leading cause with a 624.7% increase in AAMR.</div></div><div><h3>Conclusions</h3><div>Cardiovascular mortality among older adults with type 2 diabetes increased over 25 years, with a devastating acceleration during 2019–2021 that temporally coincided with the COVID-19 pandemic. Persistent sex-, racial-, and geographic-based disparities, combined with evolving cardiovascular mortality patterns, underscore the imperative for targeted interventions addressing the fundamental social determinants of health underlying these inequities.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113107"},"PeriodicalIF":7.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974483","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}
Pub Date : 2026-01-13DOI: 10.1016/j.diabres.2026.113106
Elezebeth Mathews , Thakarakkattil Narayanan Nair Anand , Anjaly Joseph , Bhagiaswari Kodapally , Rajendra Pilankatta , K M Venkat Narayan , Brian Oldenburg , Kavumpurathu Raman Thankappan
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.
目的：我们评估生活方式改变（LSM）干预对孤立性空腹血糖受损（i-IFG）女性糖尿病前期缓解的有效性。方法：我们在印度喀拉拉邦进行了一项基于社区、平行组、开放标签、随机对照试验。年龄在30-60岁 的i-IFG女性被随机分配（1:1）接受12个月的LSM计划或标准治疗（糖尿病信息手册）。随机化是由计算机生成的，分配是隐藏的，直到分配。主要结局是基于12 个月的口服葡萄糖耐量试验的糖尿病前期缓解。次要结局包括进展为2型糖尿病以及血糖标志物、人体测量、身体成分和血压的变化。分析采用意向治疗方法。结果：在1092名随机参与者中，1080名（98.9 %）完成了12个月的随访。LSM组糖尿病前期缓解明显高于对照组（45.9 % vs 6.3 %;RR 7.04, 95 % CI 5.12-10.06）。LSM对空腹血糖（-5.2 mg/dL）、糖化血红蛋白（-0.09 %）、homa - ir (log)（-0.38）、体重（-3.7 kg）、腰围（-1.4 cm）、脂肪量（-2.9 kg）和无脂量（+0.86 kg）也有更大的改善。需要治疗糖尿病前期缓解的人数为2.8（1.8-4.0）。结论：结构化LSM干预可有效促进i-IFG女性糖尿病前期缓解，改善心脏代谢健康。
{"title":"Effectiveness of lifestyle modification in prediabetes remission among women with isolated impaired fasting glucose: A community-based, randomised controlled trial in India","authors":"Elezebeth Mathews , Thakarakkattil Narayanan Nair Anand , Anjaly Joseph , Bhagiaswari Kodapally , Rajendra Pilankatta , K M Venkat Narayan , Brian Oldenburg , Kavumpurathu Raman Thankappan","doi":"10.1016/j.diabres.2026.113106","DOIUrl":"10.1016/j.diabres.2026.113106","url":null,"abstract":"<div><h3>Aims</h3><div>We evaluated the effectiveness of a lifestyle modification (LSM) intervention in prediabetes remission among women with isolated impaired fasting glucose (i-IFG).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>A structured LSM intervention effectively promotes prediabetes remission in women with i-IFG and improves cardio metabolic health.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113106"},"PeriodicalIF":7.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988745","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}
{"title":"Beyond GDP and HbA1c: Reframing equity and outcomes in global paediatric diabetes care","authors":"Shambo Samrat Samajdar , Sunil Gupta , Banshi Saboo , Shatavisa Mukherjee , Anuj Maheshwari , Shashank Joshi","doi":"10.1016/j.diabres.2026.113105","DOIUrl":"10.1016/j.diabres.2026.113105","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113105"},"PeriodicalIF":7.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974484","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}
Pub Date : 2026-01-12DOI: 10.1016/j.diabres.2026.113102
Zainab Irfan , Jitu Halder , Sumon Giri , Ekbal Ali Molla , Sofia Khanam
Type 2 diabetes mellitus is associated with gut dysbiosis, decreased microbial diversity, short-chain fatty acid synthesis, and altered GLP secretion, which are crucial for intestinal integrity, insulin sensitivity, and postprandial glucose control. Evidence from peer-reviewed mechanistic studies, observational research, clinical trials, and meta-analyses was summarised in this review. Prebiotics, an emerging potential treatment, increase the formation of SCFA during fermentation, thereby enhancing the release of GLP through FFAR2/3 signalling. This chain of events enhances glucose-dependent insulin production, inhibits glucagon secretion, delays stomach