Pub Date : 2026-01-11DOI: 10.1016/j.diabres.2026.113100
Teresa Vanessa Fiorentino , Chiara Maria Assunta Cefalo , Mariangela Rubino , Alessia Riccio , Elena Succurro , Velia Cassano , Gaia Chiara Mannino , Maria Perticone , Angela Sciacqua , Francesco Andreozzi , Giorgio Sesti
Aims
To investigate whether subjects with intermediate hyperglycemia (IH) and type 2 diabetes (T2D), defined according International Diabetes Federation (IDF) criteria based on 1-hour post-load glucose (1hPG), have an increased risk of coronary artery disease (CAD).
Methods
Presence of CAD was evaluated in 3362 adults classified according to IDF recommendation as having normal glucose tolerance (NGT), isolated impaired fasting glucose, IH, and T2D.
Results
Prevalence of CAD was higher among individuals with IH and T2D than NGT group. In a logistic regression analysis adjusted for several cardiovascular risk factors individuals with IH and T2D had 2.52-fold and 2.05-fold higher odds of having CAD compared to NGT group. Subdividing subjects with IH based on 1hPG and 2hPG, we found that subjects with isolated 1hPG 155–208 mg/dL and those with 2hPG 140–199 mg/dL displayed a 2.8- and 2.21-fold increased odds of CAD as compared to the NGT group. Subjects with T2D, defined by isolated 1hPG ≥ 209 mg/dL or 2hPG ≥ 200 mg/dL, had higher odds of CAD (OR: 2.0 and 2.28, respectively) compared to NGT group.
Conclusions
The IDF-recommended 1hPG criterion for defining IH and T2D identifies subjects with an increased odds of CAD, independent of other cardiovascular risk factors.
{"title":"Risk of coronary artery disease in intermediate hyperglycemia and type 2 diabetes defined by 1-hour post-load glucose levels according to the new IDF criteria","authors":"Teresa Vanessa Fiorentino , Chiara Maria Assunta Cefalo , Mariangela Rubino , Alessia Riccio , Elena Succurro , Velia Cassano , Gaia Chiara Mannino , Maria Perticone , Angela Sciacqua , Francesco Andreozzi , Giorgio Sesti","doi":"10.1016/j.diabres.2026.113100","DOIUrl":"10.1016/j.diabres.2026.113100","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate whether subjects with intermediate hyperglycemia (IH) and type 2 diabetes (T2D), defined according International Diabetes Federation (IDF) criteria based on 1-hour post-load glucose (1hPG), have an increased risk of coronary artery disease (CAD).</div></div><div><h3>Methods</h3><div>Presence of CAD was evaluated in 3362 adults classified according to IDF recommendation as having normal glucose tolerance (NGT), isolated impaired fasting glucose, IH, and T2D.</div></div><div><h3>Results</h3><div>Prevalence of CAD was higher among individuals with IH and T2D than NGT group. In a logistic regression analysis adjusted for several cardiovascular risk factors individuals with IH and T2D had 2.52-fold and 2.05-fold higher odds of having CAD compared to NGT group. Subdividing subjects with IH based on 1hPG and 2hPG, we found that subjects with isolated 1hPG 155–208 mg/dL and those with 2hPG 140–199 mg/dL displayed a 2.8- and 2.21-fold increased odds of CAD as compared to the NGT group. Subjects with T2D, defined by isolated 1hPG ≥ 209 mg/dL or 2hPG ≥ 200 mg/dL, had higher odds of CAD (OR: 2.0 and 2.28, respectively) compared to NGT group.</div></div><div><h3>Conclusions</h3><div>The IDF-recommended 1hPG criterion for defining IH and T2D identifies subjects with an increased odds of CAD, independent of other cardiovascular risk factors.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113100"},"PeriodicalIF":7.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965739","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.2026.113101
Jiaqi Li , Guishao Tang , Zhiguo Xie , Lin Yang , Zhiguang Zhou , Keyu Guo
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.
