Pub Date : 2025-11-21DOI: 10.1016/j.jdiacomp.2025.109228
Jared Rosenberg , Allison Williams , Anny Gano , Molly M. Deak , Gabriel Q. Shaibi , Joon Young Kim
Gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), the two incretin hormones, play an important pathophysiological role in glucose homeostasis with insulinotropic effects on the pancreatic β-cells. While two previous studies in youth have examined the effects of a lifestyle intervention on incretin concentrations, neither study focused on improvements in glycemic status or oral glucose tolerance test (OGTT)-derived biomarkers. Therefore, we aimed to examine changes in the incretin responses during an OGTT before and after a 12-week lifestyle intervention in Latino youth with obesity and impaired glucose tolerance (IGT). A total of 9 Latino youth with obesity and IGT underwent a two-hour OGTT with 30-min blood samples collected for the measurement of glucose, insulin, and incretin hormones before and after the lifestyle intervention (nutrition education and 180 min of moderate-vigorous exercise weekly for a total of 12 weeks). From pre- to post-intervention, a trend towards reduction was observed in the total GIP area under the curve (AUC) during the OGTT (5499.1 ± 715.3 vs. 4085.2 ± 389.5 pg/mL, p = 0.059), with no change in GLP-1. Moreover, BMI%, glucose AUC, and two-hour glucose concentrations were significantly reduced after the intervention. Our data suggest that a lifestyle intervention in Latino youth with obesity and IGT could influence incretin and glucose metabolism. Future studies should examine if the GIP response to a lifestyle intervention is mediated by baseline glycemic status.
胃抑制多肽（GIP）和胰高血糖素样肽-1 （GLP-1）是两种肠促胰岛素激素，在葡萄糖稳态中起重要的病理生理作用，对胰腺β细胞具有促胰岛素作用。虽然之前有两项针对年轻人的研究考察了生活方式干预对肠促胰岛素浓度的影响，但这两项研究都没有关注血糖状态的改善或口服葡萄糖耐量试验（OGTT）衍生的生物标志物。因此，我们的目的是研究肥胖和糖耐量受损（IGT）的拉丁裔青年在12周生活方式干预前后OGTT中肠促胰岛素反应的变化。共有9名患有肥胖和IGT的拉丁裔青年接受了两个小时的OGTT，并在生活方式干预（营养教育和每周180分钟的中等剧烈运动，共12周）前后采集了30分钟的血液样本，用于测量葡萄糖、胰岛素和肠促胰岛素激素。从干预前到干预后，OGTT期间总GIP曲线下面积（AUC）有降低的趋势（5499.1±715.3 vs 4085.2±389.5 pg/mL, p = 0.059）， GLP-1无变化。此外，干预后BMI%、葡萄糖AUC和两小时葡萄糖浓度显著降低。我们的数据表明，对肥胖和IGT的拉丁裔青年进行生活方式干预可能会影响肠促胰岛素和葡萄糖代谢。未来的研究应该检查GIP对生活方式干预的反应是否由基线血糖状态介导。
{"title":"The effects of a 12-week lifestyle intervention on incretin response during an oral glucose tolerance test in Latino youth with obesity and impaired glucose tolerance","authors":"Jared Rosenberg , Allison Williams , Anny Gano , Molly M. Deak , Gabriel Q. Shaibi , Joon Young Kim","doi":"10.1016/j.jdiacomp.2025.109228","DOIUrl":"10.1016/j.jdiacomp.2025.109228","url":null,"abstract":"<div><div>Gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), the two incretin hormones, play an important pathophysiological role in glucose homeostasis with insulinotropic effects on the pancreatic β-cells. While two previous studies in youth have examined the effects of a lifestyle intervention on incretin concentrations, neither study focused on improvements in glycemic status or oral glucose tolerance test (OGTT)-derived biomarkers. Therefore, we aimed to examine changes in the incretin responses during an OGTT before and after a 12-week lifestyle intervention in Latino youth with obesity and impaired glucose tolerance (IGT). A total of 9 Latino youth with obesity and IGT underwent a two-hour OGTT with 30-min blood samples collected for the measurement of glucose, insulin, and incretin hormones before and after the lifestyle intervention (nutrition education and 180 min of moderate-vigorous exercise weekly for a total of 12 weeks). From pre- to post-intervention, a trend towards reduction was observed in the total GIP area under the curve (AUC) during the OGTT (5499.1 ± 715.3 vs. 4085.2 ± 389.5 pg/mL, <em>p</em> = 0.059), with no change in GLP-1. Moreover, BMI%, glucose AUC, and two-hour glucose concentrations were significantly reduced after the intervention. Our data suggest that a lifestyle intervention in Latino youth with obesity and IGT could influence incretin and glucose metabolism. Future studies should examine if the GIP response to a lifestyle intervention is mediated by baseline glycemic status.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109228"},"PeriodicalIF":3.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-15DOI: 10.1016/j.jdiacomp.2025.109209
Daniel de Luis, Olatz Izaola, David Primo, Daniel Rico, Juan Jose López
Background and aims
No studies to date have specifically evaluated the effect of the rs1801282 polymorphism on body weight loss. This study evaluates the role of the PPARG rs1801282 polymorphism in modulating body weight loss and cardiovascular risk factor improvements in response to a partial meal replacement (pMR) hypocaloric diet among Caucasian patients with obesity.
Methods
A total of 512 subjects with severe obesity, defined by a body mass index (BMI) exceeding 35 kg/m2, were recruited for the study. Each participant was instructed to follow a pMR hypocaloric diet a 12-week intervention period. Throughout the trial, comprehensive assessments were performed, including anthropometric parameters (body weight, BMI, fat mass, and waist circumference), blood pressure, biochemical profiling (lipid concentrations, fasting insulin levels, and calculation of the homeostatic model assessment of insulin resistance (HOMA-IR)) and Metabolic syndrome (MS).
