Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献_第4页

Global research trends and hotspots in gestational diabetes and long-term cardiovascular health: A bibliometric analysis 妊娠糖尿病与长期心血管健康的全球研究趋势和热点：文献计量分析。

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103144

Yanxi Jia , Qing Hu , Hua Liao , Hongyan Liu , Zhaomin Zeng , Haiyan Yu

Aims

To identify emerging trends and hotspots in research regarding cardiovascular disease (CVD) risk linked to gestational diabetes mellitus (GDM).

Methods

A systematic bibliometric review of the literature on the risk of long-term CVD in patients with GDM between 1990 and 2022 from the Web of Science Core Collection (WoSCC) was performed by using Citespace and VOSviewer.

Results

This analysis gathered a total of 1185 articles, with 77 publications in 2019 and 119 in 2022, demonstrating a steady growth in the amount of research on the relationship between GDM and CVD in recent years. The United States of America (USA) led in national publications, followed by the United Kingdom (UK) and Canada. Key institutions included Harvard University, the University of Toronto, and the University of Oslo, with Prof. Ravi Retnakaran and Prof. Jane W. Rich-Edwards being prominent figures. The most productive journal was the Journal of Clinical Endocrinology &Metabolism, while Diabetes Care was the most influential and most co-cited journal. Common terms over the last 20 years included “risk,” “type 2 diabetes,” “cardiovascular disease,” and “gestational diabetes,” with recent focus shifting towards “prevention,” “gene expression,” and “DNA methylation”.

Conclusion

This is the first bibliometric analysis linking CVD and GDM. Future research should investigate pathways between GDM and CVD, emphasizing gene expression and inflammation, while advocating for collaborative prevention strategies.

目的：确定与妊娠糖尿病（GDM）相关的心血管疾病（CVD）风险研究的新趋势和热点：方法：利用 Citespace 和 VOSviewer 对 1990 年至 2022 年间 Web of Science Core Collection (WoSCC) 中有关妊娠糖尿病患者长期心血管疾病风险的文献进行了系统的文献计量学回顾：该分析共收集了1185篇文章，其中2019年发表了77篇，2022年发表了119篇，这表明近年来有关GDM与心血管疾病关系的研究数量在稳步增长。美利坚合众国（U.S. USA）的论文数量居首位，其次是英国（U.S. UK）和加拿大。主要机构包括哈佛大学、多伦多大学和奥斯陆大学，Ravi Retnakaran 教授和 Jane W. Rich-Edwards 教授是其中的佼佼者。产量最高的期刊是《临床内分泌学与新陈代谢杂志》，而《糖尿病护理》则是最具影响力和被联合引用次数最多的期刊。过去 20 年中的常见术语包括 "风险"、"2 型糖尿病"、"心血管疾病 "和 "妊娠糖尿病"，最近的重点转向 "预防"、"基因表达 "和 "DNA 甲基化"：这是首次将心血管疾病与妊娠糖尿病联系起来的文献计量分析。未来的研究应调查 GDM 和心血管疾病之间的途径，强调基因表达和炎症，同时倡导合作预防策略。

{"title":"Global research trends and hotspots in gestational diabetes and long-term cardiovascular health: A bibliometric analysis","authors":"Yanxi Jia , Qing Hu , Hua Liao , Hongyan Liu , Zhaomin Zeng , Haiyan Yu","doi":"10.1016/j.dsx.2024.103144","DOIUrl":"10.1016/j.dsx.2024.103144","url":null,"abstract":"<div><h3>Aims</h3><div>To identify emerging trends and hotspots in research regarding cardiovascular disease (CVD) risk linked to gestational diabetes mellitus (GDM).</div></div><div><h3>Methods</h3><div>A systematic bibliometric review of the literature on the risk of long-term CVD in patients with GDM between 1990 and 2022 from the Web of Science Core Collection (WoSCC) was performed by using Citespace and VOSviewer.</div></div><div><h3>Results</h3><div>This analysis gathered a total of 1185 articles, with 77 publications in 2019 and 119 in 2022, demonstrating a steady growth in the amount of research on the relationship between GDM and CVD in recent years. The United States of America (USA) led in national publications, followed by the United Kingdom (UK) and Canada. Key institutions included Harvard University, the University of Toronto, and the University of Oslo, with Prof. Ravi Retnakaran and Prof. Jane W. Rich-Edwards being prominent figures. The most productive journal was the <em>Journal of Clinical Endocrinology &Metabolism</em>, while <em>Diabetes Care</em> was the most influential and most co-cited journal. Common terms over the last 20 years included “risk,” “type 2 diabetes,” “cardiovascular disease,” and “gestational diabetes,” with recent focus shifting towards “prevention,” “gene expression,” and “DNA methylation”.</div></div><div><h3>Conclusion</h3><div>This is the first bibliometric analysis linking CVD and GDM. Future research should investigate pathways between GDM and CVD, emphasizing gene expression and inflammation, while advocating for collaborative prevention strategies.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103144"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gestational diabetes mellitus - Neonatal and maternal outcomes in women treated with insulin or diet: A propensity matched analysis 妊娠糖尿病--接受胰岛素或饮食治疗的妇女的新生儿和产妇结局：倾向匹配分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103145

Sunil S. Gupta , Shlok S. Gupta , Rajeev Chawla , Kavita S. Gupta , Parvinder R. Bamrah , Rutul A. Gokalani

Aims

Pregnant women worldwide face the risk of developing gestational diabetes mellitus (GDM), if left untreated, can cause complications. The study explores factors influencing the choice between diet control and insulin therapy for pregnant women with GDM. It aims to understand how these choices impact maternal and neonatal outcomes.

