Pub Date : 2025-11-11DOI: 10.1016/s2213-8587(25)00334-1
No Abstract
没有抽象的
{"title":"Diabetes support at work: an unmet need","authors":"","doi":"10.1016/s2213-8587(25)00334-1","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00334-1","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"23 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145492209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-11DOI: 10.1016/s2213-8587(25)00298-0
Rebecca J Vitale, Elena Toschi, Jacob Ortega, Medha N Munshi, Ruth S Weinstock, Lori M Laffel, Anna R Kahkoska
Type 1 diabetes affects individuals of all ages, with different clinical priorities and support needs at different stages of life. In this Personal View, we define the two major transitions that occur across the lifespan in type 1 diabetes: the emerging adult transition (typically occurring between age 18 years and age 25 years, as individuals transition to self-management and transfer to adult care), and the older adult transition (occurring at variable ages as individuals develop comorbidities and complications that could require increased assistance with management and customisation of glycaemic targets). We identify a framework considering these life stage transitions, including eight domains common to both stages. These domains include the following: needs from the medical care team, diabetes self-management education and support needs, adapting diabetes management to evolving physiology, comorbidities affecting self-care and diabetes management, changing neurocognitive physiology and self-management capabilities, functional status and activity levels, degrees of independence (living situations and social support), and changing financial context. We discuss key clinical gaps and research needs, focusing on how the similarities in these major transitions can be leveraged to improve care for people with type 1 diabetes across the lifespan.
{"title":"Life stage transitions for people with type 1 diabetes","authors":"Rebecca J Vitale, Elena Toschi, Jacob Ortega, Medha N Munshi, Ruth S Weinstock, Lori M Laffel, Anna R Kahkoska","doi":"10.1016/s2213-8587(25)00298-0","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00298-0","url":null,"abstract":"Type 1 diabetes affects individuals of all ages, with different clinical priorities and support needs at different stages of life. In this Personal View, we define the two major transitions that occur across the lifespan in type 1 diabetes: the emerging adult transition (typically occurring between age 18 years and age 25 years, as individuals transition to self-management and transfer to adult care), and the older adult transition (occurring at variable ages as individuals develop comorbidities and complications that could require increased assistance with management and customisation of glycaemic targets). We identify a framework considering these life stage transitions, including eight domains common to both stages. These domains include the following: needs from the medical care team, diabetes self-management education and support needs, adapting diabetes management to evolving physiology, comorbidities affecting self-care and diabetes management, changing neurocognitive physiology and self-management capabilities, functional status and activity levels, degrees of independence (living situations and social support), and changing financial context. We discuss key clinical gaps and research needs, focusing on how the similarities in these major transitions can be leveraged to improve care for people with type 1 diabetes across the lifespan.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"1 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145492206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/s2213-8587(25)00265-7
Joanna Y Gong, Jedidiah I Morton, Lei Chen, Julian W Sacre, Bendix Carstensen, Edward W Gregg, Meda E Pavkov, Martti Arffman, Gillian L Booth, Jonne G ter Braake, Luan Manh Chu, Kelly Fleetwood, Sandrine Fosse-Edorh, Milda Garbuviene, Marie Guion, Kyoung Hwa Ha, Padma Kaul, Calvin Ke, Ilmo Keskimäki, Dae Jung Kim, Dianna J Magliano
Background
Contemporary trends in cardiovascular disease (CVD) cause-specific mortality by diabetes status are inadequately described. We examined trends by diabetes status in coronary heart disease (CHD), cerebrovascular disease, and heart failure mortality, and mortality rate ratios (people with diabetes versus those without diabetes) across nine high-income jurisdictions.
Methods
We assembled CVD cause-specific mortality data from nine administrative datasets (Europe [n=5], Australia [n=1], Canada [n=2], and South Korea [n=1]), spanning 2000–23. Using Poisson regression, we estimated mortality rates by diabetes status and mortality rate ratios.
Findings
There were 2·92 million CVD deaths over 1·30 billion person-years of follow-up. In all jurisdictions and in both people with and without diabetes, the total CVD and CHD mortality rates fell across the observed time period. The 5-year percent changes in CHD mortality ranged from −11·5% to −32·3%. Reductions in heart failure mortality were smaller than those for CHD mortality (except in Scotland) and smaller than those for cerebrovascular mortality (except in Scotland and Denmark). Heart failure mortality increased in Ontario, Canada. The excess CHD mortality associated with diabetes (mortality rate ratio ~2·0) fell in three of nine jurisdictions and was stable or uncertain in the remainder. No jurisdiction had a fall in excess heart failure mortality associated with diabetes.
Interpretation
Declines in heart failure mortality in both people with and without diabetes were less marked than were declines in CHD and cerebrovascular disease mortality in most jurisdictions. Heart failure mortality rate ratios have not decreased. A greater focus on reducing heart failure mortality in people with and without diabetes might be required.
Funding
US Centers for Disease Control and Prevention, Diabetes Australia Research Program, Victoria State Government Operational Infrastructure Support Program.
