Pub Date : 2025-10-01DOI: 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.
{"title":"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","authors":"Yve Han , Huaxing Lou , Peng Zhao , Hui Li , Congyi Zhang , Hongru Sun","doi":"10.1016/j.dsx.2025.103324","DOIUrl":"10.1016/j.dsx.2025.103324","url":null,"abstract":"<div><h3>Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 10","pages":"Article 103324"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558898","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 : 2025-10-01DOI: 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.
{"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}
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。
{"title":"Association of body roundness index with stroke and mortality among people with normal body mass index","authors":"Yuan Shen , Ruobing Tian , Xue Xia , Shuohua Chen , Xue Tian , Shouling Wu , Anxin Wang","doi":"10.1016/j.dsx.2025.103313","DOIUrl":"10.1016/j.dsx.2025.103313","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em> for trend = 0.002) and mortality (<em>P</em> for trend <0.001), independent of BMI. The association was primarily linked to ischemic stroke (<em>P</em> 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 (<em>P</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 9","pages":"Article 103313"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365410","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 : 2025-09-01DOI: 10.1016/j.dsx.2025.103317
Ningjian Wang , Anoop Misra
{"title":"Highlights of the current issue","authors":"Ningjian Wang , Anoop Misra","doi":"10.1016/j.dsx.2025.103317","DOIUrl":"10.1016/j.dsx.2025.103317","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 9","pages":"Article 103317"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624059","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 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.
{"title":"Interventions for prediabetes: an umbrella review of systematic reviews and meta-analyses of randomized controlled trials","authors":"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","doi":"10.1016/j.dsx.2025.103303","DOIUrl":"10.1016/j.dsx.2025.103303","url":null,"abstract":"<div><h3>Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Systematic review registration</h3><div>PROSPERO CRD42025649619.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 9","pages":"Article 103303"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395694","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 : 2025-09-01DOI: 10.1016/j.dsx.2025.103305
Bethany L. Armentrout , Megan L. Wenzell , Kingman P. Strohl , Sybil L. Crawford , Jamie R. Wood , Chiang-shan R. Li , Ronald L. Hickman Jr. , Stephanie Alisha Griggs
Aims
To investigate the preliminary efficacy of a cognitive behavioral sleep and circadian intervention on glycemic and psychological outcomes in young adults with type 1 diabetes.
Methods
Glycemic and psychological outcomes were evaluated in 39 young adults (mean age 21.08, diabetes duration 11.7 years, mean glycated hemoglobin 8.46 %, 41 % female) from March 2022 to October 2023. Participants were randomly assigned (1:1) to a 12-week cognitive behavioral sleep and circadian condition (n = 21) or a time-balanced attention control condition (n = 18). Data were collected using continuous glucose monitors, research-grade actigraphy, and daily sleep surveys at baseline, post-intervention, and 3-month follow-up.
Results
The cognitive behavioral sleep and circadian intervention condition showed significant improvements in glycemic outcomes, with reductions in the coefficient of variation and mean amplitude of glucose excursions three months post-intervention. It also resulted in decreased diabetes distress at both time points, unlike the Attention Control group, which had minimal changes.
Conclusions
Future research should confirm these preliminary findings in larger, more diverse samples with varied intervention lengths and a longer-term follow-up.
{"title":"A randomized pilot sleep and circadian behavior clinical trial to improve glycemic and psychological outcomes in young adults with type 1 diabetes (NCT04975230)","authors":"Bethany L. Armentrout , Megan L. Wenzell , Kingman P. Strohl , Sybil L. Crawford , Jamie R. Wood , Chiang-shan R. Li , Ronald L. Hickman Jr. , Stephanie Alisha Griggs","doi":"10.1016/j.dsx.2025.103305","DOIUrl":"10.1016/j.dsx.2025.103305","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the preliminary efficacy of a cognitive behavioral sleep and circadian intervention on glycemic and psychological outcomes in young adults with type 1 diabetes.</div></div><div><h3>Methods</h3><div>Glycemic and psychological outcomes were evaluated in 39 young adults (mean age 21.08, diabetes duration 11.7 years, mean glycated hemoglobin 8.46 %, 41 % female) from March 2022 to October 2023. Participants were randomly assigned (1:1) to a 12-week cognitive behavioral sleep and circadian condition (n = 21) or a time-balanced attention control condition (n = 18). Data were collected using continuous glucose monitors, research-grade actigraphy, and daily sleep surveys at baseline, post-intervention, and 3-month follow-up.</div></div><div><h3>Results</h3><div>The cognitive behavioral sleep and circadian intervention condition showed significant improvements in glycemic outcomes, with reductions in the coefficient of variation and mean amplitude of glucose excursions three months post-intervention. It also resulted in decreased diabetes distress at both time points, unlike the Attention Control group, which had minimal changes.</div></div><div><h3>Conclusions</h3><div>Future research should confirm these preliminary findings in larger, more diverse samples with varied intervention lengths and a longer-term follow-up.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 9","pages":"Article 103305"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331424","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 : 2025-09-01DOI: 10.1016/j.dsx.2025.103302
Bernard Kwadwo Yeboah Asiamah-Asare , Sean Randall , George Mnatzaganian , Richard Varhol , Crystal Man Ying Lee , Kevin Chai , James Boyd , Gill Cowen , Sangita Shakya , Lan Gao , Suzanne Robinson
Background
Diabetes poses huge financial implications for individuals and healthcare systems. This study aims to quantify the incremental direct healthcare costs associated with diabetes in Australia.
