Diabetes & metabolism最新文献_第3页

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

Epicardial adipose tissue volume and diabetic retinopathy 心外膜脂肪组织体积与糖尿病视网膜病变。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-10-08 DOI: 10.1016/j.diabet.2025.101706

Emmanuel Cosson , Sopio Tatulashvili , Marouane Boubaya , Amir Abdul Khalife , Imen Rezgani , Lucie Allard , Meriem Sal , Ines Barka , Mohamed Lamine Mariko , Mohamed Zerguine , Omar Nouhou Koutcha , Bénédicte Gaborit , Coralie Bloch-Queyrat , Pierre-Yves Brillet , Héloïse Torres-Villaros , Audrey Giocanti-Aurégan , Hélène Bihan

Introduction

We explored the association between epicardial adipose tissue (EAT) volume and diabetic retinopathy.

Methods

We used clinical data from a monocentric mixed retrospective and prospective observational study of 1093 individuals living with diabetes who had a computed tomography (CT) scan in order to calculate their coronary artery calcium (CAC) score. This scan was also used to compute EAT volume. For the present study, only persons whose diabetic retinopathy status was known (i.e., yes/no) were included.

Results

We included 1037 individuals living with diabetes (type 2 79.1 %, type 1 14.8 %, other types 6.2 %) for 14.6 ± 9.9 years. Mean body mass index was 29.4 ± 5.9 kg/m², HbA1c was 8.7 ± 2.2 %, 38.2 % had diabetic retinopathy, and EAT volume was 93 ± 40 cm³. Diabetic retinopathy was positively associated with North African ethnicity, type 1 diabetes, longer diabetes duration, higher HbA1c levels, and more hypertension and diabetes-related complications (nephropathy, neuropathy, macroangiopathy and a high CAC score). EAT volume was lower in patients with diabetic retinopathy than in those without (87 ± 37 vs 97 ± 42 cm³, P < 0.0001), independently of confounders (per 10cm³ increase: odds ratio 0.89 [95 % confidence interval 0.84;0.93], P < 0.0001).

Conclusion

We found an unexpected negative association between the volume of EAT—a proinflammatory tissue—and diabetic retinopathy prevalence. This finding warrants further mechanistic investigation.

前言：我们探讨了心外膜脂肪组织（EAT）体积与糖尿病视网膜病变之间的关系。方法：我们使用了一项来自1093例糖尿病患者的单中心混合回顾性和前瞻性观察研究的临床数据，这些糖尿病患者进行了计算机断层扫描（CT），以计算他们的冠状动脉钙（CAC）评分。该扫描也用于计算EAT体积。在本研究中，仅包括糖尿病视网膜病变状态已知的人（即，是/否）。结果：纳入1037例糖尿病患者（2型79.1%，1型14.8%，其他型6.2%），随访14.6±9.9年。平均体重指数为29.4±5.9 kg/m²，糖化血红蛋白为8.7±2.2%，糖尿病视网膜病变38.2%，EAT体积为93±40 cm3。糖尿病视网膜病变与北非种族、1型糖尿病、糖尿病病程较长、HbA1c水平较高、高血压和糖尿病相关并发症（肾病、神经病变、大血管病变和高CAC评分）呈正相关。糖尿病视网膜病变患者的EAT体积低于无糖尿病视网膜病变患者（87±37 vs 97±42 cm3, P < 0.0001），独立于混杂因素（每增加10cm3：优势比0.89[95%可信区间0.84;0.93],P < 0.0001）。结论：我们发现促炎组织eat的体积与糖尿病视网膜病变患病率之间存在意想不到的负相关。这一发现值得进一步的机理研究。

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引用次数: 0

Comment on “Association between smoking status and suicide mortality in patients with type 2 diabetes: A nationwide population-based cohort study” 对“吸烟状况与2型糖尿病患者自杀死亡率的关系：一项全国性人群队列研究”的评论。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-09-19 DOI: 10.1016/j.diabet.2025.101705

Hamza Khan

引用次数: 0

Glycemic and renal effects of SGLT2 Inhibitors in Prader-Willi syndrome: Benefits and risks SGLT2抑制剂对Prader-Willi综合征的血糖和肾脏影响：益处和风险

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-09-18 DOI: 10.1016/j.diabet.2025.101704

Juliette Jacquot-Thierry , Sarah Chalopin , Héléna Mosbah , Émilie Montastier , Fabien Mourre , Blandine Gatta-Cherifi , Julien Bourry , Eléonore Guichard , Pauline Faucher , Christine Poitou , Chloé Amouyal

Objective

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely used in type 2 diabetes (T2D) management, but their efficacy and tolerance in Prader-Willi syndrome (PWS) remains unknown. Given the early onset of diabetes and treatment challenges, evaluating SGLT2is in this population is essential.

