Amy Coulden, Christina Antza, Orighomisan Awala, Nihit Shah, Leelavathy Kandaswamy, Ananda Nahar, Angela Phillips, Sneha Upadhyaya, Ayesha Asif, Zara Khan, Feaz Babwah, Matthew Armstrong, Samiul Mostaf, Wasim Hanif
Background
Anecdotally, patients with diabetes mellitus after undertaking a liver transplant have reported improved glycaemic control and reduced insulin requirements, compared to other organ transplants where glycaemic control often worsens. This study aimed to evaluate possible changes in anti-glycaemic agent requirements pre- and post-liver transplantation and correlate them with the immunosuppression used and the reason for transplant.
Methods
In this observational, retrospective study, we investigated 258 adults with pre-existing diabetes mellitus who underwent liver transplant from October 2009 to January 2020 at a tertiary UK center. We compared pre- and post-transplant insulin treatment requirements.
Results
The mean age was 56 years, and the median duration of diabetes was 96 months. From a subgroup of 100 patients (38.8%) using insulin therapy, there was a reduction in insulin requirements from 60.5 ± 44.6 units/day before transplant to 51.1 ± 31.2 units/day at 1 month post-transplantation (15.5%, p = 0.02), 43.4 ± 29.5 units/day at 3 months post-transplantation (28.2%, p < 0.0001) and 33.6 ± 29.7 units/day at 6 months post-transplantation (44.4%, p < 0.0001). There was a significant correlation between the difference in insulin requirement before and 6 months post-transplant and the tacrolimus dose used as immunosuppressive therapy post-liver transplant. There was no correlation with the use of other immunosuppressive therapies and change in insulin requirement.
Conclusions
Insulin requirements significantly reduced post-liver transplant by almost 50%, despite initiation of immunosuppressive therapy. This is one of the first studies showing this effect, highlighting the role of the liver in regulating glucose metabolism, insulin utilization, and insulin resistance. Pooled data from other specialist centers need to be examined.
{"title":"The Effect of Liver Transplantation on Anti-Glycaemic Agents in Patients With Pre-Existing Diabetes Mellitus: A Population-Based Cohort Study","authors":"Amy Coulden, Christina Antza, Orighomisan Awala, Nihit Shah, Leelavathy Kandaswamy, Ananda Nahar, Angela Phillips, Sneha Upadhyaya, Ayesha Asif, Zara Khan, Feaz Babwah, Matthew Armstrong, Samiul Mostaf, Wasim Hanif","doi":"10.1111/1753-0407.70088","DOIUrl":"https://doi.org/10.1111/1753-0407.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anecdotally, patients with diabetes mellitus after undertaking a liver transplant have reported improved glycaemic control and reduced insulin requirements, compared to other organ transplants where glycaemic control often worsens. This study aimed to evaluate possible changes in anti-glycaemic agent requirements pre- and post-liver transplantation and correlate them with the immunosuppression used and the reason for transplant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this observational, retrospective study, we investigated 258 adults with pre-existing diabetes mellitus who underwent liver transplant from October 2009 to January 2020 at a tertiary UK center. We compared pre- and post-transplant insulin treatment requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age was 56 years, and the median duration of diabetes was 96 months. From a subgroup of 100 patients (38.8%) using insulin therapy, there was a reduction in insulin requirements from 60.5 ± 44.6 units/day before transplant to 51.1 ± 31.2 units/day at 1 month post-transplantation (15.5%, <i>p</i> = 0.02), 43.4 ± 29.5 units/day at 3 months post-transplantation (28.2%, <i>p</i> < 0.0001) and 33.6 ± 29.7 units/day at 6 months post-transplantation (44.4%, <i>p</i> < 0.0001). There was a significant correlation between the difference in insulin requirement before and 6 months post-transplant and the tacrolimus dose used as immunosuppressive therapy post-liver transplant. There was no correlation with the use of other immunosuppressive therapies and change in insulin requirement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Insulin requirements significantly reduced post-liver transplant by almost 50%, despite initiation of immunosuppressive therapy. This is one of the first studies showing this effect, highlighting the role of the liver in regulating glucose metabolism, insulin utilization, and insulin resistance. Pooled data from other specialist centers need to be examined.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635496","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}
Ruixue Feng, Donge Yan, Mingxin Bai, Xingwu Ran, Dawei Chen, Chun Wang, Lihong Chen, Shuang Lin, Sen He, Yan Liu, Murong Wu, Zhiyi Lei, Yun Gao
Background
To investigate the association between different categories of diabetic autonomic neuropathy (DAN) and left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (T2DM).
