Journal of diabetes and its complications最新文献_第4页

Association between Mediterranean diet adherence and peripheral artery disease in type 2 diabetes mellitus: An observational study 2型糖尿病患者坚持地中海饮食与外周动脉疾病之间的关系：一项观察性研究。

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-23 DOI: 10.1016/j.jdiacomp.2024.108871

Sara Zúnica-García , José F. Javier Blanquer-Gregori , Ruth Sánchez-Ortiga , Esther Chicharro-Luna , María Isabel Jiménez-Trujillo

Introduction

To evaluate the relationship between adherence to the Mediterranean diet (MD) and periphereal artery disease (PAD) in patients with type 2 diabetes mellitus (T2DM).

Methods

An observational sectional study was conducted with 174 patients diagnosed with T2DM, of which 78 patients had PAD. A patient was considered to have PAD if they obtained an ankle-brachial index (ABI) < 0.9 and/or absence of both distal pulses in one of the two feet. Data on sociodemographic and anthropometric variables, physical activity, smoking habits, biochemical blood parameters, and comorbidities were recorded. Good adherence to the MD was considered with a score ≥ 9 in MEDAS-14. Vascular factors independently associated with adherence to the MD in patients with T2DM were identified through multivariate logistic regression analysis.

Results

ABI, DFU, intermittent claudication and pedal pulse absence correlated with MD adherence. DFU, intermittent claudication and posterior tibial pulse absence were associated with the final score obtained in the MEDAS-14. Nut consumption, white meat preference and sautéed dish intake were associated with PAD presence. Multivariate analysis linked MD adherence to sex (OR = 0.044, 95 % CI 0.003–0619), age (OR = 0.139, 95 % CI 0.029–0.666), duration of T2DM (OR = 7.383, 95 % CI 1.523–35.779) and age at diagnosis of T2DM (OR = 6082, 95 % IC 1.415–26.136), as well as the presence of DFU (OR = 0.000, 95 % IC 0.000–0.370) and intermittent claudication (OR = 0.004, 95 % IC 0.000–0.534).

Conclusions

Adherence to the MD is associated with a reduction in vascular complications in T2DM, highlighting its potential as a dietary intervention strategy.

简介：目的：评估2型糖尿病（T2DM）患者坚持地中海饮食（MD）与周身动脉疾病（PAD）之间的关系：评估地中海饮食（Mediterranean diet，MD）与 2 型糖尿病（T2DM）患者周身动脉疾病（PAD）之间的关系：方法：对 174 名确诊为 T2DM 的患者进行了观察性分段研究，其中 78 名患者患有 PAD。如果患者获得了踝肱指数（ABI），则被认为患有 PAD：ABI、DFU、间歇性跛行和足部脉搏缺失与坚持用药相关。DFU、间歇性跛行和胫后脉搏缺失与 MEDAS-14 的最终得分相关。坚果摄入量、白肉偏好和炒菜摄入量与是否存在 PAD 相关。多变量分析显示，MD 的坚持率与性别（OR = 0.044，95 % CI 0.003-0619）、年龄（OR = 0.139，95 % CI 0.029-0.666）、T2DM 持续时间（OR = 7.383，95 % CI 1.523-35.779）和诊断年龄有关。779）、诊断 T2DM 时的年龄（OR = 6082，95 % IC 1.415-26.136）以及是否存在 DFU（OR = 0.000，95 % IC 0.000-0.370）和间歇性跛行（OR = 0.004，95 % IC 0.000-0.534）：结论：坚持MD与T2DM血管并发症的减少有关，突出了其作为饮食干预策略的潜力。

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引用次数: 0

Lipid profile is similar in both subjects with high 1-hour postload glucose and 2-hour postload glucose and is related to cardio-metabolic profile in prediabetes 负荷后 1 小时血糖高和负荷后 2 小时血糖高的受试者的血脂状况相似，并且与糖尿病前期的心血管代谢状况有关。

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-18 DOI: 10.1016/j.jdiacomp.2024.108869

Rumyana Dimova, Nevena Chakarova, Mina Serdarova, Tsvetalina Tankova

Aim

The study aimed to investigate a lipid profile in people with normal glucose tolerance (NGT), NGT and 1hrOGTT > 8.6 mmol/l, and impaired glucose tolerance (IGT); and to assess its association with some cardio-metabolic parameters.