{"title":"Identification of oral microbial biomarkers for prediabetes in young adults: A two-stage population-based study","authors":"Jiaqi Li , Guishao Tang , Zhiguo Xie , Lin Yang , Zhiguang Zhou , Keyu Guo","doi":"10.1016/j.diabres.2026.113101","DOIUrl":"10.1016/j.diabres.2026.113101","url":null,"abstract":"<div><h3>Aim</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Prediabetes-enriched taxa comprised Bacteroidetes, <em>Prevotella_7</em>, and <em>Veillonella</em>. In contrast, normoglycemic controls showed a higher presence of Firmicutes and <em>Streptococcus</em>. The combined models, constructed from indicators identified by LASSO regression, including BMI, HOMA-IR, and specific microbiota (<em>Prevotella_7</em> or <em>Veillonella</em>), 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.</div></div><div><h3>Conclusion</h3><div>Reproducible alterations and enrichment of <em>Prevotella_7</em> and <em>Veillonella</em> 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.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113101"},"PeriodicalIF":7.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965779","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 : 2026-01-08DOI: 10.1016/j.diabres.2026.113093
Zhenhua Huang , Yuting Gao , Lixiang Liu , Maolin Li , Qinghua Yuan
Background
Insulin resistance (IR) indices like the TyG index are predictors of type 2 diabetes (T2DM), but their comparative performance across BMI categories in East Asians is unclear.
Methods
This retrospective cohort study enrolled 114,293 Chinese adults without diabetes. Four IR indices (TyG, TyG-BMI, TG/HDL-C, METS-IR) were calculated. Their associations with incident T2DM were assessed using Cox models, restricted cubic splines, and machine learning, stratified by BMI. Findings were replicated in 15,453 Japanese adults from the NAGALA cohort.
Results
Over a mean 3.10-year follow-up, 2,435 participants developed T2DM. All indices were independently associated with diabetes risk, but the association strength declined with higher BMI. For TyG, the fully adjusted hazard ratios were 4.60, 3.10, and 2.62 in the non-overweight, overweight, and obese groups, respectively—a “reverse gradient” observed for all indices. Non-linear relationships with clear inflection points were identified. Predictive performance was highest in the non-overweight group (e.g., TyG AUC 76.74%). External replication confirmed these findings.
Conclusions
IR indices, particularly TyG and TyG-BMI, are powerful predictors of T2DM across all BMI categories. Their predictive ability is most pronounced in non-overweight individuals, challenging the obesity-centric diabetes screening paradigm and underscoring the need for early metabolic risk assessment in lean adults.
{"title":"Association between the insulin resistance indices and incident type 2 diabetes across different body mass index states: a cohort study and external validation from two East Asian populations","authors":"Zhenhua Huang , Yuting Gao , Lixiang Liu , Maolin Li , Qinghua Yuan","doi":"10.1016/j.diabres.2026.113093","DOIUrl":"10.1016/j.diabres.2026.113093","url":null,"abstract":"<div><h3>Background</h3><div>Insulin resistance (IR) indices like the TyG index are predictors of type 2 diabetes (T2DM), but their comparative performance across BMI categories in East Asians is unclear.</div></div><div><h3>Methods</h3><div>This retrospective cohort study enrolled 114,293 Chinese adults without diabetes. Four IR indices (TyG, TyG-BMI, TG/HDL-C, METS-IR) were calculated. Their associations with incident T2DM were assessed using Cox models, restricted cubic splines, and machine learning, stratified by BMI. Findings were replicated in 15,453 Japanese adults from the NAGALA cohort.</div></div><div><h3>Results</h3><div> <!-->Over a mean 3.10-year follow-up, 2,435 participants developed T2DM. All indices were independently associated with diabetes risk, but the association strength declined with higher BMI. For TyG, the fully adjusted hazard ratios were 4.60, 3.10, and 2.62 in the non-overweight, overweight, and obese groups, respectively—a “reverse gradient” observed for all indices. Non-linear relationships with clear inflection points were identified. Predictive performance was highest in the non-overweight group (e.g., TyG AUC 76.74%). External replication confirmed these findings.</div></div><div><h3>Conclusions</h3><div> <!-->IR indices, particularly TyG and TyG-BMI, are powerful predictors of T2DM across all BMI categories. Their predictive ability is most pronounced in non-overweight individuals, challenging the obesity-centric diabetes screening paradigm and underscoring the need for early metabolic risk assessment in lean adults.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113093"},"PeriodicalIF":7.4,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948578","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 : 2026-01-07DOI: 10.1016/j.diabres.2026.113092
Siyuan Tan , Ting Huang , Zixi Zhang , Jiabao Zhou , Hao Chen , Tao Tu , Qiuzhen Lin , Yichao Xiao , Qiming Liu
Background
Cardiovascular disease (CVD) and metabolic dysfunction–associated steatotic liver disease (MASLD) are metabolically linked, yet their combined burden and mortality impact remain underexplored.