Methods
We conducted a cross-sectional study of 3440 participants with T2DM recruited in Diabetic Foot Care Center of West China Hospital, Sichuan University from January 2016 to February 2024. LVDD was assessed via echocardiography, defined as an average E/e′ ratio > 14. Twenty-four hour Holter ECG, postvoid residual volume (PVR) examinations, and gastric emptying scintigraphy were employed to evaluate cardiac autonomic dysfunction, diabetic neurogenic bladder (DNB), and diabetic gastrointestinal autonomic neuropathy (DGAN), respectively. Logistic regression and propensity score matching (PSM) analyses were employed to examine the associations.
Results
Severe cardiac autonomic dysfunction (SDNN < 50 ms) was independently associated with LVDD, with odds ratios (OR) 1.731 (95% CI: 1.103–2.719, p = 0,018) after adjustment for potential confounding factors. LVDD tended to be independently associated with DNB (OR 1.356; 95% CI [0.992, 1.856]; p = 0.056). PSM analysis further validated the independent associations of SDNN < 50 ms (OR 1.587, 95% CI 1.028, 2.450, p = 0.037) and DNB (OR 1.454, 95% CI 1.011, 2.090, p = 0.043). However, DGAN was not independently associated with LVDD. Additionally, women had a higher risk of LVDD compared to men (OR 1.995, 95% CI 1.379, 2.885, p < 0.001).
Conclusions
Severe (SDNN < 50 ms), rather than mild–moderate, cardiac autonomic dysfunction, and DNB are independently associated with LVDD in individuals with T2DM. Additionally, women have a higher risk of LVDD than men.
研究2型糖尿病（T2DM）患者不同类型的糖尿病自主神经病变（DAN）与左室舒张功能障碍（LVDD）的关系。方法对2016年1月至2024年2月在四川大学华西医院糖尿病足护理中心招募的3440名T2DM患者进行横断面研究。通过超声心动图评估LVDD，定义为平均E/ E比值>； 14。采用24小时动态心电图（Holter ECG）、空后残余容量（PVR）检查和胃排空显像分别评估心脏自主神经功能障碍、糖尿病神经源性膀胱（DNB）和糖尿病胃肠道自主神经病变（DGAN）。采用Logistic回归和倾向评分匹配（PSM）分析来检验相关性。结果校正潜在混杂因素后，严重心脏自主神经功能障碍（SDNN < 50 ms）与LVDD独立相关，优势比（OR）为1.731 （95% CI: 1.103-2.719, p = 0.018）。LVDD倾向于与DNB独立相关(OR 1.356；95% ci [0.992, 1.856]；p = 0.056)。PSM分析进一步验证了SDNN <； 50 ms （OR 1.587, 95% CI 1.028, 2.450, p = 0.037）和DNB （OR 1.454, 95% CI 1.011, 2.090, p = 0.043）的独立相关性。然而，DGAN与LVDD并不独立相关。此外，与男性相比，女性LVDD的风险更高（OR 1.995, 95% CI 1.379, 2.885, p < 0.001）。结论重度（SDNN < 50 ms）心脏自主神经功能障碍和DNB与T2DM患者LVDD独立相关，而非轻度-中度。此外，女性比男性有更高的LVDD风险。
{"title":"Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross-Sectional Study","authors":"Ruixue Feng, Donge Yan, Mingxin Bai, Xingwu Ran, Dawei Chen, Chun Wang, Lihong Chen, Shuang Lin, Sen He, Yan Liu, Murong Wu, Zhiyi Lei, Yun Gao","doi":"10.1111/1753-0407.70124","DOIUrl":"https://doi.org/10.1111/1753-0407.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To investigate the association between different categories of diabetic autonomic neuropathy (DAN) and left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study of 3440 participants with T2DM recruited in Diabetic Foot Care Center of West China Hospital, Sichuan University from January 2016 to February 2024. LVDD was assessed via echocardiography, defined as an average E/e′ ratio > 14. Twenty-four hour Holter ECG, postvoid residual volume (PVR) examinations, and gastric emptying scintigraphy were employed to evaluate cardiac autonomic dysfunction, diabetic neurogenic bladder (DNB), and diabetic gastrointestinal autonomic neuropathy (DGAN), respectively. Logistic regression and propensity score matching (PSM) analyses were employed to examine the associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Severe cardiac autonomic dysfunction (SDNN < 50 ms) was independently associated with LVDD, with odds ratios (OR) 1.731 (95% CI: 1.103–2.719, <i>p</i> = 0,018) after adjustment for potential confounding factors. LVDD tended to be independently associated with DNB (OR 1.356; 95% CI [0.992, 1.856]; <i>p</i> = 0.056). PSM analysis further validated the independent associations of SDNN < 50 ms (OR 1.587, 95% CI 1.028, 2.450, <i>p</i> = 0.037) and DNB (OR 1.454, 95% CI 1.011, 2.090, <i>p</i> = 0.043). However, DGAN was not independently associated with LVDD. Additionally, women had a higher risk of LVDD compared to men (OR 1.995, 95% CI 1.379, 2.885, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Severe (SDNN < 50 ms), rather than mild–moderate, cardiac autonomic dysfunction, and DNB are independently associated with LVDD in individuals with T2DM. Additionally, women have a higher risk of LVDD than men.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624665","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}
Yang Meng, Yuan Liu, Runping Duan, Baoyi Liu, Zhuangling Lin, Yuan Ma, Lan Jiang, Zijian Qin, Tao Li
Background
To evaluate the global, regional, and national trends of vision impairment associated with diabetic retinopathy (DR) in the working-age population (20–65 years) from 1990 to 2021.
