Diabetes research and clinical practice最新文献_第8页

Diabetes in the Western Pacific: Unravelling complexities, forging solutions

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112011

引用次数: 0

Incidence trends in ischaemic and non-ischaemic heart failure in people with and without type 2 diabetes, 2000–2019: An observational study in England 2000-2019年2型糖尿病患者和非2型糖尿病患者缺血性和非缺血性心力衰竭发病率趋势：英国的一项观察性研究

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2024.111980

Kajal Panchal , Claire Lawson , Sharmin Shabnam , Kamlesh Khunti , Francesco Zaccardi

Aim

To investigate trends in ischaemic and non-ischaemic heart failure (HF) in adults with type 2 diabetes and without diabetes between 1st January 2000 and 31st December 2019 in England.

Methods

We used the Clinical Practice Research Datalink datasets, linked to the Hospital Episode Statistics and Office for National Statistics, to estimate sex-specific crude and age-standardised rates of incident ischaemic and non-ischaemic HF up to 10 years per calendar year of diabetes diagnosis and diabetes status.

Results

In a cohort of 735,810 individuals, 5,073 ischaemic (2,038 in people with type 2 diabetes and 3,035 in those without) and 16,501 non-ischaemic (6,358 and 10,143, respectively) HF events were recorded during a median follow-up of 10 years. From 2000 to 2004 to 2005–2009, the age-standardised rates of ischaemic HF marginally declined, while rates remained stable for non-ischaemic HF and were consistently higher for non-ischaemic than ischaemic HF, regardless of diabetes status or sex. Adjusted incidence rate ratios demonstrated negligible impact on trends after accounting for differences in demographics, comorbidities and medications.

Conclusions

Improving HF prevention and management strategies remains crucial to decrease the risk of HF in the general population and reduce the persistent risk-gap associated with type 2 diabetes in England.

目的：调查2000年1月1日至2019年12月31日期间英国2型糖尿病和非糖尿病成人缺血性和非缺血性心力衰竭（HF）的趋势。方法：我们使用临床实践研究数据链数据集，与医院发作统计和国家统计办公室相关联，估计每日历年10 年的缺血性和非缺血性心力衰竭发生率。结果：在735,810人的队列中，在中位随访10 年期间，记录了5,073例缺血性HF事件（2型糖尿病患者2,038例，无2型糖尿病患者3,035例）和16,501例非缺血性HF事件（分别为6,358例和10,143例）。从2000年到2004年到2005-2009年，缺血性HF的年龄标准化率略有下降，而非缺血性HF的发病率保持稳定，并且与糖尿病状态或性别无关，非缺血性HF的发病率始终高于缺血性HF。在考虑了人口统计学、合并症和药物方面的差异后，调整后的发病率比对趋势的影响可以忽略不计。结论：在英国，改善心衰预防和管理策略对于降低普通人群心衰风险和减少与2型糖尿病相关的持续风险差距至关重要。

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引用次数: 0

Bidirectional interplay of sleep apnea syndrome and cardio-vascular disorders in diabetes 糖尿病患者睡眠呼吸暂停综合征与心血管疾病的双向相互作用。

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2024.111984

Paul Valensi , Karima Benmohammed , Mohamed Zerguine

Although often overlooked sleep apnea has emerged as a significant public health concern. Obstructive sleep apnea (OSA) and diabetes commonly co-exist with a vicious cycle worsening the incidence and severity of both conditions. OSA has many implications including cardiometabolic disorders and impaired cardiovascular (CV) prognosis. OSA combined with diabetes generates a cumulative effect on CV outcomes. The association of OSA with several comorbidities including CV disease and heart failure is bi-directional meaning that some of them are likely to contribute to OSA. In patients with diabetes, OSA treatment should be integrated in a holistic strategy of prevention of CV and microvascular complications. This article provides some clues to advance the understanding of the interplay between OSA and CV disorders in diabetes and to consider the role of some CV risk markers like cardiac autonomic neuropathy and artery stiffness and of novel metrics for hypoxic-related events in CV risk stratification, and offers a discussion on the effects of medical approaches including weight loss strategies, GLP1-receptor agonists and sodium–glucose cotransporter 2 inhibitors. It provides a guidance to improve screening and diagnosis of OSA, and adherence to OSA treatment in patients with diabetes.

