Journal of Diabetes最新文献

The ramifications of the effects of diabetes on the kidney and the relationships of renal disease to the complications of diabetes are manifold, and several recent studies have addressed important aspects of the implications and the management of diabetic kidney disease (DKD).

An estimate of the prevalence of DKD among persons with type 1 diabetes (T1D) was made based on the National Health and Nutrition Examination Survey (NHANES) database of 19 225 adults in the United States from 2015 to 2018; 47 had T1D, among whom 20 had estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m² or urine albumin/creatinine ratio (UACR) ≥30 mg/g, allowing estimates of 1 202 739 adults in the United States with T1D and a weighted estimate that 21.5% of people with T1D in the United States have DKD.¹ A report from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database mortality statistics from 1999 to 2020 reflected the dramatic increase in mortality associated with DKD; more than 500 000 deaths were reported among adults with DKD during this period, with an age-adjusted annual mortality rate per 100 000 persons of approximately 2.0 in 1999–2005, increasing to approximately 4.0 in 2007–2010, but then to 22.0 in 2012–2019 and to 25.0 in 2020.² In an analysis suggesting interrelationships between DKD and cognitive function (CF), among 2977 people with type 2 diabetes (T2D) in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) memory in diabetes trial, there was a greater decline over 40 months in CF with standard than with intensive glycemic treatment among those with urine albumin <0.4 mg/dL, whereas those with higher levels of albuminuria had no evidence of benefit with intensive treatment, and for those with eGFR < 60, CF decline was greater with intensive than with standard glycemic treatment. Similarly, CF decline was greater with standard than intensive glycemic treatment in the subset age <60 years, suggesting that T2D with better renal function and lower age might particularly benefit from more intensive glycemic treatment.³ There may be a different relationship between age and renal outcome with intensive lifestyle intervention (ILI); in a 12-year follow-up of the Look AHEAD (Action for Health in Diabetes) trial, prespecified analysis of the relationship between the ILI and age showed that among 5112 participants with baseline eGFR ≥ 45, those aged >60 years at baseline randomized to ILI had a 25% lower likelihood of eGFR decreasing to <45 mL/min/1.73 m², whereas this was not seen in the younger participants.⁴

The optimal blood pressure treatment target is still not certain. The 11 255-person Effects of Intensive Systolic Blood Pressure Lowering Treatment in Reducing Risk of Vascular Events (ESPRIT) trial included 4359 persons with diabetes with systolic b

Imelda Lee was one of the most important members of the Journal of Diabetes team—our founding administrator. Imelda started the Journal of Diabetes group with all of us more than 15 years ago. We pay attention to the scientists and physicians who nominally “run” the Journal, but it would be wrong to overlook those crucial to the daily operations “behind-the-scenes.”

Imelda grew up in Hong Kong in the early 1950s, and her sisters Lee and Frances remembered her to us as a fierce protector of all her family throughout her youth. After her secondary education, she worked in Hong Kong, then moved to the United States, and while working with her family at their business in Indiana, she was also able to attend and graduate from Purdue University, much to the admiration of those who knew her. She returned to China and moved to Shanghai, where she became an administrator at Rui Jin Hospital. She was recruited to manage the Journal of Diabetes as it was being started, when one of us (Z.B.) had the pleasure of meeting her. The same fierce spirit that led to her defending her siblings in Hong Kong and to her both working and going to college at night in the United States, led to her wonderful work at the new Journal. The impact of her administrative work was felt by all of us and by the editorial group; being both in China and in the United States, she was able to literally keep us going “24 × 7.” She challenged all of us to work harder, to learn the quirks of the Journal's complex computer system, and to reach out to the world of diabetes research to help develop the Journal in its formative period. She was quiet unless there was an issue, but then she would be fierce in helping all of us to accomplish more.

The Biblical term Eshet Chayil is usually translated as “Woman of Valor,” but has multiple meanings, referring as well to capacity and power, and Imelda was indeed a woman of true inner strength who exemplified wisdom and industry in her professional endeavors. Above all, she was guided by a strong moral compass, following a basic set of principles, accepting our efforts and uplifting and empowering us, and leaving us better for being her colleagues. Her active and optimistic attitude toward difficulties also greatly influenced us, with her readiness to help others a model for all to emulate. Imelda's deep faith was always an inspiring example to us but never more so than when she became ill several years ago. We did not hear words of unhappiness or despair; rather, she exemplified courage in the face of adversity.

We remember her, and we deeply miss her. As much as any of us, Imelda truly was a founder of the Journal, and we hope that the concept of the Journal of Diabetes in supporting a dialog between East and West in all aspects of the understanding of diabetes will continue as a memorial to her efforts.