Results
The cohort included 107 individuals (20.9 %) homozygous for the CC allele, 203 individuals (39.6 %) heterozygous (CG), and 202 individuals (39.5 %) homozygous for the GG allele. BMI (−2.3 ± 0.3 kg/m2 vs − 1.0 ± 0.1 kg/m2 (p = 0.01)), body weight (−9.0 ± 1.1 kg vs − 3.8 ± 2.1 kg (p = 0.01)), fat mass (−8.1 ± 0.2 kg vs − 2.8 ± 0.2 kg (p = 0.01)), waist circumference (−6.8 ± 0.1 cm vs − 5.1 ± 0.1 cm (p = 0.01)), glucose levels (−15.1 ± 1.9 mg/dl vs − 4.1 ± 2.8 mg/dl, p = 0.01), insulin (−9.8 ± 1.3 UI/L vs − 3.7 ± 2.1 UI/L, p = 0.01), HOMA-IR (−2.2 ± 1.0 units vs − 0.60 ± 0.2 units, p = 0.01), CRP (−1.3 ± 0.1 mg/dl vs − 0.2 ± 0.2 mg/dl, p = 0.01), triglycerides (−24.1 ± 3.3 mg/dl vs − 4.1 ± 3.2 mg/dl, p = 0.01), total-cholesterol (−23.2 ± 1.1 mg/dl vs − 8.9 ± 1.2 mg/dl, p = 0.01), LDL-cholesterol (−17.2 ± 1.2 mg/dl vs − 5.7 ± 1.1 mg/dl, p = 0.01), and HDL-cholesterol (8.2 ± 0.3 mg/dl vs 2.3 ± 1.2 mg/dl, p = 0.01) modifications were better in non-G allele carriers. After intervention, the odds ratio (OR) of MS in non-carrier of G allele improved OR 0.39 (95 %CI: 0.24–0.63; p = 0.02).
Conclusions
This study shows that the PPARG rs1801282 polymorphism modulates the response to pMR in Caucasian patients with obesity, with G allele carriers displaying a less favourable improvement in body weight and metabolic parameters.
背景与目的：迄今为止，尚无研究专门评估rs1801282多态性对体重减轻的影响。本研究评估了PPARG rs1801282多态性在调节高加索肥胖患者部分代餐（pMR）低热量饮食后体重减轻和心血管危险因素改善中的作用。方法：共招募512名体重指数（BMI）超过35 kg/m2的重度肥胖受试者。每位参与者被要求在12周的干预期内遵循pMR低热量饮食。在整个试验过程中，进行了全面的评估，包括人体测量参数（体重、BMI、脂肪量和腰围）、血压、生化分析（脂质浓度、空腹胰岛素水平，以及胰岛素抵抗（HOMA-IR）的稳态模型评估计算）和代谢综合征（MS）。结果：CC等位基因纯合子107例（20.9%），CG杂合子203例（39.6%），GG等位基因纯合子202例（39.5%）。BMI(-2.3±0.3 kg / m2 vs - 1.0±0.1 kg / m2) (p = 0.01),体重(-9.0±1.1公斤vs - 3.8±2.1公斤(p = 0.01)),脂肪量(-8.1±0.2公斤vs - 2.8±0.2公斤(p = 0.01)),腰围(-6.8±0.1厘米和5.1±0.1厘米(p = 0.01),血糖水平(-15.1±1.9 mg / dl vs - 4.1±2.8 mg / dl, p = 0.01),胰岛素(-9.8±1.3 UI / UI / L L vs - 3.7±2.1,p = 0.01), HOMA-IR(-2.2±1.0单位vs - 0.60±0.2单位,p = 0.01), c反应蛋白(-1.3±0.1 mg / dl vs - 0.2±0.2 mg / dl, p = 0.01),甘油三酯(-24.1±3.3 mg / dl vs - 4.1±3.2 mg / dl, p = 0.01),总胆固醇(-23.2±1.1 mg / dl vs - 8.9±1.2 mg / dl, p = 0.01),低密度脂蛋白胆固醇(-17.2±1.2 mg / dl vs - 5.7±1.1 mg / dl, p = 0.01),和脂蛋白胆固醇(8.2±0.3 mg / dl vs 2.3±1.2 mg / dl, p = 0.01)修改好non-G等位基因携带者。干预后，非G等位基因携带者MS的优势比（OR）改善OR 0.39 （95% CI: 0.24 ~ 0.63; p = 0.02）。结论：本研究表明，PPARG rs1801282多态性调节了高加索肥胖患者对pMR的反应，G等位基因携带者在体重和代谢参数方面表现出不太有利的改善。
{"title":"Effect of the PPARG rs1801282 polymorphism on weight reduction and metabolic syndrome outcomes in obese individuals undergoing a partial meal replacement hypocaloric diet","authors":"Daniel de Luis, Olatz Izaola, David Primo, Daniel Rico, Juan Jose López","doi":"10.1016/j.jdiacomp.2025.109209","DOIUrl":"10.1016/j.jdiacomp.2025.109209","url":null,"abstract":"<div><h3>Background and aims</h3><div>No studies to date have specifically evaluated the effect of the <em>rs1801282</em> polymorphism on body weight loss. This study evaluates the role of the PPARG <em>rs1801282</em> polymorphism in modulating body weight loss and cardiovascular risk factor improvements in response to a partial meal replacement (pMR) hypocaloric diet among Caucasian patients with obesity.</div></div><div><h3>Methods</h3><div>A total of 512 subjects with severe obesity, defined by a body mass index (BMI) exceeding 35 kg/m<sup>2</sup>, were recruited for the study. Each participant was instructed to follow a pMR hypocaloric diet a 12-week intervention period. Throughout the trial, comprehensive assessments were performed, including anthropometric parameters (body weight, BMI, fat mass, and waist circumference), blood pressure, biochemical profiling (lipid concentrations, fasting insulin levels, and calculation of the homeostatic model assessment of insulin resistance (HOMA-IR)) and Metabolic syndrome (MS).