Pub Date : 2026-03-01Epub Date: 2026-03-04DOI: 10.1016/j.diabet.2026.101745
Gérard Reach
This editorial argues that technological innovation in diabetes, particularly continuous glucose monitoring and hybrid closed-loop systems, must be integrated into a humane medicine centred on both metrics and persons. It was written under the pressure of observing that diabetes distress persists in a substantial proportion of patients who benefit from the most advanced technologies, including hybrid closed‑loop systems. The author describes each patient’s situation as a “mental puzzle” of beliefs, emotions and social constraints and highlights the biographical ruptures caused by disease and technology. The clinical encounter has a double object—the disease and the person—held together through clinical conversation that translates innovation into livable choices for each individual. It is where technicality meets humanity.
{"title":"Towards humane diabetes care in the era of technological innovation","authors":"Gérard Reach","doi":"10.1016/j.diabet.2026.101745","DOIUrl":"10.1016/j.diabet.2026.101745","url":null,"abstract":"<div><div>This editorial argues that technological innovation in diabetes, particularly continuous glucose monitoring and hybrid closed-loop systems, must be integrated into a humane medicine centred on both metrics and persons. It was written under the pressure of observing that diabetes distress persists in a substantial proportion of patients who benefit from the most advanced technologies, including hybrid closed‑loop systems. The author describes each patient’s situation as a “mental puzzle” of beliefs, emotions and social constraints and highlights the biographical ruptures caused by disease and technology. The clinical encounter has a double object—the disease and the person—held together through clinical conversation that translates innovation into livable choices for each individual. It is where technicality meets humanity.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101745"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess the outcomes of teleophthalmology-based diabetic retinopathy (DR) screening in individuals over 70 years within the OPHDIAT network and to compare them with those of patients aged 18–69 years.
Methods
A cohort of 16,459 diabetic patients, without known DR or with mild non-proliferative DR (NPDR), screened in 2024 in 32 OPHDIAT centers, was included and divided into two groups: < 70 years (n = 13,639) and ≥ 70 years (n = 2,820). Two non-mydriatic retinal photographs per eye were analyzed by certified ophthalmologists.
Results
Among patients aged ≥70 years, 21.3% (95% CI: 19.8–22.8) had any DR, and 6.1% (95% CI: 5.2–6.9) were referred to an ophthalmologist for moderate NPDR or a more severe form of the disease, including suspected macular edema. These proportions did not significantly differ from those found in patients < 70 years: 21.9% (95% CI: 21.2–22.6) and 6.1% (95% CI:5.6–6.5), respectively. Severe NPDR or proliferative DR were rare in both groups (1.0%, 95% CI: 0.6–1.4% vs. 1.7%, 95% CI: 1.5–1.9%, P < 0.001). The proportion of ungradable images was higher in the group ≥70 year (14.4%, 95% CI:13.1–15.7% vs. 6.1%, 95% CI: 5.7–6.5%, P < 0.001), particularly in phakic eyes, although 80% of patients had interpretable images for both eyes. Pupil dilation significantly improved image quality in this group. Screening also allowed detecting other ocular disorders, including age-related macular degeneration and glaucoma, which were more common in the group ≥ 70 years (2.1%, 95% CI: 1.5–2.6% vs. 0.6%, 95% CI: 0.4–0.7% P < 0.001).
Conclusion
Teleophthalmology-based DR screening appeared feasible and clinically relevant in patients aged ≥70 years, allowing identifying patients requiring ophthalmologic evaluation, while also detecting other age-related ocular diseases. Pupil dilation is recommended to optimize image quality in this population.
