Pub Date : 2025-05-01DOI: 10.1016/j.dsx.2025.103239
Ashish Gupta , Raveena Singh , Sanjay Kumar Bhadada , Edward B. Jude , Ashu Rastogi
Background
Ankle-brachial index (ABI) is not a reliable index predicting cardiovascular events, as a significant number of patients with normal ABI do have cardiovascular events. Brachial-ankle pulse wave velocity (BaPWV), a non-invasive vascular assessment index for predicting CV events in normal ABI is not studied in type 2 diabetes (T2D).
Methods
This prospective study included people with T2D from year 2013 until December 2022 or death. Demographics and T2D related complications were recorded. All participants had ABI and BaPWV measured at study entry and grouped based on initial ABI (group A: ABI 0.7–0.9, group B: ABI 0.9–1.2, and group C: ABI >1.2) and sub-categorised based on BaPWV quartiles. The primary objective was to identify BaPWV cut-offs for prediction of all-cause mortality despite normal ABI.
Results
A total of 16000 patients with T2D were screened and 2186 individuals with first incident diabetic foot ulcer (DFU) were evaluated. The median age of participants was 61 (53–67) years, duration of T2D 10 (6–15) years, and follow-up of 6 (2–8) years. Overall, BaPWV>1882 cm/s was associated with reduced survival [HR 0.750 (0.622–0.904); p = 0.003]. Participants with BaPWV >2210 cm/s (HR = 0.48, 95 % CI: 0.33–0.70, p < 0.001) and BaPWV<1642 cm/s (HR = 0.75, 95 % CI: 0.56–1.002, p = 0.051) had higher mortality risk compared to BaPWV 1642–2210 cm/s, despite normal ABI.
Conclusions
A BaPWV>1882 cm/s is associated with reduced survival in people of diabetes. Despite a normal ABI, a BaPWV>2210 cm/s or <1642 cm/s are associated with increased all-cause mortality in people with T2D.
{"title":"Ankle brachial index and brachial-ankle pulse wave velocity as predictor for major adverse limb events and all-cause mortality in diabetes","authors":"Ashish Gupta , Raveena Singh , Sanjay Kumar Bhadada , Edward B. Jude , Ashu Rastogi","doi":"10.1016/j.dsx.2025.103239","DOIUrl":"10.1016/j.dsx.2025.103239","url":null,"abstract":"<div><h3>Background</h3><div>Ankle-brachial index (ABI) is not a reliable index predicting cardiovascular events, as a significant number of patients with normal ABI do have cardiovascular events. Brachial-ankle pulse wave velocity (BaPWV), a non-invasive vascular assessment index for predicting CV events in normal ABI is not studied in type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This prospective study included people with T2D from year 2013 until December 2022 or death. Demographics and T2D related complications were recorded. All participants had ABI and BaPWV measured at study entry and grouped based on initial ABI (group A: ABI 0.7–0.9, group B: ABI 0.9–1.2, and group C: ABI >1.2) and sub-categorised based on BaPWV quartiles. The primary objective was to identify BaPWV cut-offs for prediction of all-cause mortality despite normal ABI.</div></div><div><h3>Results</h3><div>A total of 16000 patients with T2D were screened and 2186 individuals with first incident diabetic foot ulcer (DFU) were evaluated. The median age of participants was 61 (53–67) years, duration of T2D 10 (6–15) years, and follow-up of 6 (2–8) years. Overall, BaPWV>1882 cm/s was associated with reduced survival [HR 0.750 (0.622–0.904); p = 0.003]. Participants with BaPWV >2210 cm/s (HR = 0.48, 95 % CI: 0.33–0.70, p < 0.001) and BaPWV<1642 cm/s (HR = 0.75, 95 % CI: 0.56–1.002, p = 0.051) had higher mortality risk compared to BaPWV 1642–2210 cm/s, despite normal ABI.</div></div><div><h3>Conclusions</h3><div>A BaPWV>1882 cm/s is associated with reduced survival in people of diabetes. Despite a normal ABI, a BaPWV>2210 cm/s or <1642 cm/s are associated with increased all-cause mortality in people with T2D.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103239"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.dsx.2025.103250
Anoop Misra , Shashank Joshi , Ambrish Mithal
Aim
To critically evaluate the historical context, diagnostic ambiguity, epidemiological relevance, and recent proposals to reclassify malnutrition-related diabetes mellitus (MRDM) amid changing nutritional landscapes and existing metabolic data.
