Diabetes & metabolism最新文献_第2页

Epicardial adipose tissue measurement is an interesting biomarker for cardiovascular health in a case control study of patients with familial partial type 2 lipodystrophy 在家族性部分2型脂肪营养不良患者的病例对照研究中，心外膜脂肪组织测量是心血管健康的一个有趣的生物标志物。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-12-03 DOI: 10.1016/j.diabet.2025.101719

Mathilde Simonson , Patricia Ancel , Romain Mortier , Mohamed Lamine Mariko , Bénédicte Fontaine , Julie Koue-Chon-Lim , Jules Martel , Estelle Nobécourt , Bénédicte Gaborit

Aim

Clinical cardiovascular risk scoring and Coronary artery calcification evaluation are lacking in Type 2 Familial Partial Lipodystrophy patients who present higher cardiovascular events and risk factors. The epicardial adipose tissue volume - a visceral adipose tissue which is accumulated during lipodystrophy - is higher in type 2 diabetic patients with coronary artery disease. In this case control study, we assessed epicardial adipose tissue volume as a new marker of interest in these patients.

Methods

Patients with type 2 Familial Partial Lipodystrophy or control patients, in primary prevention for cardiovascular events, were followed up at the University Hospital of La Réunion. Type 2 Familial Partial Lipodystrophy patients undergoing both coronary artery calcification and clinical cardiovascular risk scoring were retrospectively included and paired with control patients for age, sex and body mass index (NCT07090629). The epicardial adipose tissue volume was measured for each of the 126 subjects, with a semi-automated technique using deep learning and AI. Results: Type 2 Familial Partial Lipodystrophy patients displayed significantly higher adipose tissue volume (77 ± 39 cm³) than control subjects at high cardiovascular risk (60 ± 30 cm³; P = 0.010).

Conclusions

we show for the first time patients with Type 2 Familial Partial Lipodystrophy present higher values of epicardial adipose tissue volume, an interesting biomarker to add to coronary artery calcification and clinical scoring.

目的：2型家族性部分脂肪营养不良患者存在较高的心血管事件和危险因素，缺乏临床心血管风险评分和冠状动脉钙化评估。心外膜脂肪组织体积-脂肪营养不良期间积累的内脏脂肪组织-在2型糖尿病合并冠状动脉疾病患者中较高。在这个病例对照研究中，我们评估了心外膜脂肪组织体积作为这些患者感兴趣的新标志物。方法：在拉西姆大学医院对2型家族性部分脂肪营养不良患者或对照患者进行心血管事件一级预防随访。回顾性纳入接受冠状动脉钙化和临床心血管风险评分的2型家族性部分脂肪营养不良患者，并根据年龄、性别和体重指数（NCT07090629）与对照患者配对。通过使用深度学习和人工智能的半自动技术，测量了126名受试者的心外膜脂肪组织体积。结果：2型家族性部分脂肪营养不良患者脂肪组织体积（77±39 cm3）明显高于心血管高危对照组（60±30 cm3, P = 0.010）。结论：我们首次发现2型家族性部分脂肪营养不良患者的心外膜脂肪组织体积值更高，这是一个有趣的生物标志物，可以增加冠状动脉钙化和临床评分。

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引用次数: 0

Pancreatic polypeptide in patients with type 1 diabetes and exocrine failure or chronic pancreatitis. The DIAPP study 胰腺多肽在1型糖尿病和外分泌衰竭或慢性胰腺炎患者中的作用。DIAPP的研究。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-09 DOI: 10.1016/j.diabet.2025.101712

Lea Dehghani , Fideline Bonnet-Serrano , Hendy Abdul , Laure Alexandre-Heymann , Jean Guibourdenche , Etienne Larger

Introduction

. - Exocrine dysfunction can occur in type 1 diabetes (T1D). When exocrine function is impaired, it is unclear whether alterations also involve other endocrine cell types beyond beta cells. Pancreatic polypeptide (PP) is, besides insulin, the sole hormone that is specific to islets of Langerhans. The aim of the DIAPP study was to evaluate if PP secretion is also altered when T1D is complicated by exocrine failure.