目的:。-评估在OPHDIAT网络中70岁以上个体的远程眼科糖尿病视网膜病变（DR）筛查的结果，并将其与18-70岁患者的结果进行比较。方法:。研究纳入了2024年在32个OPHDIAT中心筛选的16,459例糖尿病患者，这些患者没有已知的DR或轻度非增殖性DR (NPDR)，并分为两组：< 70岁（n=13,639）和≥70岁（n=2,820）。每只眼睛的两张非散光视网膜照片由注册眼科医生分析。结果：在年龄≥70岁的患者中，21.3% （95% CI: 19.8-22.8）有任何DR， 6.1% （95% CI: 5.2-6.9）因中度NPDR或更严重的疾病（包括疑似黄斑水肿）而转诊给眼科医生。这些比例与< 70岁患者的比例没有显著差异：分别为21.9% （95% CI: 21.2-22.6）和6.1% （95% CI:5.6-6.5）。严重的NPDR或增殖性DR在两组中都很少见（1.0%,95% CI: 0.6-1.4% vs. 1.7%, 95% CI: 1.5-1.9%, P < 0.001）。≥70岁组的不可分级图像比例更高（14.4%,95% CI:13.1-15.7% vs. 6.1%, 95% CI: 5.7-6.5%, P < 0.001），特别是在有晶态眼中，尽管80%的患者双眼图像可解释。瞳孔扩张明显改善了图像质量。筛查还允许检测其他眼部疾病，包括年龄相关性黄斑变性和青光眼，这些疾病在≥70岁的人群中更为常见（2.1%,95% CI: 1.5-2.6% vs. 0.6%, 95% CI: 0.4-0.7% P < 0.001）。结论:。-在年龄≥70岁的患者中，基于远距眼科的DR筛查似乎可行且具有临床相关性，可以识别需要眼科评估的患者，同时还可以检测其他与年龄相关的眼部疾病。在这个人群中，推荐瞳孔扩张来优化图像质量。
{"title":"Telemedicine-based diabetic retinopathy screening in patients over 70 Years: a French cohort study within the OPHDIAT network","authors":"Héloïse Torres-Villaros , Joseph Albou , Franck Fajnkuchen , Aude Couturier , Audrey Giocanti-Aurégan , Pascale Massin","doi":"10.1016/j.diabet.2026.101728","DOIUrl":"10.1016/j.diabet.2026.101728","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the outcomes of teleophthalmology-based diabetic retinopathy (DR) screening in individuals over 70 years within the OPHDIAT network and to compare them with those of patients aged 18–69 years.</div></div><div><h3>Methods</h3><div>A cohort of 16,459 diabetic patients, without known DR or with mild non-proliferative DR (NPDR), screened in 2024 in 32 OPHDIAT centers, was included and divided into two groups: < 70 years (<em>n</em> = 13,639) and ≥ 70 years (<em>n</em> = 2,820). Two non-mydriatic retinal photographs per eye were analyzed by certified ophthalmologists.</div></div><div><h3>Results</h3><div>Among patients aged ≥70 years, 21.3% (95% CI: 19.8–22.8) had any DR, and 6.1% (95% CI: 5.2–6.9) were referred to an ophthalmologist for moderate NPDR or a more severe form of the disease, including suspected macular edema. These proportions did not significantly differ from those found in patients < 70 years: 21.9% (95% CI: 21.2–22.6) and 6.1% (95% CI:5.6–6.5), respectively. Severe NPDR or proliferative DR were rare in both groups (1.0%, 95% CI: 0.6–1.4% <em>vs</em>. 1.7%, 95% CI: 1.5–1.9%, <em>P</em> < 0.001). The proportion of ungradable images was higher in the group ≥70 year (14.4%, 95% CI:13.1–15.7% <em>vs</em>. 6.1%, 95% CI: 5.7–6.5%, <em>P</em> < 0.001), particularly in phakic eyes, although 80% of patients had interpretable images for both eyes. Pupil dilation significantly improved image quality in this group. Screening also allowed detecting other ocular disorders, including age-related macular degeneration and glaucoma, which were more common in the group ≥ 70 years (2.1%, 95% CI: 1.5–2.6% <em>vs</em>. 0.6%, 95% CI: 0.4–0.7% <em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Teleophthalmology-based DR screening appeared feasible and clinically relevant in patients aged ≥70 years, allowing identifying patients requiring ophthalmologic evaluation, while also detecting other age-related ocular diseases. Pupil dilation is recommended to optimize image quality in this population.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101728"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carbohydrate counting enables flexible prandial insulin dosing in type 1 diabetes but remains cognitively demanding. Concerns persist that such sustained attention to food may contribute to disordered eating behaviors. The primary aim of this study was to examine whether carbohydrate-counting knowledge is associated with disordered eating behaviors.