Methods
This review synthesizes data from early clinical reports, WHO documents, epidemiological studies, and recent literature on malnutrition and diabetes. Emphasis is placed on diagnostic inconsistencies, the overuse of low BMI as a surrogate for malnutrition, and evolving nutrition trends in India and low- and middle-income countries (LMICs).
Results
MRDM was initially associated with protein-energy malnutrition, low BMI, and insulin-requiring but ketosis-resistant diabetes. However, overlap with other diabetes types, especially autoimmune forms, has raised doubts about its distinct identity. Low BMI is an unreliable proxy for malnutrition in often constitutionally lean populations in LMICs. A 2022 study suggested insulin secretory defects in MRDM, but was limited by small, male-only samples and lack of follow-up. Proposals to classify MRDM as “type 5 diabetes” are questionable, as types 3 and 4 lack formal recognition. Moreover, declining undernutrition rates in LMICs further diminish MRDM's current relevance. Emerging evidence also indicates malnutrition may be more often a consequence than a cause of diabetes.
Conclusion
Given its heterogeneity, diagnostic uncertainty, and diminishing epidemiological significance, reclassifying MRDM as a distinct type of diabetes (“type 5 diabetes”) is presently unwarranted. Future classification efforts should prioritize data-driven subtypes with clear therapeutic and prognostic implications, rather than reviving outdated constructs with limited contemporary utility.
{"title":"Malnutrition-related diabetes mellitus: Rushing toward “type 5” amid unresolved questions and limited evidence","authors":"Anoop Misra , Shashank Joshi , Ambrish Mithal","doi":"10.1016/j.dsx.2025.103250","DOIUrl":"10.1016/j.dsx.2025.103250","url":null,"abstract":"<div><h3>Aim</h3><div>To critically evaluate the historical context, diagnostic ambiguity, epidemiological relevance, and recent proposals to reclassify malnutrition-related diabetes mellitus (MRDM) amid changing nutritional landscapes and existing metabolic data.</div></div><div><h3>Methods</h3><div>This review synthesizes data from early clinical reports, WHO documents, epidemiological studies, and recent literature on malnutrition and diabetes. Emphasis is placed on diagnostic inconsistencies, the overuse of low BMI as a surrogate for malnutrition, and evolving nutrition trends in India and low- and middle-income countries (LMICs).</div></div><div><h3>Results</h3><div>MRDM was initially associated with protein-energy malnutrition, low BMI, and insulin-requiring but ketosis-resistant diabetes. However, overlap with other diabetes types, especially autoimmune forms, has raised doubts about its distinct identity. Low BMI is an unreliable proxy for malnutrition in often constitutionally lean populations in LMICs. A 2022 study suggested insulin secretory defects in MRDM, but was limited by small, male-only samples and lack of follow-up. Proposals to classify MRDM as “type 5 diabetes” are questionable, as types 3 and 4 lack formal recognition. Moreover, declining undernutrition rates in LMICs further diminish MRDM's current relevance. Emerging evidence also indicates malnutrition may be more often a consequence than a cause of diabetes.</div></div><div><h3>Conclusion</h3><div>Given its heterogeneity, diagnostic uncertainty, and diminishing epidemiological significance, reclassifying MRDM as a distinct type of diabetes (“type 5 diabetes”) is presently unwarranted. Future classification efforts should prioritize data-driven subtypes with clear therapeutic and prognostic implications, rather than reviving outdated constructs with limited contemporary utility.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103250"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.dsx.2025.103257
Ningjian Wang , Anoop Misra
{"title":"Highlights of the current issue","authors":"Ningjian Wang , Anoop Misra","doi":"10.1016/j.dsx.2025.103257","DOIUrl":"10.1016/j.dsx.2025.103257","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103257"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.dsx.2025.103251
Xiaohan Xu , Duolao Wang , Uazman Alam , Shanhu Qiu , Yuzhi Ding , Zilin Sun , Anupam Garrib
Aim
To identify risk factors for retinopathy and to develop a nomogram for individualised risk prediction in a multi-ethnic Chinese cohort.