Methods
This matched retrospective cohort study used a linked administrative dataset for Western Australia. Diabetes cases (n = 18,937) were matched 1:1 to controls based on age, sex, remoteness, and weight status. Direct healthcare costs incurred by the government, including costs of hospital admissions, emergency presentations, prescribed medications, general practice visits, and pathology tests, were estimated for 2021, with costs expressed in 2024 Australian Dollars (AUD). The incremental cost was calculated as the difference between the average annual costs of people with diabetes and those without diabetes, and the cost was extrapolated to the total population in 2024.
Results
Average annual healthcare costs per person with diabetes (AUD 9677) were 2.1 times higher than those without diabetes (AUD 4669). The average annual costs attributable to people with Type 2 Diabetes (AUD 5135) were higher than those with Type 1 Diabetes (AUD 4295). The incremental costs of diabetes (AUD 5008) significantly varied across age groups, remoteness, weight status, socioeconomic status and smoking status. In Australia, the total healthcare cost associated with diabetes in 2024 was estimated at AUD 14.2 billion, and the total incremental cost associated with diabetes was estimated at AUD 7.3 billion.
Conclusions
Diabetes imposes a substantial excess direct healthcare cost burden. Evidence could guide the planning and allocation of resources, as well as support the need for targeted health interventions.
{"title":"The economic impact of diabetes: Assessing incremental direct costs in Australia using linked administrative data","authors":"Bernard Kwadwo Yeboah Asiamah-Asare , Sean Randall , George Mnatzaganian , Richard Varhol , Crystal Man Ying Lee , Kevin Chai , James Boyd , Gill Cowen , Sangita Shakya , Lan Gao , Suzanne Robinson","doi":"10.1016/j.dsx.2025.103302","DOIUrl":"10.1016/j.dsx.2025.103302","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes poses huge financial implications for individuals and healthcare systems. This study aims to quantify the incremental direct healthcare costs associated with diabetes in Australia.</div></div><div><h3>Methods</h3><div>This matched retrospective cohort study used a linked administrative dataset for Western Australia. Diabetes cases (n = 18,937) were matched 1:1 to controls based on age, sex, remoteness, and weight status. Direct healthcare costs incurred by the government, including costs of hospital admissions, emergency presentations, prescribed medications, general practice visits, and pathology tests, were estimated for 2021, with costs expressed in 2024 Australian Dollars (AUD). The incremental cost was calculated as the difference between the average annual costs of people with diabetes and those without diabetes, and the cost was extrapolated to the total population in 2024.</div></div><div><h3>Results</h3><div>Average annual healthcare costs per person with diabetes (AUD 9677) were 2.1 times higher than those without diabetes (AUD 4669). The average annual costs attributable to people with Type 2 Diabetes (AUD 5135) were higher than those with Type 1 Diabetes (AUD 4295). The incremental costs of diabetes (AUD 5008) significantly varied across age groups, remoteness, weight status, socioeconomic status and smoking status. In Australia, the total healthcare cost associated with diabetes in 2024 was estimated at AUD 14.2 billion, and the total incremental cost associated with diabetes was estimated at AUD 7.3 billion.</div></div><div><h3>Conclusions</h3><div>Diabetes imposes a substantial excess direct healthcare cost burden. Evidence could guide the planning and allocation of resources, as well as support the need for targeted health interventions.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 9","pages":"Article 103302"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351288","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 : 2025-09-01DOI: 10.1016/j.dsx.2025.103312
José Seijas-Amigo , Ángel Salgado-Barreira , Rosana Castelo-Dominguez , María Teresa Pérez-Álvarez , Belén Ponce-Piñón , Marlén Fernández-Silva , Marta Rodríguez-Barreiro , Mercedes Pereira-Pía , Jose Manuel Iglesias-Moreno , Mar Gago-García , Raquel Montáns-García , Agustina Fernandez-Perez , Dolores Fraga-Gayoso , Montse Fernandez-Montenegro , Beatriz Riveiro-Barciela , Natalia Rilla-Villar , Begoña Cardeso-Paredes , Marta Ribeiro-Ferreiro , Diego Rodriguez-Penas , Alberto Cordero , José R. González-Juanatey
Aims
Patients with Type 2 diabetes mellitus face elevated cardiovascular risk. We assessed the effect of GLP-1 receptor agonists on 10-year CVR in a primary prevention cohort.