Materials and Methods

. - Seven patients with T1D and normal pancreatic function (T1DN), 9 patients with T1D and exocrine failure (T1DEF) were compared to 13 patients with type 3c diabetes; i. e. with chronic pancreatitis (CP). All of them had a mixed meal test (MMT), C-peptide and PP being determined before and at 60, 90 and 120 minutes.

Results

. – The area under the curve of C-peptide during MMT (AUC_Cpep) was significantly greater in the CP group than in both T1D groups (P < 0.0001 vs. the T1DEF group and P < 0.001 vs. the T1D group) while the area under the curve of PP (AUC_PP) was significantly smaller in the CP group than in both T1D groups (P < 0.01 vs. both groups). The AUC_PP / AUC_Cpep ratio was higher in the CP group than in both T1D groups (P < 0.0001 vs. both groups).

Conclusion

. - PP secretion was altered specifically in patients with CP, not in T1D, even when associated with pancreatic exocrine failure.

作品简介:。外分泌功能障碍可发生在1型糖尿病（T1D）。当外分泌功能受损时，尚不清楚这种改变是否也涉及β细胞以外的其他内分泌细胞类型。胰多肽（PP）是除胰岛素外唯一的朗格汉斯胰岛特有的激素。DIAPP研究的目的是评估当T1D合并外分泌衰竭时，PP分泌是否也会改变。材料与方法：。-将7例T1D伴胰腺功能正常（T1DN）患者，9例T1D伴外分泌功能衰竭（T1DEF）患者与13例3c型糖尿病患者进行比较；即慢性胰腺炎（CP）。试验前、60分钟、90分钟、120分钟分别进行混餐试验（MMT）、c肽和PP测定。结果:。- MMT过程中，CP组c肽曲线下面积（AUCCpep）显著大于T1D组（P < 0.0001 vs. T1DEF组，P < 0.001 vs. T1D组），而CP组PP曲线下面积（AUCPP）显著小于T1D组（P < 0.01 vs.两组）。CP组AUCPP / AUCCpep比值高于T1D组（P < 0.0001）。结论:。- PP分泌在CP患者中发生特异性改变，而在T1D患者中没有，即使与胰腺外分泌衰竭相关。

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引用次数: 0

Handgrip strength cut-off points for identifying French adults at risk of type 2 diabetes 确定法国成人2型糖尿病风险的握力分界点

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-09 DOI: 10.1016/j.diabet.2025.101713

Thi Chi Phuong Nguyen , Jean-Michel Oppert , Laurent Bourhis , Alice Bellicha , Bernard Srour , Emmanuelle Kesse-Guyot , Serge Hercberg , Pilar Galan , Mathilde Touvier , Léopold K Fezeu , Jérémy Vanhelst

Aim

To identify cut-off points for handgrip strength (HGS) detecting T2D risk among adults in France, and to examine the relationships between absolute and relative HGS and the incidence of T2D.

Methods

Data from 18,519 adults (5096 men) in the NutriNet-Santé cohort, were analyzed. HGS was measured using dynamometry on both hands. Nine indicators were derived, including absolute values and those relative to body weight and BMI. Receiver Operating Characteristic curves and cubic splines were used to assess predictive performance, as well as cut-off points for HGS that maximize this performance. Cox proportional hazards models were used to evaluate associations between reduced HGS and T2D.

Results

Over 9.8 years, 329 incident T2D cases were validated. Absolute HGS showed not associated with T2D risk, whereas higher relative HGS was associated with lower risk (e.g. HR for HGS relative to body weight: 1.30, 95 % CI: 1.07–1.58). Relative HGS showed better discrimination (AUC 0.623–0.675) than absolute HGS (≤ 0.44). Optimal cut-offs were 0.446 kg/kg and 1.086 kg/kg/m² (dominant hand), and 0.397 kg/kg and 1.033 kg/kg/m² (non-dominant). Low relative HGS was associated with increased risk (HRs 1.42–1.68), consistent across sensitivity, sex, and age analyses.

Conclusions

Relative, but not absolute, handgrip strength is independently associated with T2D incidence and shows modest discriminative ability. Given its simplicity and cost-effectiveness, grip strength may be a useful screening tool in clinical and public health settings.