Material and methods

A total of 90 subjects, of mean age 46.7 ± 10.5 years and mean BMI of 32.0 ± 6.3 kg/m² were enrolled. They were divided into 3 groups: 19 with NGT, 22 with NGT and 1hrOGTT > 8.6 mmol/l, and 49 with IGT; and subdivided into 2 subgroups according to HOMA-IR: 40 with HOMA-IR < 2.5 and 50 with HOMA-IR ≥ 2.5. Body composition (Inbody 720) and advanced glycation end products (AGE Reader) were assessed. Two functional tests (OGTT; MMTT) were performed and AUC for glucose, insulin and triglycerides were calculated.

Results

There was no difference across the glucose tolerance groups for all evaluated lipids. The results showed higher AUC_insulin during OGTT (p = 0.037 and 0.020), AUC_{triglycerides} during MMTT (p = 0.048) and triglycerides/HDL ratio (p = 0.064 and 0.016) in the 1hrOGTT and IGT subgroups with HOMA-IR ≥ 2.5 in comparison to those with HOMA-IR < 2.5. AUC_{triglycerides} during OGTT is independently related to body composition, b-cell function and insulin sensitivity; and AUC_{triglycerides} during MMTT is independently related to blood pressure and hsCRP in prediabetes. Triglycerides/HDL-C ratio emerged as an independent contributor to glycaemia and insulinemia.

Conclusion

Our results demonstrate a similar lipid profile in subjects with 1hrOGTT > 8.6 mmol/l and IGT, whereas increased AUC_{triglycerides} during OGTT, AUC_{triglycerides} during MMTT and triglycerides/HDL-C ratio have been found in the subgroups with insulin resistance. The triglycerides/HDL-C ratio outlined as an independent predictor of insulin secretion and action, and postload triglycerides appear to be independently related to most of the metabolic parameters.

目的：该研究旨在调查正常糖耐量（NGT）、NGT 和 1hrOGTT > 8.6 mmol/l 以及糖耐量受损（IGT）人群的血脂状况，并评估其与一些心血管代谢参数的关系：共招募了 90 名受试者，平均年龄为 46.7 ± 10.5 岁，平均体重指数为 32.0 ± 6.3 kg/m2。他们被分为 3 组：19 人患有 NGT，22 人患有 NGT 且 1hrOGTT > 8.6 mmol/l，49 人患有 IGT；根据 HOMA-IR 再分为 2 个亚组：40 人患有 HOMA-IR 结果：各糖耐量组的血脂评估结果均无差异。结果显示，与 HOMA-IR ≥ 2.5 的 1hrOGTT 和 IGT 亚组相比，HOMA-IR ≥ 2.5 的 1hrOGTT 和 IGT 亚组在 OGTT 期间的胰岛素 AUC（p = 0.037 和 0.020）、MMTT 期间的甘油三酯 AUC（p = 0.048）和甘油三酯/高密度脂蛋白比率（p = 0.064 和 0.016）更高。与 HOMA-IR ≥ 2.5 的亚组相比，OGTT 期间的甘油三酯与身体组成、b 细胞功能和胰岛素敏感性独立相关；MMTT 期间的甘油三酯 AUC 与糖尿病前期的血压和 hsCRP 独立相关。甘油三酯/高密度脂蛋白胆固醇比率是导致血糖和胰岛素血症的独立因素：我们的研究结果表明，1hrOGTT > 8.6 mmol/l 和 IGT 受试者的血脂状况相似，而在胰岛素抵抗亚组中，OGTT 期间的 AUCtriglycerides、MMTT 期间的 AUCtriglycerides 和甘油三酯/HDL-C 比率均有所增加。甘油三酯/HDL-C比率是胰岛素分泌和作用的独立预测指标，负荷后甘油三酯似乎与大多数代谢参数都有独立的关系。

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引用次数: 0

Effectiveness of screening for foot complications in people with diabetes – A systematic review 糖尿病患者足部并发症筛查的有效性--系统性综述

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-18 DOI: 10.1016/j.jdiacomp.2024.108865

Aleksandra Staniszewska , Amy Jones , Sarah Rudd , Frank de Vocht , Robert Hinchliffe

Background

A quarter of people with diabetes develop foot ulcer in their lifetime and are six times more likely to require a major lower limb amputation compared to the general population. Risk stratification tools can reliably identify those at the highest risk of ulceration, but it remains unclear if screening for foot complications can prevent limb loss in people with diabetes.

