Pub Date : 2026-02-01DOI: 10.1016/j.pcd.2025.11.001
Zhipeng Dou, Lele Peng
{"title":"Glycemic status and effect on mortality: Multifactorial prevention programme for cardiovascular disease in Finnish primary care","authors":"Zhipeng Dou, Lele Peng","doi":"10.1016/j.pcd.2025.11.001","DOIUrl":"10.1016/j.pcd.2025.11.001","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Page 142"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.pcd.2025.11.010
Long Pu
This commentary provides methodological reflections on a recent multi-country study investigating insulin resistance (IR) marker heterogeneity in adults newly diagnosed with diabetes across 14 low and middle-income countries (LMICs). While commending the significant contribution of this research, we highlight three key considerations to refine the interpretation of findings and guide future studies. First, we discuss the need for population-specific validation of non-insulin-based IR markers, as their performance varies substantially across ethnic groups. Second, we examine the implications of relying on a single fasting glucose measurement for diabetes diagnosis, which may impact phenotypic characterization and subtype differentiation. Finally, we explore the importance of quantifying the relative contributions of multi-level factors—including adiposity, lifestyle, and healthcare system variables—to better understand the observed cross-country heterogeneity. Addressing these methodological aspects in future research will strengthen the evidence base for developing tailored diabetes care strategies in diverse global populations.
{"title":"Comment on ‘Non-insulin-based markers of insulin resistance at diabetes diagnosis: A pooled analysis of 14 national health surveys’","authors":"Long Pu","doi":"10.1016/j.pcd.2025.11.010","DOIUrl":"10.1016/j.pcd.2025.11.010","url":null,"abstract":"<div><div>This commentary provides methodological reflections on a recent multi-country study investigating insulin resistance (IR) marker heterogeneity in adults newly diagnosed with diabetes across 14 low and middle-income countries (LMICs). While commending the significant contribution of this research, we highlight three key considerations to refine the interpretation of findings and guide future studies. First, we discuss the need for population-specific validation of non-insulin-based IR markers, as their performance varies substantially across ethnic groups. Second, we examine the implications of relying on a single fasting glucose measurement for diabetes diagnosis, which may impact phenotypic characterization and subtype differentiation. Finally, we explore the importance of quantifying the relative contributions of multi-level factors—including adiposity, lifestyle, and healthcare system variables—to better understand the observed cross-country heterogeneity. Addressing these methodological aspects in future research will strengthen the evidence base for developing tailored diabetes care strategies in diverse global populations.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Page 145"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.pcd.2025.11.008
Kristine D. Gu , Daniel Shinnick , Tanayott Thaweethai , Jessica Cheng , Deborah J. Wexler , Anne N. Thorndike
Aims
Low-income adults face barriers to diabetes prevention and self-management, especially healthy eating. This study assessed factors associated with diet quality in low-income adults with prediabetes or type 2 diabetes (T2D), particularly modifiable factors that could be targeted in diabetes self-management education and support (DSMES).
Methods
This secondary analysis of a cohort of low-income health center patients in Boston, Massachusetts determined the association between diet quality and sociodemographic (e.g., race/ethnicity, social support) and behavioral (e.g., depression) factors in adults with prediabetes or T2D. Primary outcome was Healthy Eating Index-2020 (HEI; range 0–100, higher=healthier). Random forests, interpreted using Shapley Additive Explanation values, were fit to determine relative importance of factors in predicting HEI.
Results
Of 278 participants, 42 % had prediabetes and 58 % had T2D. Median age (IQR) was 52 (43, 57); 58 % were Hispanic. Top factors associated with higher HEI were older age, female gender, and Hispanic ethnicity; other important factors were non-smoking, greater dietary variety, less time sitting, higher sleep quality, lower stress, more social support, and fewer depression symptoms.
Conclusion
Modifiable factors for low diet quality, such as dietary variety, social support, and stress, could be emphasized in diabetes prevention and DSMES programs tailored for low-income populations.