Methods
Data were derived from the SENSIBLE-Cohort, excluding participants with retinopathy at baseline. Two nomograms were constructed: one using baseline data only (Baseline), and one incorporating baseline and follow-up data (Combination). Predictor selection involved Cox regression, Boruta, least absolute shrinkage and selection operator (LASSO), and recursive feature elimination (RFE). Model performance was evaluated using Harrell's C-index, confusion matrix, and Brier Score. The receiver operating characteristic (ROC) curves, the area under the ROC curve (AUC), the DeLong test, and the decision curve analysis (DCA) were used for comparative assessment.
Results
A total of 2,447 participants were included (mean age: 53.0 ± 8.6 years; 66.1 % female; BMI: 25.4 ± 3.5 kg/m2), including 1,380 with normal glucose tolerance, 762 with prediabetes, and 305 with diabetes. During follow-up, 144 (5.9 %) people developed retinopathy. Key predictors included BMI, waist-to-hip ratio, triglycerides, systolic and diastolic blood pressure, hypertension history, and ethnicity.
The Combination nomogram showed superior discrimination compared to the Baseline nomogram (AUC: 0.75 vs. 0.64, P < 0.001) and demonstrated balanced sensitivity and specificity. DCA demonstrated greater clinical utility of the Combination nomogram across a range of risk thresholds.
Conclusion
The Combination nomogram enables early retinopathy risk stratification using accessible clinical data. It may support personalised screening and introduces the broader concept of metabolic retinopathy.
目的确定中国多民族人群视网膜病变的危险因素，并建立个体化风险预测的nomogram。方法数据来源于sensible队列，排除基线时患有视网膜病变的参与者。构建了两个nomogram：一个仅使用基线数据（baseline），另一个包含基线和随访数据（Combination）。预测器选择包括Cox回归、Boruta、最小绝对收缩和选择算子（LASSO）和递归特征消除（RFE）。采用Harrell’s c指数、混淆矩阵和Brier评分对模型性能进行评估。采用受试者工作特征（ROC）曲线、ROC曲线下面积（AUC）、DeLong检验和决策曲线分析（DCA）进行比较评价。结果共纳入2447例受试者(平均年龄：53.0±8.6岁；女性占66.1%；BMI: 25.4±3.5 kg/m2)，其中糖耐量正常1380人，糖尿病前期762人，糖尿病305人。随访期间，144人（5.9%）发生视网膜病变。主要预测因素包括BMI、腰臀比、甘油三酯、收缩压和舒张压、高血压史和种族。与基线nomogram (AUC: 0.75 vs. 0.64, P <；0.001)，并表现出平衡的敏感性和特异性。DCA在一系列风险阈值范围内显示了更大的联合nomogram临床应用。结论联合nomogram视网膜病变风险分层方法可用于早期视网膜病变风险分层。它可能支持个性化筛查，并引入更广泛的代谢性视网膜病变概念。
{"title":"Prediction of retinopathy risk: A prospective cohort study in China","authors":"Xiaohan Xu , Duolao Wang , Uazman Alam , Shanhu Qiu , Yuzhi Ding , Zilin Sun , Anupam Garrib","doi":"10.1016/j.dsx.2025.103251","DOIUrl":"10.1016/j.dsx.2025.103251","url":null,"abstract":"<div><h3>Aim</h3><div>To identify risk factors for retinopathy and to develop a nomogram for individualised risk prediction in a multi-ethnic Chinese cohort.</div></div><div><h3>Methods</h3><div>Data were derived from the SENSIBLE-Cohort, excluding participants with retinopathy at baseline. Two nomograms were constructed: one using baseline data only (Baseline), and one incorporating baseline and follow-up data (Combination). Predictor selection involved Cox regression, Boruta, least absolute shrinkage and selection operator (LASSO), and recursive feature elimination (RFE). Model performance was evaluated using Harrell's C-index, confusion matrix, and Brier Score. The receiver operating characteristic (ROC) curves, the area under the ROC curve (AUC), the DeLong test, and the decision curve analysis (DCA) were used for comparative assessment.