Methods
This cross-sectional study (NCT07021456) was conducted online. Participants completed questionnaires assessing carbohydrate-counting knowledge (Gluciquizz), disordered eating behaviors (DEPS-R), and likely eating disorders (SCOFF-F). Additional questionnaires evaluated quality of life (ADDQoL), diabetes-related distress (PAID-5), and fear of hypoglycemia (HFS-II short form). Elevated DEPS-R was defined as a score ≥ 20, and likely eating disorders as SCOFF-F ≥ 2.
Results
A total of 100 adults with type 1 diabetes were included. No correlation was observed between Gluciquizz and DEPS-R (ρ = −0.03, 95% CI (−0.23 to 0.17), P = 0.73). Similarly, Gluciquizz scores did not differ between participants with SCOFF-F < 2 and ≥ 2 (P = 0.745). Diabetes-related distress was significantly higher among participants with elevated DEPS-R scores (PAID-5 median 15 vs 8; P = 0.006), whereas ADDQoL and HFS-II did not differ significantly.
Conclusion
In this selected adult population with type 1 diabetes, carbohydrate-counting knowledge was not associated with disordered eating behaviors. However, positive DEB screening was linked with higher diabetes-related distress, supporting the importance of psychosocial assessment.
目的：碳水化合物计数使1型糖尿病患者的膳食胰岛素剂量灵活，但仍需要认知。人们一直担心，这种对食物的持续关注可能会导致饮食失调。本研究的主要目的是研究碳水化合物计数知识是否与饮食紊乱行为有关。方法：本横断面研究（NCT07021456）在线进行。参与者完成了评估碳水化合物计数知识（Gluciquizz）、饮食失调行为（DEPS-R）和可能的饮食失调（SCOFF-F）的问卷调查。额外的问卷评估生活质量（ADDQoL）、糖尿病相关的痛苦（pay -5）和对低血糖的恐惧（HFS-II）。dps - r升高定义为评分≥20，SCOFF-F≥2为可能的饮食失调。结果：共纳入100例成人1型糖尿病患者。Gluciquizz与DEPS-R无相关性（ρ = -0.03,95% CI (-0.23 ~ 0.17), P = 0.73）。同样，SCOFF-F < 2和≥2的受试者之间的Gluciquizz评分也没有差异（P = 0.745）。在dps -r评分升高的参与者中，糖尿病相关的痛苦显著增加（pay -5中位数为15 vs 8； P = 0.006），而ADDQoL和HFS-II没有显著差异。结论：在这一选定的1型糖尿病成年人群中，碳水化合物计数知识与饮食失调行为无关。然而，阳性的DEB筛查与较高的糖尿病相关痛苦有关，这支持了心理社会评估的重要性。
{"title":"No association between carbohydrate-counting knowledge and disordered eating behaviors in adults with type 1 diabetes","authors":"Laura Albaladejo , Melissa Ferguene , Béatrice Genoux , Lucien Marchand , Hélène du Boullay , Sandrine Lablanche , Céline Vermorel , Aurélie Gauchet , Jean-Luc Bosson , Cécile Bétry","doi":"10.1016/j.diabet.2026.101735","DOIUrl":"10.1016/j.diabet.2026.101735","url":null,"abstract":"<div><h3>Aims</h3><div>Carbohydrate counting enables flexible prandial insulin dosing in type 1 diabetes but remains cognitively demanding. Concerns persist that such sustained attention to food may contribute to disordered eating behaviors. The primary aim of this study was to examine whether carbohydrate-counting knowledge is associated with disordered eating behaviors.</div></div><div><h3>Methods</h3><div>This cross-sectional study (NCT07021456) was conducted online. Participants completed questionnaires assessing carbohydrate-counting knowledge (Gluciquizz), disordered eating behaviors (DEPS-R), and likely eating disorders (SCOFF-F). Additional questionnaires evaluated quality of life (ADDQoL), diabetes-related distress (PAID-5), and fear of hypoglycemia (HFS-II short form). Elevated DEPS-R was defined as a score ≥ 20, and likely eating disorders as SCOFF-F ≥ 2.