</div></div><div><h3>Results</h3><div>The cohort included 107 individuals (20.9 %) homozygous for the CC allele, 203 individuals (39.6 %) heterozygous (CG), and 202 individuals (39.5 %) homozygous for the GG allele. BMI (−2.3 ± 0.3 kg/m<sup>2</sup> vs − 1.0 ± 0.1 kg/m<sup>2</sup> (p = 0.01)), body weight (−9.0 ± 1.1 kg vs − 3.8 ± 2.1 kg (p = 0.01)), fat mass (−8.1 ± 0.2 kg vs − 2.8 ± 0.2 kg (p = 0.01)), waist circumference (−6.8 ± 0.1 cm vs − 5.1 ± 0.1 cm (p = 0.01)), glucose levels (−15.1 ± 1.9 mg/dl vs − 4.1 ± 2.8 mg/dl, p = 0.01), insulin (−9.8 ± 1.3 UI/L vs − 3.7 ± 2.1 UI/L, p = 0.01), HOMA-IR (−2.2 ± 1.0 units vs − 0.60 ± 0.2 units, p = 0.01), CRP (−1.3 ± 0.1 mg/dl vs − 0.2 ± 0.2 mg/dl, p = 0.01), triglycerides (−24.1 ± 3.3 mg/dl vs − 4.1 ± 3.2 mg/dl, p = 0.01), total-cholesterol (−23.2 ± 1.1 mg/dl vs − 8.9 ± 1.2 mg/dl, p = 0.01), LDL-cholesterol (−17.2 ± 1.2 mg/dl vs − 5.7 ± 1.1 mg/dl, p = 0.01), and HDL-cholesterol (8.2 ± 0.3 mg/dl vs 2.3 ± 1.2 mg/dl, p = 0.01) modifications were better in non-G allele carriers. After intervention, the odds ratio (OR) of MS in non-carrier of G allele improved OR 0.39 (95 %CI: 0.24–0.63; p = 0.02).</div></div><div><h3>Conclusions</h3><div>This study shows that the PPARG rs1801282 polymorphism modulates the response to pMR in Caucasian patients with obesity, with G allele carriers displaying a less favourable improvement in body weight and metabolic parameters.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109209"},"PeriodicalIF":3.1,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-10DOI: 10.1016/j.jdiacomp.2025.109227
Anahita Golchin , Karen C. Johnson , Denise K. Houston , Jose A. Luchsinger , Kristen M. Beavers , Alain G. Bertoni , Haiying Chen , Lynne Wagenknecht , Mark A. Espeland , for the Action for Health in Diabetes (Look AHEAD) Aging Study Group
Aims
Type 2 diabetes and obesity accelerate cognitive decline. Maintaining salutary levels of multiple lifestyle and clinical risk factors might be expected to protect against this. We examined whether healthier levels of adiposity, cardiorespiratory fitness, physical activity, and diabetes control were associated with better cognitive functioning.
Methods
Data are from the Action for Health in Diabetes clinical trial of adults with type 2 diabetes and overweight or obesity. Standardized measures of body mass indices, percent body fat, objective and self-reported physical activity, cardiorespiratory fitness, and HbA1c were collected across 4 and 8 years. Associations between healthier versus less healthy levels (categorized based on ± one standard deviation from the cohort mean) of these measures with subsequent standardized (z-scores) assessments of cognitive function were assessed using linear regression.
Results
Among 3723 participants, high versus low cardiorespiratory fitness was associated with 0.08 to 0.13 standard deviation better global cognitive function, executive function, and attention (p < 0.001). Lower versus high HbA1c was associated with 0.17 to 0.22 standard deviation better cognitive function for all domains (p < 0.001). Associations that fitness and HbA1c had with cognitive function were independent and additive. No significant associations with cognitive function were found for physical activity or adiposity.
Conclusions
Maintaining greater cardiorespiratory fitness and better diabetes control may protect cognitive function in type 2 diabetes.