</div></div><div><h3>Results</h3><div>A total of 2,447 participants were included (mean age: 53.0 ± 8.6 years; 66.1 % female; BMI: 25.4 ± 3.5 kg/m<sup>2</sup>), including 1,380 with normal glucose tolerance, 762 with prediabetes, and 305 with diabetes. During follow-up, 144 (5.9 %) people developed retinopathy. Key predictors included BMI, waist-to-hip ratio, triglycerides, systolic and diastolic blood pressure, hypertension history, and ethnicity.</div><div>The Combination nomogram showed superior discrimination compared to the Baseline nomogram (AUC: 0.75 vs. 0.64, P < 0.001) and demonstrated balanced sensitivity and specificity. DCA demonstrated greater clinical utility of the Combination nomogram across a range of risk thresholds.</div></div><div><h3>Conclusion</h3><div>The Combination nomogram enables early retinopathy risk stratification using accessible clinical data. It may support personalised screening and introduces the broader concept of metabolic retinopathy.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103251"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Numerous clinical studies have suggested that flaxseed supplementation may be effective in diabetic patients, but the findings are controversial. Therefore, this study aimed to examine the effects of flaxseed on blood pressure, anthropometry, and lipid profile parameters in diabetic patients.
Methods
PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched until June 2024. A random-effects model was utilized to analyze standardized mean differences (SMDs).
Results
Meta-analysis of 16 trials with 1136 participants indicated significant improvements in weight (SMD: 0.81; 95 % CI: 1.54 to −0.09, p = 0.028; I2 = 88.7 %, p < 0.001), waist circumference (SMD: 1.54; 95 % CI: 2.77 to −0.31, p = 0.002; I2 = 85.3 %, p < 0.001), and triglyceride (SMD: 0.56; 95 % CI: 1.02 to −0.10, p = 0.016; I2 = 87.4 %, p < 0.001), but not BMI (SMD: 0.63; 95 % CI: 1.28 to 0.02, p = 0.058; I2 = 87.9 %, p = 0.005), systolic blood pressure (SMD: 0.50; 95 % CI: 1.25, 0.25, p = 0.193; I2 = 87.6 %, p < 0.001), diastolic blood pressure (SMD: 0.74; 95 % CI: 1.51, 0.03, p = 0.060; I2 = 88.1 %, p < 0.001), total cholesterol (SMD: 0.43; 95 % CI: 0.99 to 0.12, p = 0.128; I2 = 93.6 %, p < 0.001), low-density lipoprotein cholesterol (SMD: 0.09; 95 % CI: 0.87 to 0.70, p = 0.830; I2 = 96.3 %, p < 0.001), and high-density lipoprotein cholesterol (SMD: 0.08; 95 % CI: 0.30 to 0.46, p = 0.673; I2 = 87.2 %, p < 0.001).
Conclusion
Flaxseed supplementation effectively reduces anthropometric indices and triglyceride levels in individuals with type 2 diabetes but does not suggest any benefit on blood pressure and other lipid profile parameters. Therefore, conducting more extensive, well-designed trials to validate these findings is crucial.
