Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献

英文中文

Letter to editor: Malnutrition-related diabetes mellitus: Rushing toward “type 5” amid unresolved questions and limited evidence 致编辑：营养不良相关的糖尿病：在尚未解决的问题和有限的证据中冲向“5型”

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.dsx.2025.103315

Alok Bhatt , Pentela Bhavani , Ashwini Kumar Sapate , Fayaz Ahamed

引用次数: 0

Short-term 24h dietary recalls from observational studies cannot support claims on mortality 观察性研究的短期24小时饮食回顾不能支持死亡率的说法。

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.dsx.2025.103316

Emily N.C. Manoogian , Courtney M. Peterson , Dorothy D. Sears , Mary Playdon , Siobhan Banks , Maxine Bonham , Amandine Chaix , Lisa S. Chow , Adriana Coletta , Rafael De Cabo , Paula Desplats , Charna Dibner , Kelsey Gabel , Sheri L. Johnson , Lance J. Kriegsfeld , Sheetal Hardikar , John A. Hawley , Leonie K. Heilbronn , John Hogenesch , Dara L. James , Tinh-Hai Collet

引用次数: 0

Highlights of the current issue 当前问题的重点

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.dsx.2025.103344

Ningjian Wang , Anoop Misra

引用次数: 0

Differential associations between smoking, e-cigarette use, and diabetes prevalence 吸烟、电子烟使用与糖尿病患病率之间的差异关联

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.dsx.2025.103331

Yusuff Adebayo Adebisi , Chimwemwe Ngoma , Davide Campagna , Antonio Ceriello , Najim Z. Alshahrani , Anoop Misra , Abdul Basit , Cristina Russo , Tadej Battelino , Noel Somasundaram , Muhammad Yazid Jalaludin , Phuong Le Dinh , Yoshifumi Saisho , Magdalena Walicka , Venera Tomaselli , Giulio Cantone , Othmar Moser , Riccardo Polosa

Background

Cigarette smoking is a well-established risk factor for diabetes, but the relationship between e-cigarette use and diabetes remains uncertain. Evidence to date has been drawn almost entirely from North America and Asia, with little information from European populations.

Methods

We conducted a cross-sectional study of 17,854 adults aged 16 years and older from the 2017, 2018, 2019, and 2021 waves of the nationally representative Scottish Health Survey. Diabetes status was based on self-report of doctor-diagnosed diabetes. Participants were classified into six mutually exclusive categories of smoking and e-cigarette use: never users of either cigarettes or e-cigarettes, ex-smokers (former smokers who never used e-cigarettes), current exclusive cigarette smokers, current exclusive e-cigarette users, current dual users, and former e-cigarette users. Weighted prevalence estimates and survey-weighted binary logistic regression models were used to examine associations, adjusting for age group, sex, education, deprivation quintile, ethnicity, alcohol use, physical activity, and hypertension.

Results

Diabetes prevalence was highest among ex-smokers (11.3 %, 95 % CI: 10.1–12.5). Prevalence was 5.7 % (95 % CI: 5.2–6.2) among never users of either cigarettes or e-cigarettes, 6.2 % (95 % CI: 4.9–7.9) among current exclusive cigarette smokers, 4.9 % (95 % CI: 3.4–7.1) among current exclusive e-cigarette users, 8.3 % (95 % CI: 5.8–11.8) among current dual users, and 5.1 % (95 % CI: 4.1–6.3) among former e-cigarette users. In adjusted models, ex-smokers had 35 % higher odds of diabetes compared with never users of either cigarettes or e-cigarettes (OR = 1.35, 95 % CI = 1.14–1.60, p < 0.001), whereas current exclusive smokers (OR = 0.78, 95 % CI = 0.58–1.03, p = 0.084), current exclusive e-cigarette users (OR = 0.81, 95 % CI = 0.53–1.22, p = 0.309), current dual users (OR = 1.49, 95 % CI = 0.94–2.38, p = 0.091), and former e-cigarette users (OR = 1.00, 95 % CI = 0.78–1.29, p = 0.973) were not significantly different from never users. Sensitivity analyses restricting ex-smokers to those with ≥5 years since cessation and limiting the sample to adults aged ≥45 years reproduced the same pattern of results.