</div></div><div><h3>Results</h3><div>A total of 100 adults with type 1 diabetes were included. No correlation was observed between Gluciquizz and DEPS-R (ρ = −0.03, 95% CI (−0.23 to 0.17), P = 0.73). Similarly, Gluciquizz scores did not differ between participants with SCOFF-F < 2 and ≥ 2 (P = 0.745). Diabetes-related distress was significantly higher among participants with elevated DEPS-R scores (PAID-5 median 15 vs 8; P = 0.006), whereas ADDQoL and HFS-II did not differ significantly.</div></div><div><h3>Conclusion</h3><div>In this selected adult population with type 1 diabetes, carbohydrate-counting knowledge was not associated with disordered eating behaviors. However, positive DEB screening was linked with higher diabetes-related distress, supporting the importance of psychosocial assessment.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101735"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-16DOI: 10.1016/j.diabet.2026.101734
Arnaud Dosda , Grégoire Fauchier , Nadia Sabbah , Laurent Fauchier , Thierry Lecomte , Pierre Henri Ducluzeau
Objectives
To evaluate the association between glucagon-like peptide-1 receptor agonist (GLP1-RA) use and all-cause mortality in patients with type 2 diabetes treated for colorectal cancer, using a real-world health database.
Methods
This retrospective cohort study was conducted using the TriNetX global health records network. Adult patients with type 2 diabetes diagnosed with colorectal cancer between 2010 and 2025 were included. Patients were divided into two cohorts based on GLP1-RA exposure versus other oral antidiabetic drugs. Propensity score matching was applied to balance covariates. Overall survival (primary outcome) and metastasis-free survival (secondary outcome) were analysed using Kaplan-Meier curves and Cox proportional hazards models.
Results
After propensity score matching, each cohort included 751 patients. Median follow-up period was 731 days in the GLP1-RA cohort and 779 days in the non-GLP1-RA cohort. GLP1-RA users had a significantly reduced all-cause mortality rate (11.5%) compared with non-users a (20.4%), with a hazard ratio of 0.58 (95%CI: 0.45–0.76; P < 0.001). Metastasis-free survival rate were 5.3% in the GLP1-RA cohort versus 8.9% in the matched non-user cohort, with a hazard ratio of 0.60 (95%CI: 0.40–0.87; P = 0.01). The incidence of major adverse cardiovascular events (MACE) did not differ significantly between cohorts, with a hazard ratio of 0.84 (95%CI: 0.66–1.06; P = 0.16).
Conclusions
In this real-world cohort of diabetic patients treated for colorectal cancer, GLP1-RA therapy was associated with a significant improvement in overall survival. These findings support the continued use of GLP1-RA agents in this population and may provide reassurance to clinicians and patients regarding the safety and potential benefit of these agents following a colorectal cancer diagnosis.
