Trabecular bone score (TBS) and brachial-ankle pulse wave velocity (baPWV) are established indicators of bone microstructure and arterial stiffness. However, their association has not been explored in the context of type 2 diabetes (T2DM). We aimed to investigate the factors influencing bone microarchitectural deterioration in patients with T2DM, examining the associations of baPWV with both TBS and bone mineral density (BMD).
Materials and Methods
This study comprised 646 participants with T2DM. L1–L4 TBS was assessed via dual-energy X-ray bone densitometry and categorized into three groups. Independent risk factors influencing L1–L4 TBS in T2DM patients were examined by stepwise linear regression. The independent association between baPWV and TBS was further analyzed using linear regression with sequential adjustment, while the relationship between baPWV and BMD was assessed using univariable and multivariable linear regression.
Results
Age, Body Mass Index (BMI), Urinary Albumin-to-Creatinine Ratio, diastolic blood pressure, Total Type I collagen N-terminal Propeptide, Alkaline Phosphatase, and baPWV were identified as independent risk factors for L1–L4 TBS. In a series of progressively adjusted models, baPWV remained significantly and independently negatively associated with L1–L4 TBS (β = −0.076, 95% CI: −0.114, −0.038). Furthermore, when baPWV exceeded 1531 cm/s, the risk of degraded bone microarchitecture significantly increased. However, baPWV showed no significant independent association with BMD after multivariable adjustment (p > 0.05).
Conclusion
In patients with T2DM, baPWV demonstrated an independent inverse association with L1–L4 TBS, suggesting a potential link between arterial stiffness and bone microarchitectural deterioration and offering a new clinical perspective on the bone–vascular axis.
{"title":"Association Between Arterial Stiffness and Bone Microarchitectural Deterioration in Type 2 Diabetes: A Cross-Sectional Study","authors":"Yangting Wang, Xiaoting Chen, Jinjian Xu, Qifeng Ying, Lizhi Liang, Xiaohong Wu","doi":"10.1111/1753-0407.70181","DOIUrl":"10.1111/1753-0407.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trabecular bone score (TBS) and brachial-ankle pulse wave velocity (baPWV) are established indicators of bone microstructure and arterial stiffness. However, their association has not been explored in the context of type 2 diabetes (T2DM). We aimed to investigate the factors influencing bone microarchitectural deterioration in patients with T2DM, examining the associations of baPWV with both TBS and bone mineral density (BMD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This study comprised 646 participants with T2DM. L1–L4 TBS was assessed via dual-energy X-ray bone densitometry and categorized into three groups. Independent risk factors influencing L1–L4 TBS in T2DM patients were examined by stepwise linear regression. The independent association between baPWV and TBS was further analyzed using linear regression with sequential adjustment, while the relationship between baPWV and BMD was assessed using univariable and multivariable linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Age, Body Mass Index (BMI), Urinary Albumin-to-Creatinine Ratio, diastolic blood pressure, Total Type I collagen N-terminal Propeptide, Alkaline Phosphatase, and baPWV were identified as independent risk factors for L1–L4 TBS. In a series of progressively adjusted models, baPWV remained significantly and independently negatively associated with L1–L4 TBS (<i>β</i> = −0.076, 95% CI: −0.114, −0.038). Furthermore, when baPWV exceeded 1531 cm/s, the risk of degraded bone microarchitecture significantly increased. However, baPWV showed no significant independent association with BMD after multivariable adjustment (<i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with T2DM, baPWV demonstrated an independent inverse association with L1–L4 TBS, suggesting a potential link between arterial stiffness and bone microarchitectural deterioration and offering a new clinical perspective on the bone–vascular axis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 12","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhenyu Shan, Yanrui Jia, Xingsheng Wang, Guyu Zhang, Chenchen Hang, Le An, Rui Shao, Ziren Tang
Background
Blood glucose levels and glycemic variability are associated with poor prognosis in critically ill patients. This study aims to investigate the relationship between average glucose (AG) and glycemic variability (GV) with 28-day mortality in patients with cardiac arrest (CA).
Methods
This retrospective study extracted glucose measurements during ICU stay from all patients diagnosed with CA in the eICU Collaborative Research Database (version 2.0), the Medical Information Mart for Intensive Care III (version 1.4) and IV (version 3.1), and the Emergency Intensive Care Unit of Beijing Chaoyang Hospital. Multivariable Cox proportional hazards regression models and restricted cubic spline (RCS) analysis were used to explore the associations between AG, GV, and outcomes, with subgroup analyses performed to validate the findings.