{"title":"Associations of modifiable lifestyle and clinical factors with cognitive function in adults with type 2 diabetes","authors":"Anahita Golchin , Karen C. Johnson , Denise K. Houston , Jose A. Luchsinger , Kristen M. Beavers , Alain G. Bertoni , Haiying Chen , Lynne Wagenknecht , Mark A. Espeland , for the Action for Health in Diabetes (Look AHEAD) Aging Study Group","doi":"10.1016/j.jdiacomp.2025.109227","DOIUrl":"10.1016/j.jdiacomp.2025.109227","url":null,"abstract":"<div><h3>Aims</h3><div>Type 2 diabetes and obesity accelerate cognitive decline. Maintaining salutary levels of multiple lifestyle and clinical risk factors might be expected to protect against this. We examined whether healthier levels of adiposity, cardiorespiratory fitness, physical activity, and diabetes control were associated with better cognitive functioning.</div></div><div><h3>Methods</h3><div>Data are from the Action for Health in Diabetes clinical trial of adults with type 2 diabetes and overweight or obesity. Standardized measures of body mass indices, percent body fat, objective and self-reported physical activity, cardiorespiratory fitness, and HbA1c were collected across 4 and 8 years. Associations between healthier versus less healthy levels (categorized based on ± one standard deviation from the cohort mean) of these measures with subsequent standardized (z-scores) assessments of cognitive function were assessed using linear regression.</div></div><div><h3>Results</h3><div>Among 3723 participants, high versus low cardiorespiratory fitness was associated with 0.08 to 0.13 standard deviation better global cognitive function, executive function, and attention (<em>p</em> < 0.001). Lower versus high HbA1c was associated with 0.17 to 0.22 standard deviation better cognitive function for all domains (p < 0.001). Associations that fitness and HbA1c had with cognitive function were independent and additive. No significant associations with cognitive function were found for physical activity or adiposity.</div></div><div><h3>Conclusions</h3><div>Maintaining greater cardiorespiratory fitness and better diabetes control may protect cognitive function in type 2 diabetes.</div></div><div><h3><span><span><strong>ClinicalTrials.gov</strong></span><svg><path></path></svg></span> <strong>Identifier</strong></h3><div><span><span>NCT00017953</span><svg><path></path></svg></span></div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109227"},"PeriodicalIF":3.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-10DOI: 10.1016/S1056-8727(25)00274-0
{"title":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(25)00274-0","DOIUrl":"10.1016/S1056-8727(25)00274-0","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109221"},"PeriodicalIF":3.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.jdiacomp.2025.109216
Ruili Qin , Changqin Jiang , Mengnan Zhang , Xueyan Hou , Xiaoling Tao , Shuang Pan , Zhaoqian Wang
Background
This study aimed to investigate the predictive value of non-alcoholic fatty liver disease (NAFLD), pericoronary fat attenuation index (FAI), and computed tomography-derived fractional flow reserve (CT-FFR) for major adverse cardiovascular events (MACE) in diabetic patients with suspected coronary artery disease.
Methods
This study retrospectively included 466 diabetic patients who underwent coronary computed tomography angiography (CCTA) and non-contrast chest CT from January 2017 to December 2018. The clinical data and imaging parameters of patients were collected. MACE was defined as rehospitalization for unstable angina, non-fatal myocardial infarction, late coronary revascularization, cardiac death, and all-cause mortality.
Results
During a median follow-up of 70 months, 76 patients experienced MACE. NAFLD (hazard ratio [HR] = 2.248; 95 % confidence interval [CI]: 1.362–3.710; P = 0.002), pericoronary FAI > −71.42 HU (HR = 4.063; 95 % CI: 2.316–7.131; P < 0.001), and CT-FFR ≤ 0.80 (HR = 6.023; 95 % CI: 2.567–14.132; P < 0.001) associated with MACE independently. We developed six MACE prediction models: model 1: traditional clinical risk factors; model 2: model 1 + NAFLD; model 3: model 2 + CCTA characteristics; model 4: model 3 + CT-FFR ≤ 0.80; model 5: model 3 + pericoronary FAI > −71.42 HU; model 6: model 5 + CT-FFR ≤ 0.80. The areas under curve of above six models were 0.698, 0.741, 0.861, 0.890, 0.917 and 0.936 respectively.
Conclusions
NAFLD, pericoronary FAI, and CT-FFR were independent predictors of MACE in diabetic patients. The multiparametric model 6 demonstrated the optimal predictive performance for MACE.
背景：本研究旨在探讨非酒精性脂肪性肝病（NAFLD）、冠状动脉周围脂肪衰减指数（FAI）和CT-FFR对疑似冠状动脉疾病的糖尿病患者主要不良心血管事件（MACE）的预测价值。方法：本研究回顾性纳入2017年1月至2018年12月接受冠状动脉计算机断层血管造影（CCTA）和胸部非对比CT检查的466例糖尿病患者。收集患者的临床资料及影像学参数。MACE定义为不稳定心绞痛、非致死性心肌梗死、晚期冠状动脉血运重建术、心源性死亡和全因死亡率的再住院。结果：在中位随访70个月期间，76例患者经历了MACE。NAFLD（风险比[HR] = 2.248； 95%可信区间[CI]: 1.362-3.710; P = 0.002），冠状动脉周围FAI > -71.42 HU (HR = 4.063; 95% CI: 2.316-7.131; P -71.42 HU；模型6：模型5 + CT-FFR≤0.80。上述6个模型的曲线下面积分别为0.698、0.741、0.861、0.890、0.917和0.936。结论：NAFLD、冠状动脉周围FAI和CT-FFR是糖尿病患者MACE的独立预测因子。多参数模型6显示了MACE的最佳预测性能。
{"title":"Prognostic value of non-alcoholic fatty liver disease, pericoronary fat attenuation index and computed tomography-derived fractional flow reserve in diabetic patients with suspected coronary artery disease","authors":"Ruili Qin , Changqin Jiang , Mengnan Zhang , Xueyan Hou , Xiaoling Tao , Shuang Pan , Zhaoqian Wang","doi":"10.1016/j.jdiacomp.2025.109216","DOIUrl":"10.1016/j.jdiacomp.2025.109216","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the predictive value of non-alcoholic fatty liver disease (NAFLD), pericoronary fat attenuation index (FAI), and computed tomography-derived fractional flow reserve (CT-FFR) for major adverse cardiovascular events (MACE) in diabetic patients with suspected coronary artery disease.</div></div><div><h3>Methods</h3><div>This study retrospectively included 466 diabetic patients who underwent coronary computed tomography angiography (CCTA) and non-contrast chest CT from January 2017 to December 2018. The clinical data and imaging parameters of patients were collected. MACE was defined as rehospitalization for unstable angina, non-fatal myocardial infarction, late coronary revascularization, cardiac death, and all-cause mortality.</div></div><div><h3>Results</h3><div>During a median follow-up of 70 months, 76 patients experienced MACE. NAFLD (hazard ratio [HR] = 2.248; 95 % confidence interval [CI]: 1.362–3.710; <em>P</em> = 0.002), pericoronary FAI > −71.42 HU (HR = 4.063; 95 % CI: 2.316–7.131; <em>P</em> < 0.001), and CT-FFR ≤ 0.80 (HR = 6.023; 95 % CI: 2.567–14.132; <em>P</em> < 0.001) associated with MACE independently. We developed six MACE prediction models: model 1: traditional clinical risk factors; model 2: model 1 + NAFLD; model 3: model 2 + CCTA characteristics; model 4: model 3 + CT-FFR ≤ 0.80; model 5: model 3 + pericoronary FAI > −71.42 HU; model 6: model 5 + CT-FFR ≤ 0.80. The areas under curve of above six models were 0.698, 0.741, 0.861, 0.890, 0.917 and 0.936 respectively.</div></div><div><h3>Conclusions</h3><div>NAFLD, pericoronary FAI, and CT-FFR were independent predictors of MACE in diabetic patients. The multiparametric model 6 demonstrated the optimal predictive performance for MACE.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109216"},"PeriodicalIF":3.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.jdiacomp.2025.109210
Tommy Slater , Gema Hernández Ibarburu , Zuzanna Drebert , Joseph Henson , Jonathan Goldney , Francesco Zaccardi , Jack A. Sargeant , Karen Brown , David R. Webb , Dimitris Papamargaritis , Juliana C.N. Chan , Edward W. Gregg , Kamlesh Khunti , Melanie J. Davies , Thomas Yates
Aims
To investigate whether the association between type 2 diabetes diagnosis and relative and absolute risk of obesity-related cancers differs based on age at diabetes diagnosis.