目的：确定法国成年人的握力（HGS）检测T2D风险的分界点，并研究绝对和相对HGS与T2D发病率之间的关系。方法：对来自nutrinet - sant队列的18,519名成年人（5,096名男性）的数据进行分析。HGS采用双手测力法测量。得出了9个指标，包括绝对值和相对于体重和BMI的值。接受者工作特征曲线和三次样条用于评估预测性能，以及HGS的截止点，使该性能最大化。Cox比例风险模型用于评估HGS降低与T2D之间的关系。结果：在9.8年的时间里，确诊了329例T2D病例。绝对HGS与T2D风险无关，而较高的相对HGS与较低的风险相关（例如，HGS相对于体重的HR: 1.30, 95% CI: 1.07-1.58）。相对HGS （AUC 0.623 ~ 0.675）优于绝对HGS （AUC≤0.44）。最优截断值为优势手0.446 kg/kg和1.086 kg/kg/m²，非优势手0.397 kg/kg和1.033 kg/kg/m²。低相对HGS与风险增加相关（HRs 1.42-1.68），在敏感性、性别和年龄分析中一致。结论：相对而非绝对握力与T2D发病率独立相关，并表现出适度的判别能力。鉴于其简单性和成本效益，握力可能是临床和公共卫生环境中有用的筛查工具。

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引用次数: 0

Increased epicardial adipose tissue is part of the phenotype of LMNA-associated partial lipodystrophy and could contribute to increased cardiovascular risk 心外膜脂肪组织增加是lmna相关部分脂肪营养不良表型的一部分，可能导致心血管风险增加

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-01 DOI: 10.1016/j.diabet.2025.101710

Sophie Lamothe , Patricia Ancel , Inès Belalem , Leïla Lecaque , Joris Fournel , Alexis Jacquier , Zouhair Houhou , Jean-Baptiste Julla , Jean-François Gautier , Corinne Vigouroux , Bénédicte Gaborit , Camille Vatier

LMNA-associated familial partial lipodystrophy (FPLD2) is characterized by limb lipoatrophy, cervicofacial and visceral abdominal lipohypertrophy, insulin resistance-related complications and early coronary artery disease (CAD), but epicardial adipose tissue (EAT) is poorly described. We aimed to characterize EAT as a potential new marker of cardiovascular risk in patients with FPLD2. Using a validated deep-learning algorithm, we measured EAT volume from cardiac CT-scans routinely performed for coronary artery calcium (CAC) scoring in patients with FPLD2 (n = 26, 24 women, 65 % with diabetes, median age 49 [32;57] years) compared to patients with type-2 diabetes (T2D) (n = 44, 40 women, age 49 [41;59], p = 0.18). Although lower BMI (23.3 [21;26.6] vs. 27.2 [24.7;29.6], P = 0.03) and HbA1c (6.5 [5.8;7.7] vs. 7.8 [7;8.5] %, P = 0.003) in patients with FPLD2 vs. T2D, EAT volume (110 [72;150] vs. 60 [42;78] ml, P < 0.001) and prevalence of CAD (19 vs. 2 %, P = 0.003) were higher. EAT was positively related to CAC score in the FPLD2 group. Our findings support that EAT is increased in patients with FPLD2 and represents a specific ectopic adipose tissue which could contribute to the increased cardiovascular risk.

lmna相关家族性部分脂肪营养不良（FPLD2）的特征是肢体脂肪萎缩、颈面和内脏腹部脂肪肥大、胰岛素抵抗相关并发症和早期冠状动脉疾病（CAD），但对心外膜脂肪组织（EAT）的描述很少。我们的目的是将EAT作为FPLD2患者心血管风险的潜在新标志物。使用经过验证的深度学习算法，我们测量了FPLD2患者（n = 26,24名女性，65%患有糖尿病，中位年龄49[32；57]岁）与2型糖尿病（T2D）患者（n = 44,40名女性，年龄49 [41；59],p = 0.18）常规心脏ct扫描的EAT体积。虽然FPLD2与T2D患者的BMI（23.3[21；26.6]比27.2 [24.7;29.6],P = 0.03）和HbA1c（6.5[5.8；7.7]比7.8 [7;8.5]%,P = 0.003）较低，但EAT体积（110[72；150]比60 [42；78]ml, P < 0.001）和CAD患病率（19比2%，P = 0.003）较高。在FPLD2组中，EAT与CAC评分呈正相关。我们的研究结果支持，FPLD2患者的EAT增加，代表了一种特殊的异位脂肪组织，可能导致心血管风险增加。

