Pub Date : 2025-01-01DOI: 10.1016/j.diabres.2024.111964
Charlotte Wahlich , Lakshmi Chandrasekaran , Umar A.R. Chaudhry , Kathryn Willis , Ryan Chambers , Louis Bolter , John Anderson , Royce Shakespeare , Abraham Olvera-Barrios , Jiri Fajtl , Roshan Welikala , Sarah Barman , Catherine A. Egan , Adnan Tufail , Christopher G. Owen , Alicja R. Rudnicka
Aims
Automated retinal image analysis using Artificial Intelligence (AI) can detect diabetic retinopathy as accurately as human graders, but it is not yet licensed in the NHS Diabetic Eye Screening Programme (DESP) in England. This study aims to assess perceptions of People Living with Diabetes (PLD) and Healthcare Practitioners (HCP) towards AI’s introduction in DESP.
Methods
Two online surveys were co-developed with PLD and HCP from a diverse DESP in North East London. Surveys were validated through interviews across three centres and distributed via DESP centres, charities, and the British Association of Retinal Screeners. A coding framework was used to analyse free-text responses.
Results
387 (24%) PLD and 98 (37%) HCP provided comments. Themes included trust, workforce impact, the patient-practitioner relationship, AI implementation challenges, and inequalities. Both groups agreed AI in DESP was inevitable, would improve efficiency, and save costs. Concerns included job losses, data security, and AI decision safety. A common misconception was that AI would directly affect patient interactions, though it only processes retinal images.
Conclusions
Limited understanding of AI was a barrier to acceptance. Educating diverse PLD groups and HCP about AI’s accuracy and reliability is crucial to building trust and facilitating its integration into screening practices.
{"title":"Patient and practitioner perceptions around use of artificial intelligence within the English NHS diabetic eye screening programme","authors":"Charlotte Wahlich , Lakshmi Chandrasekaran , Umar A.R. Chaudhry , Kathryn Willis , Ryan Chambers , Louis Bolter , John Anderson , Royce Shakespeare , Abraham Olvera-Barrios , Jiri Fajtl , Roshan Welikala , Sarah Barman , Catherine A. Egan , Adnan Tufail , Christopher G. Owen , Alicja R. Rudnicka","doi":"10.1016/j.diabres.2024.111964","DOIUrl":"10.1016/j.diabres.2024.111964","url":null,"abstract":"<div><h3>Aims</h3><div>Automated retinal image analysis using Artificial Intelligence (AI) can detect diabetic retinopathy as accurately as human graders, but it is not yet licensed in the NHS Diabetic Eye Screening Programme (DESP) in England. This study aims to assess perceptions of People Living with Diabetes (PLD) and Healthcare Practitioners (HCP) towards AI’s introduction in DESP.</div></div><div><h3>Methods</h3><div>Two online surveys were co-developed with PLD and HCP from a diverse DESP in North East London. Surveys were validated through interviews across three centres and distributed via DESP centres, charities, and the British Association of Retinal Screeners. A coding framework was used to analyse free-text responses.</div></div><div><h3>Results</h3><div>387 (24%) PLD and 98 (37%) HCP provided comments. Themes included trust, workforce impact, the patient-practitioner relationship, AI implementation challenges, and inequalities. Both groups agreed AI in DESP was inevitable, would improve efficiency, and save costs. Concerns included job losses, data security, and AI decision safety. A common misconception was that AI would directly affect patient interactions, though it only processes retinal images.</div></div><div><h3>Conclusions</h3><div>Limited understanding of AI was a barrier to acceptance. Educating diverse PLD groups and HCP about AI’s accuracy and reliability is crucial to building trust and facilitating its integration into screening practices.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111964"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.diabres.2024.111970
Alisa D. Kjaergaard , Allan Vaag , Verena H. Jensen , Michael H. Olsen , Kurt Højlund , Peter Vestergaard , Torben Hansen , Reimar W. Thomsen , Niels Jessen
Aims
We investigated the association of the inflammatory biomarker YKL-40 with cardiovascular events (CVEs) and mortality in individuals with type 2 diabetes.