{"title":"Time trends in mortality from heart failure and atherosclerotic cardiovascular disease in people with and without diabetes: a multi-national population-based study","authors":"Joanna Y Gong, Jedidiah I Morton, Lei Chen, Julian W Sacre, Bendix Carstensen, Edward W Gregg, Meda E Pavkov, Martti Arffman, Gillian L Booth, Jonne G ter Braake, Luan Manh Chu, Kelly Fleetwood, Sandrine Fosse-Edorh, Milda Garbuviene, Marie Guion, Kyoung Hwa Ha, Padma Kaul, Calvin Ke, Ilmo Keskimäki, Dae Jung Kim, Dianna J Magliano","doi":"10.1016/s2213-8587(25)00265-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00265-7","url":null,"abstract":"<h3>Background</h3>Contemporary trends in cardiovascular disease (CVD) cause-specific mortality by diabetes status are inadequately described. We examined trends by diabetes status in coronary heart disease (CHD), cerebrovascular disease, and heart failure mortality, and mortality rate ratios (people with diabetes versus those without diabetes) across nine high-income jurisdictions.<h3>Methods</h3>We assembled CVD cause-specific mortality data from nine administrative datasets (Europe [n=5], Australia [n=1], Canada [n=2], and South Korea [n=1]), spanning 2000–23. Using Poisson regression, we estimated mortality rates by diabetes status and mortality rate ratios.<h3>Findings</h3>There were 2·92 million CVD deaths over 1·30 billion person-years of follow-up. In all jurisdictions and in both people with and without diabetes, the total CVD and CHD mortality rates fell across the observed time period. The 5-year percent changes in CHD mortality ranged from −11·5% to −32·3%. Reductions in heart failure mortality were smaller than those for CHD mortality (except in Scotland) and smaller than those for cerebrovascular mortality (except in Scotland and Denmark). Heart failure mortality increased in Ontario, Canada. The excess CHD mortality associated with diabetes (mortality rate ratio ~2·0) fell in three of nine jurisdictions and was stable or uncertain in the remainder. No jurisdiction had a fall in excess heart failure mortality associated with diabetes.<h3>Interpretation</h3>Declines in heart failure mortality in both people with and without diabetes were less marked than were declines in CHD and cerebrovascular disease mortality in most jurisdictions. Heart failure mortality rate ratios have not decreased. A greater focus on reducing heart failure mortality in people with and without diabetes might be required.<h3>Funding</h3>US Centers for Disease Control and Prevention, Diabetes Australia Research Program, Victoria State Government Operational Infrastructure Support Program.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"234 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145455469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/s2213-8587(25)00287-6
Ranjit Mohan Anjana
No Abstract
没有抽象的
{"title":"Cardiovascular mortality trends among people with and without diabetes","authors":"Ranjit Mohan Anjana","doi":"10.1016/s2213-8587(25)00287-6","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00287-6","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"4 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145455470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-09DOI: 10.1016/S2213-8587(25)00217-7
Lauryn K Stafford, Anna Gage, Yvonne Yiru Xu, Madeleine Conrad, Ismael Barreras Beltran, Edward J Boyko, Bruce B Duncan, Simon I Hay, Hailey Lenox, Rafael Lozano, Dianna J Magliano, Carlos A Aguilar Salinas, Nikhil Tandon, Pedro Zitko, Christopher J L Murray, Theo Vos, Annie Haakenstad, Kanyin Liane Ong
<p><strong>Background: </strong>Diabetes is a serious global health challenge, with a rising prevalence and substantial effect on disability and mortality worldwide. Despite medical advancements, gaps in the cascade of diabetes care-comprising diagnosis, treatment, and glycaemic management-persist, hindering effective management. We aimed to comprehensively assess the state of the diabetes cascade of care globally, identifying areas of strength and needs for improvement in diabetes management.</p><p><strong>Methods: </strong>Using data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), this modelling analysis spanned the years 2000 to 2023 and covered 204 countries and territories. We systematically reviewed cross-sectional surveys that are representative of the general population and the published and grey literature to estimate the proportion of people with diabetes who are undiagnosed, diagnosed but untreated, receiving treatment with suboptimal glycaemic concentrations, and receiving treatment with optimal glycaemic concentrations. Treatment was defined as current use of insulin or other hypoglycaemic medication. We separately modelled these quantities by location, year, age, and sex using DisMod-MR 2.1, a hierarchical Bayesian meta-regression modelling tool, then scaled the estimates so that they sum to 100% of people living with diabetes in each stratum. Using GBD 2023 estimates of the number of people with diabetes, we calculated the diabetes cascade of care: proportion of people diagnosed among those with diabetes, proportion of people receiving treatment among those with diagnosed diabetes, and proportion of people with optimal glycaemic concentrations among those receiving treatment for diabetes across all strata.