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引用次数: 0

The association of sweetened beverage intake with risk of type 2 diabetes in an Australian population: A longitudinal study 澳大利亚人群中含糖饮料摄入与2型糖尿病风险的关系：一项纵向研究。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-01 DOI: 10.1016/j.diabet.2025.101665

Robel Hussen Kabthymer , Tongzhi Wu , Sara Beigrezaei , Oscar H Franco , Allison M Hodge , Barbora de Courten

Aim

Globally, sugar intake from sugar-sweetened beverages (SSBs) exceeds the daily recommended limits for intake levels of free sugar. Artificially sweetened beverages (ASBs), widely used to replace SSBs, are increasingly linked to adverse health outcomes. Hence, we assessed the association of sweetened beverage intake (SSBs and ASBs) with the risk of type 2 diabetes (T2DM).

Methods

Data from the Melbourne Collaborative Cohort Study (MCCS) on 36,608 individuals aged 40 to 69 years were used. Self-reported data on diabetes were collected. The frequency of SSBs and ASBs consumption was categorized as: never or < 1 time/month; 1–3 per month; 1–6 times per week; ≥1 time / day. The association of sweetened beverage intake with the incidence of T2DM was assessed using modified Poisson regression, adjusted for lifestyle, obesity, socioeconomic, and other confounders.

Results

Intakes of SSBs and ASBs were associated with an increased risk of T2DM. A high intake (≥ 1 time/day) compared to a low intake (never or < 1 time / month) was associated with increased risk of T2DM for SSB intake (incidence risk ratio (IRR) = 1.23; 95 % CI: 1.05–1.45; P for trend = 0.006) and for ASB intake (IRR = 1.38; 95 % CI: 1.18–1.61; P for trend < 0.001). Further adjustment for body mass index (BMI) and waist-to hip ratio (WHR) eliminated the association for SSBs, but not ASBs intake.

Conclusions

Both sugar and artificially sweetened beverages were linked to an increased risk of T2DM. The findings highlight the need for public health measures to control the intake of sweetened beverages.

目的：在全球范围内，从含糖饮料（SSBs）中摄入的糖超过了每日游离糖摄入量的推荐限制。人工加糖饮料（asb）被广泛用于替代ssb，与不良健康结果的联系越来越紧密。因此，我们评估了甜饮料摄入（ssb和asb）与2型糖尿病（T2DM）风险的关系。方法：来自墨尔本合作队列研究（MCCS）的数据，涉及36,608名年龄在40至69岁之间的个体。收集自我报告的糖尿病数据。SSBs和ASBs的使用频率分为：从不或< 1次/月；每月1-3次；每周1-6次；≥1次/天。使用修正泊松回归评估含糖饮料摄入量与T2DM发病率的关系，并根据生活方式、肥胖、社会经济和其他混杂因素进行调整。结果：ssb和asb的摄入与T2DM风险增加相关。高摄入量（≥1次/天）与低摄入量（从不或< 1次/月）相比，SSB摄入增加了T2DM的风险(发病率风险比（IRR） = 1.23；95% ci: 1.05-1.45；趋势P = 0.006)和ASB摄入量P (IRR = 1.38；95% ci: 1.18-1.61；P表示趋势< 0.001)。进一步调整身体质量指数（BMI）和腰臀比（WHR）消除了与ssb的关联，但没有消除与asb摄入量的关联。结论：糖和人工加糖饮料都与2型糖尿病风险增加有关。研究结果强调需要采取公共卫生措施来控制加糖饮料的摄入。