{"title":"Sociodemographic and behavioral factors associated with diet quality in low-income adults with prediabetes and type 2 diabetes","authors":"Kristine D. Gu , Daniel Shinnick , Tanayott Thaweethai , Jessica Cheng , Deborah J. Wexler , Anne N. Thorndike","doi":"10.1016/j.pcd.2025.11.008","DOIUrl":"10.1016/j.pcd.2025.11.008","url":null,"abstract":"<div><h3>Aims</h3><div>Low-income adults face barriers to diabetes prevention and self-management, especially healthy eating. This study assessed factors associated with diet quality in low-income adults with prediabetes or type 2 diabetes (T2D), particularly modifiable factors that could be targeted in diabetes self-management education and support (DSMES).</div></div><div><h3>Methods</h3><div>This secondary analysis of a cohort of low-income health center patients in Boston, Massachusetts determined the association between diet quality and sociodemographic (e.g., race/ethnicity, social support) and behavioral (e.g., depression) factors in adults with prediabetes or T2D. Primary outcome was Healthy Eating Index-2020 (HEI; range 0–100, higher=healthier). Random forests, interpreted using Shapley Additive Explanation values, were fit to determine relative importance of factors in predicting HEI.</div></div><div><h3>Results</h3><div>Of 278 participants, 42 % had prediabetes and 58 % had T2D. Median age (IQR) was 52 (43, 57); 58 % were Hispanic. Top factors associated with higher HEI were older age, female gender, and Hispanic ethnicity; other important factors were non-smoking, greater dietary variety, less time sitting, higher sleep quality, lower stress, more social support, and fewer depression symptoms.</div></div><div><h3>Conclusion</h3><div>Modifiable factors for low diet quality, such as dietary variety, social support, and stress, could be emphasized in diabetes prevention and DSMES programs tailored for low-income populations.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Pages 120-126"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.pcd.2025.12.002
Yujin Park , Hye Rin Choi , Ji-eun Lee , Boram Choi , Chang-bo Noh , Jae-Heon Kang , Ye Seul Bae
Objective
This study evaluated the impact of real-time continuous glucose monitoring (CGM) combined with personalized digital health coaching on glycemic control and lifestyle behaviors in individuals with type 2 diabetes (T2DM) and prediabetes.
Method
A prospective cohort study was conducted involving 110 participants recruited from a chronic disease management service. The participants underwent an 8-week intervention where CGM data were used to provide real-time feedback, complemented by personalized lifestyle coaching. Baseline and post-intervention data included fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body mass index (BMI), and lifestyle factors such as physical activity and eating habits. Participants were divided into tertiles based on mean amplitude of glycemic excursion (MAGE) to evaluate the effects of the intervention by glycemic variability (GV) level.
Results
Significant improvements in glycemic control were observed across all tertiles. The highest GV group (T3) showed the greatest reductions in HbA1c (7.39 % to 6.82 %, p = 0.004) and FBG. The physical activity scores significantly increased in the T3 group (p = 0.005), and all tertiles reported healthier dietary habits following the intervention.
Conclusions
The integration of CGM with personalized digital health coaching was associated with significant short-term improvements in glycemic control and lifestyle behaviors, particularly among individuals with high GV.