emptying, strengthens the intestinal barrier, and reduces inflammation throughout the body. Human trials demonstrate statistically significant but clinically modest improvements in HbA1c, postprandial glucose fluctuations, and an increased response to incretin-based treatments, with meta-analytic evidence reporting decreased fasting glucose and HbA1c levels. Prebiotics effect on incretin hormones in humans appears to be diverse, depending on the type, dose, duration, and baseline microbiota composition. Resistant starch and inulin-type fructans have the most consistent effects for lowering postprandial glucose. Prebiotics are viable supplementary therapy for improving glycaemic management by regulating the gut microbiota-SCFA-incretin axis. While the molecular evidence is substantial, clinical effects are moderate and diverse. Long-term microbiome-specific trials are required to understand therapeutic potential and optimise tailored therapies fully.
{"title":"Therapeutic potential of prebiotics in modulating postprandial GLP-1, GLP-2, and glucose homeostasis in type 2 diabetes mellitus: Targeting gut dysbiosis and insulin resistance","authors":"Zainab Irfan , Jitu Halder , Sumon Giri , Ekbal Ali Molla , Sofia Khanam","doi":"10.1016/j.diabres.2026.113102","DOIUrl":"10.1016/j.diabres.2026.113102","url":null,"abstract":"<div><div>Type 2 diabetes mellitus is associated with gut dysbiosis, decreased microbial diversity, short-chain fatty acid synthesis, and altered GLP secretion, which are crucial for intestinal integrity, insulin sensitivity, and postprandial glucose control. Evidence from peer-reviewed mechanistic studies, observational research, clinical trials, and meta-analyses was summarised in this review. Prebiotics, an emerging potential treatment, increase the formation of SCFA during fermentation, thereby enhancing the release of GLP through FFAR2/3 signalling. This chain of events enhances glucose-dependent insulin production, inhibits glucagon secretion, delays stomach emptying, strengthens the intestinal barrier, and reduces inflammation throughout the body. Human trials demonstrate statistically significant but clinically modest improvements in HbA1c, postprandial glucose fluctuations, and an increased response to incretin-based treatments, with meta-analytic evidence reporting decreased fasting glucose and HbA1c levels. Prebiotics effect on incretin hormones in humans appears to be diverse, depending on the type, dose, duration, and baseline microbiota composition. Resistant starch and inulin-type fructans have the most consistent effects for lowering postprandial glucose. Prebiotics are viable supplementary therapy for improving glycaemic management by regulating the gut microbiota-SCFA-incretin axis. While the molecular evidence is substantial, clinical effects are moderate and diverse. Long-term microbiome-specific trials are required to understand therapeutic potential and optimise tailored therapies fully.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113102"},"PeriodicalIF":7.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974270","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}
To develop and internally validate an interpretable machine learning model using eXtreme Gradient Boosting (XGBoost) and Shapley Additive exPlanations (SHAP) to predict postpartum glucose intolerance among women with GDM using routine antenatal clinical data.
Study design
This retrospective study included 600 women with GDM who completed a 6-week postpartum 75-g OGTT. Forty-three antenatal variables were extracted from electronic medical records. An XGBoost model was trained using stratified 5-fold cross-validation, ROSE oversampling, and gridsearch optimisation. Model performance was evaluated using AUC, precision, recall, F1-score and negative predictive value (NPV). SHAP analysis was used to assess feature importance and interpretability.