Methods
Using Global Burden of Disease (GBD) 2023 data, we assessed temporal and regional trends in CVD, MASLD, and metabolic risk factors. National Health and Nutrition Examination Survey (NHANES) data were subsequently analyzed to examine the association between CVD–MASLD comorbidity and mortality using multivariable and survival models.
Results
From 1990 to 2023, the global burden of CVD declined steadily, whereas MASLD rose continuously, showing divergent and regionally heterogeneous trends. In high-income countries, CVD indicators decreased despite increasing MASLD burden, whereas this inverse pattern was weaker in upper–middle-income regions. In NHANES, individuals with CVD–MASLD comorbidity exhibited the highest metabolic abnormalities and mortality risk. Compared with those without comorbidities, adjusted hazard ratios were 1.68 for all-cause and 2.68 for cardiovascular mortality. Mortality rose progressively with fibrosis severity. PAF analyses showed that CVD, MASLD, and their comorbidity accounted for 13.3%, 1.3%, and 7.8% of cardiovascular deaths, respectively, totaling 22.4%. These associations demonstrated marked age-related heterogeneity.
Conclusion
CVD–MASLD comorbidity is an emerging global concern associated with excess mortality, emphasizing the need to incorporate MASLD screening and fibrosis evaluation into cardiovascular prevention strategies.
{"title":"The burden and mortality impact of cardiovascular disease–metabolic dysfunction–associated steatotic liver disease comorbidity","authors":"Siyuan Tan , Ting Huang , Zixi Zhang , Jiabao Zhou , Hao Chen , Tao Tu , Qiuzhen Lin , Yichao Xiao , Qiming Liu","doi":"10.1016/j.diabres.2026.113092","DOIUrl":"10.1016/j.diabres.2026.113092","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) and metabolic dysfunction–associated steatotic liver disease (MASLD) are metabolically linked, yet their combined burden and mortality impact remain underexplored.</div></div><div><h3>Methods</h3><div>Using Global Burden of Disease (GBD) 2023 data, we assessed temporal and regional trends in CVD, MASLD, and metabolic risk factors. National Health and Nutrition Examination Survey (NHANES) data were subsequently analyzed to examine the association between CVD–MASLD comorbidity and mortality using multivariable and survival models.</div></div><div><h3>Results</h3><div>From 1990 to 2023, the global burden of CVD declined steadily, whereas MASLD rose continuously, showing divergent and regionally heterogeneous trends. In high-income countries, CVD indicators decreased despite increasing MASLD burden, whereas this inverse pattern was weaker in upper–middle-income regions. In NHANES, individuals with CVD–MASLD comorbidity exhibited the highest metabolic abnormalities and mortality risk. Compared with those without comorbidities, adjusted hazard ratios were 1.68 for all-cause and 2.68 for cardiovascular mortality. Mortality rose progressively with fibrosis severity. PAF analyses showed that CVD, MASLD, and their comorbidity accounted for 13.3%, 1.3%, and 7.8% of cardiovascular deaths, respectively, totaling 22.4%. These associations demonstrated marked age-related heterogeneity.</div></div><div><h3>Conclusion</h3><div>CVD–MASLD comorbidity is an emerging global concern associated with excess mortality, emphasizing the need to incorporate MASLD screening and fibrosis evaluation into cardiovascular prevention strategies.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113092"},"PeriodicalIF":7.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145943004","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 : 2026-01-07DOI: 10.1016/j.diabres.2026.113091
Minjeong Jeon , Bin Hong , Hwa Yeon Ko , Hong Ji Song , Soo Heon Kwak , Ju Hwan Kim , Ju-Young Shin
Aims
To compare the risk of osteoarthritis among patients with type 2 diabetes mellitus (T2DM) initiating glucagon-like peptide-1 receptor agonists (GLP-1RAs) versus dipeptidyl peptidase-4 inhibitors (DPP4Is).
Methods
We conducted a nationwide cohort study applying a target trial emulation framework. From the National Health Insurance Service data of South Korea (2010–2022), eligible patients included adult patients with T2DM initiated GLP-1RAs or DPP4Is. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% CIs of incident osteoarthritis, and were weighted using propensity score fine stratification.