目的：利用真实世界的健康数据库，评估胰高血糖素样肽-1受体激动剂（GLP1-RA）的使用与结直肠癌治疗的2型糖尿病患者全因死亡率之间的关系。方法：采用TriNetX全球健康记录网络进行回顾性队列研究。研究对象包括2010年至2025年间诊断为结直肠癌的成年2型糖尿病患者。根据GLP1-RA暴露与其他口服降糖药的对比，将患者分为两组。使用倾向得分匹配来平衡协变量。使用Kaplan-Meier曲线和Cox比例风险模型分析总生存期（主要结局）和无转移生存期（次要结局）。结果：倾向评分匹配后，每个队列纳入751例患者。GLP1-RA组的中位随访期为731天，非GLP1-RA组的中位随访期为779天。GLP1-RA服用者的全因死亡率（11.5%）明显低于不服用者（20.4%），风险比为0.58 （95%CI: 0.45-0.76; P < 0.001）。GLP1-RA组无转移生存率为5.3%，而匹配的非用户组为8.9%，风险比为0.60 （95%CI: 0.40-0.87; P = 0.01）。主要不良心血管事件（MACE）发生率在队列间无显著差异，风险比为0.84 （95%CI: 0.66-1.06; P = 0.16）。结论：在接受结直肠癌治疗的糖尿病患者的现实世界队列中，GLP1-RA治疗与总生存期的显着改善相关。这些发现支持在该人群中继续使用GLP1-RA药物，并可能为临床医生和患者在结直肠癌诊断后使用这些药物的安全性和潜在益处提供保证。
{"title":"Association between glucagon-like peptide-1 receptor agonists and colorectal cancer survival: A population-based cohort study","authors":"Arnaud Dosda , Grégoire Fauchier , Nadia Sabbah , Laurent Fauchier , Thierry Lecomte , Pierre Henri Ducluzeau","doi":"10.1016/j.diabet.2026.101734","DOIUrl":"10.1016/j.diabet.2026.101734","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the association between glucagon-like peptide-1 receptor agonist (GLP1-RA) use and all-cause mortality in patients with type 2 diabetes treated for colorectal cancer, using a real-world health database.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted using the TriNetX global health records network. Adult patients with type 2 diabetes diagnosed with colorectal cancer between 2010 and 2025 were included. Patients were divided into two cohorts based on GLP1-RA exposure versus other oral antidiabetic drugs. Propensity score matching was applied to balance covariates. Overall survival (primary outcome) and metastasis-free survival (secondary outcome) were analysed using Kaplan-Meier curves and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>After propensity score matching, each cohort included 751 patients. Median follow-up period was 731 days in the GLP1-RA cohort and 779 days in the non-GLP1-RA cohort. GLP1-RA users had a significantly reduced all-cause mortality rate (11.5%) compared with non-users a (20.4%), with a hazard ratio of 0.58 (95%CI: 0.45–0.76; <em>P</em> < 0.001). Metastasis-free survival rate were 5.3% in the GLP1-RA cohort versus 8.9% in the matched non-user cohort, with a hazard ratio of 0.60 (95%CI: 0.40–0.87; <em>P</em> = 0.01). The incidence of major adverse cardiovascular events (MACE) did not differ significantly between cohorts, with a hazard ratio of 0.84 (95%CI: 0.66–1.06; <em>P</em> = 0.16).</div></div><div><h3>Conclusions</h3><div>In this real-world cohort of diabetic patients treated for colorectal cancer, GLP1-RA therapy was associated with a significant improvement in overall survival. These findings support the continued use of GLP1-RA agents in this population and may provide reassurance to clinicians and patients regarding the safety and potential benefit of these agents following a colorectal cancer diagnosis.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101734"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-26DOI: 10.1016/j.diabet.2026.101737
Dured Dardari
{"title":"When “good” comes too fast: rapid glycemic correction and the kidney: a “metabolic descent” hypothesis","authors":"Dured Dardari","doi":"10.1016/j.diabet.2026.101737","DOIUrl":"10.1016/j.diabet.2026.101737","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101737"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-07DOI: 10.1016/j.diabet.2026.101722
Jakob Starup-Linde , Katrine Hygum , Henrik Støvring , Jens-Erik Beck Jensen , Pia Eiken , Pernille Hermann , Bente Langdahl , Torben Harsløf
Aims
Traditional risk factors underestimate fracture risk in individuals with diabetes. In this population-based case-control study we aimed to determine T-score thresholds for type 1 and 2 diabetes (T1D and T2D) with equivalent risk of fractures as that of individuals without diabetes and a T-score of -2.5.