Aims

The aim of this systematic review was to determine whether population-based foot screening in people with diabetes reduces lower limb complications as assessed by development of foot ulceration, minor and major lower limb amputations, hospitalisation, or death.

Methods

MEDLINE, Embase, Emcare and CINAHL databases were searched to identify randomised and non-randomised controlled trials and observational studies (cohort, case-control and cross-sectional surveys). The screening process, study quality assessment and data extraction were performed by two independent reviewers.

Results

Following abstract screening and assessment for eligibility, five out of 10,771 identified studies were included in the analysis. Of these studies, one demonstrated 24 % reduction in development of new ulceration following introduction of screening. Major amputations decreased by between 17 and 96 % in three studies. Hospitalisation rates were contradictory, with one study showing doubling in hospital admissions and another one reduction by 33 %. One study demonstrated no impact of screening on minor or major amputation rates. None of the studies addressed the effect of foot screening on all-cause mortality.

Conclusions

The number and quality of studies to support population-based foot screening to prevent lower limb complications in people with diabetes is low. Current evidence suggests variable impact of screening on important clinical outcomes.

背景四分之一的糖尿病患者在其一生中会出现足部溃疡，与普通人群相比，他们需要进行下肢大截肢的几率要高出六倍。风险分层工具可以可靠地识别出溃疡风险最高的人群，但目前仍不清楚足部并发症筛查能否预防糖尿病患者的肢体损失。目的本系统性综述旨在确定糖尿病患者的足部筛查是否能减少下肢并发症，其评估指标包括足部溃疡、轻度和重度下肢截肢、住院或死亡。方法检索了MEDLINE、Embase、Emcare和CINAHL数据库，以确定随机和非随机对照试验以及观察性研究（队列、病例对照和横断面调查）。筛选过程、研究质量评估和数据提取由两名独立审稿人完成。结果经过摘要筛选和资格评估，10771 项已确定的研究中有 5 项纳入了分析。在这些研究中，有一项研究表明，在引入筛查后，新发溃疡减少了 24%。在三项研究中，重大截肢减少了 17% 到 96%。住院率则存在矛盾，一项研究显示住院率增加了一倍，而另一项研究则减少了 33%。一项研究表明，筛查对轻度或重度截肢率没有影响。没有一项研究涉及足部筛查对全因死亡率的影响。结论：支持通过足部筛查预防糖尿病患者下肢并发症的研究数量少、质量低。目前的证据表明，筛查对重要临床结果的影响各不相同。

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引用次数: 0

Circulating CD31+ Angiogenic T cells are reduced in prediabetes and increase with exercise training 循环 CD31+ 血管生成 T 细胞在糖尿病前期会减少，在运动训练后会增加

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-17 DOI: 10.1016/j.jdiacomp.2024.108868

Callum J. Baker , Danqing Min , Felix Marsh-Wakefield , Elisha Siwan , James Gerofi , Xiaoyu Wang , Samantha L. Hocking , Stephen Colagiuri , Nathan A. Johnson , Stephen M. Twigg

Aims

To investigate circulating angiogenic cells in adults with prediabetes and the effect of a structured exercise program.

Methods

A cohort of adults with overweight/obesity and either normal glucose (NG) or prediabetes were randomised to receive exercise (Exercise) (as twice weekly supervised combined high intensity aerobic exercise and progressive resistance training, and once weekly home-based aerobic exercise) or an unsupervised stretching intervention (Control) for 12 weeks. Circulating angiogenic T cells, muscle strength, and cardiovascular disease risk factors, including blood lipids, arterial stiffness, central haemodynamic responses, and cardiorespiratory fitness (VO₂peak) in those with prediabetes (n = 35, 16 Control, 19 Exercise) and NG (n = 37, 17 Control, 20 Exercise) were analysed at baseline and after the 12-week intervention.

Results

At baseline, compared with NG those with prediabetes demonstrated reduced VO₂peak, angiogenic CD31⁺CD8⁺ T cells and VEGFR2⁺CD4⁺ T cells, and increased systolic blood pressure. CD31⁺ T cells were negatively correlated with cardiovascular disease (CVD) risk. Compared with Control, exercise training increased muscle strength, VO₂peak, and CD31⁺CD4⁺ and CD31⁺CD8⁺ T cells in NG and prediabetes.