Results
Among 2,056,824 eligible patients, 9,866 started GLP-1RAs (mean age 45 years; 55% male; 67% dulaglutide) and 2,047,158 started DPP4Is (mean age 56 years; 70% male). After weighting, all covariates were well balanced, with patients having a mean age of 45 years and 55% being male. The incidence rates per 100 person-years for osteoarthritis were 3.99 (95% CI, 3.54–4.48) and 4.36 (4.34–4.38) among GLP-1RAs and DPP4Is users, respectively. Compared to DPP4Is, GLP-1RAs were not associated with a lower risk of osteoarthritis (HR 0.93, 95% CI, 0.83–1.05).
Conclusions
The use of GLP-1RAs, primarily dulaglutide, was not associated with lower risk of osteoarthritis compared with DPP4Is use among patients with T2DM.
{"title":"Glucagon-like peptide-1 receptor agonists and risk of osteoarthritis among individuals with type 2 diabetes: A population-based cohort study","authors":"Minjeong Jeon , Bin Hong , Hwa Yeon Ko , Hong Ji Song , Soo Heon Kwak , Ju Hwan Kim , Ju-Young Shin","doi":"10.1016/j.diabres.2026.113091","DOIUrl":"10.1016/j.diabres.2026.113091","url":null,"abstract":"<div><h3>Aims</h3><div>To compare the risk of osteoarthritis among patients with type 2 diabetes mellitus (T2DM) initiating glucagon-like peptide-1 receptor agonists (GLP-1RAs) versus dipeptidyl peptidase-4 inhibitors (DPP4Is).</div></div><div><h3>Methods</h3><div>We conducted a nationwide cohort study applying a target trial emulation framework. From the National Health Insurance Service data of South Korea (2010–2022), eligible patients included adult patients with T2DM initiated GLP-1RAs or DPP4Is. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% CIs of incident osteoarthritis, and were weighted using propensity score fine stratification.</div></div><div><h3>Results</h3><div>Among 2,056,824 eligible patients, 9,866 started GLP-1RAs (mean age 45 years; 55% male; 67% dulaglutide) and 2,047,158 started DPP4Is (mean age 56 years; 70% male). After weighting, all covariates were well balanced, with patients having a mean age of 45 years and 55% being male. The incidence rates per 100 person-years for osteoarthritis were 3.99 (95% CI, 3.54–4.48) and 4.36 (4.34–4.38) among GLP-1RAs and DPP4Is users, respectively. Compared to DPP4Is, GLP-1RAs were not associated with a lower risk of osteoarthritis (HR 0.93, 95% CI, 0.83–1.05).</div></div><div><h3>Conclusions</h3><div>The use of GLP-1RAs, primarily dulaglutide, was not associated with lower risk of osteoarthritis compared with DPP4Is use among patients with T2DM.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113091"},"PeriodicalIF":7.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145942980","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 : 2026-01-06DOI: 10.1016/j.diabres.2026.113084
Tomás P Griffin , Jennifer Hagan , Radhika Chauhan , Thomas SJ Crabtree , Dawn Ackroyd , Jackie Elliott , Parth Narendran , Zosanglura Bawlchhim , Emma G Wilmot , Michelle Hadjiconstantinou , Pratik Choudhary
Aims
This study evaluated the impact of ≥3 months of HCL use on patient-reported outcomes (PROs) in PwT1D and their partners.
Methods
Participants enrolled on the NHS England HCL pilot were invited to take part in a mixed-methods study. Here, we present the results of the quantitative study. PwT1D completed online questionnaires, including INSPIRE (0–100), DTSQc (−18 to +18), System Usability Scale (0–100), and bespoke measures. Self-reported clinical data were collected. Optionally, partners completed the INSPIRE for partners questionnaire.
Results
A total of 125 PwT1D and 33 partners participated. PROs included: INSPIRE 88/100 (IQR 73–95) and DTSQc 17/18(14–18). In INSPIRE, >70 % strongly agree that HCL improved HbA1c, time in range and overall quality of life. In DTSQc, >70 % noted that their blood glucose levels had been unacceptably low/high much less of the time since starting HCL. However, 54.4 % reported increased alarm burden and 21.6 % information overload. People who found HCL harder to use based on the SUS score had lower INSPIRE, DTSQs and DTSQc scores and higher HbA1c than those who found HCL easier to use.