</p><p><strong>Findings: </strong>In 2023, an estimated 55·8% (95% UI 49·3-62·3) of people with diabetes aged 15 years and older were diagnosed with diabetes globally. The proportion of people with diagnosed diabetes who were on treatment was 91·4% (88·0-94·2), and the proportion of people on diabetes treatment with optimal glycaemic concentrations was 41·6% (35·7-48·5). Among all people with diabetes, the proportion with optimal glycaemic concentrations on treatment was 21·2% (17·4-25·6) in 2023 globally. Substantial regional differences were observed, with the highest rates of diagnosis in high-income North America, the highest rates of treatment among those with diagnosed diabetes in high-income Asia Pacific, and the highest rates of optimal glycaemic concentrations among those receiving treatment for diabetes in southern Latin America. Between 2000 and 2023, globally, the proportion of people diagnosed with diabetes increased by 8·3 (6·6-10·0) percentage points, and the proportion of people receiving treatment among those diagnosed increased by 7·2 (5·7-8·8) percentage points. The proportion of people receiving treatment who had optimal glycaemic concentrations increased by 1·3 (0·8-1·8)
{"title":"Global, regional, and national cascades of diabetes care, 2000-23: a systematic review and modelling analysis using findings from the Global Burden of Disease Study.","authors":"Lauryn K Stafford, Anna Gage, Yvonne Yiru Xu, Madeleine Conrad, Ismael Barreras Beltran, Edward J Boyko, Bruce B Duncan, Simon I Hay, Hailey Lenox, Rafael Lozano, Dianna J Magliano, Carlos A Aguilar Salinas, Nikhil Tandon, Pedro Zitko, Christopher J L Murray, Theo Vos, Annie Haakenstad, Kanyin Liane Ong","doi":"10.1016/S2213-8587(25)00217-7","DOIUrl":"10.1016/S2213-8587(25)00217-7","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a serious global health challenge, with a rising prevalence and substantial effect on disability and mortality worldwide. Despite medical advancements, gaps in the cascade of diabetes care-comprising diagnosis, treatment, and glycaemic management-persist, hindering effective management. We aimed to comprehensively assess the state of the diabetes cascade of care globally, identifying areas of strength and needs for improvement in diabetes management.</p><p><strong>Methods: </strong>Using data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), this modelling analysis spanned the years 2000 to 2023 and covered 204 countries and territories. We systematically reviewed cross-sectional surveys that are representative of the general population and the published and grey literature to estimate the proportion of people with diabetes who are undiagnosed, diagnosed but untreated, receiving treatment with suboptimal glycaemic concentrations, and receiving treatment with optimal glycaemic concentrations. Treatment was defined as current use of insulin or other hypoglycaemic medication. We separately modelled these quantities by location, year, age, and sex using DisMod-MR 2.1, a hierarchical Bayesian meta-regression modelling tool, then scaled the estimates so that they sum to 100% of people living with diabetes in each stratum. Using GBD 2023 estimates of the number of people with diabetes, we calculated the diabetes cascade of care: proportion of people diagnosed among those with diabetes, proportion of people receiving treatment among those with diagnosed diabetes, and proportion of people with optimal glycaemic concentrations among those receiving treatment for diabetes across all strata.</p><p><strong>Findings: </strong>In 2023, an estimated 55·8% (95% UI 49·3-62·3) of people with diabetes aged 15 years and older were diagnosed with diabetes globally. The proportion of people with diagnosed diabetes who were on treatment was 91·4% (88·0-94·2), and the proportion of people on diabetes treatment with optimal glycaemic concentrations was 41·6% (35·7-48·5). Among all people with diabetes, the proportion with optimal glycaemic concentrations on treatment was 21·2% (17·4-25·6) in 2023 globally. Substantial regional differences were observed, with the highest rates of diagnosis in high-income North America, the highest rates of treatment among those with diagnosed diabetes in high-income Asia Pacific, and the highest rates of optimal glycaemic concentrations among those receiving treatment for diabetes in southern Latin America. Between 2000 and 2023, globally, the proportion of people diagnosed with diabetes increased by 8·3 (6·6-10·0) percentage points, and the proportion of people receiving treatment among those diagnosed increased by 7·2 (5·7-8·8) percentage points. The proportion of people receiving treatment who had optimal glycaemic concentrations increased by 1·3 (0·8-1·8)","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"924-934"},"PeriodicalIF":41.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1016/s2213-8587(25)00282-7
Tongzhi Wu, Christopher K Rayner, Karen L Jones, Michael Horowitz
{"title":"Dual incretin therapy for type 2 diabetes inadequately controlled on basal insulin in Chinese adults: clinical and research implications","authors":"Tongzhi Wu, Christopher K Rayner, Karen L Jones, Michael Horowitz","doi":"10.1016/s2213-8587(25)00282-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00282-7","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"99 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/s2213-8587(25)00328-6
Peter Chedraui, Federica Barbagallo, Rossella Cannarella, Aldo E Calogero, Rossella E Nappi
{"title":"From reproduction to metabolism: FSH as a key modulator in menopause","authors":"Peter Chedraui, Federica Barbagallo, Rossella Cannarella, Aldo E Calogero, Rossella E Nappi","doi":"10.1016/s2213-8587(25)00328-6","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00328-6","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"1 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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