背景和目的大量临床研究表明，亚麻籽补充剂可能对糖尿病患者有效，但研究结果存在争议。因此，本研究旨在探讨亚麻籽对糖尿病患者血压、人体测量和血脂参数的影响。方法截至2024年6月检索spubmed、Cochrane Library、Web of Science、Scopus、Embase和谷歌Scholar数据库。采用随机效应模型分析标准化平均差异（SMDs）。结果对16项试验1136名受试者的荟萃分析显示体重有显著改善(SMD: 0.81；95% CI: 1.54 ~ - 0.09, p = 0.028；I2 = 88.7%, p <；0.001)，腰围(SMD: 1.54；95% CI: 2.77 ~ - 0.31, p = 0.002；I2 = 85.3%, p <；0.001)，甘油三酯(SMD: 0.56；95% CI: 1.02 ~ - 0.10, p = 0.016；I2 = 87.4%, p <；0.001)，但BMI没有(SMD: 0.63；95% CI: 1.28 ~ 0.02, p = 0.058；I2 = 87.9%, p = 0.005)，收缩压(SMD: 0.50；95% CI: 1.25, 0.25, p = 0.193；I2 = 87.6%, p <；0.001)，舒张压(SMD: 0.74；95% CI: 1.51, 0.03, p = 0.060；I2 = 88.1%, p <；0.001)、总胆固醇(SMD: 0.43；95% CI: 0.99 ~ 0.12, p = 0.128；I2 = 93.6%, p <；0.001)，低密度脂蛋白胆固醇(SMD: 0.09；95% CI: 0.87 ~ 0.70, p = 0.830；I2 = 96.3%, p <；0.001)，高密度脂蛋白胆固醇(SMD: 0.08；95% CI: 0.30 ~ 0.46, p = 0.673；I2 = 87.2%, p <；0.001)。结论补充亚麻籽可有效降低2型糖尿病患者的人体测量指数和甘油三酯水平，但对血压和其他血脂参数没有任何益处。因此，进行更广泛、设计良好的试验来验证这些发现是至关重要的。
{"title":"The effect of flaxseed supplementation on anthropometric indices, blood pressure, and lipid profile in diabetic patients: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials","authors":"Vali Musazadeh , Shokufeh Nezamoleslami , Amir Hossein Faghfouri , Farzad Shidfar , Naheed Aryaeian","doi":"10.1016/j.dsx.2025.103241","DOIUrl":"10.1016/j.dsx.2025.103241","url":null,"abstract":"<div><h3>Background and aims</h3><div>Numerous clinical studies have suggested that flaxseed supplementation may be effective in diabetic patients, but the findings are controversial. Therefore, this study aimed to examine the effects of flaxseed on blood pressure, anthropometry, and lipid profile parameters in diabetic patients.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched until June 2024. A random-effects model was utilized to analyze standardized mean differences (SMDs).</div></div><div><h3>Results</h3><div>Meta-analysis of 16 trials with 1136 participants indicated significant improvements in weight (SMD: 0.81; 95 % CI: 1.54 to −0.09, p = 0.028; <em>I</em><sup>2</sup> = 88.7 %, p < 0.001), waist circumference (SMD: 1.54; 95 % CI: 2.77 to −0.31, p = 0.002; <em>I</em><sup>2</sup> = 85.3 %, p < 0.001), and triglyceride (SMD: 0.56; 95 % CI: 1.02 to −0.10, p = 0.016; <em>I</em><sup>2</sup> = 87.4 %, p < 0.001), but not BMI (SMD: 0.63; 95 % CI: 1.28 to 0.02, p = 0.058; <em>I</em><sup>2</sup> = 87.9 %, p = 0.005), systolic blood pressure (SMD: 0.50; 95 % CI: 1.25, 0.25, p = 0.193; <em>I</em><sup>2</sup> = 87.6 %, p < 0.001), diastolic blood pressure (SMD: 0.74; 95 % CI: 1.51, 0.03, p = 0.060; <em>I</em><sup>2</sup> = 88.1 %, p < 0.001), total cholesterol (SMD: 0.43; 95 % CI: 0.99 to 0.12, p = 0.128; <em>I</em><sup>2</sup> = 93.6 %, p < 0.001), low-density lipoprotein cholesterol (SMD: 0.09; 95 % CI: 0.87 to 0.70, p = 0.830; <em>I</em><sup>2</sup> = 96.3 %, p < 0.001), and high-density lipoprotein cholesterol (SMD: 0.08; 95 % CI: 0.30 to 0.46, p = 0.673; <em>I</em><sup>2</sup> = 87.2 %, p < 0.001).</div></div><div><h3>Conclusion</h3><div>Flaxseed supplementation effectively reduces anthropometric indices and triglyceride levels in individuals with type 2 diabetes but does not suggest any benefit on blood pressure and other lipid profile parameters. Therefore, conducting more extensive, well-designed trials to validate these findings is crucial.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103241"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.dsx.2025.103249
Naveed Sattar FMedSci , Anoop Misra MD
{"title":"Adiposity at the core of the rising tide of young-onset type 2 diabetes worldwide","authors":"Naveed Sattar FMedSci , Anoop Misra MD","doi":"10.1016/j.dsx.2025.103249","DOIUrl":"10.1016/j.dsx.2025.103249","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103249"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.dsx.2025.103252
Laura Suhlrie , Raga Ayyagari , Camille Mba , Kjell Olsson , Harold Torres-Aparcana , Steven James , Elpida Vounzoulaki , Daniel B. Ibsen
Objective
To evaluate the effectiveness of telemedicine-delivered diet and/or exercise interventions to prevent type 2 diabetes (T2D) in people at risk.