Conclusions
HCL therapy is associated with improved PROs in PwT1D. However, system usability significantly influences outcomes, and alarm and data burden remain concerns.
{"title":"The results of ProHCL: Patient-reported outcomes in people living with type 1 diabetes on hybrid closed-loop insulin pump therapy − experiences from the NHS England pilot","authors":"Tomás P Griffin , Jennifer Hagan , Radhika Chauhan , Thomas SJ Crabtree , Dawn Ackroyd , Jackie Elliott , Parth Narendran , Zosanglura Bawlchhim , Emma G Wilmot , Michelle Hadjiconstantinou , Pratik Choudhary","doi":"10.1016/j.diabres.2026.113084","DOIUrl":"10.1016/j.diabres.2026.113084","url":null,"abstract":"<div><h3>Aims</h3><div>This study evaluated the impact of ≥3 months of HCL use on patient-reported outcomes (PROs) in PwT1D and their partners.</div></div><div><h3>Methods</h3><div>Participants enrolled on the NHS England HCL pilot were invited to take part in a mixed-methods study. Here, we present the results of the quantitative study. PwT1D completed online questionnaires, including INSPIRE (0–100), DTSQc (−18 to +18), System Usability Scale (0–100), and bespoke measures. Self-reported clinical data were collected. Optionally, partners completed the INSPIRE for partners questionnaire.</div></div><div><h3>Results</h3><div>A total of 125 PwT1D and 33 partners participated. PROs included: INSPIRE 88/100 (IQR 73–95) and DTSQc 17/18(14–18). In INSPIRE, >70 % strongly agree that HCL improved HbA1c, time in range and overall quality of life. In DTSQc, >70 % noted that their blood glucose levels had been unacceptably low/high much less of the time since starting HCL. However, 54.4 % reported increased alarm burden and 21.6 % information overload. People who found HCL harder to use based on the SUS score had lower INSPIRE, DTSQs and DTSQc scores and higher HbA1c than those who found HCL easier to use.</div></div><div><h3>Conclusions</h3><div>HCL therapy is associated with improved PROs in PwT1D. However, system usability significantly influences outcomes, and alarm and data burden remain concerns.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113084"},"PeriodicalIF":7.4,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932739","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 : 2026-01-03DOI: 10.1016/j.diabres.2026.113082
Nilhan Töyer Şahin , Seda Pehlivan
Background
This study was conducted to examine the effects of eHealth and artificial intelligence literacy on disease self-management in patients with diabetes.
Methods
The cross-sectional study was conducted with 212 patients with diabetes who were followed up in Endocrinology clinics and outpatient clinics of a hospital between October 2024 and June 2025. Data were collected through face-to-face interviews using a Personal Information Form, the eHealth Literacy Scale, the Artificial Intelligence (AI) Literacy Scale, and the Diabetes Self-Management Questionnaire. Data were analysed using the SPSS-27 software, and p = 0.05 was considered statistically significant.
Results
The mean age of the 212 patients was 52.09 ± 17.02, and their mean disease duration was 9.66 ± 8.47 years. The patients had mean Diabetes Self-Management Questionnaire, eHealth Literacy Scale, and AI Literacy Scale scores of 6.47 ± 1.50, 27.87 ± 8.83, and 48.12 ± 11.26, respectively. Diabetes self-management was significantly and positively correlated with eHealth literacy (r = 0.505; p = 0.000) and AI literacy (r = 0.499; p = 0.000). Additionally, a positive significant relationship was found between general eHealth literacy and AI literacy (r = 0.865; p = 0.000).
Conclusions
The results of this study suggest that general eHealth and AI literacy play a significant role in supporting diabetes self-management.