{"title":"The association of sweetened beverage intake with risk of type 2 diabetes in an Australian population: A longitudinal study","authors":"Robel Hussen Kabthymer , Tongzhi Wu , Sara Beigrezaei , Oscar H Franco , Allison M Hodge , Barbora de Courten","doi":"10.1016/j.diabet.2025.101665","DOIUrl":"10.1016/j.diabet.2025.101665","url":null,"abstract":"<div><h3>Aim</h3><div>Globally, sugar intake from sugar-sweetened beverages (SSBs) exceeds the daily recommended limits for intake levels of free sugar. Artificially sweetened beverages (ASBs), widely used to replace SSBs, are increasingly linked to adverse health outcomes. Hence, we assessed the association of sweetened beverage intake (SSBs and ASBs) with the risk of type 2 diabetes (T2DM).</div></div><div><h3>Methods</h3><div>Data from the Melbourne Collaborative Cohort Study (MCCS) on 36,608 individuals aged 40 to 69 years were used. Self-reported data on diabetes were collected. The frequency of SSBs and ASBs consumption was categorized as: never or < 1 time/month; 1–3 per month; 1–6 times per week; ≥1 time / day. The association of sweetened beverage intake with the incidence of T2DM was assessed using modified Poisson regression, adjusted for lifestyle, obesity, socioeconomic, and other confounders.</div></div><div><h3>Results</h3><div>Intakes of SSBs and ASBs were associated with an increased risk of T2DM. A high intake (≥ 1 time/day) compared to a low intake (never or < 1 time / month) was associated with increased risk of T2DM for SSB intake (incidence risk ratio (IRR) = 1.23; 95 % CI: 1.05–1.45; P for trend = 0.006) and for ASB intake (IRR = 1.38; 95 % CI: 1.18–1.61; P for trend < 0.001). Further adjustment for body mass index (BMI) and waist-to hip ratio (WHR) eliminated the association for SSBs, but not ASBs intake.</div></div><div><h3>Conclusions</h3><div>Both sugar and artificially sweetened beverages were linked to an increased risk of T2DM. The findings highlight the need for public health measures to control the intake of sweetened beverages.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 6","pages":"Article 101665"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096645","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}

引用次数: 0

In adults living with type 1 diabetes, additional autoimmune diseases are associated with more chronic complications and depression. A BETTER registry analysis 在患有1型糖尿病的成年人中，额外的自身免疫性疾病与更多的慢性并发症和抑郁症相关。更好的注册表分析。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-11-01 DOI: 10.1016/j.diabet.2025.101667

Cassandra A.A. Locatelli , Meryem K. Talbo , Virginie Messier , Caroline Grou , Maha Lebbar , Erin E. Mulvihill , Anne-Sophie Brazeau , Rémi Rabasa-Lhoret

Aim

People living with type 1 diabetes (T1D) are at elevated risk of additional autoimmune diseases (ADs) than the general population. We aimed to describe the association between additional ADs and T1D-related physical and mental burden in adults.

Methods

This was a cross-sectional analysis using data from the BEhaviors, Therapies, TEchnologies, and hypoglycemic Risk in T1D (BETTER) registry. Using patient reported-outcomes and validated questionnaires, we compared prevalence of vascular complications, hypoglycemia, and mental health issues between those with T1D alone (AD-) and T1D with additional AD (AD+).

Results

Among 3222 participants (66.2 % female, 42.7 ± 15.0 years), 36.3 % reported ≥ 1 AD+. The AD+ group was older (+4.4 years) and more female (+17.7 %) than the AD- group. The AD+ group had similar HbA1c (P = 0.20) but was more likely to report level 2 hypoglycemia in the past month (OR: 1.27 [95 %Cl 1.06–1.52]) and level 3 hypoglycemia since diagnosis (1.22 [1.05–1.42]). The AD+ group reported more cardiovascular disease (1.40 [1.03 to 1.90]), nephropathy (1.49 [1.19–1.86]), neuropathy (1.38 [1.13–1.69]), retinopathy (1.48 [1.22–1.78]), higher depression scores (p = 0.015), and anxiety/depression medication use (1.31 [1.10–1.56]). Number of AD+ was positively associated with depression scores (1 AD+ P = 0.055, 2+ AD+ p = 0.027), level 3 hypoglycemia since diagnosis (1 AD+ p = 0.037, 2+ AD+ P = 0.025), and number of chronic complications (1 AD+ P < 0.001, 2+ AD+ P < 0.001).