Results
In 6110 CA patients, RCS analysis revealed a nonlinear relationship between AG and 28-day mortality (p for nonlinear < 0.001), whereas GV exhibited a linear association (p for nonlinear = 0.058). Multivariable Cox regression analysis demonstrated that AG Q4 (AG ≥ 171.75 mg/dL), GV Q4 (GV ≥ 35.8%), and Group 4 (AG ≥ 139.7 and GV ≥ 25.8%) were associated with increased 28-day death risk (AG Q4: Hazard Ratio [95% Confidence Interval] 1.90 [1.69, 2.14], p < 0.001; GV Q4: 1.45 [1.30, 1.62], p < 0.001; Group 4: 1.80 [1.61, 2.00], p < 0.001), consistent across subgroup analyses.
Conclusions
Our study showed that higher AG and GV were associated with mortality in CA patients. Furthermore, AG and GV were independent predictors of 28-day mortality in these patients.
{"title":"Association of Average Glucose and Glycemic Variability With 28-Day Mortality in Patients With Cardiac Arrest: A Retrospective Study","authors":"Zhenyu Shan, Yanrui Jia, Xingsheng Wang, Guyu Zhang, Chenchen Hang, Le An, Rui Shao, Ziren Tang","doi":"10.1111/1753-0407.70179","DOIUrl":"10.1111/1753-0407.70179","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Blood glucose levels and glycemic variability are associated with poor prognosis in critically ill patients. This study aims to investigate the relationship between average glucose (AG) and glycemic variability (GV) with 28-day mortality in patients with cardiac arrest (CA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study extracted glucose measurements during ICU stay from all patients diagnosed with CA in the eICU Collaborative Research Database (version 2.0), the Medical Information Mart for Intensive Care III (version 1.4) and IV (version 3.1), and the Emergency Intensive Care Unit of Beijing Chaoyang Hospital. Multivariable Cox proportional hazards regression models and restricted cubic spline (RCS) analysis were used to explore the associations between AG, GV, and outcomes, with subgroup analyses performed to validate the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 6110 CA patients, RCS analysis revealed a nonlinear relationship between AG and 28-day mortality (<i>p</i> for nonlinear < 0.001), whereas GV exhibited a linear association (<i>p</i> for nonlinear = 0.058). Multivariable Cox regression analysis demonstrated that AG Q4 (AG ≥ 171.75 mg/dL), GV Q4 (GV ≥ 35.8%), and Group 4 (AG ≥ 139.7 and GV ≥ 25.8%) were associated with increased 28-day death risk (AG Q4: Hazard Ratio [95% Confidence Interval] 1.90 [1.69, 2.14], <i>p</i> < 0.001; GV Q4: 1.45 [1.30, 1.62], <i>p</i> < 0.001; Group 4: 1.80 [1.61, 2.00], <i>p</i> < 0.001), consistent across subgroup analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study showed that higher AG and GV were associated with mortality in CA patients. Furthermore, AG and GV were independent predictors of 28-day mortality in these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 12","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this cross-sectional study, the protective effect of cardiorespiratory fitness (CRF) on coronary heart disease (CHD) risk differed between non-diabetic and diabetic individuals, with a significantly greater reduction in CHD risk observed among participants with diabetes who had higher CRF levels. These findings highlight the importance of improving CRF for CHD prevention, particularly in diabetic individuals.
{"title":"Diabetes Status Modifies the Association Between Cardiorespiratory Fitness and Coronary Heart Disease: A Cross-Sectional Study","authors":"Li Wang, Yan Lu, Huifang Zhang","doi":"10.1111/1753-0407.70176","DOIUrl":"10.1111/1753-0407.70176","url":null,"abstract":"<p>In this cross-sectional study, the protective effect of cardiorespiratory fitness (CRF) on coronary heart disease (CHD) risk differed between non-diabetic and diabetic individuals, with a significantly greater reduction in CHD risk observed among participants with diabetes who had higher CRF levels. These findings highlight the importance of improving CRF for CHD prevention, particularly in diabetic individuals.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 12","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dickkopf1 (DKK1) is a protein with established links to metabolic diseases. However, its association with polycystic ovary syndrome (PCOS) and insulin resistance (IR) remains ambiguous.