Methods
We followed 11,346 individuals recently diagnosed with type 2 diabetes for up to 14 years. Baseline YKL-40 levels (measured in 9,010 individuals) were grouped into percentiles (0–33 %, 34–66 %, 67–90 %, and 91–100 %) and analyzed continuously (per 1 SD log increment), with comparisons to CRP (measured in 9,644 individuals). Cox regression assessed associations with atrial fibrillation (AF), ischemic stroke (IS), venous thromboembolism (VTE), myocardial infarction (MI), heart failure (HF), peripheral artery disease (PAD), and all-cause, cardiovascular, and cancer mortality.
Results
Adjusted HRs (95% CIs) for the highest (91–100%) versus the lowest (0–33%) YKL-40 percentile category were 1.31 (1.04–1.66) for AF, 1.43 (0.98–2.07) for IS, 1.07 (0.65–1.76) VTE, 0.88 (0.52–1.48) for MI, 1.66 (1.19–2.31) for HF, 1.66 (1.12–2.48) for PAD, and 2.18 (1.85–2.56) for all-cause, 1.64 (1.07–2.50) for cardiovascular, and 2.73 (2.05–3.63) for cancer mortality. Each 1 SD log increase in YKL-40 and CRP levels similarly increased CVE risks, with CRP being superior for MI and cardiovascular mortality.
Conclusions
YKL-40 is a prognostic biomarker for most CVEs, and even more so for all-cause mortality, primarily driven by cancer-related causes.
{"title":"YKL-40, cardiovascular events, and mortality in individuals recently diagnosed with type 2 diabetes: A Danish cohort study","authors":"Alisa D. Kjaergaard , Allan Vaag , Verena H. Jensen , Michael H. Olsen , Kurt Højlund , Peter Vestergaard , Torben Hansen , Reimar W. Thomsen , Niels Jessen","doi":"10.1016/j.diabres.2024.111970","DOIUrl":"10.1016/j.diabres.2024.111970","url":null,"abstract":"<div><h3>Aims</h3><div>We investigated the association of the inflammatory biomarker YKL-40 with cardiovascular events (CVEs) and mortality in individuals with type 2 diabetes.</div></div><div><h3>Methods</h3><div>We followed 11,346 individuals recently diagnosed with type 2 diabetes for up to 14 years. Baseline YKL-40 levels (measured in 9,010 individuals) were grouped into percentiles (0–33 %, 34–66 %, 67–90 %, and 91–100 %) and analyzed continuously (per 1 SD log increment), with comparisons to CRP (measured in 9,644 individuals). Cox regression assessed associations with atrial fibrillation (AF), ischemic stroke (IS), venous thromboembolism (VTE), myocardial infarction (MI), heart failure (HF), peripheral artery disease (PAD), and all-cause, cardiovascular, and cancer mortality.</div></div><div><h3>Results</h3><div>Adjusted HRs (95% CIs) for the highest (91–100%) versus the lowest (0–33%) YKL-40 percentile category were 1.31 (1.04–1.66) for AF, 1.43 (0.98–2.07) for IS, 1.07 (0.65–1.76) VTE, 0.88 (0.52–1.48) for MI, 1.66 (1.19–2.31) for HF, 1.66 (1.12–2.48) for PAD, and 2.18 (1.85–2.56) for all-cause, 1.64 (1.07–2.50) for cardiovascular, and 2.73 (2.05–3.63) for cancer mortality. Each 1 SD log increase in YKL-40 and CRP levels similarly increased CVE risks, with CRP being superior for MI and cardiovascular mortality.</div></div><div><h3>Conclusions</h3><div>YKL-40 is a prognostic biomarker for most CVEs, and even more so for all-cause mortality, primarily driven by cancer-related causes.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111970"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.diabres.2024.111959
Lixin Guo , Jing Wang , Li Li , Lin Yuan , Sheng Chen , Hui Wang , Tonghuan Li , Lin Qi , Hong Yang
Aim
DONATE (NCT03156985) is a large-scale real-world study investigating the safety of dapagliflozin in Chinese type 2 diabetes mellitus (T2DM) patients. This post-hoc analysis aims to further evaluate the real-world safety of dapagliflozin plus metformin.
Methods
Safety outcomes were assessed in patients receiving concomitant dapagliflozin and metformin, with or without other antidiabetics. The safety of dapagliflozin-based dual-therapies and dapagliflozin and metformin-based triple-therapies were also analysed.