{"title":"The effects of e-Health and artificial intelligence literacy levels on disease self-management in patients with diabetes","authors":"Nilhan Töyer Şahin , Seda Pehlivan","doi":"10.1016/j.diabres.2026.113082","DOIUrl":"10.1016/j.diabres.2026.113082","url":null,"abstract":"<div><h3>Background</h3><div>This study was conducted to examine the effects of eHealth and artificial intelligence literacy on disease self-management in patients with diabetes.</div></div><div><h3>Methods</h3><div>The cross-sectional study was conducted with 212 patients with diabetes who were followed up in Endocrinology clinics and outpatient clinics of a hospital between October 2024 and June 2025. Data were collected through face-to-face interviews using a Personal Information Form, the eHealth Literacy Scale, the Artificial Intelligence (AI) Literacy Scale, and the Diabetes Self-Management Questionnaire. Data were analysed using the SPSS-27 software, and p = 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The mean age of the 212 patients was 52.09 ± 17.02, and their mean disease duration was 9.66 ± 8.47 years. The patients had mean Diabetes Self-Management Questionnaire, eHealth Literacy Scale, and AI Literacy Scale scores of 6.47 ± 1.50, 27.87 ± 8.83, and 48.12 ± 11.26, respectively.<!--> <!-->Diabetes self-management was significantly and positively correlated with eHealth literacy (r = 0.505; p = 0.000) and AI literacy (r = 0.499; p = 0.000). Additionally, a positive significant relationship was found between general eHealth literacy and AI literacy (r = 0.865; p = 0.000).</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that general eHealth and AI literacy play a significant role in supporting diabetes self-management.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113082"},"PeriodicalIF":7.4,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905839","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 : 2026-01-02DOI: 10.1016/j.diabres.2025.113080
Iiris Kyläheiko , Aleksi Tarkkonen , Linda Kuusela , Juha Martola , Teemu I. Paajanen , Jussi Virkkala , Per-Henrik Groop , Lena M. Thorn , Turgut Tatlisumak , Jukka Putaala , Daniel Gordin , Hanna Jokinen , on behalf of the FinnDiane Study Group
Aims
Adults with type 1 diabetes (T1D) have an increased risk of cerebral small vessel disease (cSVD)-related brain changes already in midlife, yet their significance for cognitive functions remains poorly understood. We investigated associations between cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), and cognition in individuals with T1D and without any neurological symptoms.
Methods
Participants (n=167; age 46.4±7.7 years) underwent cross-sectional clinical and biochemical evaluations, brain magnetic resonance imaging, and neuropsychological assessment. CMB number and topography (lobar, deep/infratentorial, or mixed location) and WMHs, quantified volumetrically, were evaluated.
Results
Compared to absence of CMBs, higher burden of CMBs (≥3) was associated independently of age with poorer processing speed (standardized β from 0.18 to 0.23, p<0.05) and executive functions (standardized β from 0.18 to –0.25, p<0.05), but not with episodic memory. Mild WMHs had no independent relationships with cognition. Compared to other topographies, mixed CMB location was more often negatively related to cognition (standardized β from 0.20 to 0.32, p<0.05).
Conclusions
CMBs were related to a subtle, yet systematic impairment in cognition, whereas mild WMHs were not. The results provide insight into the development of early cSVD-related cognitive changes already in midlife and suggest an increased risk of cognitive decline in T1D.
{"title":"Cerebral microbleeds are associated with deficits in cognitive processing speed and executive functions in middle-aged adults with type 1 diabetes","authors":"Iiris Kyläheiko , Aleksi Tarkkonen , Linda Kuusela , Juha Martola , Teemu I. Paajanen , Jussi Virkkala , Per-Henrik Groop , Lena M. Thorn , Turgut Tatlisumak , Jukka Putaala , Daniel Gordin , Hanna Jokinen , on behalf of the FinnDiane Study Group","doi":"10.1016/j.diabres.2025.113080","DOIUrl":"10.1016/j.diabres.2025.113080","url":null,"abstract":"<div><h3>Aims</h3><div>Adults with type 1 diabetes (T1D) have an increased risk of cerebral small vessel disease (cSVD)-related brain changes already in midlife, yet their significance for cognitive functions remains poorly understood. We investigated associations between cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), and cognition in individuals with T1D and without any neurological symptoms.</div></div><div><h3>Methods</h3><div>Participants (n=167; age 46.4±7.7 years) underwent cross-sectional clinical and biochemical evaluations, brain magnetic resonance imaging, and neuropsychological assessment. CMB number and topography (lobar, deep/infratentorial, or mixed location) and WMHs, quantified volumetrically, were evaluated.</div></div><div><h3>Results</h3><div>Compared to absence of CMBs, higher burden of CMBs (≥3) was associated independently of age with poorer processing speed (standardized <em>β</em> from 0.18 to 0.23, p<0.05) and executive functions (standardized <em>β</em> from 0.18 to –0.25, p<0.05), but not with episodic memory. Mild WMHs had no independent relationships with cognition. Compared to other topographies, mixed CMB location was more often negatively related to cognition (standardized <em>β</em> from 0.20 to 0.32, p<0.05).</div></div><div><h3>Conclusions</h3><div>CMBs were related to a subtle, yet systematic impairment in cognition, whereas mild WMHs were not. The results provide insight into the development of early cSVD-related cognitive changes already in midlife and suggest an increased risk of cognitive decline in T1D.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113080"},"PeriodicalIF":7.4,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899383","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 : 2026-01-02DOI: 10.1016/j.diabres.2025.113081
Per Lav Madsen , Ikram Mizrak , Martin Heyn Sørensen , Peter Haulund Gæde , Annemie Stege Bojer
Objective
To evaluate if metabolic cardiomyopathy comprises different phenotypes.