Conclusions

In this nationally representative study of Scottish adults, excess diabetes prevalence was observed among ex-smokers, a pattern that may reflect both reverse causation if individuals quit smoking after diagnosis and the lasting metabolic effects of cumulative smoking exposure. Neither current nor former e-cigarette use was associated with diabetes, and the observed variation in prevalence appeared linked to smoking history rather than e-cigarette use. However, because vaping is relatively recent, further longitudinal research is needed to clarify any long-term risks.

吸烟是糖尿病的一个公认的危险因素，但使用电子烟与糖尿病之间的关系仍不确定。迄今为止的证据几乎全部来自北美和亚洲，很少有来自欧洲人口的信息。方法：我们对2017年、2018年、2019年和2021年具有全国代表性的苏格兰健康调查浪潮中的17,854名16岁及以上的成年人进行了横断面研究。糖尿病状况基于医生诊断糖尿病的自我报告。参与者被分为吸烟和电子烟使用的六个相互排斥的类别：从不使用香烟或电子烟，前吸烟者（从不使用电子烟的前吸烟者），当前独家吸烟者，当前独家电子烟用户，当前双重用户和前电子烟用户。加权患病率估计值和调查加权二元logistic回归模型用于检验相关性，调整了年龄组、性别、教育、贫困五分位数、种族、酒精使用、体育活动和高血压。结果戒烟者糖尿病患病率最高（11.3%,95% CI: 10.1-12.5）。从未吸过香烟或电子烟的人中患病率为5.7% (95% CI: 5.2-6.2)，目前独家吸电子烟的人中患病率为6.2% (95% CI: 4.9 - 7.9)，目前独家吸电子烟的人中患病率为4.9% (95% CI: 3.4-7.1)，目前双重吸电子烟的人中患病率为8.3% (95% CI: 5.8-11.8)，曾经吸过电子烟的人中患病率为5.1% （95% CI: 4.1-6.3）。在调整模型中,抽过烟的机率要高出35%糖尿病而从不香烟或电子烟的用户(or = 1.35, 95% CI -1.60 = 1.14, p & lt; 0.001),而目前独家吸烟者(or = 0.78, 95% CI -1.03 = 0.58, p = 0.084),目前独家烟用户(or = 0.81, 95% CI -1.22 = 0.53, p = 0.309),目前双用户(or = 1.49, 95% CI -2.38 = 0.94, p = 0.091),和前烟用户(or = 1.00, 95% CI -1.29 = 0.78,P = 0.973)与从未使用过的无显著差异。敏感性分析将戒烟者限定为戒烟≥5年的人，并将样本限定为≥45岁的成年人，结果也相同。结论：在这项对苏格兰成年人进行的具有全国代表性的研究中，在戒烟者中观察到糖尿病的患病率过高，这种模式可能反映了个体在诊断后戒烟的反向因果关系和累积吸烟暴露的持久代谢影响。目前和以前的电子烟使用都与糖尿病无关，观察到的患病率变化似乎与吸烟史有关，而不是与电子烟使用有关。然而，由于电子烟是相对较新的，因此需要进一步的纵向研究来阐明任何长期风险。

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引用次数: 0

Artichoke and cardiometabolic health: A systematic and meta-analytic synthesis of current evidence 洋蓟与心脏代谢健康：当前证据的系统和荟萃分析综合。

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.dsx.2025.103328

Ali Jafari , Mohammad Amin Karimi , Mahsa Mahmoudinezhad , Fatemeh Razavi , Helia Mardani , Vali Musazadeh

Background and aims

This systematic review and meta-analysis was conducted to evaluate the effects of artichoke supplementation on cardiometabolic health markers in adults.

Methods

A comprehensive literature search of PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted up to September 2024.