Conclusion

For people with T1D, living with additional ADs is associated with higher levels of physical and mental diabetes complications, warranting regular screening in this population.

目的：1型糖尿病（T1D）患者患其他自身免疫性疾病（ADs）的风险高于一般人群。我们的目的是描述额外的ad与成人t1d相关的身体和精神负担之间的关系。方法：这是一项横断面分析，使用来自T1D患者的行为、治疗、技术和低血糖风险（BETTER）登记的数据。使用患者报告的结果和有效的问卷，我们比较了单独T1D （AD-）和T1D合并AD （AD+）患者血管并发症、低血糖和精神健康问题的患病率。结果：在3222名参与者中（66.2%为女性，42.7±15.0岁），36.3%报告≥1 AD+。AD+组比AD-组年龄大（+4.4岁），女性患者多（+ 17.7%）。AD+组HbA1c相似（P = 0.20），但在过去一个月内报告2级低血糖（OR: 1.27 [95% Cl 1.06-1.52]）和诊断后报告3级低血糖（OR: 1.22[1.05-1.42]）的可能性更大。AD+组出现更多心血管疾病（1.40[1.03 ~ 1.90]）、肾病（1.49[1.19 ~ 1.86]）、神经病变（1.38[1.13 ~ 1.69]）、视网膜病变（1.48[1.22 ~ 1.78]）、抑郁评分（p = 0.015）和焦虑/抑郁药物使用（1.31[1.10 ~ 1.56]）。AD+次数与抑郁评分（1 AD+ P = 0.055, 2+ AD+ P = 0.027）、诊断以来3级低血糖（1 AD+ P = 0.037, 2+ AD+ P = 0.025）、慢性并发症次数（1 AD+ P < 0.001, 2+ AD+ P < 0.001）呈正相关。结论：对于T1D患者，患有额外ad的患者与更高水平的身体和精神糖尿病并发症相关，需要对该人群进行定期筛查。

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引用次数: 0

Patient-reported outcome measures (PROMs) are differently associated with treatment modalities, household income, and diabetes-related events in children with type 1 diabetes, their mothers, and their fathers: a French nationwide survey 法国一项全国性调查显示，患者报告的预后指标（PROMs）与1型糖尿病儿童及其父母的治疗方式、家庭收入和糖尿病相关事件有不同的关联

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-10-24 DOI: 10.1016/j.diabet.2025.101711

Emmanuelle Labarre , Laurent Poiroux , Marc De Kerdanet , Line Lobel , Bétina Porcel , Aurélie Donzeau , Carine Choleau , Jacques Beltrand , Regis Coutant

Aim

To conduct a population-based study on the quality of life (QoL) in families (mothers, fathers, and children) of children using closed loop (CL) compared to those using multiple daily injections (MDI), open loop (OL), and low glucose suspend (LGS) systems.

Methods

A nationwide French survey of children with type 1 diabetes (T1D) and their parents was conducted through the national family association, Familles AJD, in 2024. Six validated questionnaires were used for assessing QoL, anxiety, time spent managing diabetes, and sleep quality. Multivariate analyses were performed.

Results

We collected 1593 surveys (1093 from mothers, 242 from fathers, and 258 from children > 8 years). T1D children were aged 11.3 ± 4 years, had diabetes for 4.7 ± 3.8 years; 18% used MDI, 41% OL, 13% LGS, and 29% CL. HbA1c was 7.3 ± 0.6% with CL, vs. 7.7 ± 1.0% for other treatments (P < 0.05). CL was associated with improved QoL scores in parents (compared to OL and MDI), and children (compared to OL, not MDI). Time spent managing diabetes was lower with CL in parents, not children. Anxiety and sleep quality were not improved with CL. Child age (in parents) and household income (in all) were associated with improved QoL. HbA1c and a history of ketoacidosis (in mothers), or a history of severe hypoglycemia (in children), had a deleterious effect. Mothers experienced lower QoL, but scores correlated within the household.