Methods
This was a population-based analysis using data from the Global Burden of Disease Study 2021. Vision impairment was defined as low vision (Snellen visual acuity of < 6/18 to ≥ 3/60) and blindness (Snellen visual acuity of < 3/60 or central visual field < 10°). The burden of DR-related vision impairment, that is, prevalence and years lived with disability (YLD), was analyzed by sex, age, location, and sociodemographic index (SDI). A Bayesian age-period-cohort analysis was employed to forecast the future burden up to 2035.
Results
From 1990 to 2021, the global prevalence rate and YLD rate of DR-related vision impairment increased significantly. In 2021, 2.85 million prevalent cases and 250 117 YLDs were reported, representing 2.8-fold and 3.0-fold increases compared to 1990, respectively. South Asia and China were identified as the most severely burdened region and country in 2021, respectively. Throughout 1990–2021, females consistently bore a greater burden than males. In terms of SDI, the burden was predominantly concentrated in middle-SDI countries. Predictive analysis suggests a continued increase in the number of patients and YLDs by 2035.
Conclusions
Globally, there has been a substantial increase in the burden of DR-related vision impairment among working-age individuals, with disparities observed in terms of sex, location, and SDI. Given the projected worsening of this burden, targeted interventions are needed to address this global health challenge.
{"title":"Global, Regional, and National Epidemiology of Vision Impairment due to Diabetic Retinopathy Among Working-Age Population, 1990–2021","authors":"Yang Meng, Yuan Liu, Runping Duan, Baoyi Liu, Zhuangling Lin, Yuan Ma, Lan Jiang, Zijian Qin, Tao Li","doi":"10.1111/1753-0407.70121","DOIUrl":"https://doi.org/10.1111/1753-0407.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To evaluate the global, regional, and national trends of vision impairment associated with diabetic retinopathy (DR) in the working-age population (20–65 years) from 1990 to 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a population-based analysis using data from the Global Burden of Disease Study 2021. Vision impairment was defined as low vision (Snellen visual acuity of < 6/18 to ≥ 3/60) and blindness (Snellen visual acuity of < 3/60 or central visual field < 10°). The burden of DR-related vision impairment, that is, prevalence and years lived with disability (YLD), was analyzed by sex, age, location, and sociodemographic index (SDI). A Bayesian age-period-cohort analysis was employed to forecast the future burden up to 2035.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1990 to 2021, the global prevalence rate and YLD rate of DR-related vision impairment increased significantly. In 2021, 2.85 million prevalent cases and 250 117 YLDs were reported, representing 2.8-fold and 3.0-fold increases compared to 1990, respectively. South Asia and China were identified as the most severely burdened region and country in 2021, respectively. Throughout 1990–2021, females consistently bore a greater burden than males. In terms of SDI, the burden was predominantly concentrated in middle-SDI countries. Predictive analysis suggests a continued increase in the number of patients and YLDs by 2035.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Globally, there has been a substantial increase in the burden of DR-related vision impairment among working-age individuals, with disparities observed in terms of sex, location, and SDI. Given the projected worsening of this burden, targeted interventions are needed to address this global health challenge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624664","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}
<div> <section> <h3> Background</h3> <p>Mutations in the <i>WFS1</i> gene are implicated in Wolfram syndrome (WS), Wolfram-like syndrome (WFLS), and maturity-onset diabetes of the young (MODY). Wolfram syndrome 1 (<i>WFS1</i>) is a diabetes-related gene encoding wolframin, a glycoprotein with nine transmembrane domains localized in the endoplasmic reticulum. However, the relationship between <i>WFS1</i> mutations and their associated phenotypes remains incompletely understood, requiring additional patient data collection for further investigation. Here we collected and analyzed clinical data from three diabetes pedigrees, and to assess the genotype-phenotype correlation.</p> </section> <section> <h3> Methods</h3> <p>High-throughput sequencing was employed to detect <i>WFS1</i> gene mutations, followed by pathogenicity and conservation analysis using bioinformatics software. A three-dimensional wolframin protein structure was constructed to investigate the potential effects of the mutations. Moreover, the distribution of <i>WFS1</i> mutations and their associated clinical phenotypes were analyzed by summarizing genetic variations of the <i>WFS1</i> gene recorded in the Human Gene Mutation Database.