{"title":"Impact of real-time continuous glucose monitoring and personalized digital health coaching on glycemic control and lifestyle in patients with type 2 diabetes and prediabetes","authors":"Yujin Park , Hye Rin Choi , Ji-eun Lee , Boram Choi , Chang-bo Noh , Jae-Heon Kang , Ye Seul Bae","doi":"10.1016/j.pcd.2025.12.002","DOIUrl":"10.1016/j.pcd.2025.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated the impact of real-time continuous glucose monitoring (CGM) combined with personalized digital health coaching on glycemic control and lifestyle behaviors in individuals with type 2 diabetes (T2DM) and prediabetes.</div></div><div><h3>Method</h3><div>A prospective cohort study was conducted involving 110 participants recruited from a chronic disease management service. The participants underwent an 8-week intervention where CGM data were used to provide real-time feedback, complemented by personalized lifestyle coaching. Baseline and post-intervention data included fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body mass index (BMI), and lifestyle factors such as physical activity and eating habits. Participants were divided into tertiles based on mean amplitude of glycemic excursion (MAGE) to evaluate the effects of the intervention by glycemic variability (GV) level.</div></div><div><h3>Results</h3><div>Significant improvements in glycemic control were observed across all tertiles. The highest GV group (T3) showed the greatest reductions in HbA1c (7.39 % to 6.82 %, p = 0.004) and FBG. The physical activity scores significantly increased in the T3 group (p = 0.005), and all tertiles reported healthier dietary habits following the intervention.</div></div><div><h3>Conclusions</h3><div>The integration of CGM with personalized digital health coaching was associated with significant short-term improvements in glycemic control and lifestyle behaviors, particularly among individuals with high GV.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Pages 61-67"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.pcd.2025.12.005
Hyeon Jeong Lee, Pusoon Chun
Aim
To compare osteoporosis risk associated with sodium–glucose cotransporter 2 inhibitor (SGLT2i) versus dipeptidyl peptidase-4 inhibitor (DPP-4i) in older women with type 2 diabetes (T2D).
Methods
This cohort study used the Korean National Health Insurance database. Adjusted hazard ratios (aHRs) were estimated using multivariable Cox regression. Sensitivity analysis was performed using inverse probability of treatment weighting (IPTW).
Results
Among 1715,337 women aged ≥ 55 years with T2D, 5364 SGLT2i users and 26,504 DPP-4i users were analyzed. The incidence rates of osteoporosis were 6.7 (95 % CI, 6.0–7.4) and 7.0 (95 % CI, 6.7–7.3) per 100 person-years in the SGLT2i and DPP-4i groups, respectively. Osteoporosis risk with SGLT2i was comparable to DPP-4i (aHR, 0.93; 95 % CI, 0.89–1.04). These results remained consistent in the sensitivity analysis using IPTW (aHR, 0.95; 95 % CI, 0.89–1.00). Subgroup analyses showed a slightly lower osteoporosis risk with SGLT2i in patients aged 55–64 years (aHR, 0.84; 95 % CI, 0.76–0.93), those without prior rheumatoid arthritis (aHR, 0.90; 95 % CI, 0.83–0.97), proton pump inhibitor use (aHR, 0.88; 95 % CI, 0.80–0.96), or oral corticosteroid use (aHRs, 0.91; 95 % CI, 0.85–0.97).
Conclusion
SGLT2i was comparable to DPP-4i in osteoporosis risk among older women with T2D.
{"title":"Comparative risk of osteoporosis in older women with type 2 diabetes receiving sodium–glucose cotransporter 2 inhibitor or dipeptidyl peptidase-4 inhibitor: A nationwide cohort study","authors":"Hyeon Jeong Lee, Pusoon Chun","doi":"10.1016/j.pcd.2025.12.005","DOIUrl":"10.1016/j.pcd.2025.12.005","url":null,"abstract":"<div><h3>Aim</h3><div>To compare osteoporosis risk associated with sodium–glucose cotransporter 2 inhibitor (SGLT2i) versus dipeptidyl peptidase-4 inhibitor (DPP-4i) in older women with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This cohort study used the Korean National Health Insurance database. Adjusted hazard ratios (aHRs) were estimated using multivariable Cox regression. Sensitivity analysis was performed using inverse probability of treatment weighting (IPTW).</div></div><div><h3>Results</h3><div>Among 1715,337 women aged ≥ 55 years with T2D, 5364 SGLT2i users and 26,504 DPP-4i users were analyzed. The incidence rates of osteoporosis were 6.7 (95 % CI, 6.0–7.4) and 7.0 (95 % CI, 6.7–7.3) per 100 person-years in the SGLT2i and DPP-4i groups, respectively. Osteoporosis risk with SGLT2i was comparable to DPP-4i (aHR, 0.93; 95 % CI, 0.89–1.04). These results remained consistent in the sensitivity analysis using IPTW (aHR, 0.95; 95 % CI, 0.89–1.00). Subgroup analyses showed a slightly lower osteoporosis risk with SGLT2i in patients aged 55–64 years (aHR, 0.84; 95 % CI, 0.76–0.93), those without prior rheumatoid arthritis (aHR, 0.90; 95 % CI, 0.83–0.97), proton pump inhibitor use (aHR, 0.88; 95 % CI, 0.80–0.96), or oral corticosteroid use (aHRs, 0.91; 95 % CI, 0.85–0.97).</div></div><div><h3>Conclusion</h3><div>SGLT2i was comparable to DPP-4i in osteoporosis risk among older women with T2D.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Pages 106-114"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.pcd.2025.10.003
B.T. Strooij , S. Remmelzwaal , M. Muilwijk , J.A. Overbeek , R.M.C. Herings , P.J.M. Elders , H.P.J. van Hout , O.R. Maarsingh , I.G.M. van Valkengoed , M.T. Blom
Aims
Type 2 diabetes (T2D) disproportionally affects migrants. We compared T2D-care in primary care between migrants and non-migrants in the Netherlands.