Methods
In this 44-week prospective, non-randomized study, 135 patients with type 2 diabetes mellitus and obesity were included across 13 healthcare centers. The primary endpoint was the change in 10-year cardiovascular risk, estimated using the AHA ASCVD Risk Estimator Plus tool at baseline and week 44. Secondary endpoints included weight loss, HbA1c, fasting plasma glucose, and lipid profiles. Patients received subcutaneous semaglutide, oral semaglutide, dulaglutide, or other GLP-1RAs.
Results
In the primary prevention cohort (n = 105), mean 10-year CVR decreased by 3.28 percentage points, a relative reduction of 13.45 % (p < 0.001). Subcutaneous semaglutide showed the greatest weight loss (−8.1 kg), followed by oral semaglutide (−6.5 kg) and dulaglutide (−5.6 kg). HbA1c improved from 8.1 % to 6.6 %, and fasting plasma glucose decreased by 45.8 mg/dL (both p < 0.001).
Conclusions
GLP-1 receptor agonists reduce 10-year cardiovascular risk in primary prevention and improve metabolic control. Findings support early use in high-risk people with type 2 diabetes.
{"title":"Effects of GLP-1 agonists on 10-year cardiovascular risk reduction in primary prevention: A 44-week open label prospective study","authors":"José Seijas-Amigo , Ángel Salgado-Barreira , Rosana Castelo-Dominguez , María Teresa Pérez-Álvarez , Belén Ponce-Piñón , Marlén Fernández-Silva , Marta Rodríguez-Barreiro , Mercedes Pereira-Pía , Jose Manuel Iglesias-Moreno , Mar Gago-García , Raquel Montáns-García , Agustina Fernandez-Perez , Dolores Fraga-Gayoso , Montse Fernandez-Montenegro , Beatriz Riveiro-Barciela , Natalia Rilla-Villar , Begoña Cardeso-Paredes , Marta Ribeiro-Ferreiro , Diego Rodriguez-Penas , Alberto Cordero , José R. González-Juanatey","doi":"10.1016/j.dsx.2025.103312","DOIUrl":"10.1016/j.dsx.2025.103312","url":null,"abstract":"<div><h3>Aims</h3><div>Patients with Type 2 diabetes mellitus face elevated cardiovascular risk. We assessed the effect of GLP-1 receptor agonists on 10-year CVR in a primary prevention cohort.</div></div><div><h3>Methods</h3><div>In this 44-week prospective, non-randomized study, 135 patients with type 2 diabetes mellitus and obesity were included across 13 healthcare centers. The primary endpoint was the change in 10-year cardiovascular risk, estimated using the AHA ASCVD Risk Estimator Plus tool at baseline and week 44. Secondary endpoints included weight loss, HbA1c, fasting plasma glucose, and lipid profiles. Patients received subcutaneous semaglutide, oral semaglutide, dulaglutide, or other GLP-1RAs.</div></div><div><h3>Results</h3><div>In the primary prevention cohort (n = 105), mean 10-year CVR decreased by 3.28 percentage points, a relative reduction of 13.45 % (p < 0.001). Subcutaneous semaglutide showed the greatest weight loss (−8.1 kg), followed by oral semaglutide (−6.5 kg) and dulaglutide (−5.6 kg). HbA1c improved from 8.1 % to 6.6 %, and fasting plasma glucose decreased by 45.8 mg/dL (both p < 0.001).</div></div><div><h3>Conclusions</h3><div>GLP-1 receptor agonists reduce 10-year cardiovascular risk in primary prevention and improve metabolic control. Findings support early use in high-risk people with type 2 diabetes.</div></div><div><h3>Trial registration</h3><div><span><span>clinicaltrials.gov</span><svg><path></path></svg></span> Identifier: NCT05136287.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 9","pages":"Article 103312"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357537","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 : 2025-09-01DOI: 10.1016/j.dsx.2025.103314
Lindsay A. Courtney , Jennifer N. Clements , Diana Isaacs , Jamie M. Pitlick , Sara Mandy Reece , Heather P. Whitley
Aims
This article aims to summarize the role of compounded incretin mimetics in clinical practice and in the context of drug shortages.