</p> </section> <section> <h3> Results</h3> <p>Four heterozygous <i>WFS1</i> mutations were identified in three diabetes families. Among these, c.1523_1524del/p.Y508Cfs*34 was identified as a frameshift mutation, while the others were missense mutations. Bioinformatics predictions revealed that c.766A>G/p.K256E is a benign and novel mutation, whereas the remaining mutations were classified as pathogenic. Furthermore, c.985T>A/p.F329I was validated as a MODY-associated mutation within a specific family. A comprehensive summary of all reported <i>WFS1</i> mutations indicated that mutations associated with WS phenotypes are approximately 18.7 times more frequent than those associated with MODY phenotypes. Missense mutations accounted for the highest proportion of <i>WFS1</i> mutations associated with different clinical phenotypes, with the majority located in exon 8.</p> </section> <section> <h3> Conclusions</h3> <p>This study identified a novel <i>WFS1</i> mutation, c.766A>G/p.K256E, expanding the known mutation spectrum of the <i>WFS1</i> gene. The findings suggest that inactivating mutations and benign missense mutations are associated with more severe WS phenotypes compared to purely pathogenic missense mutations. Moreover, c.985T>A/p.F329I was validated as a MODY associated mutation. Finally, by summarizing the genotype–phenotype relationship
{"title":"Characterization of Novel WFS1 Variants in Three Diabetes Pedigrees","authors":"ChangQing Liu, HangYu Fang, Dong Wang, YiPing Cheng, Ping Shi, ChunXiao Yu, XiaoHong Li, Hui Zhao, Wei Hou, ZhenKui Guo, Chao Xu, QingBo Guan","doi":"10.1111/1753-0407.70114","DOIUrl":"https://doi.org/10.1111/1753-0407.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mutations in the <i>WFS1</i> gene are implicated in Wolfram syndrome (WS), Wolfram-like syndrome (WFLS), and maturity-onset diabetes of the young (MODY). Wolfram syndrome 1 (<i>WFS1</i>) is a diabetes-related gene encoding wolframin, a glycoprotein with nine transmembrane domains localized in the endoplasmic reticulum. However, the relationship between <i>WFS1</i> mutations and their associated phenotypes remains incompletely understood, requiring additional patient data collection for further investigation. Here we collected and analyzed clinical data from three diabetes pedigrees, and to assess the genotype-phenotype correlation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>High-throughput sequencing was employed to detect <i>WFS1</i> gene mutations, followed by pathogenicity and conservation analysis using bioinformatics software. A three-dimensional wolframin protein structure was constructed to investigate the potential effects of the mutations. Moreover, the distribution of <i>WFS1</i> mutations and their associated clinical phenotypes were analyzed by summarizing genetic variations of the <i>WFS1</i> gene recorded in the Human Gene Mutation Database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four heterozygous <i>WFS1</i> mutations were identified in three diabetes families. Among these, c.1523_1524del/p.Y508Cfs*34 was identified as a frameshift mutation, while the others were missense mutations. Bioinformatics predictions revealed that c.766A>G/p.K256E is a benign and novel mutation, whereas the remaining mutations were classified as pathogenic. Furthermore, c.985T>A/p.F329I was validated as a MODY-associated mutation within a specific family. A comprehensive summary of all reported <i>WFS1</i> mutations indicated that mutations associated with WS phenotypes are approximately 18.7 times more frequent than those associated with MODY phenotypes. Missense mutations accounted for the highest proportion of <i>WFS1</i> mutations associated with different clinical phenotypes, with the majority located in exon 8.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identified a novel <i>WFS1</i> mutation, c.766A>G/p.K256E, expanding the known mutation spectrum of the <i>WFS1</i> gene. The findings suggest that inactivating mutations and benign missense mutations are associated with more severe WS phenotypes compared to purely pathogenic missense mutations. Moreover, c.985T>A/p.F329I was validated as a MODY associated mutation. Finally, by summarizing the genotype–phenotype relationship","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598385","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}
The association of sleep behaviors with microvascular complications and cardiovascular outcomes in diabetic patients is not clear. Furthermore, serum biomarkers that can be used to evaluate this association have not been characterized. Therefore, this study investigated the association of the overall sleep score with the diabetic complications and the potential underlying serum metabolic biomarkers in patients with type 2 diabetes mellitus (T2DM).
Methods
This prospective cohort study included 30 915 T2DM patients without complications from the UK Biobank. The sleep score of the participants was evaluated based on sleep behaviors such as sleep duration, insomnia, snoring, chronotype, and daytime sleepiness. The potential biomarkers, including cystatin C (Cys C), apolipoprotein A (Apo A), C-reactive protein (CRP), albumin, and γ-glutamyl transpeptidase (GGT), were also determined to evaluate their role as potential indicators of the association between the sleep score and the diabetic complications.