Methods
Embase (via Ovid), Medline (via Ovid), Web of Science, CINAHL, Scopus and SciELO were searched from January 2010–December 2020 for intervention studies using a diet and/or exercise intervention delivered through telemedicine for T2D prevention in people at risk. Parallel randomised controlled trials were meta-analysed, and other intervention designs narratively synthesized.
Results
We identified 11,645 studies via database searches, of which 226 were full-text screened, and 52 interventions included; 32 were included in the meta-analysis and 20 in the narrative synthesis. Telemedicine interventions reduced body weight (mean difference (MD): −1.66 kg, 95 % confidence interval (CI) −2.48,-0.90, I2 = 81 %, nstudies = 17), body mass index (MD -0.71 kg/m2, 95 % CI -1.06,-0.37, I2 = 70 %, nstudies = 11), waist circumference (MD -2.82 cm, 95 % CI -5.16,-2.35, I2 = 84 %, nstudies = 8) and HbA1c (MD -0.07 %, 95 % CI -0.14,0.00, I2 = 71 %, nstudies = 11). No significant effects were found for other clinical outcomes. The narrative synthesis supported the results. The longest follow-up time was up to 24 months.
Conclusions
Our study demonstrates effectiveness for telemedicine-delivered interventions in preventing T2D in people at risk, specifically in people with overweight/obesity.
目的评价远程医疗饮食和/或运动干预对高危人群预防2型糖尿病（T2D）的有效性。方法检索sembase（通过Ovid）、Medline（通过Ovid）、Web of Science、CINAHL、Scopus和SciELO，检索2010年1月至2020年12月通过远程医疗提供的饮食和/或运动干预对高危人群预防T2D的干预研究。对平行随机对照试验进行meta分析，并对其他干预设计进行叙述性综合。结果：我们通过数据库检索确定了11,645项研究，其中226项是全文筛选，包括52项干预措施；32例纳入元分析，20例纳入叙事综合。远程医疗干预降低了体重（平均差值（MD）： - 1.66 kg， 95%可信区间（CI）： - 2.48,-0.90, I2 = 81%, nstudies = 17），体重指数（MD -0.71 kg/m2, 95% CI -1.06,-0.37, I2 = 70%, nstudies = 11），腰围（MD -2.82 cm, 95% CI -5.16,-2.35, I2 = 84%, nstudies = 8）和糖化血红蛋白（MD - 0.07%, 95% CI -0.14,0.00, I2 = 71%, nstudies = 11）。其他临床结果未发现显著影响。叙事综合支持了结果。最长随访时间达24个月。我们的研究证明了远程医疗干预在高危人群，特别是超重/肥胖人群中预防T2D的有效性。
{"title":"The effectiveness of telemedicine in the prevention of type 2 diabetes mellitus: a systematic review and meta-analysis of interventions","authors":"Laura Suhlrie , Raga Ayyagari , Camille Mba , Kjell Olsson , Harold Torres-Aparcana , Steven James , Elpida Vounzoulaki , Daniel B. Ibsen","doi":"10.1016/j.dsx.2025.103252","DOIUrl":"10.1016/j.dsx.2025.103252","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of telemedicine-delivered diet and/or exercise interventions to prevent type 2 diabetes (T2D) in people at risk.