Methods

In this quasi-experimental study, clinicians determined treatment (diet control or insulin) for 1030 individuals with GDM at a private practice from 2010 to 2020 based on baseline characteristics. Propensity scores (PS), reflecting the probability of treatment allocation, were derived through multiple logistic regression.

Results

After PS matching, 386 individuals were paired from two study groups. The insulin-treated group exhibited a 4.43 times higher risk of neonatal hypoglycemia than the diet group. Insulin-treated individuals, stratified by PS, revealed that the high-risk quartile had significantly higher mean insulin requirements and a doubled dose at full term compared to the lower-risk quartiles. The mean insulin dose did not significantly differ in the first three quartiles, but the last quartile showed a significant increase (p = 0.008), particularly for individuals with PS exceeding 0.70, indicating a higher insulin dose requirement for effective glucose control.

Conclusion

This study reveals that individuals with a bad obstetrics history, a family history of diabetes, obesity, and elevated baseline glycemic parameters necessitate higher insulin doses. This insight improves clinicians' decision-making in diagnosis and treatment planning, enhancing the precision of medical practices.

目的：全世界的孕妇都面临着罹患妊娠糖尿病（GDM）的风险，如果不及时治疗，会引发并发症。本研究探讨了影响妊娠糖尿病孕妇在饮食控制和胰岛素治疗之间做出选择的因素。研究旨在了解这些选择如何影响孕产妇和新生儿的预后：在这项准实验研究中，2010 年至 2020 年，临床医生根据基线特征为一家私人诊所的 1030 名 GDM 患者确定了治疗方法（饮食控制或胰岛素）。通过多元逻辑回归得出了反映治疗分配概率的倾向分数（PS）：经过倾向评分匹配，386 人从两个研究组中配对。胰岛素治疗组发生新生儿低血糖的风险是饮食治疗组的 4.43 倍。按PS分层的胰岛素治疗个体显示，与低风险四分位数相比，高风险四分位数的平均胰岛素需求量明显更高，足月时的胰岛素剂量也增加了一倍。前三个四分位数的胰岛素平均剂量没有显著差异，但最后一个四分位数的胰岛素平均剂量显著增加（p = 0.008），尤其是 PS 超过 0.70 的个体，这表明有效控制血糖需要更高的胰岛素剂量：本研究表明，有不良产科病史、糖尿病家族史、肥胖和基线血糖参数升高的人需要更高的胰岛素剂量。这一见解有助于临床医生在诊断和治疗计划中做出决策，提高医疗实践的精确性。

{"title":"Gestational diabetes mellitus - Neonatal and maternal outcomes in women treated with insulin or diet: A propensity matched analysis","authors":"Sunil S. Gupta , Shlok S. Gupta , Rajeev Chawla , Kavita S. Gupta , Parvinder R. Bamrah , Rutul A. Gokalani","doi":"10.1016/j.dsx.2024.103145","DOIUrl":"10.1016/j.dsx.2024.103145","url":null,"abstract":"<div><h3>Aims</h3><div>Pregnant women worldwide face the risk of developing gestational diabetes mellitus (GDM), if left untreated, can cause complications. The study explores factors influencing the choice between diet control and insulin therapy for pregnant women with GDM. It aims to understand how these choices impact maternal and neonatal outcomes.</div></div><div><h3>Methods</h3><div>In this quasi-experimental study, clinicians determined treatment (diet control or insulin) for 1030 individuals with GDM at a private practice from 2010 to 2020 based on baseline characteristics. Propensity scores (PS), reflecting the probability of treatment allocation, were derived through multiple logistic regression.</div></div><div><h3>Results</h3><div>After PS matching, 386 individuals were paired from two study groups. The insulin-treated group exhibited a 4.43 times higher risk of neonatal hypoglycemia than the diet group. Insulin-treated individuals, stratified by PS, revealed that the high-risk quartile had significantly higher mean insulin requirements and a doubled dose at full term compared to the lower-risk quartiles. The mean insulin dose did not significantly differ in the first three quartiles, but the last quartile showed a significant increase (p = 0.008), particularly for individuals with PS exceeding 0.70, indicating a higher insulin dose requirement for effective glucose control.</div></div><div><h3>Conclusion</h3><div>This study reveals that individuals with a bad obstetrics history, a family history of diabetes, obesity, and elevated baseline glycemic parameters necessitate higher insulin doses. This insight improves clinicians' decision-making in diagnosis and treatment planning, enhancing the precision of medical practices.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103145"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630317","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}

引用次数: 0

Determinants of and barriers to diabetes care among patients with serious mental illness: A scoping review with recommendations 重症精神病患者接受糖尿病护理的决定因素和障碍：范围界定审查及建议

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103139

A.S. Prathiksha , Pawar Mansi Shantaram , Muhammed Rashid , Pooja Gopal Poojari , Sreedharan Nair , Leelavathi D. Acharya , Girish Thunga

Aim

We performed a scoping review to identify the diabetes care determinants and barriers in patients with serious mental illness (SMI), in view of limited evidence and clarity.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines. PubMed, EMBASE, and Scopus were searched from inception to September 2023 to identify eligible studies. Observational studies that reported the determinants of and barriers to diabetes care among SMI patients were considered. A narrative synthesis of review results was performed to gather evidence. Recommendations were framed in the context of this evidence.

Results

Of the 8727 non-duplicate records, only 10 studies that met the inclusion criteria were considered for this review. Of these, four were cohort, two were case-control, and four were cross-sectional in design. All 10 studies were observed to have robust methodologies. Diabetes measures examined in these studies included not only the Healthcare Effectiveness Data and Information Set (HEDIS) measures (HbA1c, retinopathy, nephropathy, and blood pressure), but also lipid, foot, and BMI. Factors contributing to inadequate diabetes care can be attributed to the healthcare system, healthcare providers, and at the patient-level.