Research Design and Methods
We collected dual energy x-ray absorptiometry (DXA) data (2000–2019), information on diagnoses (1977–2019) and redeemed medications (1997–2019) from the National Danish Registries which are linked by a unique identifier. Cases were individuals with the first incident major osteoporotic fracture (MOF) within two years before or one year after a DXA and controls were fracture free and matched on age, gender, and time period of the DXA. Logistic regression modelling was used in the case-control analysis.
Results
We identified 17,703 cases and 17,703 controls. T1D and T2D were associated with an increased risk of MOF (odds ratio: 1.8, 95 % CI:1.4;2.3 and 1.2, 95 % CI:1.1;1.3, respectively) adjusted for hip BMD. T1D and T2D patients had a similar risk of MOF at T-scores (total hip) = -1.4 and -2.1, respectively, as patients without diabetes with a T-score of -2.5. For hip fracture, the equivalent risk was correspondingly reached with T-scores of -1.9 and -1.6. Similar findings apply for femoral neck and lumbar spine BMD.
Conclusions
Compared to individuals without diabetes, fracture risk was increased in patients with T1D and T2D independent of BMD. Our study suggests that the T-score thresholds for treatment initiation in T1D and T2D should be increased.
{"title":"Fracture risk and treatment thresholds in patients with diabetes","authors":"Jakob Starup-Linde , Katrine Hygum , Henrik Støvring , Jens-Erik Beck Jensen , Pia Eiken , Pernille Hermann , Bente Langdahl , Torben Harsløf","doi":"10.1016/j.diabet.2026.101722","DOIUrl":"10.1016/j.diabet.2026.101722","url":null,"abstract":"<div><h3>Aims</h3><div>Traditional risk factors underestimate fracture risk in individuals with diabetes. In this population-based case-control study we aimed to determine T-score thresholds for type 1 and 2 diabetes (T1D and T2D) with equivalent risk of fractures as that of individuals without diabetes and a T-score of -2.5.</div></div><div><h3>Research Design and Methods</h3><div>We collected dual energy x-ray absorptiometry (DXA) data (2000–2019), information on diagnoses (1977–2019) and redeemed medications (1997–2019) from the National Danish Registries which are linked by a unique identifier. Cases were individuals with the first incident major osteoporotic fracture (MOF) within two years before or one year after a DXA and controls were fracture free and matched on age, gender, and time period of the DXA. Logistic regression modelling was used in the case-control analysis.</div></div><div><h3>Results</h3><div>We identified 17,703 cases and 17,703 controls. T1D and T2D were associated with an increased risk of MOF (odds ratio: 1.8, 95 % CI:1.4;2.3 and 1.2, 95 % CI:1.1;1.3, respectively) adjusted for hip BMD. T1D and T2D patients had a similar risk of MOF at T-scores (total hip) = -1.4 and -2.1, respectively, as patients without diabetes with a T-score of -2.5. For hip fracture, the equivalent risk was correspondingly reached with T-scores of -1.9 and -1.6. Similar findings apply for femoral neck and lumbar spine BMD.</div></div><div><h3>Conclusions</h3><div>Compared to individuals without diabetes, fracture risk was increased in patients with T1D and T2D independent of BMD. Our study suggests that the T-score thresholds for treatment initiation in T1D and T2D should be increased.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101722"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-08DOI: 10.1016/j.diabet.2026.101723
David M Williams , Jagadish Nagaraj , Laura Wilkinson , Jeffrey W Stephens , Thinzar Min
{"title":"Views and understanding of metabolic dysfunction-associated steatotic liver disease in patients with diabetes","authors":"David M Williams , Jagadish Nagaraj , Laura Wilkinson , Jeffrey W Stephens , Thinzar Min","doi":"10.1016/j.diabet.2026.101723","DOIUrl":"10.1016/j.diabet.2026.101723","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101723"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-14DOI: 10.1016/j.diabet.2026.101742
Baodong Wang , Jiayuan Huang , Zhiyun Chen
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used in type 2 diabetes, yet their management after colorectal cancer diagnosis remains uncertain. A recent population-based cohort study reported lower mortality and fewer metastatic events among GLP-1 RA users than among patients receiving other glucose-lowering therapies. However, causal inference is limited by potential immortal time bias from the exposure definition, incomplete reporting of key prognostic and treatment factors (stage, surgery, systemic therapy, performance status), and unclear cohort entry and follow-up windows. In addition, reliance on routine administrative codes may misclassify outcomes. Time-varying exposure models, active-comparator new-user or landmark designs, and registry linkage/validation would strengthen the evidence.