Results
Among the 2,990 patients in DONATE, 2,165 (72.4%) received concomitant metformin. Among these 2,165 patients, 780 (36.0%) experienced ≥1 adverse event (AE), 129 (6.0%) experienced serious AE (SAE), and 96 (4.4%) experienced AE leading to dapagliflozin discontinuation. The most common AEs were upper respiratory tract infection (4.0%), urinary tract infection (UTI, 2.1%) and constipation (1.5%). The most common AEs of special interest of dapagliflozin were UTI (2.3%), genital tract infection (1.5%) and hypoglycaemia (1.1%). In the dapagliflozin and metformin dual-therapy subgroup, the incidences of AE, SAE and AE leading to dapagliflozin discontinuation were 26.7%, 2.5%, and 1.9%, respectively, numerically lower than that of the total population and most other dual-therapy subgroups. These patients also had numerically improved metabolic outcomes than baseline.
Conclusion
Dapagliflozin and metformin combination therapy is well-tolerated in real-world Chinese T2DM patients.
{"title":"Real-world safety of dapagliflozin plus metformin in patients of type 2 diabetes mellitus in China: Post-hoc analysis of the DONATE study","authors":"Lixin Guo , Jing Wang , Li Li , Lin Yuan , Sheng Chen , Hui Wang , Tonghuan Li , Lin Qi , Hong Yang","doi":"10.1016/j.diabres.2024.111959","DOIUrl":"10.1016/j.diabres.2024.111959","url":null,"abstract":"<div><h3>Aim</h3><div>DONATE (NCT03156985) is a large-scale real-world study investigating the safety of dapagliflozin in Chinese type 2 diabetes mellitus (T2DM) patients. This post-hoc analysis aims to further evaluate the real-world safety of dapagliflozin plus metformin.</div></div><div><h3>Methods</h3><div>Safety outcomes were assessed in patients receiving concomitant dapagliflozin and metformin, with or without other antidiabetics. The safety of dapagliflozin-based dual-therapies and dapagliflozin and metformin-based triple-therapies were also analysed.</div></div><div><h3>Results</h3><div>Among the 2,990 patients in DONATE, 2,165 (72.4%) received concomitant metformin. Among these 2,165 patients, 780 (36.0%) experienced ≥1 adverse event (AE), 129 (6.0%) experienced serious AE (SAE), and 96 (4.4%) experienced AE leading to dapagliflozin discontinuation. The most common AEs were upper respiratory tract infection (4.0%), urinary tract infection (UTI, 2.1%) and constipation (1.5%). The most common AEs of special interest of dapagliflozin were UTI (2.3%), genital tract infection (1.5%) and hypoglycaemia (1.1%). In the dapagliflozin and metformin dual-therapy subgroup, the incidences of AE, SAE and AE leading to dapagliflozin discontinuation were 26.7%, 2.5%, and 1.9%, respectively, numerically lower than that of the total population and most other dual-therapy subgroups. These patients also had numerically improved metabolic outcomes than baseline.</div></div><div><h3>Conclusion</h3><div>Dapagliflozin and metformin combination therapy is well-tolerated in real-world Chinese T2DM patients.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111959"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.diabres.2024.111941
Chiara Maria Assunta Cefalo , Alessia Riccio , Teresa Vanessa Fiorentino , Elena Succurro , Gaia Chiara Mannino , Maria Perticone , Angela Sciacqua , Francesco Andreozzi , Giorgio Sesti
Aims: The International Diabetes Federation (IDF) has recently recommended determination of 1-hour glucose during an oral glucose tolerance test (OGTT) to diagnose intermediate hyperglycemia (IH) and type 2 diabetes (T2D). Herein, we investigated the implications of IDF recommendation for characterizing the risk of cardiovascular target organ damage including left ventricular mass normalized by body surface area (LVM index [LVMI]), and myocardial mechano-energetic efficiency normalized by LVM (MEEi) in individuals with IH and T2D. Methods: LVMI, and MEEi were assessed in 1847 adults classified on the basis of fasting, 1-hour and 2- hour glucose during an OGTT according to the IDF recommendation as having normal glucose tolerance (NGT, n = 736), isolated impaired fasting glucose (iIFG, n = 105), IH (n = 676), and newly diagnosed T2D (n = 330). Results: As compared with NGT group, individuals with either IH or T2D exhibited significantly higher LVMI (97 ± 26, 109 ± 30, and 116 ± g/m2, P < 0.001, respectively), and a decrease in MEEi (0.42 ± 0.11, 0.37 ± 0.10, and 0.35 ± 0.11 ml/sec*g-1, P < 0.001, respectively). LVMI, and MEEi did not differ between NGT and iIFG groups. Conclusion: The thresholds of 1-hour post-load glucose proposed by IDF as diagnostic criteria for IH and T2D are capable of detecting individuals at risk of cardiovascular target organ damage.