Conclusions

Circulating angiogenic CD31⁺ T cells are decreased in people with prediabetes and are enhanced with exercise training. Exercise increases CD31⁺ T cells, and through this mechanism it is proposed that it may reduce CVD risk.

Trial registration

Australian New Zealand Clinical Trials Registry number: ACTRN12617000552381.

方法将一组超重/肥胖、血糖正常（NG）或糖尿病前期的成年人随机分配到接受运动（运动）（每周两次有监督的高强度有氧运动和渐进阻力训练，每周一次在家进行有氧运动）或无监督拉伸干预（对照组）的人群中，为期 12 周。对糖尿病前期患者（n = 35，16 个对照组，19 个运动组）和 NG 患者（n = 37，17 个对照组，20 个运动组）在基线和 12 周干预后的循环血管生成 T 细胞、肌肉力量和心血管疾病风险因素（包括血脂、动脉僵化、中心血流动力学反应和心肺功能（VO2 峰值））进行分析。结果基线时，与 NG 相比，糖尿病前期患者的 VO2 峰值、血管生成 CD31+CD8+ T 细胞和 VEGFR2+CD4+ T 细胞均有所降低，收缩压也有所升高。CD31+ T细胞与心血管疾病（CVD）风险呈负相关。与对照组相比，运动训练可增加 NG 和糖尿病前期患者的肌力、VO2 峰值、CD31+CD4+ 和 CD31+CD8+ T 细胞。运动可增加 CD31+ T 细胞，通过这一机制，运动可降低心血管疾病风险：ACTRN12617000552381。

{"title":"Circulating CD31+ Angiogenic T cells are reduced in prediabetes and increase with exercise training","authors":"Callum J. Baker , Danqing Min , Felix Marsh-Wakefield , Elisha Siwan , James Gerofi , Xiaoyu Wang , Samantha L. Hocking , Stephen Colagiuri , Nathan A. Johnson , Stephen M. Twigg","doi":"10.1016/j.jdiacomp.2024.108868","DOIUrl":"10.1016/j.jdiacomp.2024.108868","url":null,"abstract":"<div><h3>Aims</h3><p>To investigate circulating angiogenic cells in adults with prediabetes and the effect of a structured exercise program.</p></div><div><h3>Methods</h3><p>A cohort of adults with overweight/obesity and either normal glucose (NG) or prediabetes were randomised to receive exercise (Exercise) (as twice weekly supervised combined high intensity aerobic exercise and progressive resistance training, and once weekly home-based aerobic exercise) or an unsupervised stretching intervention (Control) for 12 weeks. Circulating angiogenic T cells, muscle strength, and cardiovascular disease risk factors, including blood lipids, arterial stiffness, central haemodynamic responses, and cardiorespiratory fitness (VO<sub>2</sub>peak) in those with prediabetes (<em>n</em> = 35, 16 Control, 19 Exercise) and NG (<em>n</em> = 37, 17 Control, 20 Exercise) were analysed at baseline and after the 12-week intervention.</p></div><div><h3>Results</h3><p>At baseline, compared with NG those with prediabetes demonstrated reduced VO<sub>2</sub>peak, angiogenic CD31<sup>+</sup>CD8<sup>+</sup> T cells and VEGFR2<sup>+</sup>CD4<sup>+</sup> T cells, and increased systolic blood pressure. CD31<sup>+</sup> T cells were negatively correlated with cardiovascular disease (CVD) risk. Compared with Control, exercise training increased muscle strength, VO<sub>2</sub>peak, and CD31<sup>+</sup>CD4<sup>+</sup> and CD31<sup>+</sup>CD8<sup>+</sup> T cells in NG and prediabetes.</p></div><div><h3>Conclusions</h3><p>Circulating angiogenic CD31<sup>+</sup> T cells are decreased in people with prediabetes and are enhanced with exercise training. Exercise increases CD31<sup>+</sup> T cells, and through this mechanism it is proposed that it may reduce CVD risk.</p></div><div><h3>Trial registration</h3><p>Australian New Zealand Clinical Trials Registry number: ACTRN12617000552381.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 11","pages":"Article 108868"},"PeriodicalIF":2.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241137","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}

引用次数: 0

Glycogenic hepatopathy associated with hepatic steatosis in type 1 diabetes 与 1 型糖尿病肝脂肪变性相关的糖源性肝病

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-17 DOI: 10.1016/j.jdiacomp.2024.108870

Stephanie Teasdale , Xin Dong , Alison Griffin , Paul James Clark , Janelle Nisbet , Adam Morton , Liza Phillips , Mitchell Anthony Sullivan , Graham Galloway

Aims

Glycogenic hepatopathy is associated with significant psychosocial consequences and health costs. Metabolic Dysfunction-Associated Steatotic Liver Disease and glycogenic hepatopathy are frequently confused as “fatty liver” when seen on ultrasonography. We wished to examine liver fat and glycogen content in groups defined based on metabolic and liver disease phenotypes.