Conclusion

Currently, there is lack of evidence on determinants of quality diabetes care among SMI patients. Further, adequately powered long term follow-up studies are needed to understand the impact of diabetes care on their clinical outcomes.

目的鉴于证据有限且不明确，我们进行了一项范围界定综述，以确定严重精神疾病（SMI）患者的糖尿病护理决定因素和障碍。方法我们遵循了《范围界定综述的系统综述和元分析首选报告项目》（PRISMA-ScR）指南。我们检索了从开始到 2023 年 9 月的 PubMed、EMBASE 和 Scopus，以确定符合条件的研究。研究考虑了报告 SMI 患者糖尿病护理的决定因素和障碍的观察性研究。对综述结果进行了叙述性综合，以收集证据。结果在 8727 条非重复记录中，仅有 10 项符合纳入标准的研究被纳入本次综述。其中，4 项为队列研究，2 项为病例对照研究，4 项为横断面研究。据观察，所有 10 项研究都采用了可靠的方法。这些研究中考察的糖尿病指标不仅包括医疗保健有效性数据和信息集（HEDIS）指标（HbA1c、视网膜病变、肾病和血压），还包括血脂、足部和体重指数。导致糖尿病护理不足的因素可归因于医疗保健系统、医疗保健提供者以及患者层面。此外，还需要进行充分的长期跟踪研究，以了解糖尿病护理对其临床疗效的影响。

{"title":"Determinants of and barriers to diabetes care among patients with serious mental illness: A scoping review with recommendations","authors":"A.S. Prathiksha , Pawar Mansi Shantaram , Muhammed Rashid , Pooja Gopal Poojari , Sreedharan Nair , Leelavathi D. Acharya , Girish Thunga","doi":"10.1016/j.dsx.2024.103139","DOIUrl":"10.1016/j.dsx.2024.103139","url":null,"abstract":"<div><h3>Aim</h3><div>We performed a scoping review to identify the diabetes care determinants and barriers in patients with serious mental illness (SMI), in view of limited evidence and clarity.</div></div><div><h3>Methods</h3><div>We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines. PubMed, EMBASE, and Scopus were searched from inception to September 2023 to identify eligible studies. Observational studies that reported the determinants of and barriers to diabetes care among SMI patients were considered. A narrative synthesis of review results was performed to gather evidence. Recommendations were framed in the context of this evidence.</div></div><div><h3>Results</h3><div>Of the 8727 non-duplicate records, only 10 studies that met the inclusion criteria were considered for this review. Of these, four were cohort, two were case-control, and four were cross-sectional in design. All 10 studies were observed to have robust methodologies. Diabetes measures examined in these studies included not only the Healthcare Effectiveness Data and Information Set (HEDIS) measures (HbA1c, retinopathy, nephropathy, and blood pressure), but also lipid, foot, and BMI. Factors contributing to inadequate diabetes care can be attributed to the healthcare system, healthcare providers, and at the patient-level.</div></div><div><h3>Conclusion</h3><div>Currently, there is lack of evidence on determinants of quality diabetes care among SMI patients. Further, adequately powered long term follow-up studies are needed to understand the impact of diabetes care on their clinical outcomes.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103139"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532067","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}

引用次数: 0

MicroRNA-34a and promoter methylation contribute to peroxisome proliferator-activated receptor gamma gene expression in patients with type 2 diabetes 微RNA-34a和启动子甲基化有助于2型糖尿病患者过氧化物酶体增殖激活受体γ基因的表达。

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103156

Mona Moghadasi , Mozhgan Taherimoghaddam , Esmaeel Babaeenezhad , Mehdi Birjandi , Mozhgan Kaviani , Mostafa Moradi Sarabi

Aims

This study aimed to investigate the roles of DNA methylation and miR-34a in the regulation of peroxisome proliferator-activated receptor gamma (PPARγ) in patients with type 2 diabetes (T2D).

Methods

We investigated the methylation status of four regions of the PPARγ promoter and PPARγ expression in a panel of 84 T2D patients using methylation-specific PCR (MSP) and RT-qPCR, respectively. Moreover, we quantified DNA methyltransferases (DNMTs) expression and global DNA methylation levels by RT-qPCR and ELISA, respectively. We measured the expression levels of miR-34a and protein expression of PPARγ by stem-loop RT-qPCR and ELISA, respectively.

Results

We found significant DNA hypermethylation in the R2 and R3 regions of the PPARγ promoter in people with diabetes. Functionally, this was associated with a significant reduction in PPARγ expression. In addition, we observed a significant increase in 5-methylcytosine levels in people with diabetes. A marked increase in circulating miR-34a in the early stages of T2D (up to 10 years) and a significant decrease in circulating miR-34a with increasing diabetes duration from 10 years after the onset of diabetes. Interestingly, upregulation of DNA methyltransferases 1 (DNMT1), DNMT3A, and DNMT3B was observed in people with diabetes, and the average expression of DNMTs was negatively correlated with circulating miR-34a levels. In contrast, the serum protein level of PPARγ, a direct target of miR-34a, increased considerably with diabetes duration and showed a negative correlation with circulating miR-34a, cholesterol, triglyceride, and low-density lipoprotein.

Conclusion

PPARγ promoter hypermethylation and miR-34a upregulation are associated with T2D pathogenesis through PPARγ dysregulation.