目的：国际糖尿病联合会（IDF）最近推荐在口服葡萄糖耐量试验（OGTT）中检测1小时葡萄糖，以诊断中度高血糖症（IH）和2型糖尿病（T2D）。在此，我们研究了IDF推荐值对IH和T2D患者心血管靶器官损伤风险的影响，包括按体表面积归一化的左心室质量（LVM指数[LVMI]）和按LVM归一化的心肌机械能量效率（MEEi）。方法：根据IDF推荐的OGTT期间空腹、1小时和2小时血糖水平，对1847名成人进行LVMI和MEEi评估，分别为糖耐量正常（NGT, n = 736）、空腹血糖受损（iIFG, n = 105）、IH （n = 676）和新诊断的T2D （n = 330）。结果：与NGT组相比，IH和T2D组LVMI均显著升高（97 ± 26、109 ± 30和116 ± g/m2， P ）。结论：IDF提出的1小时负荷后血糖阈值作为IH和T2D的诊断标准，能够检测出有心血管靶器官损伤危险的个体。
{"title":"Differences in target organ damage in individuals with intermediate hyperglycemia and type 2 diabetes identified by 1-hour plasma glucose during an oral glucose tolerance test","authors":"Chiara Maria Assunta Cefalo , Alessia Riccio , Teresa Vanessa Fiorentino , Elena Succurro , Gaia Chiara Mannino , Maria Perticone , Angela Sciacqua , Francesco Andreozzi , Giorgio Sesti","doi":"10.1016/j.diabres.2024.111941","DOIUrl":"10.1016/j.diabres.2024.111941","url":null,"abstract":"<div><div><strong>Aims</strong>: The International Diabetes Federation (IDF) has recently recommended determination of 1-hour glucose during an oral glucose tolerance test (OGTT) to diagnose intermediate hyperglycemia (IH) and type 2 diabetes (T2D). Herein, we investigated the implications of IDF recommendation for characterizing the risk of cardiovascular target organ damage including left ventricular mass normalized by body surface area (LVM index [LVMI]), and myocardial mechano-energetic efficiency normalized by LVM (MEEi) in individuals with IH and T2D. <strong>Methods:</strong> LVMI, and MEEi were assessed in 1847 adults classified on the basis of fasting, 1-hour and 2- hour glucose during an OGTT according to the IDF recommendation as having normal glucose tolerance (NGT, n = 736), isolated impaired fasting glucose (iIFG, n = 105), IH (n = 676), and newly diagnosed T2D (n = 330). <strong>Results:</strong> As compared with NGT group, individuals with either IH or T2D exhibited significantly higher LVMI (97 ± 26, 109 ± 30, and 116 ± g/m2, P < 0.001, respectively), and a decrease in MEEi (0.42 ± 0.11, 0.37 ± 0.10, and 0.35 ± 0.11 ml/sec*g-1, P < 0.001, respectively). LVMI, and MEEi did not differ between NGT and iIFG groups. <strong>Conclusion:</strong> The thresholds of 1-hour post-load glucose proposed by IDF as diagnostic criteria for IH and T2D are capable of detecting individuals at risk of cardiovascular target organ damage.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111941"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.diabres.2024.111949
Gerardo Víquez-Molina , José María Rojas-Bonilla , Javier Aragón-Sánchez
This study suggests that conservative surgery may improve reulceration-free survival in patients with diabetes-related forefoot osteomyelitis, compared to minor amputation. By excluding patients with prior surgeries, the analysis more accurately reflects the benefits of conservative surgery. These findings highlight the importance of preserving foot structure to maintain biomechanics and reduce reulceration risk.