虽然经常被忽视的睡眠呼吸暂停已经成为一个重要的公共卫生问题。阻塞性睡眠呼吸暂停（OSA）和糖尿病通常共存，恶性循环加剧了这两种疾病的发病率和严重程度。OSA具有许多意义，包括心脏代谢紊乱和心血管预后受损。OSA合并糖尿病会对心血管结果产生累积效应。OSA与包括心血管疾病和心力衰竭在内的几种合并症的关联是双向的，这意味着其中一些合并症可能导致OSA。对于糖尿病患者，OSA治疗应纳入预防心血管和微血管并发症的整体策略。本文提供了一些线索，以促进对糖尿病患者OSA和心血管疾病之间相互作用的理解，并考虑一些心血管风险标志物（如心脏自主神经病变和动脉僵硬）和缺氧相关事件的新指标在心血管风险分层中的作用，并讨论了包括减肥策略、glp1受体激动剂和钠-葡萄糖共转运蛋白2抑制剂在内的医学方法的影响。为提高糖尿病患者OSA的筛查和诊断以及OSA治疗的依从性提供指导。

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引用次数: 0

Knowledge, attitudes, and practices of elderly diabetes patients regarding home emergency management of acute complications 老年糖尿病患者关于急性并发症家庭急救管理的知识、态度和实践。

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112000

Li Wang, Runzhi Wen, Gaizhen Zhang, Naiqian Zhao

Aims

This study aims to assess the knowledge, attitudes, and practices (KAP) of elderly diabetic patients regarding the home emergency management of acute diabetic complications, which is critical for preventing severe outcomes and ensuring timely intervention in emergencies.

Methods

This cross-sectional study was conducted between September and October 2024 at the Second Hospital of Shanxi Medical University, among all elderly diabetic patients who voluntarily participated. Demographic information and KAP scores were evaluated.

Results

A total of 409 valid questionnaires were analyzed, yielding an effective rate of 98.32 %. Among the participants, 218 (53.3 %) were female, and 134 (32.76 %) had been diagnosed with diabetes for less than 1 year. The mean scores for KAP were 12.98 ± 6.65 (possible range: 0–28), 45.76 ± 6.30 (possible range: 11–55), and 51.74 ± 8.24 (possible range: 13–65), respectively. Structural equation modeling (SEM) revealed that education level, diabetes health education, and main treatment method significantly influenced knowledge. Additionally, knowledge and complicating diseases impacted attitude, while both knowledge and attitude strongly influenced practice. Education level, diabetes health education, and main treatment method also indirectly affected attitude and practice.

Conclusion

Elderly diabetic patients demonstrated inadequate knowledge but exhibited generally positive attitudes and practices regarding the home emergency management of acute diabetic complications.

目的：本研究旨在评估老年糖尿病患者对急性糖尿病并发症家庭急救管理的知识、态度和实践（KAP），这对于预防严重后果和确保紧急情况的及时干预至关重要。方法：本横断面研究于2024年9 - 10月在山西医科大学第二医院进行，研究对象为自愿参加的老年糖尿病患者。评估人口统计信息和KAP评分。结果：共分析有效问卷409份，有效率为98.32%。在参与者中，218名（53.3%）是女性，134名（32.76%）被诊断患有糖尿病少于1年。KAP平均评分分别为12.98±6.65（可能范围0 ~ 28）、45.76±6.30（可能范围11 ~ 55）、51.74±8.24（可能范围13 ~ 65）。结构方程模型（SEM）显示，教育程度、糖尿病健康教育和主要治疗方法对知识有显著影响。此外，知识和并发症影响态度，而知识和态度都强烈影响实践。教育程度、糖尿病健康教育、主要治疗方法也间接影响态度和行为。结论：老年糖尿病患者对急性糖尿病并发症的家庭急救认识不足，但总体上表现出积极的态度和做法。

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引用次数: 0

Evolution of myocardial steatosis in high cardiovascular risk T2DM patients treated by GLP1 receptor agonists: LICAS study

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112017

Lina Houbachi , Paul Michael Walker , Isabelle Fournel , Elea Ksiazek , Jean-Michel Petit , Alexandre Cochet , Thibault Leclercq , Antoine Roger , Isabelle Simoneau , Benjamin Bouillet , Charles Guenancia

Background

We hypothesized that the reduction of intramyocardial fat content may be involved in the cardioprotective effect of glucagon-like peptide-1 receptor agonists (GLP1-RA) in patients with type 2 diabetes (T2D). Therefore, we aimed to evaluate the change in intramyocardial triglyceride content in T2D patients treated with GLP1-RA.