目的：本研究旨在探讨DNA甲基化和miR-34a在调控2型糖尿病（T2D）患者过氧化物酶体增殖激活受体γ（PPARγ）中的作用：方法：我们使用甲基化特异性 PCR（MSP）和 RT-qPCR 分别研究了 84 例 T2D 患者中 PPARγ 启动子四个区域的甲基化状态和 PPARγ 的表达。此外，我们还通过 RT-qPCR 和 ELISA 分别量化了 DNA 甲基转移酶（DNMTs）的表达和全局 DNA 甲基化水平。我们通过干环 RT-qPCR 和 ELISA 分别测定了 miR-34a 的表达水平和 PPARγ 的蛋白表达：结果：我们发现糖尿病患者 PPARγ 启动子的 R2 和 R3 区域存在明显的 DNA 高甲基化。在功能上，这与 PPARγ 表达的显著降低有关。此外，我们还观察到糖尿病患者体内的 5-甲基胞嘧啶水平明显增加。在 T2D 早期阶段（长达 10 年），循环 miR-34a 明显增加，而从糖尿病发病后 10 年开始，随着糖尿病病程的延长，循环 miR-34a 明显减少。有趣的是，在糖尿病患者中观察到 DNA 甲基转移酶 1（DNMT1）、DNMT3A 和 DNMT3B 的上调，而 DNMTs 的平均表达与循环 miR-34a 水平呈负相关。相反，miR-34a 的直接靶标 PPARγ 的血清蛋白水平随着糖尿病持续时间的延长而显著增加，并与循环 miR-34a、胆固醇、甘油三酯和低密度脂蛋白呈负相关：结论：PPARγ启动子高甲基化和miR-34a上调通过PPARγ失调与T2D发病相关。

{"title":"MicroRNA-34a and promoter methylation contribute to peroxisome proliferator-activated receptor gamma gene expression in patients with type 2 diabetes","authors":"Mona Moghadasi , Mozhgan Taherimoghaddam , Esmaeel Babaeenezhad , Mehdi Birjandi , Mozhgan Kaviani , Mostafa Moradi Sarabi","doi":"10.1016/j.dsx.2024.103156","DOIUrl":"10.1016/j.dsx.2024.103156","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to investigate the roles of DNA methylation and miR-34a in the regulation of peroxisome proliferator-activated receptor gamma (<em>PPARγ</em>) in patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>We investigated the methylation status of four regions of the <em>PPARγ</em> promoter and <em>PPARγ</em> expression in a panel of 84 T2D patients using methylation-specific PCR (MSP) and RT-qPCR, respectively. Moreover, we quantified DNA methyltransferases (<em>DNMTs</em>) expression and global DNA methylation levels by RT-qPCR and ELISA, respectively. We measured the expression levels of miR-34a and protein expression of PPARγ by stem-loop RT-qPCR and ELISA, respectively.</div></div><div><h3>Results</h3><div>We found significant DNA hypermethylation in the R2 and R3 regions of the <em>PPARγ</em> promoter in people with diabetes. Functionally, this was associated with a significant reduction in <em>PPARγ</em> expression. In addition, we observed a significant increase in 5-methylcytosine levels in people with diabetes. A marked increase in circulating miR-34a in the early stages of T2D (up to 10 years) and a significant decrease in circulating miR-34a with increasing diabetes duration from 10 years after the onset of diabetes. Interestingly, upregulation of DNA methyltransferases 1 (<em>DNMT1</em>), <em>DNMT3A</em>, and <em>DNMT3B</em> was observed in people with diabetes, and the average expression of <em>DNMTs</em> was negatively correlated with circulating miR-34a levels. In contrast, the serum protein level of PPARγ, a direct target of miR-34a, increased considerably with diabetes duration and showed a negative correlation with circulating miR-34a, cholesterol, triglyceride, and low-density lipoprotein.</div></div><div><h3>Conclusion</h3><div><em>PPARγ</em> promoter hypermethylation and miR-34a upregulation are associated with T2D pathogenesis through <em>PPARγ</em> dysregulation.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103156"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630323","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}

引用次数: 0

The effectiveness of delivery modalities of non-pharmacological diabetes prevention programs: A systematic review and component network meta-analysis 非药物性糖尿病预防计划实施模式的有效性：系统综述和成分网络荟萃分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103136

Ellesha A. Smith , Stephanie J. Hubbard , Suzanne C. Freeman , Daniel S. March , Molly Wells , Elnaz Saeedi , Louise Haddon , Kamlesh Khunti , Laura J. Gray

Background and aims

Type 2 diabetes prevention programs are effective but costly and intensive, making translation into routine primary care and community settings challenging. Identifying drivers of intervention effectiveness can inform pragmatic future implementation whilst maintaining effectiveness. Translational studies have demonstrated that delivery modalities impact their effectiveness. This systematic review and component network meta-analysis assessed which delivery modality components of non-pharmacological diabetes prevention programs are associated with reductions in type 2 diabetes incidence for individuals at high risk of type 2 diabetes (or pre-diabetes).

Methods

We searched MEDLINE, The Cochrane Library, Opengrey and clinicaltrials.gov from inception to November 17, 2022 for translational studies comparing lifestyle interventions with a minimum 12-month follow-up. Two investigators extracted the data. Random effects network meta-analyses and component network meta-analyses estimated the intervention effects.

Results

We identified 50 eligible studies involving 29,286 participants including thirty-six (72.0 %) randomized controlled trials, 10 (20.0 %) cluster randomized controlled trials, and four (8.0 %) observational studies. Component network meta-analyses found in-person (individually) delivery was associated with greater reduction in incidence of type 2 diabetes (hazard ratio: 0.66, 95 % credible interval: 0.41, 0.96) and in-person (group-based) delivery was associated with greater reductions in weight (mean difference: −1.53 kg, 95 % credible interval: −2.18, −0.85) and HbA1c (mean difference: −0.74 mmol/mol, 95 % credible interval: −1.28, −0.17), relative to usual care.

Conclusions

This analysis suggests in-person delivery modalities are most effective for diabetes prevention. Future research should focus on improving the effectiveness of digital programs and ensuring preferential delivery for target populations to reduce health inequalities.