{"title":"Conservative surgery for forefoot osteomyelitis may increase reulceration-free survival compared to minor amputation in diabetes-related foot disease","authors":"Gerardo Víquez-Molina , José María Rojas-Bonilla , Javier Aragón-Sánchez","doi":"10.1016/j.diabres.2024.111949","DOIUrl":"10.1016/j.diabres.2024.111949","url":null,"abstract":"<div><div>This study suggests that conservative surgery may improve reulceration-free survival in patients with diabetes-related forefoot osteomyelitis, compared to minor amputation. By excluding patients with prior surgeries, the analysis more accurately reflects the benefits of conservative surgery. These findings highlight the importance of preserving foot structure to maintain biomechanics and reduce reulceration risk.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111949"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823990","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 : 2025-01-01DOI: 10.1016/j.diabres.2024.111943
Qiaosong Wang , Kun Zhang , Xueling Zhang , Jie Fu , Fangyi Liu , Yinge Gao , Rongjin Lin
Background
The mHealth has been increasing in pregnancy. However, the WeChat mini-program based gestational glucose management model for gestational diabetes mellitus (GDM) during pregnancy has not been established.
Methods
56 GDM pregnant women were selected. The control group received routine pregnancy health care, and the experimental group received WeChat mini-program GDM women’s blood glucose management model, Intervention from diagnosis of GDM to delivery. Two-hour postprandial glucose, self-management ability, maternal and infant outcomes, satisfaction and so on were collected, with an additional mHealth app usability questionnaire collected by the experimental group.
Results
The WeChat mini-program GDM women’s blood glucose management model reduced two-hour postprandial glucose, the birth weight of newborns and the incidence of other complications(P < 0.05). The model also improved self-management ability and blood glucose management satisfaction(P < 0.01). The mHealth app usability questionnaire score tends to be close to 1, which indicates that the WeChat mini-program has usability.
Conclusion
The WeChat mini-program blood glucose management model reduces two-hour postprandial glucose and improves the self-management ability, which verifies the feasibility and effectiveness of the blood glucose management model relying on the WeChat mini-program.
{"title":"WeChat mini-program, a preliminary applied study of the gestational blood glucose management model for pregnant women with gestational diabetes mellitus","authors":"Qiaosong Wang , Kun Zhang , Xueling Zhang , Jie Fu , Fangyi Liu , Yinge Gao , Rongjin Lin","doi":"10.1016/j.diabres.2024.111943","DOIUrl":"10.1016/j.diabres.2024.111943","url":null,"abstract":"<div><h3>Background</h3><div>The mHealth has been increasing in pregnancy. However, the WeChat mini-program based gestational glucose management model for gestational diabetes mellitus (GDM) during pregnancy has not been established.</div></div><div><h3>Methods</h3><div>56 GDM pregnant women were selected. The control group received routine pregnancy health care, and the experimental group received WeChat mini-program GDM women’s blood glucose management model, Intervention from diagnosis of GDM to delivery. Two-hour postprandial glucose, self-management ability, maternal and infant outcomes, satisfaction and so on were collected, with an additional mHealth app usability questionnaire collected by the experimental group.</div></div><div><h3>Results</h3><div>The WeChat mini-program GDM women’s blood glucose management model reduced two-hour postprandial glucose, the birth weight of newborns and the incidence of other complications(P < 0.05). The model also improved self-management ability and blood glucose management satisfaction(P < 0.01). The mHealth app usability questionnaire score tends to be close to 1, which indicates that the WeChat mini-program has usability.</div></div><div><h3>Conclusion</h3><div>The WeChat mini-program blood glucose management model reduces two-hour postprandial glucose and improves the self-management ability, which verifies the feasibility and effectiveness of the blood glucose management model relying on the WeChat mini-program.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111943"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767207","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 : 2025-01-01DOI: 10.1016/j.diabres.2024.111958
Peipei Wang , Yongqiang Fan , Haoyue Gao , Bei Wang
Background
There are limited population-based studies examining the correlation between body roundness index (BRI) and mortality in diabetes and prediabetes patients.
Method
Our final analysis encompassed 15,848 patients with diabetes and prediabetes sourced from the National Health and Nutrition Examination Survey(NHANES) spanning from 2003 to 2018. Cox proportional hazards model and restricted cubic splines (RCS) were utilized to assess the correlation between BRI and both all-cause mortality and cardiovascular mortality.