Results
Postpartum glucose intolerance occurred in 19% of participants. The XGBoost model achieved an AUC of 0.671 and PR-AUC of 0.35, with precision of 0.79, recall of 0.82 and an NPV of 0.87. SHAP analysis identified fasting plasma glucose, 2-hour glucose, gestational weight gain, multiparity, previous GDM and family history of diabetes as key predictors.
Conclusion
An interpretable XGBoost model with SHAP explanations using routine antenatal data shows promise for postpartum glucose risk assessment in primary care. Despite moderate predictive performance, the model demonstrated a high negative predictive value.
{"title":"Predicting postpartum glucose intolerance in women with gestational diabetes mellitus in primary care: A machine learning approach using XGBoost and SHAP values","authors":"Nur Aiza Idris , Nurul Azreen Yusof , Muhd Zulfadli Hafiz Ismail , Siti Norazlina Juhari , Nurulhuda Mat Hassan , Norwati Daud , Nurul Izza Yunus , Mohd Faeiz Pauzi","doi":"10.1016/j.diabres.2026.113098","DOIUrl":"10.1016/j.diabres.2026.113098","url":null,"abstract":"<div><h3>Objective(s)</h3><div>To develop and internally validate an interpretable machine learning model using eXtreme Gradient Boosting (XGBoost) and Shapley Additive exPlanations (SHAP) to predict postpartum glucose intolerance among women with GDM using routine antenatal clinical data.</div></div><div><h3>Study design</h3><div>This retrospective study included 600 women with GDM who completed a 6-week postpartum 75-g OGTT. Forty-three antenatal variables were extracted from electronic medical records. An XGBoost model was trained using stratified 5-fold cross-validation, ROSE oversampling, and gridsearch optimisation. Model performance was evaluated using AUC, precision, recall, F1-score and negative predictive value (NPV). SHAP analysis was used to assess feature importance and interpretability.</div></div><div><h3>Results</h3><div>Postpartum glucose intolerance occurred in 19% of participants. The XGBoost model achieved an AUC of 0.671 and PR-AUC of 0.35, with precision of 0.79, recall of 0.82 and an NPV of 0.87. SHAP analysis identified fasting plasma glucose, 2-hour glucose, gestational weight gain, multiparity, previous GDM and family history of diabetes as key predictors.</div></div><div><h3>Conclusion</h3><div>An interpretable XGBoost model with SHAP explanations using routine antenatal data shows promise for postpartum glucose risk assessment in primary care. Despite moderate predictive performance, the model demonstrated a high negative predictive value.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113098"},"PeriodicalIF":7.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974482","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}
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.
糖尿病周围神经病变（DPN）和外周动脉病变（PAD）是糖尿病常见的神经血管并发症；然而，关于他们的总体患病率的证据仍然不清楚。我们估计糖尿病患者中DPN和PAD的总患病率，并确定相关的危险因素。使用PubMed、Embase、Scopus、Web of Science和灰色文献来源（b谷歌Scholar和Garuda）进行系统回顾和荟萃分析，检索截止到2025年12月10日。155项研究中，DPN的总患病率为36% %，PAD的总患病率为19% %。与发达国家相比，发展中国家DPN（25 %对39 %）和PAD（10 %对24 %）的患病率更高。一项荟萃回归显示，慢性肾脏疾病（CKD）合并症与DPN患病率较高相关（β = 0.024;95 % CI 0.004-0.042）。联合用药的DPN患病率（39 %）高于单纯症状评估（36 %）或单纯症状评估（30 %）。临床实践应强调定期足部检查、早期血管评估和患者教育，特别是在发展中国家和CKD患者中，以确保及时发现和有效预防糖尿病相关并发症。
{"title":"Global prevalence of diabetes-related neuropathy and vascular complications: A systematic review and meta-analysis","authors":"Asmat Burhan , Ramida Subpaiboonkit , Hui-Chuan Huang","doi":"10.1016/j.diabres.2026.113103","DOIUrl":"10.1016/j.diabres.2026.113103","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113103"},"PeriodicalIF":7.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984528","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}
Pub Date : 2026-01-11DOI: 10.1016/j.diabres.2026.113099
Rohan Kankaria , J.Nicholas Charla , Kenny Ye , Leandro Slipczuk , Damini Dey , Jeffrey M. Levsky , Wanda Guzman , Daniel Amadeo , Aribah Zaidi , Jorge R. Kizer , Nir Barzilai , Sofiya Milman , Anna E. Bortnick
Aims
Higher serum insulin-like growth factor binding protein 1 (IGFBP-1) is associated with insulin sensitivity and reduced risk of obesity, diabetes, and atherosclerosis. Epicardial (EAT) and intrathoracic adipose tissue (IAT) are associated with increased atherosclerosis. Whether there is an inverse association of IGFBP-1 with EAT and IAT is unknown.