</div></div><div><h3>Methods</h3><div>Embase (via Ovid), Medline (via Ovid), Web of Science, CINAHL, Scopus and SciELO were searched from January 2010–December 2020 for intervention studies using a diet and/or exercise intervention delivered through telemedicine for T2D prevention in people at risk. Parallel randomised controlled trials were meta-analysed, and other intervention designs narratively synthesized.</div></div><div><h3>Results</h3><div>We identified 11,645 studies via database searches, of which 226 were full-text screened, and 52 interventions included; 32 were included in the meta-analysis and 20 in the narrative synthesis. Telemedicine interventions reduced body weight (mean difference (MD): −1.66 kg, 95 % confidence interval (CI) −2.48,-0.90, I<sup>2</sup> = 81 %, n<sub>studies</sub> = 17), body mass index (MD -0.71 kg/m<sup>2</sup>, 95 % CI -1.06,-0.37, I<sup>2</sup> = 70 %, n<sub>studies</sub> = 11), waist circumference (MD -2.82 cm, 95 % CI -5.16,-2.35, I<sup>2</sup> = 84 %, n<sub>studies</sub> = 8) and HbA1c (MD -0.07 %, 95 % CI -0.14,0.00, I<sup>2</sup> = 71 %, n<sub>studies</sub> = 11). No significant effects were found for other clinical outcomes. The narrative synthesis supported the results. The longest follow-up time was up to 24 months.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates effectiveness for telemedicine-delivered interventions in preventing T2D in people at risk, specifically in people with overweight/obesity.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103252"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atherosclerotic cardiovascular disease (ASCVD) is a significant cause of morbidity and mortality in type-2 diabetes mellitus (T2D) patients. This subset analysis of the PACT-MEA study compares T2D data from the UAE with data from other Middle Eastern and African (MEA) countries.
Methods
Data were extracted from the participants' medical charts from March 2022 to August 2022 across nine centers in the UAE (n = 542). The prevalence and 10-year CVD risk estimates were evaluated and categorized according to European Society of Cardiology (ESC) 2021 guidelines and compared between MEA (regional) and UAE populations.
Results
Participants with T2D from the UAE, enrolled in secondary care, had a median age of 55.7 years. The estimated 10-year CVD risk was 99.8 % in the UAE and 99.3 % in the MEA. Established ASCVD prevalence (eASCVD) was 29.7 % in the UAE and 20.9 % in the MEA. Coronary artery disease was the most common ASCVD type (95.0 %).
Conclusion
Nearly one-third of T2D patients had eASCVD in UAE, compared to one-fifth in MEA. Most participants were at high or very high risk for ASCVD, but none met all ESC 2021 guidelines, highlighting the need for developing regional strategies to reduce ASCVD risk.