Methods

This case-control study undertaken in a tertiary hospital used nuclear proton magnetic resonance spectroscopy (¹H-MRS) to examine liver fat and glycogen content in five clinical groups, each containing five participants: 1. type 1 diabetes with glycogenic hepatopathy, 2. satisfactorily controlled type 1 diabetes with no liver disease, 3. poorly controlled type 1 diabetes without liver disease, 4. a control group of body mass index- and age-matched individuals without diabetes or liver disease, and 5. hepatic steatosis.

Results

Fat content was highest in the hepatic steatosis (median 15.4 %, IQR 10.0–19.3) and glycogenic hepatopathy (median 6.5 %, IQR 4.5–9.1) groups and compared to both of these groups was lower in the control group (median 1.0 %, IQR 0.7–1.1, p 0.002 and 0.022), the T1DM group with satisfactory control (median 0.3 %, IQR 0.2–0.6, p < 0.001 and <0.001), and the T1DM group with poor control without liver disease (median 1.1 %, IQR 0.9–1.1, p 0.001 and 0.012).

No participants from the type 1 diabetes poor control, type 1 diabetes satisfactory control or the no diabetes groups had ¹H-MRS-diagnosed hepatic steatosis.

¹H-MRS glycogen content could not be interpreted in the majority of those with glycogenic hepatopathy because of interference from the fat signal.

Conclusions

In cases diagnosed with glycogenic hepatopathy there may be significant concomitant fat accumulation, compounding the already elevated cardiovascular risk in this cohort.

The technique of ¹H-MRS has not been demonstrated to be useful for diagnosing glycogenic hepatopathy.

目的糖原性肝炎与严重的社会心理后果和健康成本相关。在超声波检查中，代谢功能障碍相关性脂肪肝和糖原性肝炎经常被混淆为 "脂肪肝"。我们希望对根据代谢和肝病表型定义的组别中的肝脏脂肪和糖原含量进行检查。方法这项病例对照研究在一家三甲医院进行，使用核质子磁共振波谱（1H-MRS）对五个临床组别中的肝脏脂肪和糖原含量进行检查，每个组别包含五名参与者：结果肝脂肪变性组（中位数为 15.4%，IQR 为 10.0-19.3）和糖原性肝炎组（中位数为 6.5%，IQR 为 4.5-9.1）的脂肪含量最高。1）组和这两组相比，对照组（中位数 1.0 %，IQR 0.7-1.1，P 0.002 和 0.022）、控制满意的 T1DM 组（中位数 0.3 %，IQR 0.2-0.6，P < 0.001 和 < 0.1型糖尿病控制不佳组、1型糖尿病控制满意组或无糖尿病组的参与者均未出现 1H-MRS 诊断的肝脏脂肪变性。由于脂肪信号的干扰，大多数糖原性肝炎患者的 1H-MRS 糖原含量无法解读。

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引用次数: 0

Emerging treatment strategies for polycystic ovary syndrome women with obesity: Focus on glucagon-like peptide-1 receptor agonists 多囊卵巢综合征肥胖妇女的新兴治疗策略：聚焦胰高血糖素样肽-1 受体激动剂

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-17 DOI: 10.1016/j.jdiacomp.2024.108872

Mojca Jensterle , Manfredi Rizzo , Andrej Janez

引用次数: 0

Presence of neuropathy in children and adolescents with type 1 diabetes evaluated with bedside modalities 用床边模式评估 1 型糖尿病儿童和青少年是否存在神经病变

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-17 DOI: 10.1016/j.jdiacomp.2024.108873

Julie A. Damm , Amalie Dalgas-Madsen , Christian Stevns Hansen , Kasper A. Pilgaard , Flemming Pociot , Tine W. Hansen , Jesper Johannesen

Aims

To investigate the prevalence of diabetic polyneuropathy (DPN), cardiac autonomic neuropathy (CAN) and sudomotor dysfunction in children and adolescents with type 1 diabetes using bedside modalities. Secondly, to evaluate the co-existence of these types of diabetes neuropathies.