Results
During an average follow-up period of 92.9 months, 2655 participants (12.73 %) died, including 730 (3.44 %) from cardiovascular diseases. RCS demonstrated a U-shaped nonlinear association between BRI with all-cause mortality and cardiovascular mortality, with threshold values of 5.54 and 5.21, respectively. When BRI was below the threshold, a negative correlation was observed between BRI and all-cause mortality (HR 0.87, 95 % CI 0.81–0.93).The correlation with cardiovascular mortality is not significant. Conversely, when BRI was above the threshold, a positive correlation was observed between BRI with all-cause mortality (HR 1.10, 95 % CI 1.06–1.14) and cardiovascular mortality (HR 1.13, 95 % CI 1.07–1.20).
Conclusion
Our research indicates that among US adults with diabetes or prediabetes, BRI exhibits a U-shaped relationship with all-cause and cardiovascular mortality, with threshold values of 5.54 and 5.21, respectively.
背景：目前有有限的基于人群的研究，探讨了糖尿病和前驱糖尿病患者的身体圆度指数（BRI）与死亡率之间的相关性。方法：我们的最终分析包括来自2003年至2018年国家健康与营养检查调查（NHANES）的15848名糖尿病和前驱糖尿病患者。利用Cox比例风险模型和限制性三次样条（RCS）来评估BRI与全因死亡率和心血管死亡率之间的相关性。结果：在平均92.9 个月的随访期间，2655名参与者（12.73 %）死亡，其中730名（3.44 %）死于心血管疾病。RCS显示BRI与全因死亡率和心血管死亡率呈u型非线性相关，阈值分别为5.54和5.21。当BRI低于阈值时，BRI与全因死亡率呈负相关（HR 0.87, 95 % CI 0.81-0.93）。与心血管疾病死亡率的相关性不显著。相反，当BRI高于阈值时，BRI与全因死亡率（HR 1.10, 95 % CI 1.06-1.14）和心血管死亡率（HR 1.13, 95 % CI 1.07-1.20）呈正相关。结论：我们的研究表明，在患有糖尿病或前驱糖尿病的美国成年人中，BRI与全因死亡率和心血管死亡率呈u型关系，阈值分别为5.54和5.21。
{"title":"Body roundness index as a predictor of all-cause and cardiovascular mortality in patients with diabetes and prediabetes","authors":"Peipei Wang , Yongqiang Fan , Haoyue Gao , Bei Wang","doi":"10.1016/j.diabres.2024.111958","DOIUrl":"10.1016/j.diabres.2024.111958","url":null,"abstract":"<div><h3>Background</h3><div>There are limited population-based studies examining the correlation between body roundness index (BRI) and mortality in diabetes and prediabetes patients.</div></div><div><h3>Method</h3><div>Our final analysis encompassed 15,848 patients with diabetes and prediabetes sourced from the National Health and Nutrition Examination Survey(NHANES) spanning from 2003 to 2018. Cox proportional hazards model and restricted cubic splines (RCS) were utilized to assess the correlation between BRI and both all-cause mortality and cardiovascular mortality.</div></div><div><h3>Results</h3><div>During an average follow-up period of 92.9 months, 2655 participants (12.73 %) died, including 730 (3.44 %) from cardiovascular diseases. RCS demonstrated a U-shaped nonlinear association between BRI with all-cause mortality and cardiovascular mortality, with threshold values of 5.54 and 5.21, respectively. When BRI was below the threshold, a negative correlation was observed between BRI and all-cause mortality (HR 0.87, 95 % CI 0.81–0.93).The correlation with cardiovascular mortality is not significant. Conversely, when BRI was above the threshold, a positive correlation was observed between BRI with all-cause mortality (HR 1.10, 95 % CI 1.06–1.14) and cardiovascular mortality (HR 1.13, 95 % CI 1.07–1.20).</div></div><div><h3>Conclusion</h3><div>Our research indicates that among US adults with diabetes or prediabetes, BRI exhibits a U-shaped relationship with all-cause and cardiovascular mortality, with threshold values of 5.54 and 5.21, respectively.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111958"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827919","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 : 2025-01-01DOI: 10.1016/j.diabres.2024.111940
Alessandra T. Ayers , Cindy N. Ho , Sufyan Hussain , David C. Klonoff
{"title":"Comparison of the glycemia risk index and time in range in a case series of using automated insulin delivery to improve glycemic control in people with type 1 diabetes and end stage kidney disease on hemodialysis","authors":"Alessandra T. Ayers , Cindy N. Ho , Sufyan Hussain , David C. Klonoff","doi":"10.1016/j.diabres.2024.111940","DOIUrl":"10.1016/j.diabres.2024.111940","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111940"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767164","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 : 2025-01-01DOI: 10.1016/j.diabres.2024.111946