{"title":"Reassessing the role of GLP-1 receptor agonists in colorectal cancer Care","authors":"Baodong Wang , Jiayuan Huang , Zhiyun Chen","doi":"10.1016/j.diabet.2026.101742","DOIUrl":"10.1016/j.diabet.2026.101742","url":null,"abstract":"<div><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used in type 2 diabetes, yet their management after colorectal cancer diagnosis remains uncertain. A recent population-based cohort study reported lower mortality and fewer metastatic events among GLP-1 RA users than among patients receiving other glucose-lowering therapies. However, causal inference is limited by potential immortal time bias from the exposure definition, incomplete reporting of key prognostic and treatment factors (stage, surgery, systemic therapy, performance status), and unclear cohort entry and follow-up windows. In addition, reliance on routine administrative codes may misclassify outcomes. Time-varying exposure models, active-comparator new-user or landmark designs, and registry linkage/validation would strengthen the evidence.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101742"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report two cases of normoglycemic people with HIV well-controlled by antiretroviral therapy who were switched to a dual long-acting therapy consisting of cabotegravir (CAB), an integrase strand transfer inhibitor, and rilpivirine (RIL), a non-nucleoside analog reverse transcriptase inhibitor, administred intramuscularly once a month then every two months. Both cases developed shortly acute severe hyperglycemia with ketoacidosis or insulinopenia requiring intravenous insulin therapy. Anti-pancreatic autoantibodies were absent. The hyperglycemic episode resumed after stopping CAB/RIL and/or initiating metformin. To our knowledge these are the first reported cases of severe CAB/RIL-induced hyperglycemia. Up to now, long-acting CAB/RIL has not been associated with metabolic outcomes. These cases serve as a warning to clinicians to monitor glycemia when initiating long-acting CAB/RIL therapy.
{"title":"Severe hyperglycemia after initiation of long-acting cabotegravir in two antiretroviral treatment-controlled people with HIV","authors":"Nadia Valin , Pauline Campa , Thibault Chiarabini , Joëlle Michot , Carole Collet-Gaudillat , Stéphanie Kury Paulin , Jacqueline Capeau , Karine Lacombe","doi":"10.1016/j.diabet.2026.101744","DOIUrl":"10.1016/j.diabet.2026.101744","url":null,"abstract":"<div><div>We report two cases of normoglycemic people with HIV well-controlled by antiretroviral therapy who were switched to a dual long-acting therapy consisting of cabotegravir (CAB), an integrase strand transfer inhibitor, and rilpivirine (RIL), a non-nucleoside analog reverse transcriptase inhibitor, administred intramuscularly once a month then every two months. Both cases developed shortly acute severe hyperglycemia with ketoacidosis or insulinopenia requiring intravenous insulin therapy. Anti-pancreatic autoantibodies were absent. The hyperglycemic episode resumed after stopping CAB/RIL and/or initiating metformin. To our knowledge these are the first reported cases of severe CAB/RIL-induced hyperglycemia. Up to now, long-acting CAB/RIL has not been associated with metabolic outcomes. These cases serve as a warning to clinicians to monitor glycemia when initiating long-acting CAB/RIL therapy.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"52 2","pages":"Article 101744"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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