Methods
We conducted a cross-sectional study involving 300 participants, including 100 healthy women, 100 women with PCOS, and 100 individuals with IR. Protein interactions with DKK1 were identified using the STRING database, followed by KEGG and GO analyses to explore enriched biological processes. Serum DKK1 and Adipoq levels were measured using ELISA kits. The hepatic DKK1 was detected by western blotting.
Results
Both IR and PCOS groups showed significantly higher serum DKK1 levels and lower Adipoq levels compared to controls. Serum DKK1 levels positively correlated with body mass index (BMI), waist-hip ratio (WHR), body fat percentage (FAT%), systolic blood pressure (SBP), triglycerides (TG), fasting plasma glucose (FPG), fasting insulin (FIns), glycosylated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR). Adipoq levels negatively correlated with glucose disposal rate (M-value). Multiple regression analysis showed that BMI and Adipoq were independent factors affecting DKK1. Multiple stepwise regressions indicated that DKK1 is a risk factor for IR and PCOS. In the euglycemic-hyperinsulinemic clamp (EHC) test, serum DKK1 levels increased in the PCOS patients and decreased in the IR patients at 30 min and returned to baseline at 60 min.
Conclusions
Elevated DKK1 levels are strongly associated with PCOS and IR, suggesting a potential role in their development. This insight paves the way for further investigations into the role of DKK1 in PCOS and IR.
{"title":"Dickkopf1 as a Potential Biomarker in Polycystic Ovary Syndrome and Insulin Resistance: A Cross-Sectional Study","authors":"Jiaxiu Ling, Hao Wang, Rui Liu, Juan Xiao, Sheng Qiu, Xiaotian Lei, Mengliu Yang, Yerui Lai, Hua Huang, Zerong Liang","doi":"10.1111/1753-0407.70168","DOIUrl":"10.1111/1753-0407.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dickkopf1 (DKK1) is a protein with established links to metabolic diseases. However, its association with polycystic ovary syndrome (PCOS) and insulin resistance (IR) remains ambiguous.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study involving 300 participants, including 100 healthy women, 100 women with PCOS, and 100 individuals with IR. Protein interactions with DKK1 were identified using the STRING database, followed by KEGG and GO analyses to explore enriched biological processes. Serum DKK1 and Adipoq levels were measured using ELISA kits. The hepatic DKK1 was detected by western blotting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both IR and PCOS groups showed significantly higher serum DKK1 levels and lower Adipoq levels compared to controls. Serum DKK1 levels positively correlated with body mass index (BMI), waist-hip ratio (WHR), body fat percentage (FAT%), systolic blood pressure (SBP), triglycerides (TG), fasting plasma glucose (FPG), fasting insulin (FIns), glycosylated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR). Adipoq levels negatively correlated with glucose disposal rate (M-value). Multiple regression analysis showed that BMI and Adipoq were independent factors affecting DKK1. Multiple stepwise regressions indicated that DKK1 is a risk factor for IR and PCOS. In the euglycemic-hyperinsulinemic clamp (EHC) test, serum DKK1 levels increased in the PCOS patients and decreased in the IR patients at 30 min and returned to baseline at 60 min.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elevated DKK1 levels are strongly associated with PCOS and IR, suggesting a potential role in their development. This insight paves the way for further investigations into the role of DKK1 in PCOS and IR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 12","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaofei Luo, Lin Zhang, Boxuan Feng, Xiangqin Ou, Jingyi Lin, Danping Zhuo, Haohao Gao, Li Liu, Minghao Xu, Jialing Liu, Fan Jia, Guanwei Fan
Aims
To examine the association of insulin therapy with in-hospital death and whether this association is mediated by elevated plasma volume among chronic heart failure (CHF) patients with type 2 diabetes mellitus (T2DM).
Materials and Methods
A retrospective study combining two electronic medical records: the Medical Information Mart for Intensive Care (MIMIC) database and the Tianjin Heart Failure with Integrated Treatment (TJHFIT) database. Propensity score matching (1:2 ratio) was conducted in CHF-T2DM patients to eliminate the differences in demographics, comorbidity, and the severity of diabetes. Then, conditional logistic regression, restricted cubic spline (RCS) modeling, and mediation analysis were processed.