Methods
This retrospective, observational cohort study used data from the US Collaborative Network within the TriNetX database. Individuals with type 2 diabetes were propensity matched – for age, sex, and ethnicity – to individuals without type 2 diabetes. Crude 5-year risks of obesity-related cancer were calculated. Cox proportional-hazards models were used to assess relative rates of obesity-related cancer incidence over five years, comparing individuals with type 2 diabetes in younger (aged ≤40 years; n = 162,691) and middle-older age (aged >40 years; n = 1,616,950), with propensity-matched cohorts without type 2 diabetes.
Results
Absolute risk of developing cancer was greater in individuals with versus without type 2 diabetes. Relative rates of any cancer were greater in younger (HR: 2·01 [95 % CI: 1·85, 2·19]) than middle-older age adults (1·49 [1·48, 1·51]). The highest relative rates in younger adults were observed for corpus uteri (HR: 4·76 [3·51, 6·46]) and pancreatic cancer (4·25 [2·34, 7·72]). Corresponding HRs in middle-older age adults were 1·92 (1·84, 2·01) and 1·75 (1·68, 1·83).
Conclusions
The five-year risk of cancer was higher in those with newly diagnosed type 2 diabetes versus those without. Absolute risk was greater in middle-older age adults, although relative rates were greater amongst younger adults. This persisted across most site-specific cancers, suggesting targeted strategies for early detection and prevention may help younger adults with newly-diagnosed type 2 diabetes reduce lifetime disease burden.
{"title":"Age at type 2 diabetes diagnosis and risk of cancer: Cohort study in over 1 million individuals from the TriNetX US Collaborative Network","authors":"Tommy Slater , Gema Hernández Ibarburu , Zuzanna Drebert , Joseph Henson , Jonathan Goldney , Francesco Zaccardi , Jack A. Sargeant , Karen Brown , David R. Webb , Dimitris Papamargaritis , Juliana C.N. Chan , Edward W. Gregg , Kamlesh Khunti , Melanie J. Davies , Thomas Yates","doi":"10.1016/j.jdiacomp.2025.109210","DOIUrl":"10.1016/j.jdiacomp.2025.109210","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate whether the association between type 2 diabetes diagnosis and relative and absolute risk of obesity-related cancers differs based on age at diabetes diagnosis.</div></div><div><h3>Methods</h3><div>This retrospective, observational cohort study used data from the US Collaborative Network within the TriNetX database. Individuals with type 2 diabetes were propensity matched – for age, sex, and ethnicity – to individuals without type 2 diabetes. Crude 5-year risks of obesity-related cancer were calculated. Cox proportional-hazards models were used to assess relative rates of obesity-related cancer incidence over five years, comparing individuals with type 2 diabetes in younger (aged ≤40 years; <em>n</em> = 162,691) and middle-older age (aged >40 years; <em>n</em> = 1,616,950), with propensity-matched cohorts without type 2 diabetes.</div></div><div><h3>Results</h3><div>Absolute risk of developing cancer was greater in individuals with versus without type 2 diabetes. Relative rates of any cancer were greater in younger (HR: 2·01 [95 % CI: 1·85, 2·19]) than middle-older age adults (1·49 [1·48, 1·51]). The highest relative rates in younger adults were observed for corpus uteri (HR: 4·76 [3·51, 6·46]) and pancreatic cancer (4·25 [2·34, 7·72]). Corresponding HRs in middle-older age adults were 1·92 (1·84, 2·01) and 1·75 (1·68, 1·83).</div></div><div><h3>Conclusions</h3><div>The five-year risk of cancer was higher in those with newly diagnosed type 2 diabetes versus those without. Absolute risk was greater in middle-older age adults, although relative rates were greater amongst younger adults. This persisted across most site-specific cancers, suggesting targeted strategies for early detection and prevention may help younger adults with newly-diagnosed type 2 diabetes reduce lifetime disease burden.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109210"},"PeriodicalIF":3.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess the effect of insulin delivery and glucose monitoring technologies on quality of life in relation with glucose control in adults with type 1 diabetes (T1D).