背景和目的2型糖尿病预防计划效果显著，但成本高昂且强度大，因此将其转化为常规初级保健和社区环境具有挑战性。确定干预效果的驱动因素可以为今后的务实实施提供依据，同时保持有效性。转化研究表明，实施方式会影响其有效性。本系统综述和成分网络荟萃分析评估了非药物糖尿病预防计划的哪些实施方式与降低 2 型糖尿病（或糖尿病前期）高风险人群的 2 型糖尿病发病率有关。方法我们检索了 MEDLINE、The Cochrane Library、Opengrey 和 clinicaltrials.gov 中从开始到 2022 年 11 月 17 日至少随访 12 个月的比较生活方式干预的转化研究。两名研究人员提取了数据。结果我们发现了50项符合条件的研究，涉及29286名参与者，其中包括36项（72.0%）随机对照试验、10项（20.0%）分组随机对照试验和4项（8.0%）观察性研究。成分网络荟萃分析发现，面对面（单独）给药与 2 型糖尿病发病率的更大降低相关（危险比：0.66，95 % 可信区间：0.41, 0.96），面对面（集体）给药与体重的更大降低相关（平均差异：-1.结论这项分析表明，面对面服务模式对预防糖尿病最有效。未来的研究应侧重于提高数字化项目的有效性，并确保为目标人群优先提供服务，以减少健康不平等现象。

{"title":"The effectiveness of delivery modalities of non-pharmacological diabetes prevention programs: A systematic review and component network meta-analysis","authors":"Ellesha A. Smith , Stephanie J. Hubbard , Suzanne C. Freeman , Daniel S. March , Molly Wells , Elnaz Saeedi , Louise Haddon , Kamlesh Khunti , Laura J. Gray","doi":"10.1016/j.dsx.2024.103136","DOIUrl":"10.1016/j.dsx.2024.103136","url":null,"abstract":"<div><h3>Background and aims</h3><div>Type 2 diabetes prevention programs are effective but costly and intensive, making translation into routine primary care and community settings challenging. Identifying drivers of intervention effectiveness can inform pragmatic future implementation whilst maintaining effectiveness. Translational studies have demonstrated that delivery modalities impact their effectiveness. This systematic review and component network meta-analysis assessed which delivery modality components of non-pharmacological diabetes prevention programs are associated with reductions in type 2 diabetes incidence for individuals at high risk of type 2 diabetes (or pre-diabetes).</div></div><div><h3>Methods</h3><div>We searched MEDLINE, The Cochrane Library, Opengrey and <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> from inception to November 17, 2022 for translational studies comparing lifestyle interventions with a minimum 12-month follow-up. Two investigators extracted the data. Random effects network meta-analyses and component network meta-analyses estimated the intervention effects.</div></div><div><h3>Results</h3><div>We identified 50 eligible studies involving 29,286 participants including thirty-six (72.0 %) randomized controlled trials, 10 (20.0 %) cluster randomized controlled trials, and four (8.0 %) observational studies. Component network meta-analyses found in-person (individually) delivery was associated with greater reduction in incidence of type 2 diabetes (hazard ratio: 0.66, 95 % credible interval: 0.41, 0.96) and in-person (group-based) delivery was associated with greater reductions in weight (mean difference: −1.53 kg, 95 % credible interval: −2.18, −0.85) and HbA1c (mean difference: −0.74 mmol/mol, 95 % credible interval: −1.28, −0.17), relative to usual care.</div></div><div><h3>Conclusions</h3><div>This analysis suggests in-person delivery modalities are most effective for diabetes prevention. Future research should focus on improving the effectiveness of digital programs and ensuring preferential delivery for target populations to reduce health inequalities.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103136"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The triglyceride-glucose index, blood glucose levels, and metabolic syndrome are associated with all-cause mortality in obesity 甘油三酯-葡萄糖指数、血糖水平和代谢综合征与肥胖症患者的全因死亡率有关。

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103146

Antonio E. Pontiroli , Lucia Centofanti , Ahmed S. Zakaria , Simona Cerutti , Michele Dei Cas , Rita Paroni , Lucia La Sala , Elena Tagliabue , Silvia Magnani , Franco Folli

Background

The Triglyceride-Glucose Index (TYG) has been proposed as a prognostic index for mortality in the general population, in T2DM, and in patients with cardiovascular diseases. However, data on the respective predictive roles of TYG, glucose tolerance (GT), and metabolic syndrome (MS) for mortality in obesity are lacking.

Methods

We analyzed 1359 obese patients (371 men and 988 women), aged 44.1 ± 12.64 years, followed for 14.3 ± 4.44 years. They were subdivided according to glucose tolerance, in normal glucose tolerance (NGT), impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). We analyzed the risk of death associated with blood glucose (BG) quartiles, TYG quartiles and MS quartiles. Cox proportional-hazard models were used to evaluate the risk of death associated with independent variables that were highly statistically significant at univariate analysis.

Results

Different degrees of glucose tolerance were associated with a progressive deterioration of clinical outcomes, and increased all-cause mortality (6.3 %, 10.1 %, and 20.4 %, respectively). In all groups, age and male sex were associated with increased mortality. Higher TYG or TYG quartiles, BG or BG quartiles, and MS or MS quartiles were all associated with increased all-cause mortality in the whole cohort.

Conclusion

TYG, blood glucose and MS are risk factors for mortality in obesity, with a progressively stronger value in IFG and T2DM as compared to NGT.