Results
Participants with a healthy sleep score of 4–5 had lower risks of microvascular complications (HR = 0.80 [95% CI: 0.72, 0.89]) and cardiovascular outcomes (HR = 0.70 [95% CI: 0.61, 0.81]) compared to those with a sleep score of 0–1. Furthermore, cys C showed the best effects by explaining the associations of overall healthy sleep behaviors with microvascular complications and cardiovascular outcomes by 30.36% and 14.36%, respectively.
Conclusions
Our data showed that healthy sleep behaviors were associated with a reduced risk of diabetic complications. Moreover, serum biomarkers of renal function, lipids, systemic inflammation, and hepatic function partially mediated the relationship between sleep behaviors and diabetic complications.
{"title":"Healthy Sleep Behaviors Reduce the Risk of Microvascular and Cardiovascular Complications in Patients With Type 2 Diabetes and Are Associated With Potential Serum Biomarkers: A UK Biobank Observational Cohort Study","authors":"Rui Lan, Lina Mao, Tingting Luo, Wenjin Luo, Yao Qin, Hanwen Ye, Jingbo Hu, Shuming Yang, Qifu Li, Zhihong Wang, Xiangjun Chen","doi":"10.1111/1753-0407.70107","DOIUrl":"https://doi.org/10.1111/1753-0407.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association of sleep behaviors with microvascular complications and cardiovascular outcomes in diabetic patients is not clear. Furthermore, serum biomarkers that can be used to evaluate this association have not been characterized. Therefore, this study investigated the association of the overall sleep score with the diabetic complications and the potential underlying serum metabolic biomarkers in patients with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study included 30 915 T2DM patients without complications from the UK Biobank. The sleep score of the participants was evaluated based on sleep behaviors such as sleep duration, insomnia, snoring, chronotype, and daytime sleepiness. The potential biomarkers, including cystatin C (Cys C), apolipoprotein A (Apo A), C-reactive protein (CRP), albumin, and γ-glutamyl transpeptidase (GGT), were also determined to evaluate their role as potential indicators of the association between the sleep score and the diabetic complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants with a healthy sleep score of 4–5 had lower risks of microvascular complications (HR = 0.80 [95% CI: 0.72, 0.89]) and cardiovascular outcomes (HR = 0.70 [95% CI: 0.61, 0.81]) compared to those with a sleep score of 0–1. Furthermore, cys C showed the best effects by explaining the associations of overall healthy sleep behaviors with microvascular complications and cardiovascular outcomes by 30.36% and 14.36%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data showed that healthy sleep behaviors were associated with a reduced risk of diabetic complications. Moreover, serum biomarkers of renal function, lipids, systemic inflammation, and hepatic function partially mediated the relationship between sleep behaviors and diabetic complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 7","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514727","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}
Dietary alpha-linolenic acid (ALA) regulates lipid metabolism and insulin sensitivity, but few studies have investigated the association between ALA and the risk of mortality among adults with type 2 diabetes (T2D). This study examines whether increasing dietary ALA intake contributes to the long-term survival of adults with T2D.
Methods
This cohort study included 9603 participants with T2D, including 7953 adults from the National Health and Nutrition Examination Survey (NHANES; 1999–2018) and 1650 adults from the China Health and Nutrition Survey (CHNS; 1997–2011). Dietary information was collected through 24-h dietary recalls. Cox proportional hazards regression was employed to estimate hazard ratios (HRs) and 95% CIs for mortality from all-cause and cardiovascular disease (CVD).
Results
During 75 535 person-years of follow-up, a total of 2468 deaths were documented. After multivariate adjustment, the pooled HRs (95% CIs) of all-cause mortality were 1.00, 0.87 (0.76–0.99), and 0.79 (0.67–0.94) across tertiles of ALA (ptrend = 0.01). There was a linear inverse relationship between ALA intake and all-cause mortality, demonstrating a 9% (HR: 0.91;95% CI: 0.85_0.97) lower risk of all-cause mortality with each 1 g/day increase of dietary ALA intake in the pooled analysis (pnonlinear > 0.05). In addition, ALA intake was inversely associated with CVD mortality, and HR comparing the highest with the lowest tertile was 0.68 (0.50–0.91; ptrend = 0.01). Consistent results were observed in both the stratified and sensitivity analyses.
Conclusions
Higher dietary ALA intake was associated with a lower risk of all-cause and CVD mortality among adults with T2D.
