Pub Date : 2026-02-01Epub 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":"2026-02-01","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}
Early detection of impaired glucose tolerance (IGT) is critical for preventing overt diabetes and cardiovascular disease. Few studies have evaluated the predictors of the transition from normal glucose tolerance (NGT) to glucose intolerance (GI; IGT or type 2 diabetes, and/or impaired fasting glucose). We conducted a 5-year prospective study of individuals with NGT to evaluate the predictors of GI development.
Methods
A 75-g oral glucose tolerance test was performed to diagnose GI. We enrolled 1,008 Japanese individuals with NGT who completed a 5-year follow-up. Using logistic regression analyses, we explored the predictive factors for GI development and assessed the single-nucleotide polymorphisms of type 2 diabetes susceptibility.
Results
We identified the 1-h plasma glucose (1-h PG) level and age interaction as predictors of GI development. In the stratified analysis, the sex-and body mass index-adjusted odds ratios for GI development in individuals with 1-h PG ≥ 8.3 mmol/L and age ≥ 57 years was 12.9 (95 % CI: 5.7–29.2) compared to the reference. Genetic risk was associated with the aggravation of 1-h PG levels.
Conclusions
The combination of 1-h PG and age serves as a potential predictor of GI development in individuals with NGT.
{"title":"Simultaneous assessment of one-hour plasma glucose levels and age as a potential predictor of glucose intolerance development in individuals with normal glucose tolerance","authors":"Misaki Takakado , Yasuharu Tabara , Shota Inoue , Toshimi Hadate , Ryoichi Kawamura , Koutatsu Maruyama , Isao Saito , Jun Ohashi , Haruhiko Osawa , Yasunori Takata","doi":"10.1016/j.diabres.2025.113079","DOIUrl":"10.1016/j.diabres.2025.113079","url":null,"abstract":"<div><h3>Aims</h3><div>Early detection of impaired glucose tolerance (IGT) is critical for preventing overt diabetes and cardiovascular disease. Few studies have evaluated the predictors of the transition from normal glucose tolerance (NGT) to glucose intolerance (GI; IGT or type 2 diabetes, and/or impaired fasting glucose). We conducted a 5-year prospective study of individuals with NGT to evaluate the predictors of GI development.</div></div><div><h3>Methods</h3><div>A 75-g oral glucose tolerance test was performed to diagnose GI. We enrolled 1,008 Japanese individuals with NGT who completed a 5-year follow-up. Using logistic regression analyses, we explored the predictive factors for GI development and assessed the single-nucleotide polymorphisms of type 2 diabetes susceptibility.</div></div><div><h3>Results</h3><div>We identified the 1-h plasma glucose (1-h PG) level and age interaction as predictors of GI development. In the stratified analysis, the sex-and body mass index-adjusted odds ratios for GI development in individuals with 1-h PG ≥ 8.3 mmol/L and age ≥ 57 years was 12.9 (95 % CI: 5.7–29.2) compared to the reference. Genetic risk was associated with the aggravation of 1-h PG levels.</div></div><div><h3>Conclusions</h3><div>The combination of 1-h PG and age serves as a potential predictor of GI development in individuals with NGT.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113079"},"PeriodicalIF":7.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892256","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":"2026-02-01","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub Date: 2025-12-22DOI: 10.1016/j.diabres.2025.113065
Carolina Martinez-Mateu , Regina Duperval , Olga Kaminska-Jackowiak , Dalia Al-Abdulrazzaq , Suzanne Sap , Sunil Gupta , Marija Požgaj Šepec , Catherine Sanon , Rasha Thabet , Silvia Muñoz , Reinhard W. Holl , Danièle Pacaud , on behalf of the SWEET Study Group
Significant disparities in pediatric type 1 diabetes (T1D) care and outcomes exist globally.
Aim
To examine the relationship between national gross domestic product (GDP), diabetes care, and T1D outcomes.
Methods
Cross-sectional analysis of individuals < 25 years with T1D > 3 months from SWEET registry centers (2022–2023). Centers were grouped into GDP quartiles. Outcomes included technology use, screening rates, HbA1c, BMI SDS, diabetic ketoacidosis (DKA), and severe hypoglycemia. Multivariable regression adjusted for age, sex, and diabetes duration.
Results
Data from 54,285 individuals across 130 centers were analyzed. Technology use and BMI SDS increased with GDP. Insulin pump use ranged 17.4–70.2 %; CGM 36.2–91.5 %; AID 11.2–38.2 %; and rapid-acting analogs 56.9–78.2 %. BMI SDS ranged from + 0.04 (lowest GDP) to + 0.89 (highest). HbA1c showed a non-linear pattern: 8.74 % (lowest), 7.50 % (lower-middle), 7.66 % (higher-middle), 8.18 % (highest). Severe hypoglycemia ranged from 9.6 to 1.3 events/100 PY, while DKA ranged from 0.90 (lower-middle) to 3.10 events/100 PY (highest). Screening rates for comorbidities peaked in middle GDP quartiles.
Conclusions
GDP is significantly, but not linearly, associated with technology use and metabolic outcomes in pediatric T1D. Middle GDP countries achieved the best metabolic control, underscoring the need for equitable resource allocation.
{"title":"Comparison of demographics and treatment outcome in children with type 1 diabetes related to the economic background of their country of residence: observations from the SWEET database","authors":"Carolina Martinez-Mateu , Regina Duperval , Olga Kaminska-Jackowiak , Dalia Al-Abdulrazzaq , Suzanne Sap , Sunil Gupta , Marija Požgaj Šepec , Catherine Sanon , Rasha Thabet , Silvia Muñoz , Reinhard W. Holl , Danièle Pacaud , on behalf of the SWEET Study Group","doi":"10.1016/j.diabres.2025.113065","DOIUrl":"10.1016/j.diabres.2025.113065","url":null,"abstract":"<div><div>Significant disparities in pediatric type 1 diabetes (T1D) care and outcomes exist globally.</div></div><div><h3>Aim</h3><div>To examine the relationship between national gross domestic product (GDP), diabetes care, and T1D outcomes.</div></div><div><h3>Methods</h3><div>Cross-sectional analysis of individuals < 25 years with T1D > 3 months from SWEET registry centers (2022–2023). Centers were grouped into GDP quartiles. Outcomes included technology use, screening rates, HbA1c, BMI SDS, diabetic ketoacidosis (DKA), and severe hypoglycemia. Multivariable regression adjusted for age, sex, and diabetes duration.</div></div><div><h3>Results</h3><div>Data from 54,285 individuals across 130 centers were analyzed. Technology use and BMI SDS increased with GDP. Insulin pump use ranged 17.4–70.2 %; CGM 36.2–91.5 %; AID 11.2–38.2 %; and rapid-acting analogs 56.9–78.2 %. BMI SDS ranged from + 0.04 (lowest GDP) to + 0.89 (highest). HbA1c showed a non-linear pattern: 8.74 % (lowest), 7.50 % (lower-middle), 7.66 % (higher-middle), 8.18 % (highest). Severe hypoglycemia ranged from 9.6 to 1.3 events/100 PY, while DKA ranged from 0.90 (lower-middle) to 3.10 events/100 PY (highest). Screening rates for comorbidities peaked in middle GDP quartiles.</div></div><div><h3>Conclusions</h3><div>GDP is significantly, but not linearly, associated with technology use and metabolic outcomes in pediatric T1D. Middle GDP countries achieved the best metabolic control, underscoring the need for equitable resource allocation.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"232 ","pages":"Article 113065"},"PeriodicalIF":7.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827125","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub 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":"2026-02-01","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号