背景：甘油三酯-葡萄糖指数（TYG甘油三酯-葡萄糖指数（TYG）已被提出作为普通人群、T2DM和心血管疾病患者死亡率的预后指数。然而，关于 TYG、葡萄糖耐量（GT）和代谢综合征（MS）各自对肥胖症患者死亡率的预测作用，目前还缺乏相关数据：我们对 1359 名肥胖患者（371 名男性和 988 名女性）进行了分析，他们的年龄为 44.1 ± 12.64 岁，随访时间为 14.3 ± 4.44 年。他们根据葡萄糖耐量被细分为正常葡萄糖耐量（NGT）、空腹血糖受损（IFG）和 2 型糖尿病（T2DM）。我们分析了与血糖 (BG) 四分位数、TYG 四分位数和 MS 四分位数相关的死亡风险。我们使用 Cox 比例危险模型来评估与单变量分析中具有高度统计学意义的自变量相关的死亡风险：结果：不同程度的葡萄糖耐量与临床结果的逐渐恶化和全因死亡率的增加有关（分别为 6.3%、10.1% 和 20.4%）。在所有组别中，年龄和男性与死亡率增加有关。TYG或TYG四分位数、BG或BG四分位数以及MS或MS四分位数越高，整个队列的全因死亡率越高：结论：TYG、血糖和 MS 是肥胖症患者死亡的风险因素，与 NGT 相比，IFG 和 T2DM 的风险值更高。

{"title":"The triglyceride-glucose index, blood glucose levels, and metabolic syndrome are associated with all-cause mortality in obesity","authors":"Antonio E. Pontiroli , Lucia Centofanti , Ahmed S. Zakaria , Simona Cerutti , Michele Dei Cas , Rita Paroni , Lucia La Sala , Elena Tagliabue , Silvia Magnani , Franco Folli","doi":"10.1016/j.dsx.2024.103146","DOIUrl":"10.1016/j.dsx.2024.103146","url":null,"abstract":"<div><h3>Background</h3><div>The Triglyceride-Glucose Index (TYG) has been proposed as a prognostic index for mortality in the general population, in T2DM, and in patients with cardiovascular diseases. However, data on the respective predictive roles of TYG, glucose tolerance (GT), and metabolic syndrome (MS) for mortality in obesity are lacking.</div></div><div><h3>Methods</h3><div>We analyzed 1359 obese patients (371 men and 988 women), aged 44.1 ± 12.64 years, followed for 14.3 ± 4.44 years. They were subdivided according to glucose tolerance, in normal glucose tolerance (NGT), impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). We analyzed the risk of death associated with blood glucose (BG) quartiles, TYG quartiles and MS quartiles. Cox proportional-hazard models were used to evaluate the risk of death associated with independent variables that were highly statistically significant at univariate analysis.</div></div><div><h3>Results</h3><div>Different degrees of glucose tolerance were associated with a progressive deterioration of clinical outcomes, and increased all-cause mortality (6.3 %, 10.1 %, and 20.4 %, respectively). In all groups, age and male sex were associated with increased mortality. Higher TYG or TYG quartiles, BG or BG quartiles, and MS or MS quartiles were all associated with increased all-cause mortality in the whole cohort.</div></div><div><h3>Conclusion</h3><div>TYG, blood glucose and MS are risk factors for mortality in obesity, with a progressively stronger value in IFG and T2DM as compared to NGT.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103146"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dipeptidyl peptidase-4 inhibitors may lower body temperature: A case-control study 二肽基肽酶-4 抑制剂可能会降低体温：病例对照研究

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103142

Shuichi Okada , Kazuya Okada , Junichi Okada , Koji Kikkawa , Eijiro Yamada , Tsugumichi Saito , Tetsuro Andou , Kihachi Ohshima , Yawara Niijima

Aims

Dipeptidyl peptidase-4 inhibitors (DPP4i) enhance GABAergic transmission via the glucagon-like peptide-1 (GLP-1)/GLP-1 receptor pathway. Oral γ-aminobutyric acid (GABA) administration reduces body temperature in humans; thus, DPP4i may reduce body temperature in humans. Therefore, this study aimed to determine the effects of DPP4i administration on the body temperature of patients with type 2 diabetes (T2D).

Methods

This study included 128 outpatients with T2D who visited the hospital monthly from May to July 2022. The DPP4i group included 64 patients treated with DPP4i while the non-DPP4i group included 64 patients not treated with DPP4i. Body temperature was measured at the axilla point upon entry to the hospital and was compared between the two groups.

Results

The means of age, body mass index, T2D duration, systolic blood pressure, diastolic blood pressure, serum creatinine level, casual triglyceride level, high-density lipoprotein cholesterol level, low-density lipoprotein cholesterol level, casual plasma glucose level, and glycated hemoglobin level were not significantly different between the two groups. The mean body temperatures (°C) were 36.1 ± 0.2 and 36.4 ± 0.17 in the DPP4i and non-DPP4i groups, respectively (p = 1.123 E−05).

Conclusions

DPP4i reduced the body temperature of patients with T2D.

目的：二肽基肽酶-4抑制剂（DPP4i）可通过胰高血糖素样肽-1（GLP-1）/GLP-1受体途径增强GABA能传导。口服γ-氨基丁酸（GABA）可降低人体体温，因此，DPP4i可能会降低人体体温。因此，本研究旨在确定服用 DPP4i 对 2 型糖尿病（T2D）患者体温的影响：本研究纳入了128名门诊2型糖尿病患者，他们于2022年5月至7月期间每月到医院就诊。DPP4i组包括64名接受DPP4i治疗的患者，而非DPP4i组包括64名未接受DPP4i治疗的患者。入院时在腋窝测量体温，并对两组患者的体温进行比较：结果：两组患者的年龄、体重指数、T2D病程、收缩压、舒张压、血清肌酐水平、临时甘油三酯水平、高密度脂蛋白胆固醇水平、低密度脂蛋白胆固醇水平、临时血浆葡萄糖水平和糖化血红蛋白水平均无显著差异。DPP4i 组和非 DPP4i 组的平均体温（°C）分别为 36.1 ± 0.2 和 36.4 ± 0.17（p = 1.123 E-05）：结论：DPP4i能降低T2D患者的体温。