Methods

Cross-sectional study including 221 children and adolescents with type 1 diabetes. DPN was assessed by vibration sensation threshold and sural nerve conductance, CAN by cardiac reflex tests and sudomotor function by electrochemical skin conductance.

Results

Median (interquartile range) age was 14.2 (11.9, 16.5) years, diabetes duration 4.8 (2.7, 7.7) years and Hba1c 7.1 (6.6, 7.9) %, (54: 49, 63 mmol/mol). Three had retinopathy; all had normal albuminuria. DPN was present in 40 %, early CAN in 17 %, established CAN in 3 % and sudomotor dysfunction in the feet in 5 %. Of these, 60 % had one type of neuropathy, while 35 % had two types. Only 1 participant manifested all three types of neuropathies.

Conclusions

Bedside modalities demonstrated a high prevalence of neuropathy in children and adolescents with type 1 diabetes, despite good glycemic outcome, short diabetes duration and absence of complications. A lack of co-existing neuropathies was shown, underscoring the need for multiple screening modalities.

目的利用床旁模式调查 1 型糖尿病儿童和青少年中糖尿病多发性神经病变 (DPN)、心脏自主神经病变 (CAN) 和湿性运动功能障碍的发病率。方法：横断面研究，包括 221 名 1 型糖尿病儿童和青少年。结果中位数（四分位之间）年龄为 14.2（11.9，16.5）岁，糖尿病病程为 4.8（2.7，7.7）年，Hba1c 为 7.1（6.6，7.9）%，（54：49，63 mmol/mol）。其中三人患有视网膜病变，所有人的白蛋白尿都正常。有 40% 的人患有 DPN，17% 的人患有早期 CAN，3% 的人患有已确诊的 CAN，5% 的人患有足部运动功能障碍。其中，60%的患者有一种神经病变，35%的患者有两种神经病变。结论尽管儿童和青少年 1 型糖尿病患者的血糖状况良好、糖尿病病程短且无并发症，但其神经病变的发生率很高。尽管血糖结果良好、糖尿病病程短且无并发症，但缺乏并存的神经病变，这强调了采用多种筛查模式的必要性。

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引用次数: 0

The correlation between patients with type 2 diabetes mellitus and chronic microvascular complications during the glucose peak time 2 型糖尿病患者与血糖高峰期慢性微血管并发症的相关性

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-17 DOI: 10.1016/j.jdiacomp.2024.108866

Yanqiu Jiang , Xinlei Wang , Xiaoqin Zhao , Yi Sun , Ping Huang , Qianfeng Que , Rongfeng Shi , Xuying Zhao , Honghong Lu , Yunjuan Gu

Introduction

To assess the Type 2 Diabetes Mellitus (T2DM) patients in association with Chronic Microvascular Complications at Glucose Peak Time and the association among chronic microvascular complications in T2DM patients and the glucose peak period in the typical steamed bread meal test.

Methods

Overall 1095 T2DM patients were classified as three groups: (1) Group G1: glucose peak time ≤ 1 h (n = 84), Group G2: 1 h < glucose peak time ≤ 2 h (n = 648) and Group G3: glucose peak time > 2 h (n = 363). The clinical characteristics, insulin characteristics and glucose peak time and chronic microvascular complications markers of patients in each group was analyzed and compared. Statistical analyses were performed using SPSS 23.0, employing chi-square tests, Kruskal-Wallis tests, one-way ANOVA, and binary logistic regression analysis, with significance set at P < 0.05.

Results

Age, length of disease, glycated hemoglobin (HbA1c), urine albumin-creatinine ratio (UACR), and the number of patients with diabetic retinopathy (DR) increased (all P < 0.05) in those with postponed glucose peak time, while insulinogenic indexes, the AUC for C-p (AUCC-p), fasting, and 120-min C-peptide (C-p) decreased (all P < 0.05). Only age was connected to patients with diabetic kidney disease (DKD) independently in binary logistic regression analysis, although delayed glucose peak time was related to the presence of patients with DR. (all P < 0.05).

Conclusion

Delayed glucose peak time contributed to DR. Attention should be paid to condition of chronic microvascular complications in T2DM patients with a postponed peak glucose timing.