Results

Artichoke supplementation significantly reduced body mass index (WMD = −0.51 kg/m², 95 % CI: 0.93 to −0.09) and waist circumference (WMD = −1.21 cm, 95 % CI: 2.24 to −0.17), while its effects on body weight and hip circumference were not statistically significant. Blood pressure outcomes revealed significant reductions in both systolic (WMD = −2.49 mmHg, 95 % CI: 4.33 to −0.65) and diastolic (WMD = −1.53 mmHg, 95 % CI: 3.01 to −0.05) pressures. Significant lipid profile improvements were observed in total cholesterol (WMD = −12.29 mg/dL, 95 % CI: 19.92 to −4.65), low-density lipoprotein cholesterol (WMD = −10.31 mg/dL, 95 % CI: 18.57 to −2.04), and triglycerides (WMD = −12.85 mg/dL, 95 % CI: 24.77 to −0.93), with no significant effect on high-density lipoprotein cholesterol. Regarding glycemic indices, insulin (WMD = −1.83 mU/L, 95 % CI: 3.33 to −0.32) and homeostatic model assessment for insulin resistance (WMD = −0.92, 95 % CI: 1.33 to −0.51) were significantly reduced, whereas fasting blood glucose and HbA1c were unaffected. Among liver function markers, alanine aminotransferase (WMD = −8.47 U/L, 95 % CI: 14.71 to −2.23) and alkaline phosphatase (WMD = −7.86 U/L, 95 % CI: 15.26 to −0.45) were significantly reduced, while aspartate aminotransferase showed a borderline non-significant effect. No significant change was observed in creatinine levels.

Conclusion

Artichoke supplementation may offer modest but significant improvements in several cardiometabolic risk markers.

背景和目的：本系统综述和荟萃分析旨在评估朝鲜蓟补充剂对成人心脏代谢健康指标的影响。方法：综合检索PubMed、Scopus、Embase、Web of Science和Cochrane Central Register of Controlled Trials，检索时间截止到2024年9月。结果：洋蓟补充剂显著降低了体重指数（WMD = -0.51 kg/m2, 95% CI: 0.93 ~ -0.09）和腰围（WMD = -1.21 cm, 95% CI: 2.24 ~ -0.17），而对体重和臀围的影响无统计学意义。血压结果显示收缩压（WMD = -2.49 mmHg, 95% CI: 4.33至-0.65）和舒张压（WMD = -1.53 mmHg, 95% CI: 3.01至-0.05）均显著降低。在总胆固醇（WMD = -12.29 mg/dL, 95% CI: 19.92至-4.65）、低密度脂蛋白胆固醇（WMD = -10.31 mg/dL, 95% CI: 18.57至-2.04）和甘油三酯（WMD = -12.85 mg/dL, 95% CI: 24.77至-0.93）方面观察到显著的脂质谱改善，而对高密度脂蛋白胆固醇没有显著影响。血糖指标方面，胰岛素（WMD = -1.83 mU/L, 95% CI: 3.33 ~ -0.32）和胰岛素抵抗稳态模型评估（WMD = -0.92, 95% CI: 1.33 ~ -0.51）显著降低，而空腹血糖和HbA1c未受影响。肝功能指标中，丙氨酸转氨酶（WMD = -8.47 U/L, 95% CI: 14.71 ~ -2.23）和碱性磷酸酶（WMD = -7.86 U/L, 95% CI: 15.26 ~ -0.45）显著降低，而天冬氨酸转氨酶无显著影响。肌酐水平未见明显变化。结论：洋蓟补充剂可能对几种心脏代谢风险指标有适度但显著的改善。

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引用次数: 0

From 1990 to 2021, the burden of diabetes among the elderly in the Western Pacific Region (WPR) and projections for 2040 prevalence: A systematic analysis of the 2021 Global Burden of Disease study 1990年至2021年，西太平洋地区老年人糖尿病负担和2040年患病率预测：对2021年全球疾病负担研究的系统分析

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.dsx.2025.103324

Yve Han , Huaxing Lou , Peng Zhao , Hui Li , Congyi Zhang , Hongru Sun

Aims

The study aims to quantify the changes in the age-standardized prevalence of Type 1 and type 2 diabetes among the elderly in the Western Pacific Region (WPR) from 1990 to 2021.

Methods

We analyzed data on diabetes prevalence, mortality, and DALYs among the elderly from the GBD, stratified by sex, age, and SDI. We calculated ASR, used APC and AAPC to assess trends, and conducted correlation, decomposition, and health inequality analyses.