Methods

This monocentric proof-of-concept cohort study included patients with unbalanced T2D prior to the introduction of GLP1-RA. Patients underwent cardiac magnetic resonance imaging (MRI) coupled with nuclear magnetic resonance (NMR) spectroscopy at baseline and six months after the introduction (M6) of a GLP1-RA to assess changes in intramyocardial triglyceride levels and morphological, functional, and cardiac tissue parameters. The relative delta (Δ_r) between baseline and M6 was calculated and analyzed by Student test or sign test.

Results

Twenty-six patients (mean age = 62.2 ± 6.7 years, median HbA1c = 9.1 %) fulfilled inclusion criteria and had both NMR measures. Compared with baseline, relative intramyocardial triglyceride levels significantly decreased after six months of treatment (mean Δ_r = -26 % [95 %CI:-39; −13]p = 0.003), as well as glycated hemoglobin (HbA1c) (median Δ_r = -26 % [IQR:25], p < 0.0001), body mass index (BMI) (mean Δ_r = -6% [-9; −4], p < 0.0001) and left ventricular mass (mean Δ_r = -6 [-12; −1] p = 0.02). The relative evolution of intramyocardial triglyceride content was not correlated with the relative evolution of HbA1c (r = 0.10) and BMI (r = -0.02).

Conclusions

We demonstrate a significant reduction in intramyocardial triglyceride content in patients with T2D after six months of treatment with GLP1-RA. The lack of correlation with reductions in HbA1c and BMI suggests a specific effect of GLP1-RA on myocardial steatosis, which might contribute to their previously demonstrated cardiovascular benefits.

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引用次数: 0

Maternal vascular dysfunction in gestational diabetes is associated with birth of small neonates

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112032

Christos Chatzakis , Sarah Lausegger , Erika Sembrera , Sofia Vargas , Kypros H Nicolaides , Marietta Charakida

Aims

The study aimed to evaluate maternal hemodynamic and vascular changes in women with small-for-gestational age(SGA) and large-for-gestational age(LGA) fetuses in the presence and absence of gestational diabetes mellitus(GDM).

Materials

Women at 35⁺⁰ to 36⁺⁶ weeks’ gestation with and without GDM were included. Maternal demographics, ultrasound for fetal growth, Doppler studies of uterine and ophthalmic arteries, carotid–femoral pulse-wave velocity(PWV), augmentation index, cardiac output, and total peripheral resistance(TPR) were recorded. Multinomial logistic regression was used.

Results

Of 11,132 women, 1,228(11.0%) developed GDM. In GDM pregnancies, 158(12.8%) delivered SGA and 136(11.1%) delivered LGA neonates, while non-GDM pregnancies had 1,051(10.6%) SGA and 806(8.1%) LGA neonates. In GDM and non-GDM women, SGA groups had the highest uterine artery pulsatility index(PI) percentiles, PWV and ophthalmic artery peak systolic velocity ratio. PWV was higher in the GDM SGA group compared to non-GDM SGA group. Cardiac output was lower in SGA groups when compared to the AGA group. In women with GDM, TPR, ophthalmic artery PSV ratio and uterine artery PI percentile had a positive association with the development of SGA.

Conclusions

Women with GDM and vascular dysfunction have higher risk to deliver SGA neonates. Maternal hemodynamic and vascular maladaptation could potentially explain the development of SGA in women with GDM.

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引用次数: 0

Physical activity guidelines for adults with type 2 Diabetes: Systematic review 成人2型糖尿病患者的身体活动指南：系统综述

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2024.111982

Eda Tonga , Hannah Worboys , Rachael A. Evans , Sally J. Singh , Melanie J. Davies , G. Andre Ng , Thomas Yates

Aims

The aim of this study was to systematically review recommendations on physical activity for adults with type 2 diabetes (T2D).

Methods

Online databases were searched for clinical practice guidelines (CPGs), statements, and recommendations. Two authors screened the guidelines based on eligibility criteria. FITT (Frequency, Intensity, Time, Type) for physical activity and disease-specific precautions were extracted independently. The methodological quality of CPGs was assessed using the AGREE II instrument. Recommendations were categorized according to FITT, with disease-specific adaptations also recorded.