Research and methods

In this retrospective, multicenter study, 48 adults with PWS and T2D, among whom 24 patients receiving SGLT2is, were followed over 6 months. Glycemic and renal parameters were analyzed at baseline and 6 months.

Results

HbA1c was higher in the SGLT2i group and significantly improved (P < 0.05) while it remained stable in controls. The albumin-to-creatinine ratio also decreased significantly. No significant weight change was noted. Adverse events occurred in 37.5 % of treated patients, including acute kidney injury in 8.3 %.

Conclusions

SGLT2is improve glycemic control and renal markers in PWS with no weight loss. Close safety monitoring is warranted, particularly regarding renal function in PWS and more generally towards all complex obesity with neurodevelopmental disorders.

目的：钠-葡萄糖共转运蛋白-2抑制剂（SGLT2is）广泛用于2型糖尿病（T2D）治疗，但其在Prader-Willi综合征（PWS）中的疗效和耐受性尚不清楚。考虑到糖尿病的早期发病和治疗挑战，在这一人群中评估SGLT2is是必要的。研究与方法：在这项回顾性的多中心研究中，48例成人PWS合并T2D患者，其中24例接受SGLT2is，随访超过6个月。在基线和6个月时分析血糖和肾脏参数。结果：SGLT2i组HbA1c升高且显著改善（P < 0.05），而对照组保持稳定。白蛋白与肌酐比值也显著降低。没有发现明显的体重变化。不良事件发生率为37.5%，其中急性肾损伤发生率为8.3%。结论：SGLT2is改善了PWS患者的血糖控制和肾脏指标，但没有体重减轻。密切的安全监测是必要的，特别是关于PWS患者的肾功能，更普遍的是针对所有伴有神经发育障碍的复杂肥胖。

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引用次数: 0

Diabetic retinopathy remission in patients using an automated insulin delivery system: A prospective controlled study 使用自动胰岛素输送系统的患者糖尿病视网膜病变缓解：一项前瞻性对照研究。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-09-12 DOI: 10.1016/j.diabet.2025.101703

Beatriz Barquiel , Daniel Álvarez , Óscar Moreno Domínguez , Elena García-Pérez de Sevilla , Natalia Hillman , Ricardo Romero , Ruth Gaspar , Montserrat Arévalo , Noemí González-Perez de Villar

Aims

Diabetic retinopathy (DR) is a complication of chronic hyperglycemia in people living with type 1 diabetes (PLWT1D). The use of automated insulin delivery (AID) systems may modify this course. In this prospective observational study, we evaluated whether the MiniMed 780G AID system was associated with remission or improvement in the severity of DR.

Methods

The study included PLWT1D with DR treated either with the AID system or with multiple daily insulin injections (MDI) combined with intermittent glucose monitoring. The follow-up period was two years. DR was graded annually, and HbA1c levels were recorded. Glucose monitoring parameters were also assessed to evaluate the impact of glucose ranges and variability on retinopathy. Group comparisons were performed using univariate and multivariate statistical analyses.

Results

DR remission occurred in 15/30 (50 %) participants treated with the AID system, compared with 0/30 (0 %) in the MDI group (P < 0.001). Improvement in DR stage was observed in 15/30 (50 %) participants in the AID group, compared with 2/30 (6.7 %) in the MDI group (P < 0.001). These outcomes were associated with lower HbA1c, reduced time above range (TAR), and a lower coefficient of variation (CV) in the remission group.

Conclusion

Remission or improvement of DR was observed in patients with type 1 diabetes treated with an AID system.