Methods
This cross-sectional study included 69 adults with T1D (mean age 39.3 ± 12.1 years; 44.9 % females): 36 on multiple daily insulin injections (MDI) and 33 on continuous subcutaneous insulin infusion (CSII). Patient-reported outcomes were assessed using the Diabetes Treatment Satisfaction Questionnaire (DTSQ), Diabetes-Specific Quality of Life Scale (DSQOLS), and SF-36. Glucose control was evaluated using HbA1c and CGM metrics.
Results
Individuals in the CSII group reported higher treatment-related satisfaction (p = 0.004), and better disease acceptance (p = 0.004) compared with individuals on MDI, despite similar age, sex or disease duration (p > 0.34). Time in range (TIR) resulted higher in the CSII group than in the MDI group (p = 0.02), while time below range (TBR) resulted higher in the MDI group compared to CSII (p = 0.03). Individuals reporting high satisfaction scores demonstrated better glucose control metrics compared to those with lower satisfaction levels. The association between satisfaction and TIR was relevant, even after adjusting for treatment modality (p = 0.0003).
Conclusions
Technology may improve quality of life over MDI treatment. Improvement in glucose control may partially account for this effect.
{"title":"Impact of technologies on quality of life in relation to glucose control in patients with type 1 diabetes","authors":"Silvia Irina Briganti , Oreste Lanza , Valerio Renzelli , Giuseppe Campagna , Daria Maggi , Massimiliano Caprio , Silvia Manfrini , Rocky Strollo","doi":"10.1016/j.jdiacomp.2025.109215","DOIUrl":"10.1016/j.jdiacomp.2025.109215","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the effect of insulin delivery and glucose monitoring technologies on quality of life in relation with glucose control in adults with type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>This cross-sectional study included 69 adults with T1D (mean age 39.3 ± 12.1 years; 44.9 % females): 36 on multiple daily insulin injections (MDI) and 33 on continuous subcutaneous insulin infusion (CSII). Patient-reported outcomes were assessed using the Diabetes Treatment Satisfaction Questionnaire (DTSQ), Diabetes-Specific Quality of Life Scale (DSQOLS), and SF-36. Glucose control was evaluated using HbA1c and CGM metrics.</div></div><div><h3>Results</h3><div>Individuals in the CSII group reported higher treatment-related satisfaction (<em>p</em> = 0.004), and better disease acceptance (p = 0.004) compared with individuals on MDI, despite similar age, sex or disease duration (<em>p</em> > 0.34). Time in range (TIR) resulted higher in the CSII group than in the MDI group (<em>p</em> = 0.02), while time below range (TBR) resulted higher in the MDI group compared to CSII (<em>p</em> = 0.03). Individuals reporting high satisfaction scores demonstrated better glucose control metrics compared to those with lower satisfaction levels. The association between satisfaction and TIR was relevant, even after adjusting for treatment modality (<em>p</em> = 0.0003).</div></div><div><h3>Conclusions</h3><div>Technology may improve quality of life over MDI treatment. Improvement in glucose control may partially account for this effect.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109215"},"PeriodicalIF":3.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1016/j.jdiacomp.2025.109212
Junchen He , Haodong Zhang , Yinxi Tan , Huangda Guo , Hexiang Peng , Yi Zheng , Lunrongyi Tian , Xinru Liu , Yiqun Wu , Xueying Qin , Haiying Gong , Yao Zhao , Weifeng Wu , Tao Wu , Dafang Chen , Yonghua Hu , Mengying Wang
Background
The hemoglobin glycation index (HGI) has been increasingly recognized for predicting cardiovascular outcomes. However, its association with all-cause and cardiovascular disease (CVD) mortality in the general population remains underexplored. This study aimed to investigate the nonlinear relationship between the HGI and mortality, identify risk thresholds, and evaluate HGI's clinical utility for individualized risk stratification.
Methods
4857 participants from the Fangshan Family-based Ischemic Stroke Study in China (FISSIC) were included. Death dates were obtained by reviewing the death certificates until 2024/7/31. During a median follow-up of 8 years, 652 deaths were identified, including 379 deaths due to CVD. HGI was calculated as HGI = Observed hemoglobin A1c (HbA1c) − Predicted HbA1c. Cox proportional hazard regression models and restricted cubic splines were constructed to assess the relationship of HGI with mortality risk.
Results
This study revealed a J-shaped association of HGI with both all-cause and CVD mortality. For all-cause mortality, when HGI was below the threshold point (−0.58), the mortality risk slightly decreased with increasing HGI, with a hazard ratio (HR) of 0.821 (95 %CI: 0.666–1.011, P = 0.064). Conversely, when HGI exceeded −0.58, the mortality risk significantly increased with higher HGI (HR: 1.193, 95 % CI: 1.104–1.289, P < 0.001). CVD mortality exhibited similar threshold effects, with HGI < −0.58 trended toward lower risk (HR: 0.80, 95 %CI: 0.60–1.06, P = 0.114), whereas HGI > −0.58 showed marked risk elevation (HR: 1.23, 95 %CI: 1.11–1.36, P < 0.001).
Conclusion
This study demonstrates a nonlinear relationship of HGI with both all-cause and CVD mortality.