Conclusion

CL enhanced the QoL in families of children with T1D. Socioeconomic factors and diabetes-related events influence QoL differently depending on the respondent group.

目的开展一项基于人群的研究，比较使用闭环（CL）系统的儿童与使用每日多次注射（MDI）、开环（OL）和低糖悬液（LGS）系统的儿童家庭（母亲、父亲和儿童）的生活质量（QoL）。方法于2024年通过法国国家家庭协会famililles AJD对法国1型糖尿病儿童及其父母进行调查。六份有效的问卷用于评估生活质量、焦虑、治疗糖尿病的时间和睡眠质量。进行多变量分析。结果共收集问卷1593份，其中母亲1093份，父亲242份，8岁以下儿童258份。T1D患儿年龄11.3±4岁，糖尿病患者4.7±3.8岁；18%使用MDI， 41%使用OL， 13%使用LGS， 29%使用CL。CL组HbA1c为7.3±0.6%，其他组为7.7±1.0% （P < 0.05）。CL与父母（与OL和MDI相比）和儿童（与OL相比，而不是与MDI）的生活质量评分改善有关。治疗糖尿病的时间花费在父母身上，而不是孩子身上。治疗后焦虑和睡眠质量没有改善。儿童年龄（父母）和家庭收入（所有人）与生活质量的改善有关。HbA1c和酮症酸中毒史（母亲）或严重低血糖史（儿童）具有有害影响。母亲的生活质量较低，但在家庭内部得分相关。结论cl提高了T1D患儿家庭生活质量。社会经济因素和糖尿病相关事件对生活质量的影响因受访者群体而异。

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引用次数: 0

Management of patients with type 2 diabetes and MASLD: An overview and joint statement 2型糖尿病和MASLD患者的管理：综述和联合声明。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-10-15 DOI: 10.1016/j.diabet.2025.101709

Yasmina Chouik , Clémence M Canivet , Jean-Baptiste Julla , Thomas Mouillot , Lucia Parlati , Alexia Rouland , Sarra Smati , Blandine Tramunt , Rodolphe Anty , Jérôme Boursier , Claire Carette , Bertrand Cariou , Laurent Castera , Armand Garioud , Bruno Guerci , Pierre Gourdy , Maeva Guillaume , Guillaume Lassailly , Raluca Pais , Jean-Michel Petit , Cyrielle Caussy

Type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD) are two highly prevalent diseases with rapidly growing incidences worldwide. They are frequently associated due to their shared pathophysiology and their bidirectional influence. MASLD-related liver fibrosis is a major driver of hepatic complications and is associated with increased risk of extrahepatic complications, such as cardiovascular and renal diseases in patients with T2D. In this setting, systematic screening for advanced fibrosis related to MASLD is now unanimously recommended for patients with T2D, due to its high prevalence and specific therapeutic management. The French Association for the Study of the Liver (AFEF) and the Francophone Diabetes Society (SFD) convened a group of experts to summarize the current knowledge on MASLD screening and therapeutic management in patients with T2D and thus provide a roadmap to healthcare professionals, especially diabetologists or primary care physicians. Our focus will be on the particularities of dietary and behavioral management, pharmacological treatment of T2D, and bariatric procedures in cases of MASLD. Our goal is to provide clinical guidance for adapting drug therapy in the presence of significant fibrosis in order to slow the progression of liver disease and reduce the risk of associated clinical events.