{"title":"Prevalence of cardiovascular risk and atherosclerotic cardiovascular disease in people with type 2 diabetes in the United Arab Emirates: Results from the prevalence of atherosclerotic cardiovascular disease in patients with type 2 diabetes across Middle East and African countries (PACT-MEA) study","authors":"Fatheya Al. Awadi , Fauzia Rashid , Ghada Awada , Haitham Seifeldin , Hani Sabbour , Hazem Aly , Jalal Nafach , Khadija Hafidh , Loai Abudaqa , Mahir K. Jallo , Wael Almahmeed , Zufana Nazir","doi":"10.1016/j.dsx.2025.103224","DOIUrl":"10.1016/j.dsx.2025.103224","url":null,"abstract":"<div><h3>Aim</h3><div>Atherosclerotic cardiovascular disease (ASCVD) is a significant cause of morbidity and mortality in type-2 diabetes mellitus (T2D) patients. This subset analysis of the PACT-MEA study compares T2D data from the UAE with data from other Middle Eastern and African (MEA) countries.</div></div><div><h3>Methods</h3><div>Data were extracted from the participants' medical charts from March 2022 to August 2022 across nine centers in the UAE (n = 542). The prevalence and 10-year CVD risk estimates were evaluated and categorized according to European Society of Cardiology (ESC) 2021 guidelines and compared between MEA (regional) and UAE populations.</div></div><div><h3>Results</h3><div>Participants with T2D from the UAE, enrolled in secondary care, had a median age of 55.7 years. The estimated 10-year CVD risk was 99.8 % in the UAE and 99.3 % in the MEA. Established ASCVD prevalence (eASCVD) was 29.7 % in the UAE and 20.9 % in the MEA. Coronary artery disease was the most common ASCVD type (95.0 %).</div></div><div><h3>Conclusion</h3><div>Nearly one-third of T2D patients had eASCVD in UAE, compared to one-fifth in MEA. Most participants were at high or very high risk for ASCVD, but none met all ESC 2021 guidelines, highlighting the need for developing regional strategies to reduce ASCVD risk.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103224"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study quantitatively assesses metabolic memory by modeling the relationship between hyperglycemic exposure and renal function decline in patients with type 2 diabetes (T2D).
Methods
This retrospective longitudinal study included 381 Japanese patients with T2D. Hyperglycemic exposure was presented by calculating the area under the curve (AUC) for HbA1c ≥ 6 % (AUCHbA1c ≥ 6 %) during the observation period. A non-linear mixed-effects model was constructed to predict changes in estimated glomerular filtration rate (eGFR) based on AUCHbA1c ≥ 6 %.
Results
The relationship between AUCHbA1c ≥ 6 % and eGFR changes was shown by a sigmoidal curve, with sex, age, diabetic retinopathy, dyslipidemia, and hypertension incorporated as covariates. The predictive utility of the model was validated using goodness-of-fit plot, visual predictive check, and bootstrap methods.
Conclusions
We developed an AUCHbA1c ≥ 6 %-based model to predict renal function decline in patients with T2D, showing that AUCHbA1c ≥ 6 % may serve as a quantitative indicator of metabolic memory.
{"title":"Quantitative assessment of metabolic memory and its prediction of renal function decline in patients with type 2 diabetes: A retrospective observational study","authors":"Kentaro Oniki , Takuro Shigaki , Ayami Kajiwara-Morita , Keiichi Shigetome , Akira Yoshida , Hideaki Jinnouchi , Junji Saruwatari","doi":"10.1016/j.dsx.2025.103225","DOIUrl":"10.1016/j.dsx.2025.103225","url":null,"abstract":"<div><h3>Aims</h3><div>This study quantitatively assesses metabolic memory by modeling the relationship between hyperglycemic exposure and renal function decline in patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This retrospective longitudinal study included 381 Japanese patients with T2D. Hyperglycemic exposure was presented by calculating the area under the curve (AUC) for HbA1c ≥ 6 % (AUC<sub>HbA1c ≥ 6 %</sub>) during the observation period. A non-linear mixed-effects model was constructed to predict changes in estimated glomerular filtration rate (eGFR) based on AUC<sub>HbA1c ≥ 6 %</sub>.</div></div><div><h3>Results</h3><div>The relationship between AUC<sub>HbA1c ≥ 6 %</sub> and eGFR changes was shown by a sigmoidal curve, with sex, age, diabetic retinopathy, dyslipidemia, and hypertension incorporated as covariates. The predictive utility of the model was validated using goodness-of-fit plot, visual predictive check, and bootstrap methods.</div></div><div><h3>Conclusions</h3><div>We developed an AUC<sub>HbA1c ≥ 6 %</sub>-based model to predict renal function decline in patients with T2D, showing that AUC<sub>HbA1c ≥ 6 %</sub> may serve as a quantitative indicator of metabolic memory.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103225"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.dsx.2025.103240
Ningjian Wang , Anoop Misra
{"title":"Highlights of the current issue","authors":"Ningjian Wang , Anoop Misra","doi":"10.1016/j.dsx.2025.103240","DOIUrl":"10.1016/j.dsx.2025.103240","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103240"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号