{"title":"Alpha-Linolenic Acid and Mortality Among Adults With Type 2 Diabetes: Findings From Two National Cohorts","authors":"Boyang Chen, Qi Wu, Sibo Liu, Hongkun Di, Wen Hu, Tianzhu Qin, Yushuang Wang, Rong Chen, Han Wang, Ying Chen, Xiang Cheng, Jiawei Yin, Liegang Liu, Zhilei Shan","doi":"10.1111/1753-0407.70110","DOIUrl":"https://doi.org/10.1111/1753-0407.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dietary alpha-linolenic acid (ALA) regulates lipid metabolism and insulin sensitivity, but few studies have investigated the association between ALA and the risk of mortality among adults with type 2 diabetes (T2D). This study examines whether increasing dietary ALA intake contributes to the long-term survival of adults with T2D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cohort study included 9603 participants with T2D, including 7953 adults from the National Health and Nutrition Examination Survey (NHANES; 1999–2018) and 1650 adults from the China Health and Nutrition Survey (CHNS; 1997–2011). Dietary information was collected through 24-h dietary recalls. Cox proportional hazards regression was employed to estimate hazard ratios (HRs) and 95% CIs for mortality from all-cause and cardiovascular disease (CVD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During 75 535 person-years of follow-up, a total of 2468 deaths were documented. After multivariate adjustment, the pooled HRs (95% CIs) of all-cause mortality were 1.00, 0.87 (0.76–0.99), and 0.79 (0.67–0.94) across tertiles of ALA (<i>p</i><sub>trend</sub> = 0.01). There was a linear inverse relationship between ALA intake and all-cause mortality, demonstrating a 9% (HR: 0.91;95% CI: 0.85_0.97) lower risk of all-cause mortality with each 1 g/day increase of dietary ALA intake in the pooled analysis (<i>p</i><sub>nonlinear</sub> > 0.05). In addition, ALA intake was inversely associated with CVD mortality, and HR comparing the highest with the lowest tertile was 0.68 (0.50–0.91; <i>p</i><sub>trend</sub> = 0.01). Consistent results were observed in both the stratified and sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher dietary ALA intake was associated with a lower risk of all-cause and CVD mortality among adults with T2D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339258","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}
Hypertension is one of the most common comorbidities associated with diabetes. The standardized diagnosis and treatment of hypertension in diabetic patients, along with achieving blood pressure targets, is of great significance for reducing long-term complications, extending lifespan, and improving quality of life. Recent high-quality multicenter large-sample intervention studies have provided important evidence-based grounds for setting blood pressure targets in diabetic patients. Therefore, based on a comprehensive summary of important domestic and international research literature, and in combination with clinical practice experience, this management guideline is now formulated.
{"title":"Management Guidelines for Diabetic Patients With Hypertension","authors":"Weiqing Wang, Qin Wan, Suijun Wang, Guang Ning, Yufang Bi, Lianyong Liu, Yan Liu, Yu Liu, Xiaoying Li, Tingzhi Li, Xueyi Wu, Shengli Wu, Yubo Sha, Yifei Zhang, Rongyue Chen, Hongting Zheng, Dong Zhao, Ling Hu, Peng Duan, Xinguo Hou, Guoyue Yuan, Yu Xu, Shan Huang, Zhiqiang Kang, Qijuan Dong, Huanfeng Pan","doi":"10.1111/1753-0407.70093","DOIUrl":"https://doi.org/10.1111/1753-0407.70093","url":null,"abstract":"<p>Hypertension is one of the most common comorbidities associated with diabetes. The standardized diagnosis and treatment of hypertension in diabetic patients, along with achieving blood pressure targets, is of great significance for reducing long-term complications, extending lifespan, and improving quality of life. Recent high-quality multicenter large-sample intervention studies have provided important evidence-based grounds for setting blood pressure targets in diabetic patients. Therefore, based on a comprehensive summary of important domestic and international research literature, and in combination with clinical practice experience, this management guideline is now formulated.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339271","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 represents a significant global health concern, with diabetic cardiomyopathy (DCM) emerging as a primary cause of mortality among individuals with diabetes. Despite the prevalence of DCM, advancements in therapeutic and preventative strategies remain constrained.
Methods
Recent studies were reviewed to provide a comprehensive summary of pathogenesis and clinical treatment of DCM, effect of ferroptosis, and potential value of ferroptosis inhibitors in DCM intervention.
Results
A growing body of research indicates that oxidative stress, inflammatory reactions, and other factors play a role in the onset and progression of DCM. Oxidative stress within cardiomyocytes is a primary mechanism implicated in the development of DCM, whereby heightened intracellular reactive oxygen species (ROS) facilitate cell death via ferroptosis. Ferroptosis inhibitors hold great promise as therapeutic agents.
Conclusions
This review provides an overview of the involvement of iron homeostasis regulation, oxidative stress, and ferroptosis in DCM, and the significance of ferroptosis in the prevention and treatment of DCM.