Results

Fifteen guidelines were included. Nine underwent AGREE II evaluation, with three rated high quality and the rest moderate to low. The predominant recommendation was to engage in at least 150 min of moderate aerobic exercise per week. Adaptations for T2D focused on glucose levels, diet, foot care, weather conditions, sedentary behaviour, neuropathy, and retinopathy.

Conclusion

While guidelines consistently recommended aerobic exercise, there was limited emphasis on strength and flexibility exercises. Significant limitations in methodological and reporting quality were noted, especially in stakeholder involvement and applicability. Future guidelines should use a standardized FITT framework and adhere to standard development methods to enhance usability for healthcare professionals and patients.

目的：本研究的目的是系统地回顾2型糖尿病（T2D）成人的身体活动建议。方法：检索在线数据库中的临床实践指南（CPG）、声明和建议。两位作者根据资格标准对指南进行了筛选。独立提取体力活动和疾病特异性预防措施的FITT（频率、强度、时间、类型）。CPGs的方法学质量使用AGREE II仪器进行评估。根据FITT对建议进行了分类，并记录了针对特定疾病的适应情况。结果：纳入了15条指南。9例进行了AGREE II评估，其中3例为高质量，其余为中低质量。最主要的建议是每周至少150 分钟的适度有氧运动。T2D的适应主要集中在血糖水平、饮食、足部护理、天气条件、久坐行为、神经病变和视网膜病变。结论：虽然指南一直推荐有氧运动，但对力量和柔韧性锻炼的重视程度有限。注意到在方法和报告质量方面的重大限制，特别是在利益相关者参与和适用性方面。未来的指南应使用标准化的FITT框架，并遵循标准的开发方法，以增强医疗保健专业人员和患者的可用性。

{"title":"Physical activity guidelines for adults with type 2 Diabetes: Systematic review","authors":"Eda Tonga , Hannah Worboys , Rachael A. Evans , Sally J. Singh , Melanie J. Davies , G. Andre Ng , Thomas Yates","doi":"10.1016/j.diabres.2024.111982","DOIUrl":"10.1016/j.diabres.2024.111982","url":null,"abstract":"<div><h3>Aims</h3><div>The aim of this study was to systematically review recommendations on physical activity for adults with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>Online databases were searched for clinical practice guidelines (CPGs), statements, and recommendations. Two authors screened the guidelines based on eligibility criteria. FITT (Frequency, Intensity, Time, Type) for physical activity and disease-specific precautions were extracted independently. The methodological quality of CPGs was assessed using the AGREE II instrument. Recommendations were categorized according to FITT, with disease-specific adaptations also recorded.</div></div><div><h3>Results</h3><div>Fifteen guidelines were included. Nine underwent AGREE II evaluation, with three rated high quality and the rest moderate to low. The predominant recommendation was to engage in at least 150 min of moderate aerobic exercise per week. Adaptations for T2D focused on glucose levels, diet, foot care, weather conditions, sedentary behaviour, neuropathy, and retinopathy.</div></div><div><h3>Conclusion</h3><div>While guidelines consistently recommended aerobic exercise, there was limited emphasis on strength and flexibility exercises. Significant limitations in methodological and reporting quality were noted, especially in stakeholder involvement and applicability. Future guidelines should use a standardized FITT framework and adhere to standard development methods to enhance usability for healthcare professionals and patients.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"220 ","pages":"Article 111982"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921261","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}

引用次数: 0

Burden of vascular risk factors by age, sex, ethnicity and deprivation in young adults with and without newly diagnosed type 2 diabetes 在有和没有新诊断的2型糖尿病的年轻人中，按年龄、性别、种族和剥夺程度划分的血管危险因素负担

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112002

Jonathan Goldney , Mary M. Barker , Jack A. Sargeant , Enya Daynes , Dimitris Papamargaritis , Sharmin Shabnam , Louise M. Goff , Kamlesh Khunti , Joseph Henson , Melanie J. Davies , Francesco Zaccardi

Aims

Do associations between age at diagnosis of type 2 diabetes and vascular risk factors vary by ethnicity and deprivation?

Methods

Utilising the Clinical Practice Research Datalink, we matched 16–50-year-old individuals with newly diagnosed type 2 diabetes to ∼10 individuals without using sex, age and primary care practice. Differences in BMI, obesity, LDL-cholesterol, HbA1c, and hypertension between individuals with vs without type 2 diabetes across sex, age, ethnicity and deprivation quintiles were explored using generalised linear models.