Results

From 1990 to 2021, the age-standardized prevalence of type 1 and type 2 diabetes increased in the region's elderly. In 2021, rates were 19,573.81 per 100,000 for type 2 and 191.98 per 100,000 for type 1. Men experienced a higher burden, and type 2's burden increased with age. A negative SDI-diabetes burden correlation was observed, highlighting socio-economic complexities.

Conclusion

The rising trends in diabetes prevalence and DALYs among the elderly in the Western Pacific Region underscore the growing challenge of managing diabetes in an aging society. This highlights the need for targeted interventions and policies to address the health impacts of diabetes on the elderly population.

目的：本研究旨在量化1990年至2021年西太平洋地区（WPR）老年人1型和2型糖尿病年龄标准化患病率的变化。方法：我们分析了GBD老年人中糖尿病患病率、死亡率和DALYs的数据，并按性别、年龄和SDI分层。我们计算ASR，使用APC和AAPC评估趋势，并进行相关性、分解和健康不平等分析。结果：从1990年到2021年，该地区老年人1型和2型糖尿病的年龄标准化患病率增加。2021年，2型和1型的发病率分别为每10万人19,573.81和191.98。男性的负担更高，2型糖尿病的负担随着年龄的增长而增加。观察到sdi与糖尿病负担负相关，突出了社会经济复杂性。结论：西太平洋地区老年人糖尿病患病率和DALYs的上升趋势凸显了在老龄化社会中管理糖尿病的日益严峻的挑战。这突出表明需要有针对性的干预措施和政策，以解决糖尿病对老年人口健康的影响。

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引用次数: 0

Experience with insulin detemir for type 2 diabetes in older people and people with comorbidities 替特米特胰岛素治疗2型糖尿病老年人及合并症患者的经验

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-10-01 DOI: 10.1016/j.dsx.2025.103327

Melanie J. Davies , Amra Ciric Alibegovic , Anders Boeck Jensen , Renuka Munikrishnappa , Uffe Christian Braae

Aims

This real-world study assessed glycemic levels and further clinical outcomes, following initiation of detemir, in sub populations of people with T2D vulnerable to hypoglycemia.

Methods

This retrospective cohort study included people registered in the United Kingdom Clinical Practice Research Datalink (CPRD) GOLD database who initiated detemir between January 2004 and December 2019. Analyses were stratified by age, previous insulin experience, and history of renal, liver or cardiovascular disease (CVD).

Results

In total, 8975 eligible study participants were identified (44.4 %, aged ≥65 years; 23.7 %, renal disease; 15.6 %, CVD; 2.2 %, liver disease; 53.3 %, insulin-naïve). Six months post-index estimated changes (95 % confidence intervals [CI]) in HbA1c and body weight were −1.00 % (−1.1; −0.9) (−11 mmol/mol [−12; −9]) and 0.35 kg (0.03; 0.66), respectively. Rates of hypoglycemia were low, with no increase between pre- and post-index periods. Compared with pre-index, the mean number of oral glucose-lowering therapy prescriptions per person and mean number of people receiving each type of glucose-lowering therapy decreased post-index.

Conclusions

Detemir appears to be an effective and well-tolerated treatment for T2D in older people, and those with CVD, renal disease or liver disease.

目的：这项真实世界的研究评估了t2dm易发生低血糖的亚群患者在开始使用地替米尔后的血糖水平和进一步的临床结果。该回顾性队列研究包括在英国临床实践研究数据链（CPRD） GOLD数据库中注册的患者，他们在2004年1月至2019年12月期间开始使用detemir。分析按年龄、既往胰岛素使用经验以及肾脏、肝脏或心血管疾病（CVD）史进行分层。结果共有8975名符合条件的研究参与者（44.4%，年龄≥65岁；23.7%，肾脏疾病；15.6%，心血管疾病；2.2%，肝脏疾病；53.3%,insulin-naïve）。6个月后，HbA1c和体重的估计变化（95%置信区间[CI]）分别为- 1.00 % (- 1.1;- 0.9)（- 11 mmol/mol[- 12; - 9]）和0.35 kg（0.03; 0.66）。低血糖率很低，在指数前后没有增加。与指数前相比，指数后人均口服降糖治疗处方数和接受各类降糖治疗的平均人数均有所下降。结论地替米是治疗老年人、心血管疾病、肾脏疾病或肝脏疾病患者T2D的有效且耐受性良好的药物。