Methods
Data-driven cluster analysis with hierarchical clustering followed by gap and silhouette width analysis and clustering by k-means was conducted on cardiovascular variables in a cohort of 192 patients with type 2 diabetes (T2D).
Results
Two distinct clusters were identified. 59 % of patients with DM2 had small left ventricles and atria with normal mass, high heart rate with small stroke volumes, and only moderately impaired myocardial perfusion reserve (3.32 ± 1.20 vs. 5.07 ± 1.51 ml/min/g in normal controls, p < 0.01). With equal e/e and extracellular volumes, other 41 % of patients with T2D had eccentric hypertrophic large left ventricles with dilated left atria, high stroke volumes, and a mean 6 mmHg higher mean arterial blood pressure and mean 15 mmHg higher pulse pressure, lower heart rates and lower myocardial perfusion reserve (2.60 ± 0.87 mL/min/g, P < 0.01 vs. other groups).
Conclusions
Two distinct types of cardiomyopathies were identified. The majority exhibited small left hearts with only moderate impairment in myocardial perfusion ratio. However, when stiff conductance arteries were present, cardiomyopathy with larger and eccentrically hypertrophic left ventricles and markedly reduced myocardial perfusion ratio was observed. Future research should seek to determine if these two phenotypes carry independent prognostic implications and should be treated differently.
目的：评价代谢性心肌病是否包括不同的表型。方法：对192例2型糖尿病（T2D）患者的心血管变量进行数据驱动的分层聚类分析、间隙和轮廓宽度分析以及k-means聚类。结果：鉴定出两个不同的簇。59 %的DM2患者左心室和心房体积小，体积正常，心率高，每搏容量小，心肌灌注储备仅中度受损(正常对照为3.32 ± 1.20 vs. 5.07 ± 1.51 ml/min/g， p 结论：确定了两种不同类型的心肌病。大多数患者左心较小，心肌灌注比仅出现中度损伤。然而，当存在僵硬的传导动脉时，心肌病表现为左心室增大和偏心肥厚，心肌灌注比明显降低。未来的研究应该寻求确定这两种表型是否具有独立的预后意义，是否应该区别对待。
{"title":"Two phenotypes of metabolic cardiomyopathy: Data-driven cluster analysis of non-invasively determined cardiovascular phenotypical traits","authors":"Per Lav Madsen , Ikram Mizrak , Martin Heyn Sørensen , Peter Haulund Gæde , Annemie Stege Bojer","doi":"10.1016/j.diabres.2025.113081","DOIUrl":"10.1016/j.diabres.2025.113081","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate if metabolic cardiomyopathy comprises different phenotypes.</div></div><div><h3>Methods</h3><div>Data-driven cluster analysis with hierarchical clustering followed by gap and silhouette width analysis and clustering by k-means was conducted on cardiovascular variables in a cohort of 192 patients with type 2 diabetes (T2D).</div></div><div><h3>Results</h3><div>Two distinct clusters were identified. 59 % of patients with DM2 had small left ventricles and atria with normal mass, high heart rate with small stroke volumes, and only moderately impaired myocardial perfusion reserve (3.32 ± 1.20 <em>vs</em>. 5.07 ± 1.51 ml/min/g in normal controls, p < 0.01). With equal e/e and extracellular volumes, other 41 % of patients with T2D had eccentric hypertrophic large left ventricles with dilated left atria, high stroke volumes, and a mean 6 mmHg higher mean arterial blood pressure and mean 15 mmHg higher pulse pressure, lower heart rates and lower myocardial perfusion reserve (2.60 ± 0.87 mL/min/g, P < 0.01 <em>vs</em>. other groups).</div></div><div><h3>Conclusions</h3><div>Two distinct types of cardiomyopathies were identified. The majority exhibited small left hearts with only moderate impairment in myocardial perfusion ratio. However, when stiff conductance arteries were present, cardiomyopathy with larger and eccentrically hypertrophic left ventricles and markedly reduced myocardial perfusion ratio was observed. Future research should seek to determine if these two phenotypes carry independent prognostic implications and should be treated differently.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113081"},"PeriodicalIF":7.4,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899410","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 : 2026-01-01DOI: 10.1016/j.diabres.2025.113073
Shan-Ho Chan , Pei-Yun Li , Pin-Hung Li , Yu-Jung Lin , Wei-Hsun Wang , Yu-Nan Huang , Jia-Yuh Chen
Aims
To evaluate whether Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use at immune checkpoint inhibitor (ICI) start is associated with mortality, healthcare use, and immune-related adverse events in adults with type 2 diabetes (T2D).