Results
A total of 7997 CHF-T2DM patients were included, with 6112 from MIMIC (2241 received insulin therapy and 3871 not), and 1885 from TJHFIT (911 received insulin therapy and 974 not). Multivariable conditional logistic regression revealed a significant association between insulin therapy during hospitalization and in-hospital death in both cohorts (MIMIC: OR, 1.37 [95% CI, 1.14–1.63]; TJHFIT: OR, 2.56 [95% CI, 1.53–4.27]). Insulin therapy was associated with a higher likelihood of ΔePVS > 0 (MIMIC: OR, 1.11 [95% CI, 1.02–1.28]; TJHFIT: OR, 1.37 [95% CI, 1.13–1.66]). RCS revealed both ePVS and ΔePVS were associated with in-hospital death in a nonlinear fashion. The ePVS at discharge mediated insulin-associated in-hospital death with a proportion of 12.0% (MIMIC) and 13.2% (TJHFIT).
Conclusions
Insulin therapy was associated with elevated odds of in-hospital death among CHF-T2DM patients, which was mediated by plasma volume.
Trial Registration
The research has been registered (ChiCTR2300077220)
{"title":"Association Between Insulin Therapy and In-Hospital Death in Chronic Heart Failure Patients With Type 2 Diabetes Mellitus: Mediated by Plasma Volume","authors":"Xiaofei Luo, Lin Zhang, Boxuan Feng, Xiangqin Ou, Jingyi Lin, Danping Zhuo, Haohao Gao, Li Liu, Minghao Xu, Jialing Liu, Fan Jia, Guanwei Fan","doi":"10.1111/1753-0407.70172","DOIUrl":"10.1111/1753-0407.70172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To examine the association of insulin therapy with in-hospital death and whether this association is mediated by elevated plasma volume among chronic heart failure (CHF) patients with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective study combining two electronic medical records: the Medical Information Mart for Intensive Care (MIMIC) database and the Tianjin Heart Failure with Integrated Treatment (TJHFIT) database. Propensity score matching (1:2 ratio) was conducted in CHF-T2DM patients to eliminate the differences in demographics, comorbidity, and the severity of diabetes. Then, conditional logistic regression, restricted cubic spline (RCS) modeling, and mediation analysis were processed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 7997 CHF-T2DM patients were included, with 6112 from MIMIC (2241 received insulin therapy and 3871 not), and 1885 from TJHFIT (911 received insulin therapy and 974 not). Multivariable conditional logistic regression revealed a significant association between insulin therapy during hospitalization and in-hospital death in both cohorts (MIMIC: OR, 1.37 [95% CI, 1.14–1.63]; TJHFIT: OR, 2.56 [95% CI, 1.53–4.27]). Insulin therapy was associated with a higher likelihood of ΔePVS > 0 (MIMIC: OR, 1.11 [95% CI, 1.02–1.28]; TJHFIT: OR, 1.37 [95% CI, 1.13–1.66]). RCS revealed both ePVS and ΔePVS were associated with in-hospital death in a nonlinear fashion. The ePVS at discharge mediated insulin-associated in-hospital death with a proportion of 12.0% (MIMIC) and 13.2% (TJHFIT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Insulin therapy was associated with elevated odds of in-hospital death among CHF-T2DM patients, which was mediated by plasma volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The research has been registered (ChiCTR2300077220)</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 12","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kamran Shakir, Hadi Sarlak, Sicco A. Bus, Giulia Rogati, Alberto Leardini, Lisa Berti, Paolo Caravaggi
The recurrence of diabetic foot ulcers (DFUs) brings significant morbidity to people with diabetes and adds to healthcare costs. According to current guidelines, a DFU is considered healed when it is re-epithelialized, and the wound closure is maintained for around 2 weeks. However, recent literature suggests that the mechanical properties of the underlying plantar tissues remain altered, thus making the foot vulnerable to recurrence. The period lasting several weeks post-DFU healing can be termed the ‘transition phase’. This review aimed at exploring this critical phase, with an emphasis on the roles of tissue mechanics and current offloading strategies. An extensive search was performed on PubMed to identify studies on the mechanical properties of the tissues and preventative strategies in the post-healing period. Following the analysis of titles and abstracts, 57 studies met the inclusion criteria and were included in the review. The analysis of the literature revealed that studies are primarily focused on offloading interventions during the remission phase to mitigate long-term ulceration risks. The physiological needs of the still-vulnerable plantar soft tissue after DFU healing are seldom assessed, and no strict differentiation between re-ulceration and recurrent ulceration has been found. According to this review, there is a need for developing beyond state-of-the-art solutions targeting pressure relief and footwear adherence, which consider the varying physiological conditions of the skin and underlying tissue in the transition phase, and the different risk categories and independent risk factors.