Methods
The Endocrine and Metabolism Practice and Research Network, a focused group of the American College of Clinical Pharmacy members, convened an independent committee to evaluate the role of compounded incretin mimetics.
Results
There is limited data demonstrating positive clinical outcomes in small cohorts of patients receiving compounded semaglutide and tirzepatide. However, there remain significant legal and safety concerns since compounded incretins do not undergo approval by the Food and Drug Administration.
Conclusion
Whenever possible, healthcare providers should make every effort to assist patients with obtaining approved medications. If patients choose to obtain compounded incretins, providers can encourage safety by ensuring use of reputable compounding pharmacies and routinely monitoring patients for safety and efficacy of the compounded product.
{"title":"Compounded incretins in clinical practice: An opinion of the endocrine and metabolism practice and research network of the American College of Clinical Pharmacy","authors":"Lindsay A. Courtney , Jennifer N. Clements , Diana Isaacs , Jamie M. Pitlick , Sara Mandy Reece , Heather P. Whitley","doi":"10.1016/j.dsx.2025.103314","DOIUrl":"10.1016/j.dsx.2025.103314","url":null,"abstract":"<div><h3>Aims</h3><div>This article aims to summarize the role of compounded incretin mimetics in clinical practice and in the context of drug shortages.</div></div><div><h3>Methods</h3><div>The Endocrine and Metabolism Practice and Research Network, a focused group of the American College of Clinical Pharmacy members, convened an independent committee to evaluate the role of compounded incretin mimetics.</div></div><div><h3>Results</h3><div>There is limited data demonstrating positive clinical outcomes in small cohorts of patients receiving compounded semaglutide and tirzepatide. However, there remain significant legal and safety concerns since compounded incretins do not undergo approval by the Food and Drug Administration.</div></div><div><h3>Conclusion</h3><div>Whenever possible, healthcare providers should make every effort to assist patients with obtaining approved medications. If patients choose to obtain compounded incretins, providers can encourage safety by ensuring use of reputable compounding pharmacies and routinely monitoring patients for safety and efficacy of the compounded product.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 9","pages":"Article 103314"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424978","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 : 2025-08-01DOI: 10.1016/j.dsx.2025.103298
Stephan Peronard Mayntz , Roda Abdulkadir Mohamed , Anna Mejldal , Jens-Jakob Kjer Møller , Jes Sanddal Lindholt , Axel Cosmus Pyndt Diederichsen , Lise Marie Frohn , Jørgen Brandt , Matthias Ketzel , Jibran Khan , Jess Lambrechtsen
Aim
The global burden of type 2 diabetes (T2D) continues to rise, with evidence suggesting that air pollution may contribute to its pathogenesis. This study examines the association between long-term exposure to fine particulate matter (PM2.5) and the risk of developing T2D in a cohort of older Danish men living in a low-exposure setting.
Methods
We conducted a prospective cohort study using 16,665 participants from the Viborg Vascular (VIVA) screening trial, aged 65–74 years without T2D at baseline. Residential PM2.5 was modeled with the DEHM/UBM/AIRGIS system from historical address data; road-traffic noise was estimated with Nord2000. Cox models with age as timescale evaluated time-varying PM2.5 exposure and T2D risk, adjusting for age, BMI, smoking status, socioeconomic factors, and traffic noise exposure.
Results
Over a mean 9.3-year follow-up, 324 participants (1.9 %) developed T2D. Incidence was lower than reported in prevention trials, reflecting differences in population risk and registry-based outcome capture. Participants who developed T2D had slightly higher long-term PM2.5 exposure compared to non-cases (12.12 vs 11.93 μg/m3; p < 0.001). Although absolute differences in exposure were small, they were consistent across the exposure distribution, suggesting a population-level effect even in a low-pollution environment. In adjusted time-varying Cox models, a 1.15 μg/m3 increment in PM2.5 was associated with a 30.6 % higher risk of T2D (HR 1.306, 95 % CI 1.08–1.58; p = 0.006). Associations were independent of body mass index, smoking, socioeconomic status, and traffic noise.