简介：目的评估 2 型糖尿病（T2DM）患者在血糖峰值时间与慢性微血管并发症的关系，以及 T2DM 患者慢性微血管并发症与典型馒头餐试验中血糖峰值时间的关系。方法将1095名T2DM患者分为三组：(1) G1组：血糖峰值时间≤1 h（n = 84），G2组：1 h < 血糖峰值时间≤2 h（n = 648），G3组：血糖峰值时间 > 2 h（n = 363）。对各组患者的临床特征、胰岛素特征、血糖峰值时间和慢性微血管并发症指标进行分析和比较。使用 SPSS 23.0 进行统计分析，采用卡方检验、Kruskal-Wallis 检验、单因素方差分析和二元逻辑回归分析，显著性以 P < 0.05 为标准。结果血糖峰值时间推迟者的年龄、病程、糖化血红蛋白（HbA1c）、尿白蛋白-肌酐比值（UACR）和糖尿病视网膜病变（DR）患者人数增加（均为 P < 0.05），而胰岛素生成指数、C-p 的 AUC（AUCC-p）、空腹和 120 分钟 C 肽（C-p）降低（均为 P < 0.05）。在二元逻辑回归分析中，只有年龄与糖尿病肾病（DKD）患者独立相关，但葡萄糖峰值时间延迟与是否存在 DR 患者相关（均为 P < 0.05）。应注意血糖峰值时间推迟的 T2DM 患者的慢性微血管并发症情况。

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引用次数: 0

REAL life study of subcutaneous SEMaglutide in patients with type 2 diabetes in SPain: Ambispective, multicenter clinical study. Results in the GLP1-experienced cohort SPain的2型糖尿病患者皮下注射SEMaglutide的真实生活研究：前瞻性多中心临床研究。有 GLP1 经验人群的研究结果。

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-17 DOI: 10.1016/j.jdiacomp.2024.108874

Jersy Jair Cárdenas-Salas , Roberto Miguel Sierra Poyatos , Bogdana Luiza Luca , Begoña Sánchez Lechuga , Naiara Modroño Móstoles , Teresa Montoya Álvarez , María de la Paz Gómez Montes , Jorge Gabriel Ruiz Sánchez , Diego Meneses González , Raquel Sánchez-Lopez , Carlos Casado Cases , Víctor Pérez de Arenaza Pozo , Clotilde Vázquez Martínez

Objective

To evaluate the efficacy of switching to once-weekly subcutaneous semaglutide in patients with type 2 diabetes mellitus (T2DM) who were previously treated with other glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in a real-world setting in Spain.

Methods

The REAL Life study of SEMaglutide in Patients with Type 2 diabetes in Spain (REALSEM-SP) was conducted in four endocrinology departments in Madrid, Spain. Adult patients with T2DM who were prescribed once-weekly (OW) subcutaneous semaglutide and had been previously treated with other GLP-1 RAs were included. Baseline characteristics, including demographic, anthropometric, and laboratory variables, were recorded at baseline and at 6 ± 3 and 12 ± 3 months of follow-up. The primary outcome was the change in HbA_1c at 12 ± 3 months of follow-up, with secondary outcomes including changes in weight, BMI, and other glycemic parameters.

Results

A total of 267 patients were included in the analysis, with a mean age of 61.6 years and a mean T2DM duration of 11.3 years. The majority of patients had grade 1 or 2 obesity at baseline. Switching to OW-semaglutide was associated with a significant reduction in HbA_1c from baseline to 13 months (−0.35 % ± 0.81). Patients who reached the 1.0 mg OW-dose showed a significant reduction in HbA_1c compared to those on the ≤0.5 mg OW-dose. Significant reductions in weight, BMI, and fasting plasma glucose were also observed. Adverse events were mostly gastrointestinal and led to treatment withdrawal in few cases.

Conclusion

Switching to OW-subcutaneous semaglutide in patients with T2DM previously treated with other GLP-1 RAs was associated to improvements in glycemic control and weight management in a real-world setting in Spain. These findings support the use of OW-semaglutide as an effective option for patients with T2DM who require additional glycemic control and weight management.