Results

We included 108,061 individuals (45.6% women) with newly diagnosed type 2 diabetes and 829,946 controls. BMI, obesity, LDL-cholesterol, and hypertension were higher in individuals with vs without type 2 diabetes. Across both sexes, all ethnic groups and deprivation quintiles, these differences were larger with an earlier age, particularly for BMI and obesity. Association between age and HbA1c were variable across subgroups. Differences in BMI, obesity, and hypertension (individuals with vs without diabetes) were largest in White individuals and with less deprivation.

Conclusions

The increased vascular risk phenotype associated with an earlier age of diagnosis of type 2 diabetes was consistent across ethnic and deprivation groups. Population-based strategies are needed to address the risk associated with early-onset type 2 diabetes, especially weight-management-based strategies.

目的：2型糖尿病诊断年龄与血管危险因素之间的关系是否因种族和贫困而异？方法：利用临床实践研究数据链，我们将16-50岁的新诊断为2型糖尿病的个体与10个个体进行匹配，不使用性别、年龄和初级保健实践。使用广义线性模型探讨了2型糖尿病患者与非2型糖尿病患者在性别、年龄、种族和贫困五分位数之间的BMI、肥胖、ldl -胆固醇、HbA1c和高血压的差异。结果：我们纳入了108061例新诊断的2型糖尿病患者（45.6%为女性）和829946例对照。2型糖尿病患者的BMI、肥胖、低密度脂蛋白胆固醇和高血压均高于非2型糖尿病患者。在两性、所有种族和贫困五分之一人群中，年龄越早，这些差异就越大，尤其是在体重指数和肥胖方面。年龄与HbA1c之间的相关性在不同亚组中是不同的。白人在体重指数、肥胖和高血压（糖尿病患者与非糖尿病患者）方面的差异最大，且贫困程度较低。结论：血管风险表型的增加与2型糖尿病诊断年龄的早期相关，在种族和贫困群体中是一致的。需要以人群为基础的策略来解决与早发性2型糖尿病相关的风险，特别是以体重管理为基础的策略。

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引用次数: 0

Midline venous catheter: New insights for its use in hospitalized patients with diabetes 中线静脉导管在糖尿病住院患者中的应用

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112003

Marc Rivas , Mercè Abad , Eva Carnicero , Lidia Pereda , Raquel Corredor , Montserrat Martínez , Pablo Martínez , Francisco J. García de la Torre , Ana M. Olmo , Laura Millán , Olga Simó-Servat , Cristina Hernández , Andreea Ciudin , Rafael Simó

In a prospective study we found that in hospitalized patients with diabetes the use of mid line venous catheter (MVC) resulted in a significantly lower rate of vascular complications than short cannulas. However, a special attention should be paid to catheter obstruction when MCV is used.

在一项前瞻性研究中，我们发现在住院的糖尿病患者中，使用中线静脉导管（MVC）导致血管并发症的发生率明显低于短导管。然而，当使用MCV时，应特别注意导管阻塞。

引用次数: 0

The role of depression and diabetes distress in glycemic control: A meta-analysis

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-01-30 DOI: 10.1016/j.diabres.2025.112014

Kenni Wojujutari Ajele, Erhabor Sunday Idemudia

Aims

This study evaluated the associations between depression, diabetes distress, glycemic control (HbA1c), and self-care behaviours in individuals with diabetes. Findings on these relationships have been inconsistent, highlighting the need for systematic evaluation.

Methods

Data from 61 studies involving 19,537 participants conducted between 2001 and 2024 were analysed using random-effects models. Subgroup analyses examined variations by diabetes type, geographic location, and measurement tools. Heterogeneity was assessed using I² statistics.

Results

Depression and diabetes distress were significantly associated with poorer glycemic control (r = 0.23, 95 % CI [0.15 to 0.31], p < 0.001) and reduced self-care behaviours (r = –0.19, 95 % CI [–0.28 to –0.10], p < 0.001). Stronger correlations were observed in mixed diabetes populations (r = 0.35, 95 % CI [0.30 to 0.40], I² = 0 %) and in studies conducted in Europe (r = 0.28) and North America (r = 0.34). High heterogeneity (I² = 97.24 %) was identified.

Conclusions

Depression and diabetes distress are associated with poorer glycemic control and reduced self-care behaviours. Findings highlight the need for standardized measures and longitudinal studies to explore mechanisms underlying these associations.

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引用次数: 0