Xue Bai , Lei Zhang , Xiaoxiao Ji , Kening Chen , Xueshi Di , Fangjieyi Zheng , Peng Bai , Wenquan Niu
We aimed to explore the impact of weight change from young to middle adulthood on incident cardiovascular disease (CVD) and all-cause mortality in US diabetic adults. All study subjects aged 40–79 years were from the US National Health and Nutrition Examination Survey (NHANES) 1988–2018, and they were non-pregnant and had complete data on self-reported weight at age 25 and 10 years before baseline enrollment over average 29.4 years. CVD events occurring from 10 years ago to baseline enrollment were recorded. Relative to stable non-obesity group, the strongest association was noted for the weight-losing group, followed by the stable-obesity group and weight-gaining group over following 10 years. Referring to the stable-obesity group identified significance for the stable non-obesity group. If total population had maintained non-obese from young to middle adulthood, 12 % of CVD cases could have been averted. Relative to the stable non-obesity group, subjects who maintained obese between young and middle adulthood had an increased risk of all-cause mortality. Our findings indicated that the risk for incident CVD and all-cause mortality was potentially reinforced in diabetic adults who were obese at age 25 but non-obese at midlife and who remained stable obese vis-à-vis those with stable non-obesity.
{"title":"Long-term weight change, incident cardiovascular disease and all-cause mortality among diabetic adults","authors":"Xue Bai , Lei Zhang , Xiaoxiao Ji , Kening Chen , Xueshi Di , Fangjieyi Zheng , Peng Bai , Wenquan Niu","doi":"10.1016/j.diabres.2024.111946","DOIUrl":"10.1016/j.diabres.2024.111946","url":null,"abstract":"<div><div>We aimed to explore the impact of weight change from young to middle adulthood on incident cardiovascular disease (CVD) and all-cause mortality in US diabetic adults. All study subjects aged 40–79 years were from the US National Health and Nutrition Examination Survey (NHANES) 1988–2018, and they were non-pregnant and had complete data on self-reported weight at age 25 and 10 years before baseline enrollment over average 29.4 years. CVD events occurring from 10 years ago to baseline enrollment were recorded. Relative to stable non-obesity group, the strongest association was noted for the weight-losing group, followed by the stable-obesity group and weight-gaining group over following 10 years. Referring to the stable-obesity group identified significance for the stable non-obesity group. If total population had maintained non-obese from young to middle adulthood, 12 % of CVD cases could have been averted. Relative to the stable non-obesity group, subjects who maintained obese between young and middle adulthood had an increased risk of all-cause mortality. Our findings indicated that the risk for incident CVD and all-cause mortality was potentially reinforced in diabetic adults who were obese at age 25 but non-obese at midlife and who remained stable obese <em>vis-à-vis</em> those with stable non-obesity.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111946"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779367","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 : 2025-01-01DOI: 10.1016/j.diabres.2024.111961
Juliana N.M. Lui , Eric S.H. Lau , Abby Q.Y. Li , Yuzheng Zhang , Lee-Ling Lim , Chun-KwunO , Kelly T.C. Wong , Aimin Yang , Hongjiang Wu , Ronald C.W. Ma , Alice P.S. Kong , Risa Ozaki , Andrea O.Y. Luk , Elaine Y.K. Chow , Juliana C.N. Chan
Objective
We examined incremental healthcare costs (inpatient and outpatient) related to complications in Chinese patients with type 2 diabetes (T2D) during the year of occurrence and post-event years, utilizing the Joint Asia Diabetes Evaluation (JADE) Register cohort of Hong Kong Chinese patients with T2D between 2007 and 2019.