{"title":"Potential Significance of Targeting Ferroptosis for Intervention of Diabetic Cardiomyopathy","authors":"Qian Lei, Burton B. Yang, Juanjuan Lyu","doi":"10.1111/1753-0407.70116","DOIUrl":"https://doi.org/10.1111/1753-0407.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetes represents a significant global health concern, with diabetic cardiomyopathy (DCM) emerging as a primary cause of mortality among individuals with diabetes. Despite the prevalence of DCM, advancements in therapeutic and preventative strategies remain constrained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Recent studies were reviewed to provide a comprehensive summary of pathogenesis and clinical treatment of DCM, effect of ferroptosis, and potential value of ferroptosis inhibitors in DCM intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A growing body of research indicates that oxidative stress, inflammatory reactions, and other factors play a role in the onset and progression of DCM. Oxidative stress within cardiomyocytes is a primary mechanism implicated in the development of DCM, whereby heightened intracellular reactive oxygen species (ROS) facilitate cell death via ferroptosis. Ferroptosis inhibitors hold great promise as therapeutic agents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review provides an overview of the involvement of iron homeostasis regulation, oxidative stress, and ferroptosis in DCM, and the significance of ferroptosis in the prevention and treatment of DCM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315062","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}
<p>Obesity prevalence has increased over many decades, with one quarter of the adult population projected to be obese by 2035 [<span>1</span>]. The glucagon-like peptide 1 receptor agonists (GLP-1RA) and related agents are associated with effective and sustained weight loss and show evidence of reduction in a myriad of cardiovascular (CV) and renal outcomes [<span>2</span>], as well as improving metabolic, hepatic, respiratory, and musculoskeletal complications of obesity. An increasing concern, however, is whether concomitant reduction in skeletal muscle mass (SMM) with fat mass may have adverse consequences [<span>3</span>].</p><p>While there is normally a decrease in SMM of 10%–15% from age 20 to 80 [<span>4</span>], excessive loss in muscle mass and the accompanying reduction in strength is associated with increased mortality, both overall and that due to a variety of separate conditions, whether measured based on bioelectrical impedance [<span>5</span>], self-reported walking limitation [<span>6</span>], or reduction in maximum handgrip strength [<span>7</span>]. In the National Health and Nutrition Examination Survey, 17%, 26%, and 31% of obese people aged 60–70, 70–80, and ≥ 80 had evidence of sarcopenia based on the appendicular lean mass-to-BMI ratio using dual-energy X-ray absorptiometry [<span>8</span>]. In further evidence of the prevalence of sarcopenic obesity, reduced handgrip strength and walking speed was present in 30%, 62%, and 89% of obese persons at ages 45–60, 61–80, and ≥ 80 in the Longitudinal Aging Study in India [<span>9</span>].</p><p>Across studies of dietary weight loss, GLP-1RA, and bariatric surgery, the relationship between the fraction of body weight lost and the fraction of lean body mass lost is linear, with somewhat limited data showing approximately 5% such loss for every 10% body weight reduction [<span>10</span>]. In a meta-analysis of 36 studies of bariatric surgery, the mean decrease in SMM averaged 7.8 kg at 12 months, with the first, second, third, and fourth quartiles of decrease in SMM 11.0, 9.1, 6.7 and 4.4 kg, respectively [<span>11</span>].</p><p>About one in eight adults say they have at some point taken a GLP-1RA, with about half of these currently taking the medications [<span>12</span>]. It is, then, important to ask whether this widely used treatment is associated with a reduction in SMM. These agents on average are associated with an improvement in physical function [<span>13</span>], and some have suggested that clinical trials have not shown GLP-1RA to be associated with “clinically relevant” skeletal muscle loss [<span>14</span>]. However, clinical trial populations differ in important ways from individuals in clinical treatment [<span>15-17</span>], the latter typically older with greater degrees of frailty and multiple comorbidities. The largest meta-analysis allowing insight into the effect of GLP-1RA on SMM involves 27 studies, with the change in fat-free mass as a percentage of the cha
{"title":"Monitoring Sarcopenia With Incretin Receptor Activator Treatment","authors":"Zachary T. Bloomgarden","doi":"10.1111/1753-0407.70117","DOIUrl":"https://doi.org/10.1111/1753-0407.70117","url":null,"abstract":"<p>Obesity prevalence has increased over many decades, with one quarter of the adult population projected to be obese by 2035 [<span>1</span>]. The glucagon-like peptide 1 receptor agonists (GLP-1RA) and related agents are associated with effective and sustained weight loss and show evidence of reduction in a myriad of cardiovascular (CV) and renal outcomes [<span>2</span>], as well as improving metabolic, hepatic, respiratory, and musculoskeletal complications of obesity. An increasing concern, however, is whether concomitant reduction in skeletal muscle mass (SMM) with fat mass may have adverse consequences [<span>3</span>].