Methods
A target-trial emulation was conducted in the TriNetX US Collaborative Network among adults with cancer and T2D starting an ICI, with or without overlapping GLP-1 RA at ICI start. A new-user 1:1 propensity-score–matched, intention-to-treat design yielded 2,903 per group and 36-month follow-up. Primary endpoint was all-cause mortality; key secondaries were hospitalization, and composite immune-related adverse events (irAEs). Prespecified per-protocol, 90-day landmark, and semaglutide-only analyses assessed robustness.
Results
GLP-1 RA co-exposure was associated with lower mortality (hazard ratio [HR] 0.55, 95 % CI 0.51–0.61; 36-month absolute risk difference [ARD] − 16.41 %; number needed to treat [NNT] 5). Hospitalization (HR 0.76; ARD − 7.06 %; NNT 11), and composite irAEs (43.93 % vs 51.51 %; ARD − 7.58 %; NNT 11) were also lower. Diabetic-retinopathy progression (HR 1.75; ARD + 2.71 %) and non-arteritic anterior ischemic optic neuropathy (HR 1.51) were higher; hypoglycaemia, acute kidney injury, and dehydration/orthostatic hypotension were lower.
Conclusions
GLP-1 RA use during ICI therapy correlated with lower mortality, reduced acute care, fewer irAEs; ophthalmic signals warrant monitoring.
{"title":"GLP-1 receptor agonist use during immune checkpoint inhibitor therapy is associated with mortality and Immune-Related adverse events across cancer types in People with type 2 Diabetes: A Target-Trial emulation","authors":"Shan-Ho Chan , Pei-Yun Li , Pin-Hung Li , Yu-Jung Lin , Wei-Hsun Wang , Yu-Nan Huang , Jia-Yuh Chen","doi":"10.1016/j.diabres.2025.113073","DOIUrl":"10.1016/j.diabres.2025.113073","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate whether Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use at immune checkpoint inhibitor (ICI) start is associated with mortality, healthcare use, and immune-related adverse events in adults with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>A target-trial emulation was conducted in the TriNetX US Collaborative Network among adults with cancer and T2D starting an ICI, with or without overlapping GLP-1 RA at ICI start. A new-user 1:1 propensity-score–matched, intention-to-treat design yielded 2,903 per group and 36-month follow-up. Primary endpoint was all-cause mortality; key secondaries were hospitalization, and composite immune-related adverse events (irAEs). Prespecified per-protocol, 90-day landmark, and semaglutide-only analyses assessed robustness.</div></div><div><h3>Results</h3><div>GLP-1 RA co-exposure was associated with lower mortality (hazard ratio [HR] 0.55, 95 % CI 0.51–0.61; 36-month absolute risk difference [ARD] − 16.41 %; number needed to treat [NNT] 5). Hospitalization (HR 0.76; ARD − 7.06 %; NNT 11), and composite irAEs (43.93 % vs 51.51 %; ARD − 7.58 %; NNT 11) were also lower. Diabetic-retinopathy progression (HR 1.75; ARD + 2.71 %) and non-arteritic anterior ischemic optic neuropathy (HR 1.51) were higher; hypoglycaemia, acute kidney injury, and dehydration/orthostatic hypotension were lower.</div></div><div><h3>Conclusions</h3><div>GLP-1 RA use during ICI therapy correlated with lower mortality, reduced acute care, fewer irAEs; ophthalmic signals warrant monitoring.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"231 ","pages":"Article 113073"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843671","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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