Conclusions
Long-term PM2.5 exposure was associated with T2D incidence in this cohort of older Danish men. Findings are hypothesis-generating, most applicable to low-to-moderate exposure settings, and should be interpreted with caution.
全球2型糖尿病（T2D）负担持续上升，有证据表明空气污染可能与其发病机制有关。本研究调查了长期暴露于细颗粒物（PM2.5）与低暴露环境中丹麦老年男性患T2D风险之间的关系。方法：我们对来自Viborg血管（VIVA）筛查试验的16,665名参与者进行了一项前瞻性队列研究，这些参与者年龄在65-74岁之间，基线时无T2D。利用DEHM/UBM/AIRGIS系统对历史地址数据进行住区PM2.5建模；道路交通噪音是用Nord2000估计的。以年龄为时间尺度的Cox模型评估了随时间变化的PM2.5暴露和T2D风险，调整了年龄、BMI、吸烟状况、社会经济因素和交通噪声暴露。结果在平均9.3年的随访中，324名参与者（1.9%）发生了T2D。发病率低于预防试验报告，反映了人群风险和基于登记的结果捕获的差异。患T2D的参与者与未患T2D的参与者相比，长期暴露在PM2.5中的比例略高（12.12 vs 11.93 μg/m3; p < 0.001）。虽然暴露的绝对差异很小，但它们在暴露分布中是一致的，这表明即使在低污染环境中也存在人群水平的影响。在调整后的时变Cox模型中，PM2.5浓度每增加1.15 μg/m3， T2D风险增加30.6% （HR 1.306, 95% CI 1.08-1.58; p = 0.006）。相关性与体重指数、吸烟、社会经济地位和交通噪音无关。结论：长期暴露于PM2.5与丹麦老年男性T2D发病率相关。研究结果是假设产生的，最适用于低至中等暴露环境，应谨慎解释。
{"title":"Association between long-term fine particulate matter exposure and incident type 2 diabetes in a low-exposure Danish cohort: An AIRCARD analysis","authors":"Stephan Peronard Mayntz , Roda Abdulkadir Mohamed , Anna Mejldal , Jens-Jakob Kjer Møller , Jes Sanddal Lindholt , Axel Cosmus Pyndt Diederichsen , Lise Marie Frohn , Jørgen Brandt , Matthias Ketzel , Jibran Khan , Jess Lambrechtsen","doi":"10.1016/j.dsx.2025.103298","DOIUrl":"10.1016/j.dsx.2025.103298","url":null,"abstract":"<div><h3>Aim</h3><div>The global burden of type 2 diabetes (T2D) continues to rise, with evidence suggesting that air pollution may contribute to its pathogenesis. This study examines the association between long-term exposure to fine particulate matter (PM<sub>2.5</sub>) and the risk of developing T2D in a cohort of older Danish men living in a low-exposure setting.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study using 16,665 participants from the Viborg Vascular (VIVA) screening trial, aged 65–74 years without T2D at baseline. Residential PM<sub>2.5</sub> was modeled with the DEHM/UBM/AIRGIS system from historical address data; road-traffic noise was estimated with Nord2000. Cox models with age as timescale evaluated time-varying PM<sub>2.5</sub> exposure and T2D risk, adjusting for age, BMI, smoking status, socioeconomic factors, and traffic noise exposure.</div></div><div><h3>Results</h3><div>Over a mean 9.3-year follow-up, 324 participants (1.9 %) developed T2D. Incidence was lower than reported in prevention trials, reflecting differences in population risk and registry-based outcome capture. Participants who developed T2D had slightly higher long-term PM<sub>2.5</sub> exposure compared to non-cases (12.12 vs 11.93 μg/m<sup>3</sup>; p < 0.001). Although absolute differences in exposure were small, they were consistent across the exposure distribution, suggesting a population-level effect even in a low-pollution environment. In adjusted time-varying Cox models, a 1.15 μg/m<sup>3</sup> increment in PM<sub>2.5</sub> was associated with a 30.6 % higher risk of T2D (HR 1.306, 95 % CI 1.08–1.58; p = 0.006). Associations were independent of body mass index, smoking, socioeconomic status, and traffic noise.</div></div><div><h3>Conclusions</h3><div>Long-term PM<sub>2.5</sub> exposure was associated with T2D incidence in this cohort of older Danish men. Findings are hypothesis-generating, most applicable to low-to-moderate exposure settings, and should be interpreted with caution.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 8","pages":"Article 103298"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099509","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