2型糖尿病（T2D）和代谢功能障碍相关脂肪变性肝病（MASLD）是世界范围内发病率快速增长的两种高发疾病。由于它们共同的病理生理和双向影响，它们经常联系在一起。masld相关肝纤维化是肝脏并发症的主要驱动因素，并与T2D患者肝外并发症（如心血管和肾脏疾病）的风险增加相关。在这种情况下，由于T2D患者的高患病率和特异性治疗管理，现在一致建议对与MASLD相关的晚期纤维化进行系统筛查。法国肝脏研究协会（AFEF）和法语糖尿病协会（SFD）召集了一组专家，总结了目前关于T2D患者MASLD筛查和治疗管理的知识，从而为医疗保健专业人员，特别是糖尿病学家或初级保健医生提供了路线图。我们的重点是饮食和行为管理的特殊性，T2D的药物治疗，以及MASLD病例的减肥程序。我们的目标是为在存在显著纤维化的情况下适应药物治疗提供临床指导，以减缓肝病的进展并降低相关临床事件的风险。

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引用次数: 0

GLP-1-derived therapies and sarcopenia: plea for a specific focus on at risk special populations glp -1衍生疗法和肌肉减少症：请求特别关注高危特殊人群。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-10-14 DOI: 10.1016/j.diabet.2025.101708

André J. Scheen

Background

A risk of excessive reduction in skeletal muscle mass (SSM), potentially leading to sarcopenia, when using glucagon-like peptide-1 (GLP-1)-based therapies, is currently a matter of debate. While most available results are rather reassuring in the general population, sarcopenia may become a concern in some special subgroups with comorbidities known to be associated with a higher risk of sarcopenia, independently of any GLP-1-based therapy.

Methods

An extensive literature search was done to identify studies that investigated the effects of GLP-1-based therapies on changes in SMM and sarcopenia in special populations, i.e. older people, patients with type 2 diabetes, atherosclerotic cardiovascular disease, heart failure, chronic kidney disease, and metabolic dysfunction–associated liver disease.

Results

Several publications emphasized the risk of sarcopenia and recommended caution when prescribing GLP-1-based therapies in people with these comorbidities of interest. However, hard data remain scarce in the literature, without any evidence-based demonstration of a significantly increased risk of sarcopenia. Nevertheless, as old age potentiates the risk of sarcopenia, older patients with these comorbidities (especially advanced heart failure or renal disease) deserve more careful attention.

Conclusion

While the risk of sarcopenia associated with GLP-1-based therapies remains controversial in the general population, a higher risk in special populations with comorbidities has been repeatedly emphasized despite the lack of evidence-based data in the literature. Because these agents showed major clinical benefits in patients with such comorbidities but sarcopenia could mitigate them, there is an urgent need to implement dedicated studies with appropriate measures of sarcopenia in these special populations.

背景：当使用胰高血糖素样肽-1 （GLP-1）为基础的治疗时，骨骼肌质量（SSM）过度减少的风险，可能导致肌肉减少症，目前是一个有争议的问题。虽然大多数可用的结果在一般人群中相当令人放心，但肌少症可能会成为一些特殊亚组的担忧，这些亚组的合并症已知与肌少症的高风险相关，独立于任何基于glp -1的治疗。方法：进行了广泛的文献检索，以确定研究glp -1为基础的治疗对特殊人群（如老年人、2型糖尿病患者、动脉粥样硬化性心血管疾病、心力衰竭、慢性肾脏疾病和代谢功能障碍相关肝病）中SMM和肌肉减少症变化的影响。结果：一些出版物强调了肌肉减少症的风险，并建议在患有这些合并症的患者中使用基于glp -1的治疗时要谨慎。然而，文献中缺乏硬数据，没有任何基于证据的证据表明肌肉减少症的风险显着增加。然而，由于老年增加了肌肉减少症的风险，有这些合并症（尤其是晚期心力衰竭或肾脏疾病）的老年患者应该得到更多的注意。结论：尽管在一般人群中，基于glp -1的治疗与肌肉减少症相关的风险仍存在争议，但在具有合并症的特殊人群中，尽管缺乏文献中基于证据的数据，但风险更高已被反复强调。由于这些药物在患有这些合并症的患者中显示出主要的临床益处，但肌肉减少症可以减轻这些合并症，因此迫切需要在这些特殊人群中实施针对肌肉减少症的适当措施的专门研究。

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引用次数: 0

Ulcer topography matters: hindfoot versus forefoot outcomes in first-time diabetic foot ulcer 溃疡地形因素：首次糖尿病足溃疡的后脚与前脚的结果。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-10-10 DOI: 10.1016/j.diabet.2025.101707

Muhammad Mohid Haroon

引用次数: 0