{"title":"Nonlinear association of the hemoglobin glycation index with all-cause and cardiovascular mortality: A community-based cohort study","authors":"Junchen He , Haodong Zhang , Yinxi Tan , Huangda Guo , Hexiang Peng , Yi Zheng , Lunrongyi Tian , Xinru Liu , Yiqun Wu , Xueying Qin , Haiying Gong , Yao Zhao , Weifeng Wu , Tao Wu , Dafang Chen , Yonghua Hu , Mengying Wang","doi":"10.1016/j.jdiacomp.2025.109212","DOIUrl":"10.1016/j.jdiacomp.2025.109212","url":null,"abstract":"<div><h3>Background</h3><div>The hemoglobin glycation index (HGI) has been increasingly recognized for predicting cardiovascular outcomes. However, its association with all-cause and cardiovascular disease (CVD) mortality in the general population remains underexplored. This study aimed to investigate the nonlinear relationship between the HGI and mortality, identify risk thresholds, and evaluate HGI's clinical utility for individualized risk stratification.</div></div><div><h3>Methods</h3><div>4857 participants from the Fangshan Family-based Ischemic Stroke Study in China (FISSIC) were included. Death dates were obtained by reviewing the death certificates until 2024/7/31. During a median follow-up of 8 years, 652 deaths were identified, including 379 deaths due to CVD. HGI was calculated as <em>HGI = Observed hemoglobin A1c (HbA1c) − Predicted HbA1c</em>. Cox proportional hazard regression models and restricted cubic splines were constructed to assess the relationship of HGI with mortality risk.</div></div><div><h3>Results</h3><div>This study revealed a J-shaped association of HGI with both all-cause and CVD mortality. For all-cause mortality, when HGI was below the threshold point (−0.58), the mortality risk slightly decreased with increasing HGI, with a hazard ratio (HR) of 0.821 (95 %CI: 0.666–1.011, <em>P</em> = 0.064). Conversely, when HGI exceeded −0.58, the mortality risk significantly increased with higher HGI (HR: 1.193, 95 % CI: 1.104–1.289, <em>P</em> < 0.001). CVD mortality exhibited similar threshold effects, with HGI < −0.58 trended toward lower risk (HR: 0.80, 95 %CI: 0.60–1.06, <em>P</em> = 0.114), whereas HGI > −0.58 showed marked risk elevation (HR: 1.23, 95 %CI: 1.11–1.36, <em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>This study demonstrates a nonlinear relationship of HGI with both all-cause and CVD mortality.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109212"},"PeriodicalIF":3.1,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MicroRNAs (miRNAs) are critical regulators of gene expression and have emerged as promising biomarkers and therapeutic targets in type 2 diabetes (T2D). Among them, the miR-200 family (miR-200a, miR-200b, miR-200c, miR-141, and miR-429) plays key roles in insulin sensitivity, pancreatic β-cell survival, and inflammation. Dysregulation of miR-200a/b and miR-200c has been linked to insulin resistance and β-cell apoptosis, although findings are context dependent, with miR-200c showing both protective and deleterious effects. Therapeutic approaches include the use of antagomiRs to inhibit miR-200a/b (to improve insulin sensitivity) and miR-200c mimics at physiological/ moderate level (to enhance β-cell resilience under oxidative stress). Advances in nanoparticle delivery systems (liposomes, micelles, dendrimers) and chemical modifications such as 2′-O-methyl, 2′-O-methoxyethyl, and locked nucleic acids have improved stability and efficacy, though barriers remain in achieving tissue specificity and minimizing immune activation. In addition to therapy, miR-200 family members are attractive non-invasive biomarkers, with recent studies reporting encouraging sensitivity and specificity for early T2D detection and monitoring of disease progression. However, major challenges persist, including delivery barriers, long-term safety concerns, and limited validation in large, multi-ethnic human cohorts. This review synthesizes current evidence on the dual potential therapeutic strategies of miR-200 inhibition and mimicry, evaluates their biomarker utility, and highlights future directions needed to overcome translational gaps. By addressing these limitations, miR-200-based strategies hold potential to advance toward clinical application in T2D.
MicroRNAs （miRNAs）是基因表达的关键调控因子，已成为2型糖尿病（T2D）有前景的生物标志物和治疗靶点。其中，miR-200家族（miR-200a、miR-200b、miR-200c、miR-141和miR-429）在胰岛素敏感性、胰腺β细胞存活和炎症中起关键作用。miR-200a/b和miR-200c的失调与胰岛素抵抗和β细胞凋亡有关，尽管研究结果依赖于环境，miR-200c显示出保护和有害作用。治疗方法包括使用拮抗剂在生理/中等水平抑制miR-200a/b（改善胰岛素敏感性）和miR-200c模拟物（增强氧化应激下β细胞的恢复能力）。纳米颗粒递送系统（脂质体、胶束、树突大分子）和化学修饰（如2'- o -甲基、2'- o -甲氧基乙基和锁定核酸）的进步提高了稳定性和有效性，尽管在实现组织特异性和最小化免疫激活方面仍然存在障碍。除了治疗之外，miR-200家族成员是有吸引力的非侵入性生物标志物，最近的研究报告了早期T2D检测和疾病进展监测的令人鼓舞的敏感性和特异性。然而，主要的挑战仍然存在，包括递送障碍、长期安全问题以及在大型多种族人群中的有限验证。这篇综述综合了目前关于miR-200抑制和模仿的双重潜在治疗策略的证据，评估了它们的生物标志物效用，并强调了克服翻译空白所需的未来方向。通过解决这些局限性，基于mir -200的策略有可能在T2D的临床应用中取得进展。
{"title":"The miR-200 family in type 2 diabetes: therapeutic and biomarker perspectives","authors":"Toluwalope Esther Ajonijebu , Sithandiwe Eunice Mazibuko-Mbeje","doi":"10.1016/j.jdiacomp.2025.109211","DOIUrl":"10.1016/j.jdiacomp.2025.109211","url":null,"abstract":"<div><div>MicroRNAs (miRNAs) are critical regulators of gene expression and have emerged as promising biomarkers and therapeutic targets in type 2 diabetes (T2D). Among them, the miR-200 family (miR-200a, miR-200b, miR-200c, miR-141, and miR-429) plays key roles in insulin sensitivity, pancreatic β-cell survival, and inflammation. Dysregulation of miR-200a/b and miR-200c has been linked to insulin resistance and β-cell apoptosis, although findings are context dependent, with miR-200c showing both protective and deleterious effects. Therapeutic approaches include the use of antagomiRs to inhibit miR-200a/b (to improve insulin sensitivity) and