{"title":"Advancing Diabetic Foot Ulcer Care: Focus on the Post-Healing Transition Phase","authors":"Kamran Shakir, Hadi Sarlak, Sicco A. Bus, Giulia Rogati, Alberto Leardini, Lisa Berti, Paolo Caravaggi","doi":"10.1111/1753-0407.70173","DOIUrl":"https://doi.org/10.1111/1753-0407.70173","url":null,"abstract":"<p>The recurrence of diabetic foot ulcers (DFUs) brings significant morbidity to people with diabetes and adds to healthcare costs. According to current guidelines, a DFU is considered healed when it is re-epithelialized, and the wound closure is maintained for around 2 weeks. However, recent literature suggests that the mechanical properties of the underlying plantar tissues remain altered, thus making the foot vulnerable to recurrence. The period lasting several weeks post-DFU healing can be termed the ‘transition phase’. This review aimed at exploring this critical phase, with an emphasis on the roles of tissue mechanics and current offloading strategies. An extensive search was performed on PubMed to identify studies on the mechanical properties of the tissues and preventative strategies in the post-healing period. Following the analysis of titles and abstracts, 57 studies met the inclusion criteria and were included in the review. The analysis of the literature revealed that studies are primarily focused on offloading interventions during the remission phase to mitigate long-term ulceration risks. The physiological needs of the still-vulnerable plantar soft tissue after DFU healing are seldom assessed, and no strict differentiation between re-ulceration and recurrent ulceration has been found. According to this review, there is a need for developing beyond state-of-the-art solutions targeting pressure relief and footwear adherence, which consider the varying physiological conditions of the skin and underlying tissue in the transition phase, and the different risk categories and independent risk factors.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 12","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Huang, W. Wen, and S. Ye, “Iron-Deficiency Anemia Elevates Risk of Diabetic Kidney Disease in Type 2 Diabetes Mellitus,” Journal of Diabetes 17, no. 2 (2025): e70060. https://doi.org/10.1111/1753-0407.70060.
These corrections do not affect any statistical analyses or conclusions of the article.
{"title":"Correction to “Iron-Deficiency Anemia Elevates Risk of Diabetic Kidney Disease in Type 2 Diabetes Mellitus”","authors":"","doi":"10.1111/1753-0407.70174","DOIUrl":"10.1111/1753-0407.70174","url":null,"abstract":"<p>B. Huang, W. Wen, and S. Ye, “Iron-Deficiency Anemia Elevates Risk of Diabetic Kidney Disease in Type 2 Diabetes Mellitus,” <i>Journal of Diabetes</i> 17, no. 2 (2025): e70060. https://doi.org/10.1111/1753-0407.70060.</p><p>These corrections do not affect any statistical analyses or conclusions of the article.</p><p>We apologize for this error.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 11","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145601436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaohong Wu, Ying Zhang, Ziling Li, Agustina Alvarez, Felipe Lauand, Lydie Melas-Melt, Minlu Zhang, Lei Kang, Qin Du, Jie Zhang, Yiming Mu
<p>Early glycemic control provides lifelong benefits in individuals with type 2 diabetes (T2D) [<span>1</span>]; however, < 40% of Chinese adults with T2D achieve glycated hemoglobin (HbA1c) < 7.0% with conventional oral antidiabetic drugs (OADs), rather than early intensive treatment [<span>2, 3</span>]. Following the publication of the phase 3 Soli-D study [<span>4</span>], the current post hoc analysis evaluated whether iGlarLixi (a fixed-ratio combination [FRC] comprising insulin glargine 100 U/mL plus lixisenatide) can provide improved early glycemic control at Weeks 8 and 12 compared with the premixed insulin degludec plus insulin aspart (IDegAsp).