目的:。糖尿病视网膜病变（DR）是1型糖尿病（PLWT1D）患者慢性高血糖的并发症。使用自动胰岛素输送（AID）系统可能会改变这一过程。在这项前瞻性观察性研究中，我们评估了MiniMed 780G AID系统是否与dr严重程度的缓解或改善相关。-该研究包括PLWT1D合并DR，采用AID系统或每日多次胰岛素注射（MDI）联合间歇性血糖监测。随访期为两年。DR每年分级，记录HbA1c水平。葡萄糖监测参数也被评估，以评估血糖范围和变异性对视网膜病变的影响。采用单变量和多变量统计分析进行组间比较。结果:。-与MDI组的0/30（0%）相比，接受AID系统治疗的15/30（50%）患者出现了DR缓解（P < 0.001）。AID组15/30（50%）患者的DR期改善，而MDI组2/30（6.7%）患者的DR期改善（P < 0.001）。这些结果与缓解组较低的HbA1c、较短的高于范围时间（TAR）和较低的变异系数（CV）相关。结论:。使用AID系统治疗的1型糖尿病患者的DR得到缓解或改善。

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引用次数: 0

Peripheral neuropathy as a bedside marker for cerebral microangiopathy 周围神经病变作为脑微血管病的床边标志。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-09-12 DOI: 10.1016/j.diabet.2025.101702

Muhammad Mohid Haroon

引用次数: 0

Modelled substitution of meat with dairy products and the 20-year cumulative incidence of type 2 diabetes: Insights from the ATTICA cohort study (2002–2022) 模拟用乳制品代替肉类和20年2型糖尿病的累积发病率：来自ATTICA队列研究的见解（2002-2022）。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism

Pub Date : 2025-09-10 DOI: 10.1016/j.diabet.2025.101701

Ioanna Kechagia , Mary Yannakoulia , Fotios Barkas , Evangelos Liberopoulos , Petros P. Sfikakis , Christos Pitsavos , Demosthenes Panagiotakos

Aim

To evaluate the association between modelled substitution of total, red, and white meat with dairy subtypes (low-fat, full-fat, and fermented) and the 20-year cumulative incidence of type 2 diabetes (T2D), among apparently healthy adults.

Methods

The present analysis included data from 2000 individuals free of atherosclerotic cardiovascular disease and T2D at baseline (age 43 ± 13 years; 51% women), participating in the ATTICA cohort study (2002–2022). Food intake was assessed using a validated semi-quantitative food-frequency questionnaire.

Results

The 20-year cumulative incidence of T2D was 26.3% (95%CI [24.4, 28.3%]). Participants who developed T2D during follow-up reported significantly higher red meat consumption compared to those who did not (5.0 vs. 4.5 times/week; P = 0.016). Modelled substitution of one daily serving of total meat per 1000 kcal with full-fat dairy, in fully adjusted models, suggested a trend (at P < 0.10) of lowering 20-year T2D risk (OR 0.38, 95%CI [0.14, 1.05]); similarly, substitution of one daily serving/1000 kcal of total meat with fermented dairy showed a trend of lowering T2D risk (OR 0.39, 95%CI [0.15, 1.07]). Substituting red meat with full-fat dairy was not associated with T2D risk (OR per one daily serving/1000 kcal = 0.37, 95%CI [0.11, 1.19]); similarly, substitutions with low-fat, fermented dairy or white meat showed not significant associations with T2D risk.

Conclusion

Substituting total and red/processed meat with full-fat or fermented dairy products in modeled analyses indicated potentially favorable, though largely non-significant, associations with long-term risk of T2D.

目的：评估在表面健康的成年人中，用乳制品亚型（低脂、全脂和发酵）替代全肉、红肉和白肉与20年2型糖尿病（T2D）累积发病率之间的关系。方法：本分析包括参加ATTICA队列研究（2002-2022）的2000名基线时无动脉粥样硬化性心血管疾病和T2D的个体（年龄43±13岁；51%为女性）的数据。采用有效的半定量食物频率问卷评估食物摄入量。结果：20年T2D累计发病率为26.3% （95%CI[24.4, 28.3%]）。在随访期间发生T2D的参与者报告的红肉摄入量明显高于未发生T2D的参与者（5.0次/周vs 4.5次/周；P = 0.016）。在完全调整的模型中，用全脂乳制品代替每1000千卡每天食用一份肉类的模型显示，20年T2D风险降低的趋势（P < 0.10）（OR 0.38, 95%CI [0.14, 1.05]）；同样，用发酵乳制品代替每日一份/1000千卡的总肉类也有降低T2D风险的趋势（OR 0.39, 95%CI[0.15, 1.07]）。用全脂乳制品代替红肉与T2D风险无关（OR每一天食用/1000千卡 = 0.37,95%CI [0.11, 1.19]）；同样，低脂、发酵乳制品或白肉的替代品与糖尿病风险没有显著关联。结论：在模拟分析中，用全脂或发酵乳制品代替全肉和红肉/加工肉与T2D的长期风险存在潜在的有利关系，尽管在很大程度上不显著。

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引用次数: 0