{"title":"Experience with insulin detemir for type 2 diabetes in older people and people with comorbidities","authors":"Melanie J. Davies , Amra Ciric Alibegovic , Anders Boeck Jensen , Renuka Munikrishnappa , Uffe Christian Braae","doi":"10.1016/j.dsx.2025.103327","DOIUrl":"10.1016/j.dsx.2025.103327","url":null,"abstract":"<div><h3>Aims</h3><div>This real-world study assessed glycemic levels and further clinical outcomes, following initiation of detemir, in sub populations of people with T2D vulnerable to hypoglycemia.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included people registered in the United Kingdom Clinical Practice Research Datalink (CPRD) GOLD database who initiated detemir between January 2004 and December 2019. Analyses were stratified by age, previous insulin experience, and history of renal, liver or cardiovascular disease (CVD).</div></div><div><h3>Results</h3><div>In total, 8975 eligible study participants were identified (44.4 %, aged ≥65 years; 23.7 %, renal disease; 15.6 %, CVD; 2.2 %, liver disease; 53.3 %, insulin-naïve). Six months post-index estimated changes (95 % confidence intervals [CI]) in HbA1c and body weight were −1.00 % (−1.1; −0.9) (−11 mmol/mol [−12; −9]) and 0.35 kg (0.03; 0.66), respectively. Rates of hypoglycemia were low, with no increase between pre- and post-index periods. Compared with pre-index, the mean number of oral glucose-lowering therapy prescriptions per person and mean number of people receiving each type of glucose-lowering therapy decreased post-index.</div></div><div><h3>Conclusions</h3><div>Detemir appears to be an effective and well-tolerated treatment for T2D in older people, and those with CVD, renal disease or liver disease.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 10","pages":"Article 103327"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624735","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

Association of body roundness index with stroke and mortality among people with normal body mass index 身体质量指数正常人群的身体圆度指数与中风和死亡率的关系

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-09-01 DOI: 10.1016/j.dsx.2025.103313

Yuan Shen , Ruobing Tian , Xue Xia , Shuohua Chen , Xue Tian , Shouling Wu , Anxin Wang

Objectives

The Body Roundness Index (BRI) is a novel anthropometric measure that can predict total and regional body fat percentages. However, the effects of BRI in individuals with a normal Body Mass Index (BMI) remain unclear. This study aimed to investigate the association of BRI with stroke and all-cause mortality in individuals with a normal BMI.

Methods

This longitudinal study included 36,490 participants free from cardiovascular diseases (CVD) and possessed a normal BMI (18.5–24.0) at baseline. Cox proportional hazard models were used to estimate the associations between BRI and the risk of stroke and all-cause mortality. Receiver operating characteristic (ROC) curves were used to assess the ability of BRI to predict stroke and all-cause mortality than other anthropometric indices.

Results

During a median follow-up of 15.0 years, there were 2281 (6.3 %) recorded strokes and 5094 (14.0 %) deaths. After adjusting for potential risk factors, BRI was found to be significantly associated with increased risks of stroke (P for trend = 0.002) and mortality (P for trend <0.001), independent of BMI. The association was primarily linked to ischemic stroke (P for trend = 0.002) rather than hemorrhagic stroke. Additionally, the ROC curves indicated that BRI has better predictive power than BMI for stroke and all-cause mortality (P < 0.05).

Conclusion

In participants with a normal BMI, higher levels of BRI were significantly associated with an increased risk of stroke and all-cause mortality. However, these findings may not generalize to women or more diverse populations, as the study mostly included men from a single occupation.

目的身体圆度指数（BRI）是一种新的人体测量指标，可以预测整体和局部体脂百分比。然而，BRI对正常体重指数（BMI）个体的影响尚不清楚。本研究旨在调查BMI正常个体中BRI与卒中和全因死亡率的关系。方法本纵向研究纳入36,490名无心血管疾病（CVD）且基线BMI正常（18.5-24.0）的参与者。Cox比例风险模型用于估计BRI与卒中风险和全因死亡率之间的关系。使用受试者工作特征（ROC）曲线来评估BRI与其他人体测量指标相比预测卒中和全因死亡率的能力。结果在15.0年的中位随访中，有2281例（6.3%）中风，5094例（14.0%）死亡。在调整潜在危险因素后，发现BRI与卒中风险增加（P for trend = 0.002）和死亡率（P for trend <0.001）显著相关，与BMI无关。该关联主要与缺血性中风（趋势P = 0.002）有关，而与出血性中风无关。此外，ROC曲线显示BRI对脑卒中和全因死亡率的预测能力优于BMI （P < 0.05）。在BMI正常的参与者中，较高水平的BRI与卒中风险增加和全因死亡率显著相关。然而，这些发现可能不适用于女性或更多样化的人群，因为这项研究主要包括来自单一职业的男性。