</p><p>In Soli-D, iGlarLixi demonstrated superior efficacy to IDegAsp among Chinese adults with suboptimally controlled T2D on metformin (± a second OAD) with regard to HbA1c reductions from baseline to Week 24 [<span>4</span>]. In this analysis, changes from baseline in HbA1c, FPG, and body weight, as well as total insulin daily dose were assessed at Weeks 8 and 12, and changes in 7-point self-measured plasma glucose (SMPG) and 2-h PPG, and hypoglycemia event rates were evaluated at Week 12. The proportion of participants who achieved HbA1c < 7.0%, FPG ≤ 7.0 mmol/L, or 2-h PPG < 10.0 mmol/L were also assessed at Weeks 8 and 12. HbA1c, FPG, and 2-h PPG data were used to estimate the median time to glycemic target achievement (i.e., the time taken for 50% of participants to reach glycemic target).</p><p>Compared with IDegAsp, iGlarLixi was associated with greater reductions from baseline in HbA1c at Week 8 (least squares mean ± standard error difference −0.33 ± 0.06) and Week 12 (−0.32 ± 0.06), and in average 7-point SMPG (−0.66 ± 0.13) and 2-h PPG (−1.06 ± 0.16) at Week 12, while changes in FPG remained similar (Table 1). Additionally, iGlarLixi required lower total insulin daily doses and demonstrated body weight benefits over IDegAsp at both timepoints. The hypoglycemia event rate was numerically lower with iGlarLixi versus IDegAsp at Week 12 (Table S1), and iGlarLixi provided higher achievement rates of target HbA1c at Weeks 8 and 12, and target 2-h PPG at Week 12 compared with IDegAsp (Figure S1). The time to achievement of target HbA1c or target 2-h PPG was shorter with iGlarLixi than with IDegAsp (Figure S2).</p><p>These results at Weeks 8 and 12 are consistent with those previously reported at Week 24 in the primary analysis of Soli-D [<span>4</span>]. The early glycemic benefits of iGlarLixi over IDegAsp observed in this analysis are most likely attributable to the PPG reductions provided by the lixisenatide component of the FRC. Unlike premixed insulins, the glucagon-like peptide-1 receptor agonist (GLP-1 RA) lixisenatide acts by delaying gastric emptying and reducing glucagon secretion, providing greater reductions in PPG excursions. Based on post-trial monitoring data from the UK Prospective Diabetes Study in adults with newly diagnosed T2D [<span>1</span>], early and effect
{"title":"Early Glycemic Control With iGlarLixi Versus IDegAsp in Chinese Adults With Type 2 Diabetes: A Post Hoc Analysis of the Soli-D Study","authors":"Xiaohong Wu, Ying Zhang, Ziling Li, Agustina Alvarez, Felipe Lauand, Lydie Melas-Melt, Minlu Zhang, Lei Kang, Qin Du, Jie Zhang, Yiming Mu","doi":"10.1111/1753-0407.70171","DOIUrl":"10.1111/1753-0407.70171","url":null,"abstract":"<p>Early glycemic control provides lifelong benefits in individuals with type 2 diabetes (T2D) [<span>1</span>]; however, < 40% of Chinese adults with T2D achieve glycated hemoglobin (HbA1c) < 7.0% with conventional oral antidiabetic drugs (OADs), rather than early intensive treatment [<span>2, 3</span>]. Following the publication of the phase 3 Soli-D study [<span>4</span>], the current post hoc analysis evaluated whether iGlarLixi (a fixed-ratio combination [FRC] comprising insulin glargine 100 U/mL plus lixisenatide) can provide improved early glycemic control at Weeks 8 and 12 compared with the premixed insulin degludec plus insulin aspart (IDegAsp).</p><p>In Soli-D, iGlarLixi demonstrated superior efficacy to IDegAsp among Chinese adults with suboptimally controlled T2D on metformin (± a second OAD) with regard to HbA1c reductions from baseline to Week 24 [<span>4</span>]. In this analysis, changes from baseline in HbA1c, FPG, and body weight, as well as total insulin daily dose were assessed at Weeks 8 and 12, and changes in 7-point self-measured plasma glucose (SMPG) and 2-h PPG, and hypoglycemia event rates were evaluated at Week 12. The proportion of participants who achieved HbA1c < 7.0%, FPG ≤ 7.0 mmol/L, or 2-h PPG < 10.0 mmol/L were also assessed at Weeks 8 and 12. HbA1c, FPG, and 2-h PPG data were used to estimate the median time to glycemic target achievement (i.e., the time taken for 50% of participants to reach glycemic target).