{"title":"Dipeptidyl peptidase-4 inhibitors may lower body temperature: A case-control study","authors":"Shuichi Okada , Kazuya Okada , Junichi Okada , Koji Kikkawa , Eijiro Yamada , Tsugumichi Saito , Tetsuro Andou , Kihachi Ohshima , Yawara Niijima","doi":"10.1016/j.dsx.2024.103142","DOIUrl":"10.1016/j.dsx.2024.103142","url":null,"abstract":"<div><h3>Aims</h3><div>Dipeptidyl peptidase-4 inhibitors (DPP4i) enhance GABAergic transmission via the glucagon-like peptide-1 (GLP-1)/GLP-1 receptor pathway. Oral γ-aminobutyric acid (GABA) administration reduces body temperature in humans; thus, DPP4i may reduce body temperature in humans. Therefore, this study aimed to determine the effects of DPP4i administration on the body temperature of patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This study included 128 outpatients with T2D who visited the hospital monthly from May to July 2022. The DPP4i group included 64 patients treated with DPP4i while the non-DPP4i group included 64 patients not treated with DPP4i. Body temperature was measured at the axilla point upon entry to the hospital and was compared between the two groups.</div></div><div><h3>Results</h3><div>The means of age, body mass index, T2D duration, systolic blood pressure, diastolic blood pressure, serum creatinine level, casual triglyceride level, high-density lipoprotein cholesterol level, low-density lipoprotein cholesterol level, casual plasma glucose level, and glycated hemoglobin level were not significantly different between the two groups. The mean body temperatures (°C) were 36.1 ± 0.2 and 36.4 ± 0.17 in the DPP4i and non-DPP4i groups, respectively (<em>p</em> = 1.123 E−05).</div></div><div><h3>Conclusions</h3><div>DPP4i reduced the body temperature of patients with T2D.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103142"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607029","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}

引用次数: 0

Serum lipid peroxidation potential as a biomarker for risk-stratification of coronary artery disease in patients with type 2 diabetes mellitus 血清脂质过氧化潜能作为 2 型糖尿病患者冠状动脉疾病风险分级的生物标志物

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103143

Kavya Sugur , Swetha N. Kempegowda , Sunil K. Shambu , Manjappa Mahadevappa , Vinay K. Kengegowda , Jadeppa Gowda , Rajesh K. Thimmulappa

Aim

We examined the serum lipid peroxidation potential as an estimate of systemic oxidative stress levels in people with type 2 diabetes (T2D) for coronary artery disease (CAD) risk stratification.

Methods

We prospectively recruited patients and categorized them into four subgroups based on diabetes and severity of CAD [Gensini score <20, non-significant CAD; Gensini score >20, significant CAD]: non-diabetics with non-significant CAD, diabetics with non-significant CAD, non-diabetics with significant CAD and diabetics with significant CAD. Lipid profile, HbA1c, fasting blood glucose, and oxidized LDL were assessed. A newly developed assay estimated serum lipid peroxidation potential.

Results

Circulatory oxidized LDL levels were significantly higher in patients with severe CAD compared to non-diabetics with non-significant CAD, however no significant differences were observed across the four subgroups. Diabetics with non-significant CAD demonstrated significantly elevated serum lipid peroxidation potential compared to non-diabetics with non-significant CAD. Intriguingly, serum lipid peroxidation potential was markedly elevated in diabetics with non-significant CAD compared to both diabetics and non-diabetics with significant CAD. Poor glycemic control and reduced blood total antioxidant capacity were the primary factors contributing to increased serum lipid peroxidation potential in diabetics with non-significant CAD group.

Conclusions

We found that people with T2D who are associated with non-significant CAD are more vulnerable to oxidative stress than those with significant CAD. The study demonstrates the application of 'serum lipid peroxidation potential' assay for risk-stratification of CAD in people with T2D.

目的我们研究了用于冠状动脉疾病（CAD）风险分层的 2 型糖尿病（T2D）患者血清脂质过氧化潜能，作为全身氧化应激水平的估计值。方法我们前瞻性地招募了患者，并根据糖尿病和CAD严重程度[Gensini评分<20，非显著性CAD；Gensini评分>20，显著性CAD]将他们分为四个亚组：非显著性CAD的非糖尿病患者、非显著性CAD的糖尿病患者、显著性CAD的非糖尿病患者和显著性CAD的糖尿病患者。对血脂概况、HbA1c、空腹血糖和氧化低密度脂蛋白进行了评估。新开发的检测方法可估算血清脂质过氧化潜能值。结果与无明显CAD的非糖尿病患者相比，严重CAD患者的循环氧化低密度脂蛋白水平明显较高，但在四个亚组中未观察到明显差异。与患有非明显 CAD 的非糖尿病患者相比，患有非明显 CAD 的糖尿病患者的血清脂质过氧化潜能明显升高。耐人寻味的是，与患有明显 CAD 的糖尿病患者和非糖尿病患者相比，患有非明显 CAD 的糖尿病患者的血清脂质过氧化潜能值明显升高。血糖控制不佳和血液总抗氧化能力降低是导致非显著性 CAD 组糖尿病患者血清脂质过氧化潜能值升高的主要因素。这项研究表明，"血清脂质过氧化潜能 "测定可用于对 T2D 患者的 CAD 进行风险分级。