miR-200c mimics at physiological/ moderate level (to enhance β-cell resilience under oxidative stress). Advances in nanoparticle delivery systems (liposomes, micelles, dendrimers) and chemical modifications such as 2′-<em>O</em>-methyl, 2′-O-methoxyethyl, and locked nucleic acids have improved stability and efficacy, though barriers remain in achieving tissue specificity and minimizing immune activation. In addition to therapy, miR-200 family members are attractive non-invasive biomarkers, with recent studies reporting encouraging sensitivity and specificity for early T2D detection and monitoring of disease progression. However, major challenges persist, including delivery barriers, long-term safety concerns, and limited validation in large, multi-ethnic human cohorts. This review synthesizes current evidence on the dual potential therapeutic strategies of miR-200 inhibition and mimicry, evaluates their biomarker utility, and highlights future directions needed to overcome translational gaps. By addressing these limitations, miR-200-based strategies hold potential to advance toward clinical application in T2D.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109211"},"PeriodicalIF":3.1,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-05DOI: 10.1016/j.jdiacomp.2025.109214
Soo Lim , Cheol Young Park , In Kyung Jeong , Ji Sung Yoon , Sang Yong Kim , Eun Seok Kang , Junghyun Noh , Kyu Yeon Hur , Sungrae Kim
Aims
Sodium-glucose cotransporter-2 (SGLT2) inhibitors offer cardiovascular and renal benefits beyond glycemic control. However, their effect on glucose variability (GV) in drug-naïve individuals with type 2 diabetes (T2D) is not well established. This study compared the effects of empagliflozin versus metformin on GV and metabolic outcomes.
Methods
In this multicenter, open-label, randomized study, 46 drug-naïve adults with T2D (HbA1c 6.5 %–10.0 %) received empagliflozin (10 mg/day; n = 23) or metformin (1000 mg/day; n = 23) for 12 weeks. The primary outcome was change in mean amplitude of glucose excursions (MAGE), assessed by continuous glucose monitoring. Secondary outcomes included standard deviation of glucose, time-in-range (TIR), metabolic parameters, and safety.
Results
At Week 12, empagliflozin significantly reduced MAGE (−19.58 mg/dL; 95 % CI: −30.62, −8.53) compared with metformin (−4.33 mg/dL; 95 % CI: −7.98, −0.68) (n = 19 vs. n = 18, respectively). TIR improved in both groups, with no significant between-group differences. Empagliflozin treatment led to greater reductions in body weight and waist circumference, along with increases in HDL-cholesterol and decreases in triglyceride and uric acid levels. The decrease in HbA1c from baseline was greater in the empagliflozin group (−1.15 % [95 % CI: −1.44, −0.85]) than in the metformin group (−0.78 % [95 % CI: −1.02, −0.54]), resulting in a statistically significant between-group difference (p = 0.049). Adverse events were mild and comparable between groups.
Conclusions
Empagliflozin significantly reduced GV and provided additional metabolic benefits in drug-naïve individuals with T2D. These findings support its potential utility in early diabetes management, particularly in targeting glycemic variability.
{"title":"Empagliflozin versus metformin for glucose variability and metabolic outcomes in drug-naïve type 2 diabetes: The EMPA-FIT study","authors":"Soo Lim , Cheol Young Park , In Kyung Jeong , Ji Sung Yoon , Sang Yong Kim , Eun Seok Kang , Junghyun Noh , Kyu Yeon Hur , Sungrae Kim","doi":"10.1016/j.jdiacomp.2025.109214","DOIUrl":"10.1016/j.jdiacomp.2025.109214","url":null,"abstract":"<div><h3>Aims</h3><div>Sodium-glucose cotransporter-2 (SGLT2) inhibitors offer cardiovascular and renal benefits beyond glycemic control. However, their effect on glucose variability (GV) in drug-naïve individuals with type 2 diabetes (T2D) is not well established. This study compared the effects of empagliflozin versus metformin on GV and metabolic outcomes.</div></div><div><h3>Methods</h3><div>In this multicenter, open-label, randomized study, 46 drug-naïve adults with T2D (HbA1c 6.5 %–10.0 %) received empagliflozin (10 mg/day; <em>n</em> = 23) or metformin (1000 mg/day; <em>n</em> = 23) for 12 weeks. The primary outcome was change in mean amplitude of glucose excursions (MAGE), assessed by continuous glucose monitoring. Secondary outcomes included standard deviation of glucose, time-in-range (TIR), metabolic parameters, and safety.</div></div><div><h3>Results</h3><div>At Week 12, empagliflozin significantly reduced MAGE (−19.58 mg/dL; 95 % CI: −30.62, −8.53) compared with metformin (−4.33 mg/dL; 95 % CI: −7.98, −0.68) (<em>n</em> = 19 vs. <em>n</em> = 18, respectively). TIR improved in both groups, with no significant between-group differences. Empagliflozin treatment led to greater reductions in body weight and waist circumference, along with increases in HDL-cholesterol and decreases in triglyceride and uric acid levels. The decrease in HbA1c from baseline was greater in the empagliflozin group (−1.15 % [95 % CI: −1.44, −0.85]) than in the metformin group (−0.78 % [95 % CI: −1.02, −0.54]), resulting in a statistically significant between-group difference (<em>p</em> = 0.049). Adverse events were mild and comparable between groups.</div></div><div><h3>Conclusions</h3><div>Empagliflozin significantly reduced GV and provided additional metabolic benefits in drug-naïve individuals with T2D. These findings support its potential utility in early diabetes management, particularly in targeting glycemic variability.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109214"},"PeriodicalIF":3.1,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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