</p><p>Compared with IDegAsp, iGlarLixi was associated with greater reductions from baseline in HbA1c at Week 8 (least squares mean ± standard error difference −0.33 ± 0.06) and Week 12 (−0.32 ± 0.06), and in average 7-point SMPG (−0.66 ± 0.13) and 2-h PPG (−1.06 ± 0.16) at Week 12, while changes in FPG remained similar (Table 1). Additionally, iGlarLixi required lower total insulin daily doses and demonstrated body weight benefits over IDegAsp at both timepoints. The hypoglycemia event rate was numerically lower with iGlarLixi versus IDegAsp at Week 12 (Table S1), and iGlarLixi provided higher achievement rates of target HbA1c at Weeks 8 and 12, and target 2-h PPG at Week 12 compared with IDegAsp (Figure S1). The time to achievement of target HbA1c or target 2-h PPG was shorter with iGlarLixi than with IDegAsp (Figure S2).</p><p>These results at Weeks 8 and 12 are consistent with those previously reported at Week 24 in the primary analysis of Soli-D [<span>4</span>]. The early glycemic benefits of iGlarLixi over IDegAsp observed in this analysis are most likely attributable to the PPG reductions provided by the lixisenatide component of the FRC. Unlike premixed insulins, the glucagon-like peptide-1 receptor agonist (GLP-1 RA) lixisenatide acts by delaying gastric emptying and reducing glucagon secretion, providing greater reductions in PPG excursions. Based on post-trial monitoring data from the UK Prospective Diabetes Study in adults with newly diagnosed T2D [<span>1</span>], early and effect","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 11","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145601385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus (DM) is one of the most common chronic diseases worldwide, and diabetic cardiomyopathy (DCM) is one of the cardiovascular complications of DM, described as the development of abnormalities of myocardial structure/function associated with DM in the absence of coronary artery disease, hypertension, and valvular disease. The disease has an insidious onset and lacks effective treatment. Studies have shown that even with effective glycemic control, the progression of DCM cannot be prevented. Exploring the pathogenesis of DCM and identifying effective intervention targets is the focus and hotspot of current research. Silent message regulator 3 (Sirtuin3, SIRT3) is one of the members of the nicotinamide adenine dinucleotide (NAD+)-dependent deacetylase family of sirtuins, and studies have confirmed that SIRT3 has a protective effect on cardiovascular disease and may become a new target for the treatment of cardiovascular diseases. Therefore, this paper emphasizes the role of SIRT3 in DCM, describes the mechanism of SIRT3 in DCM, and summarizes the methods to improve DCM by elevating the level of SIRT3, aiming to provide new perspectives for treating and delaying DCM.
{"title":"Targeting SIRT3 to Ameliorate Diabetic Cardiomyopathy: Progress in Mechanistic Research and Prospects for Clinical Translation","authors":"Yuting Lin, Kun Yu, Jinjian Guo","doi":"10.1111/1753-0407.70167","DOIUrl":"10.1111/1753-0407.70167","url":null,"abstract":"<p>Diabetes mellitus (DM) is one of the most common chronic diseases worldwide, and diabetic cardiomyopathy (DCM) is one of the cardiovascular complications of DM, described as the development of abnormalities of myocardial structure/function associated with DM in the absence of coronary artery disease, hypertension, and valvular disease. The disease has an insidious onset and lacks effective treatment. Studies have shown that even with effective glycemic control, the progression of DCM cannot be prevented. Exploring the pathogenesis of DCM and identifying effective intervention targets is the focus and hotspot of current research. Silent message regulator 3 (Sirtuin3, SIRT3) is one of the members of the nicotinamide adenine dinucleotide (NAD<sup>+</sup>)-dependent deacetylase family of sirtuins, and studies have confirmed that SIRT3 has a protective effect on cardiovascular disease and may become a new target for the treatment of cardiovascular diseases. Therefore, this paper emphasizes the role of SIRT3 in DCM, describes the mechanism of SIRT3 in DCM, and summarizes the methods to improve DCM by elevating the level of SIRT3, aiming to provide new perspectives for treating and delaying DCM.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 11","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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