Methods
We measured EAT, IAT, and IGFBP-1 from n = 102 participants from the LonGenity parent study at the Albert Einstein Institute of Aging, Bronx NY, who were enrolled to investigate healthy aging in Ashkenazi Jewish offspring of parents with exceptional longevity (OPEL) vs usual survival (OPUS). Participants underwent non-contrast electrocardiogram-gated computed tomography (CT) for fat volume quantification. Multiple linear regression models for the cross-sectional association of IGFBP-1 with EAT and IAT were adjusted for demographic, clinical, and laboratory factors.
Results
Higher IGFBP-1 levels were statistically significantly associated with lower EAT and IAT, particularly in the OPEL. This inverse relationship remained significant after adjusting for age, body mass index, high-density lipoprotein cholesterol, and cardiometabolic factors. In contrast, among the OPUS, the point estimates for these associations were directionally similar but not statistically significant.
Conclusion
Circulating IGFBP-1 may be a novel biomarker for visceral adiposity and cardiometabolic risk stratification. Future studies should explore its role in cardiovascular aging.
{"title":"Inverse association of insulin-like growth factor binding protein 1 with epicardial and intrathoracic adiposity in older adults: The Longenity study","authors":"Rohan Kankaria , J.Nicholas Charla , Kenny Ye , Leandro Slipczuk , Damini Dey , Jeffrey M. Levsky , Wanda Guzman , Daniel Amadeo , Aribah Zaidi , Jorge R. Kizer , Nir Barzilai , Sofiya Milman , Anna E. Bortnick","doi":"10.1016/j.diabres.2026.113099","DOIUrl":"10.1016/j.diabres.2026.113099","url":null,"abstract":"<div><h3>Aims</h3><div>Higher serum insulin-like growth factor binding protein 1 (IGFBP-1) is associated with insulin sensitivity and reduced risk of obesity, diabetes, and atherosclerosis. Epicardial (EAT) and intrathoracic adipose tissue (IAT) are associated with increased atherosclerosis. Whether there is an inverse association of IGFBP-1 with EAT and IAT is unknown.</div></div><div><h3>Methods</h3><div>We measured EAT, IAT, and IGFBP-1 from n = 102 participants from the LonGenity parent study at the Albert Einstein Institute of Aging, Bronx NY, who were enrolled to investigate healthy aging in Ashkenazi Jewish offspring of parents with exceptional longevity (OPEL) vs usual survival (OPUS). Participants underwent non-contrast electrocardiogram-gated computed tomography (CT) for fat volume quantification. Multiple linear regression models for the cross-sectional association of IGFBP-1 with EAT and IAT were adjusted for demographic, clinical, and laboratory factors.</div></div><div><h3>Results</h3><div>Higher IGFBP-1 levels were statistically significantly associated with lower EAT and IAT, particularly in the OPEL. This inverse relationship remained significant after adjusting for age, body mass index, high-density lipoprotein cholesterol, and cardiometabolic factors. In contrast, among the OPUS, the point estimates for these associations were directionally similar but not statistically significant.</div></div><div><h3>Conclusion</h3><div>Circulating IGFBP-1 may be a novel biomarker for visceral adiposity and cardiometabolic risk stratification. Future studies should explore its role in cardiovascular aging.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113099"},"PeriodicalIF":7.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965736","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}
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