目的在西班牙的实际环境中，评估之前接受过其他胰高血糖素样肽-1受体激动剂（GLP-1 RA）治疗的2型糖尿病（T2DM）患者改用每周一次的皮下注射塞马鲁肽的疗效：西班牙 2 型糖尿病患者 SEMaglutide 真实生活研究（REALSEM-SP）在西班牙马德里的四个内分泌科进行。研究对象包括开具了每周一次（OW）皮下注射塞马鲁肽处方并曾接受过其他 GLP-1 RAs 治疗的成年 T2DM 患者。在基线、6±3 个月和 12±3 个月的随访中记录了基线特征，包括人口统计学、人体测量和实验室变量。主要结果是随访 12±3 个月时 HbA1c 的变化，次要结果包括体重、体重指数和其他血糖参数的变化：共有 267 名患者参与分析，平均年龄为 61.6 岁，T2DM 平均病程为 11.3 年。大多数患者基线肥胖程度为 1 级或 2 级。从基线到13个月期间，改用OW-西马鲁肽可显著降低HbA1c（-0.35 % ± 0.81）。与OW剂量≤0.5毫克的患者相比，OW剂量达到1.0毫克的患者HbA1c明显降低。体重、体重指数和空腹血浆葡萄糖也有显著降低。不良反应主要是胃肠道反应，导致停药的病例很少：结论：在西班牙的真实世界中，曾接受过其他 GLP-1 RAs 治疗的 T2DM 患者改用 OW 皮下注射塞马鲁肽可改善血糖控制和体重管理。这些研究结果表明，对于需要额外血糖控制和体重管理的 T2DM 患者来说，使用 OW-塞马鲁肽是一种有效的选择。

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引用次数: 0

Classification of longitudinal estimated glomerular filtration rate trajectories in Canadian adults with type 1 diabetes 加拿大成年 1 型糖尿病患者肾小球滤过率纵向估计轨迹的分类

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2024-09-16 DOI: 10.1016/j.jdiacomp.2024.108864

Kristen Favel , Jeffrey N. Bone , Tom Elliott , Constadina Panagiotopoulos , Cherry Mammen

Aims

Type 1 diabetes (T1D) increases the risk of chronic kidney disease (CKD) development. The aims of this study were to classify trajectories of estimated glomerular filtration rate (eGFR) in a cohort of Canadian adults with T1D, and to describe the risk factors associated with declining eGFR trajectories.

Methods

In this retrospective cohort of adults with T1D, data was collected between 1996 and 2020. CKD was defined as eGFR <60 mL/min/1.73 m². Latent class mixed models were used to categorize eGFR trajectories. Multinomial logistic regression was used to identify factors associated with declining eGFR trajectories.

Results

In this study, 304 adults were analyzed, with baseline measurements at a median duration of T1D of 15.3 (5.4–24.2) years. Eight percent of the cohort developed CKD over a median duration of 24.3 (13.7–34.8) years. Four classes of longitudinal eGFR trajectories were identified, broadly categorized as steeply declining (SD1, SD2) and gradual declining (GD1, GD2). Female sex, poor glycemic control, elevated body mass index, and albuminuria were associated with a steeply declining trajectory.

Conclusion

In this cohort, four distinctive eGFR trajectories were identified, including a subtype with steeply declining eGFR. Given the complex nature of CKD progression, further prospective study of this model for identification of individuals at risk for CKD based on their trajectory of kidney function may support clinicians in their decision-making.

目的1型糖尿病（T1D）会增加慢性肾病（CKD）的发病风险。本研究旨在对加拿大成年 T1D 患者队列中的估计肾小球滤过率（eGFR）轨迹进行分类，并描述与 eGFR 下降轨迹相关的风险因素。慢性肾功能衰竭的定义为 eGFR <60 mL/min/1.73 m2。采用潜类混合模型对 eGFR 轨迹进行分类。结果在这项研究中，对 304 名成人进行了分析，基线测量的 T1D 中位持续时间为 15.3（5.4-24.2）年。在中位持续时间为 24.3（13.7-34.8）年的人群中，有 8% 的人患上了慢性肾功能衰竭。纵向 eGFR 轨迹分为四类，大致分为急剧下降型（SD1、SD2）和逐渐下降型（GD1、GD2）。女性性别、血糖控制不佳、体重指数升高和白蛋白尿与急剧下降的轨迹有关。鉴于慢性肾功能衰竭进展的复杂性，进一步对该模型进行前瞻性研究，根据肾功能的变化轨迹来识别慢性肾功能衰竭的高危人群，可能有助于临床医生做出决策。

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引用次数: 0