{"title":"Serum lipid peroxidation potential as a biomarker for risk-stratification of coronary artery disease in patients with type 2 diabetes mellitus","authors":"Kavya Sugur , Swetha N. Kempegowda , Sunil K. Shambu , Manjappa Mahadevappa , Vinay K. Kengegowda , Jadeppa Gowda , Rajesh K. Thimmulappa","doi":"10.1016/j.dsx.2024.103143","DOIUrl":"10.1016/j.dsx.2024.103143","url":null,"abstract":"<div><h3>Aim</h3><div>We examined the serum lipid peroxidation potential as an estimate of systemic oxidative stress levels in people with type 2 diabetes (T2D) for coronary artery disease (CAD) risk stratification.</div></div><div><h3>Methods</h3><div>We prospectively recruited patients and categorized them into four subgroups based on diabetes and severity of CAD [Gensini score <20, non-significant CAD; Gensini score >20, significant CAD]: non-diabetics with non-significant CAD, diabetics with non-significant CAD, non-diabetics with significant CAD and diabetics with significant CAD. Lipid profile, HbA1c, fasting blood glucose, and oxidized LDL were assessed. A newly developed assay estimated serum lipid peroxidation potential.</div></div><div><h3>Results</h3><div>Circulatory oxidized LDL levels were significantly higher in patients with severe CAD compared to non-diabetics with non-significant CAD, however no significant differences were observed across the four subgroups. Diabetics with non-significant CAD demonstrated significantly elevated serum lipid peroxidation potential compared to non-diabetics with non-significant CAD. Intriguingly, serum lipid peroxidation potential was markedly elevated in diabetics with non-significant CAD compared to both diabetics and non-diabetics with significant CAD. Poor glycemic control and reduced blood total antioxidant capacity were the primary factors contributing to increased serum lipid peroxidation potential in diabetics with non-significant CAD group.</div></div><div><h3>Conclusions</h3><div>We found that people with T2D who are associated with non-significant CAD are more vulnerable to oxidative stress than those with significant CAD. The study demonstrates the application of 'serum lipid peroxidation potential' assay for risk-stratification of CAD in people with T2D.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103143"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555063","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}

引用次数: 0

Highlights of the Current Issue 本期要闻

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103158

Ningjian Wang , Anoop Misra

引用次数: 0

Clinical effectiveness and safety of preoperative oral carbohydrate loading in patients with diabetes: A systematic review 糖尿病患者术前口服碳水化合物负荷的临床有效性和安全性：系统综述

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-10-01 DOI: 10.1016/j.dsx.2024.103140

Chunxiu Zhao , Jinghong Shi , Na Zhu , Pingliang Yang , Bingbing Xiang , Yunke Dai , Shun Wang

Background

The effectiveness and safety of preoperative oral carbohydrate (POC) for people with diabetes remain controversial.

Methods

We systematically reviewed studies comparing POC to fasting or placebo in elective surgery for diabetic adults, focusing on gastric volume, postoperative complications, hospital stay, and glycemic control.

Results

Fourteen studies (n = 1870 patients) were included. POC did not significantly increase gastric volume or aspiration risk in well-controlled type 2 diabetes. Effects on perioperative glucose control varied. POC improved patient comfort and reduced preoperative hypoglycemia in gestational diabetes. Limited evidence suggested potential benefits in cardiac surgery patients.

Conclusion

POC is safe for well-controlled type 2 diabetics, enhancing comfort and reducing preoperative hypoglycemia without increasing aspiration risk. However, its effects on glucose control and postoperative outcomes vary. Personalized approaches are crucial, particularly for poorly controlled diabetes.

背景糖尿病患者术前口服碳水化合物（POC）的有效性和安全性仍存在争议。方法我们系统回顾了在糖尿病成人择期手术中比较 POC 与禁食或安慰剂的研究，重点关注胃容量、术后并发症、住院时间和血糖控制。在控制良好的 2 型糖尿病患者中，POC 不会明显增加胃容量或吸入风险。对围术期血糖控制的影响各不相同。POC 提高了患者的舒适度，减少了妊娠糖尿病患者术前低血糖的发生。有限的证据表明，POC 对心脏手术患者有潜在的益处。结论 POC 对控制良好的 2 型糖尿病患者是安全的，可提高舒适度并减少术前低血糖，同时不会增加吸入风险。然而，它对血糖控制和术后效果的影响各不相同。个性化方法至关重要，尤其是对于控制不佳的糖尿病患者。

{"title":"Clinical effectiveness and safety of preoperative oral carbohydrate loading in patients with diabetes: A systematic review","authors":"Chunxiu Zhao , Jinghong Shi , Na Zhu , Pingliang Yang , Bingbing Xiang , Yunke Dai , Shun Wang","doi":"10.1016/j.dsx.2024.103140","DOIUrl":"10.1016/j.dsx.2024.103140","url":null,"abstract":"<div><h3>Background</h3><div>The effectiveness and safety of preoperative oral carbohydrate (POC) for people with diabetes remain controversial.</div></div><div><h3>Methods</h3><div>We systematically reviewed studies comparing POC to fasting or placebo in elective surgery for diabetic adults, focusing on gastric volume, postoperative complications, hospital stay, and glycemic control.</div></div><div><h3>Results</h3><div>Fourteen studies (n = 1870 patients) were included. POC did not significantly increase gastric volume or aspiration risk in well-controlled type 2 diabetes. Effects on perioperative glucose control varied. POC improved patient comfort and reduced preoperative hypoglycemia in gestational diabetes. Limited evidence suggested potential benefits in cardiac surgery patients.</div></div><div><h3>Conclusion</h3><div>POC is safe for well-controlled type 2 diabetics, enhancing comfort and reducing preoperative hypoglycemia without increasing aspiration risk. However, its effects on glucose control and postoperative outcomes vary. Personalized approaches are crucial, particularly for poorly controlled diabetes.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103140"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578877","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}

引用次数: 0