Research Design and Methods
19,440 patients with T2D underwent structured evaluation utilizing the JADE platform with clinical outcomes data retrieved from territory-wide electronic medical records including inpatient, outpatient and emergency care. Two-part model was adopted to account for skewed healthcare costs distribution. Incremental healthcare costs associated with nine non-fatal diabetes complications and all-cause death were estimated, adjusted for demographic, clinical, lifestyle factors and comorbidities.
Results
In this prospective cohort [mean ± SD age:59.9 ± 11.9 years, 56.6 % men, duration of diabetes:7.3 ± 7.5 years, HbA1C:7.5 ± 1.6 %] observed for 7 (interquartile range:4–9) years (142,132 patient-years), the mean annual healthcare costs, mainly due to inpatient cost, were USD$2,990 ± 9,960. Lower extremity amputation (LEA) (USD$31,302; 95 %CI: 25,706–37,004), hemorrhagic stroke (USD$21,164; 17,680–24,626), ischemic stroke (USD$17,976; $15,937–20,352) and end-stage disease (ESRD) (USD$14,774; 13,405–16,250) in the year of event incurred the highest cost. Residual healthcare costs in the post-event years were highest for ESRD, LEA, haemorrhagic stroke and incident cancer.
Conclusion
These comprehensive temporal healthcare cost estimates for diabetes-related complications allows the performance of long-term, patient-level, cost-effectiveness analyses on T2D prevention and treatment strategies relevant to an Asian and possibly global contexts. These may inform decision-makers on resource allocation aimed at reducing the burden of T2D and chronic diseases.
{"title":"Temporal incremental healthcare costs associated with complications in Hong Kong Chinese patients with type 2 diabetes: A prospective study in Joint Asia diabetes evaluation (JADE) Register (2007–2019)","authors":"Juliana N.M. Lui , Eric S.H. Lau , Abby Q.Y. Li , Yuzheng Zhang , Lee-Ling Lim , Chun-KwunO , Kelly T.C. Wong , Aimin Yang , Hongjiang Wu , Ronald C.W. Ma , Alice P.S. Kong , Risa Ozaki , Andrea O.Y. Luk , Elaine Y.K. Chow , Juliana C.N. Chan","doi":"10.1016/j.diabres.2024.111961","DOIUrl":"10.1016/j.diabres.2024.111961","url":null,"abstract":"<div><h3>Objective</h3><div>We examined incremental healthcare costs (inpatient and outpatient) related to complications in Chinese patients with type 2 diabetes (T2D) during the year of occurrence and post-event years, utilizing the Joint Asia Diabetes Evaluation (JADE) Register cohort of Hong Kong Chinese patients with T2D between 2007 and 2019.</div></div><div><h3>Research Design and Methods</h3><div>19,440 patients with T2D underwent structured evaluation utilizing the JADE platform with clinical outcomes data retrieved from territory-wide electronic medical records including inpatient, outpatient and emergency care. Two-part model was adopted to account for skewed healthcare costs distribution. Incremental healthcare costs associated with nine non-fatal diabetes complications and all-cause death were estimated, adjusted for demographic, clinical, lifestyle factors and comorbidities.</div></div><div><h3>Results</h3><div>In this prospective cohort [mean ± SD age:59.9 ± 11.9 years, 56.6 % men, duration of diabetes:7.3 ± 7.5 years, HbA1C:7.5 ± 1.6 %] observed for 7 (interquartile range:4–9) years (142,132 patient-years), the mean annual healthcare costs, mainly due to inpatient cost, were USD$2,990 ± 9,960. Lower extremity amputation (LEA) (USD$31,302; 95 %CI: 25,706–37,004), hemorrhagic stroke (USD$21,164; 17,680–24,626), ischemic stroke (USD$17,976; $15,937–20,352) and end-stage disease (ESRD) (USD$14,774; 13,405–16,250) in the year of event incurred the highest cost. Residual healthcare costs in the post-event years were highest for ESRD, LEA, haemorrhagic stroke and incident cancer.</div></div><div><h3>Conclusion</h3><div>These comprehensive temporal healthcare cost estimates for diabetes-related complications allows the performance of long-term, patient-level, cost-effectiveness analyses on T2D prevention and treatment strategies relevant to an Asian and possibly global contexts. These may inform decision-makers on resource allocation aimed at reducing the burden of T2D and chronic diseases.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"219 ","pages":"Article 111961"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863664","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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