</p><p>While there is normally a decrease in SMM of 10%–15% from age 20 to 80 [<span>4</span>], excessive loss in muscle mass and the accompanying reduction in strength is associated with increased mortality, both overall and that due to a variety of separate conditions, whether measured based on bioelectrical impedance [<span>5</span>], self-reported walking limitation [<span>6</span>], or reduction in maximum handgrip strength [<span>7</span>]. In the National Health and Nutrition Examination Survey, 17%, 26%, and 31% of obese people aged 60–70, 70–80, and ≥ 80 had evidence of sarcopenia based on the appendicular lean mass-to-BMI ratio using dual-energy X-ray absorptiometry [<span>8</span>]. In further evidence of the prevalence of sarcopenic obesity, reduced handgrip strength and walking speed was present in 30%, 62%, and 89% of obese persons at ages 45–60, 61–80, and ≥ 80 in the Longitudinal Aging Study in India [<span>9</span>].</p><p>Across studies of dietary weight loss, GLP-1RA, and bariatric surgery, the relationship between the fraction of body weight lost and the fraction of lean body mass lost is linear, with somewhat limited data showing approximately 5% such loss for every 10% body weight reduction [<span>10</span>]. In a meta-analysis of 36 studies of bariatric surgery, the mean decrease in SMM averaged 7.8 kg at 12 months, with the first, second, third, and fourth quartiles of decrease in SMM 11.0, 9.1, 6.7 and 4.4 kg, respectively [<span>11</span>].</p><p>About one in eight adults say they have at some point taken a GLP-1RA, with about half of these currently taking the medications [<span>12</span>]. It is, then, important to ask whether this widely used treatment is associated with a reduction in SMM. These agents on average are associated with an improvement in physical function [<span>13</span>], and some have suggested that clinical trials have not shown GLP-1RA to be associated with “clinically relevant” skeletal muscle loss [<span>14</span>]. However, clinical trial populations differ in important ways from individuals in clinical treatment [<span>15-17</span>], the latter typically older with greater degrees of frailty and multiple comorbidities. The largest meta-analysis allowing insight into the effect of GLP-1RA on SMM involves 27 studies, with the change in fat-free mass as a percentage of the cha","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308971","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}
Antibiotics in childhood are commonly used and have been linked to gut microbiome dysbiosis and metabolic disorders. However, direct evidence regarding the association between long-term or recurrent antibiotic use (LRAU) during early life and diabetes was scarce. We performed this study to investigate this association in two population-based studies.
Methods
We undertook a prospective analysis encompassing 147 010 participants from the UK Biobank. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of self-reported LRAU during early life on diabetes risk. We also conducted a case–control study within the Chinese population, in which 263 diabetes cases and 526 controls were matched for age and living location. Odds ratios (ORs) and 95% CI were was calculated using logistic regression models.
Results
We identified 4314 incident cases of type 2 diabetes over 1 840 944 person-years of follow-up in the UK Biobank. LRAU during early life was associated with a 26% higher risk of diabetes after accounting for putative risk factors (HR, 1.26; 95% CI, 1.16–1.37) in the UK biobank. We observed a more evident association between LRAU and an elevated risk of diabetes in the case–control study (OR, 3.32; 95% CI, 2.06–5.38). The primary finding was robust to several subgroup analyses and sensitivity analyses.
Conclusions
LRAU during early life may increase the risk of type 2 diabetes. Caution should be exercised when prescribing long-term or recurrent antibiotics to children and adolescents.
{"title":"Long-Term or Recurrent Antibiotic Use in Early Life and the Risk of Type 2 Diabetes: A Population-Based Prospective Cohort and a Case–Control Study","authors":"Zijun Li, Qiangsheng He, Xin He, Xin Xing, Songbo Fu, Xiaoping Sun, Mina Ma, Danni Wang, Ningning Mi, Jinyu Zhao, Jinqiu Yuan, Kehu Yang","doi":"10.1111/1753-0407.70113","DOIUrl":"https://doi.org/10.1111/1753-0407.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antibiotics in childhood are commonly used and have been linked to gut microbiome dysbiosis and metabolic disorders. However, direct evidence regarding the association between long-term or recurrent antibiotic use (LRAU) during early life and diabetes was scarce. We performed this study to investigate this association in two population-based studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We undertook a prospective analysis encompassing 147 010 participants from the UK Biobank. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of self-reported LRAU during early life on diabetes risk. We also conducted a case–control study within the Chinese population, in which 263 diabetes cases and 526 controls were matched for age and living location. Odds ratios (ORs) and 95% CI were was calculated using logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 4314 incident cases of type 2 diabetes over 1 840 944 person-years of follow-up in the UK Biobank. LRAU during early life was associated with a 26% higher risk of diabetes after accounting for putative risk factors (HR, 1.26; 95% CI, 1.16–1.37) in the UK biobank. We observed a more evident association between LRAU and an elevated risk of diabetes in the case–control study (OR, 3.32; 95% CI, 2.06–5.38). The primary finding was robust to several subgroup analyses and sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LRAU during early life may increase the risk of type 2 diabetes. Caution should be exercised when prescribing long-term or recurrent antibiotics to children and adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315125","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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