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引用次数: 0

Highlights of the current issue 当前问题的重点

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-09-01 DOI: 10.1016/j.dsx.2025.103317

Ningjian Wang , Anoop Misra

引用次数: 0

Interventions for prediabetes: an umbrella review of systematic reviews and meta-analyses of randomized controlled trials 前驱糖尿病的干预措施：随机对照试验的系统评价和荟萃分析综述。

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-09-01 DOI: 10.1016/j.dsx.2025.103303

Nicola Veronese , Stefania Maggi , Cristina Giussani , Matteo Bianchini , Hend Alfadul , Shaun Sabico , Nasser Al-Daghri , Lee Smith , Damiano Pizzol , Federica Limongi , Jacopo Demurtas , Alessandra Bartolini , Michela Zanetti

Aims

This umbrella review synthesized evidence from systematic reviews and meta-analyses of randomized controlled trials (RCTs) to assess the effectiveness of interventions for preventing adverse outcomes in individuals with prediabetes.

Methods

A total of 23 meta-analyses comprising 602 RCTs and over 30,000 participants were analyzed from databases including Medline, Embase, Web of Science, and Cochrane through February 1, 2025. Interventions evaluated included both pharmacological and non-pharmacological strategies compared to placebo or usual care. Studies reporting only bio-humoral markers were excluded. The GRADE approach was used to assess the certainty of evidence.

Results

Among 15 evaluated interventions, four were supported by high-certainty evidence for diabetes prevention: GLP-1 receptor agonists (RR = 0.26), liraglutide/exenatide/semaglutide (OR = 0.29), orlistat (OR = 0.67), and structured self-care programs (OR = 0.58). High-certainty evidence also supported modest reductions in systolic blood pressure (∼2–3 mmHg) from lifestyle interventions, digital health tools, and liraglutide. Significant reductions in BMI and waist circumference were observed with pharmacologic agents, aerobic exercise, and digital platforms. However, metformin combined with lifestyle changes did not yield notable anthropometric benefits.

Conclusion

These findings underscore the value of a multidimensional and personalized approach to prediabetes management, emphasizing evidence-based pharmacological options alongside behavioral and digital health strategies.

Systematic review registration

PROSPERO CRD42025649619.

目的：本综述综合了来自随机对照试验（rct）的系统评价和荟萃分析的证据，以评估干预措施对预防糖尿病前期患者不良后果的有效性。方法：截至2025年2月1日，从Medline、Embase、Web of Science和Cochrane等数据库中共分析了23项荟萃分析，包括602项随机对照试验和30,000多名参与者。与安慰剂或常规治疗相比，评估的干预措施包括药理学和非药理学策略。仅报道生物体液标志物的研究被排除在外。GRADE方法用于评估证据的确定性。结果：在评估的15项干预措施中，有4项干预措施得到了糖尿病预防的高确定性证据支持：GLP-1受体激动剂（RR = 0.26）、利拉鲁肽/艾塞那肽/semaglutide （OR = 0.29）、奥利司他（OR = 0.67）和结构化自我保健计划（OR = 0.58）。高确定性证据还支持生活方式干预、数字健康工具和利拉鲁肽可适度降低收缩压（~ 2-3 mmHg）。通过药物、有氧运动和数字平台观察到BMI和腰围的显著降低。然而，二甲双胍结合生活方式的改变并没有产生显著的人体测量益处。结论：这些发现强调了多维和个性化方法对糖尿病前期管理的价值，强调了基于证据的药理学选择以及行为和数字健康策略。系统评价注册：PROSPERO CRD42025649619。

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引用次数: 0

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