Methods
We performed a dynamic cohort study based on routine care data (2015–2019) from the DIAbetes MANagement and Treatment (DIAMANT) cohort linked to databases of Statistics Netherlands. Persons aged ≥ 35years with T2D treated in primary care were included. Outcomes included annual monitoring of HbA1c, systolic blood pressure and LDL; meeting of treatment targets; and medication prescription. Generalized estimating equations logistic regression models estimated the associations between having a migration background and outcomes.
Results
We included 165,670 persons: 83.7 % non-migrants, 2.1 % Turkish, 3.0 % Moroccan, 2.1 % Surinamese, 3.3 % European, and 5.7 % other non-European migrants. Most migrant groups had similar or higher odds of having annual monitoring compared to non-migrants, but lower odds of meeting the HbA1c and LDL treatment targets, with the lowest odds for Turkish migrants (OR 0.61, 95 %-CI 0.57–0.64; OR 0.86, 95 %-CI 0.81–0.91). Exploratory analyses demonstrated insulins to be less often prescribed to migrants.
Conclusions
Most migrant groups were equally or better monitored for T2D-parameters compared to non-migrants, but were less likely to meet HbA1c targets. This might partly reflect the less frequent insulin prescriptions to migrants. Further research is needed on underlying mechanisms and the specific needs of migrant groups to optimize T2D-care for all.
{"title":"Type 2 diabetes monitoring and control in migrants and non-migrants: A population-based cohort study in primary care in the Netherlands","authors":"B.T. Strooij , S. Remmelzwaal , M. Muilwijk , J.A. Overbeek , R.M.C. Herings , P.J.M. Elders , H.P.J. van Hout , O.R. Maarsingh , I.G.M. van Valkengoed , M.T. Blom","doi":"10.1016/j.pcd.2025.10.003","DOIUrl":"10.1016/j.pcd.2025.10.003","url":null,"abstract":"<div><h3>Aims</h3><div>Type 2 diabetes (T2D) disproportionally affects migrants. We compared T2D-care in primary care between migrants and non-migrants in the Netherlands.</div></div><div><h3>Methods</h3><div>We performed a dynamic cohort study based on routine care data (2015–2019) from the DIAbetes MANagement and Treatment (DIAMANT) cohort linked to databases of Statistics Netherlands. Persons aged ≥ 35years with T2D treated in primary care were included. Outcomes included annual monitoring of HbA1c, systolic blood pressure and LDL; meeting of treatment targets; and medication prescription. Generalized estimating equations logistic regression models estimated the associations between having a migration background and outcomes.</div></div><div><h3>Results</h3><div>We included 165,670 persons: 83.7 % non-migrants, 2.1 % Turkish, 3.0 % Moroccan, 2.1 % Surinamese, 3.3 % European, and 5.7 % other non-European migrants. Most migrant groups had similar or higher odds of having annual monitoring compared to non-migrants, but lower odds of meeting the HbA1c and LDL treatment targets, with the lowest odds for Turkish migrants (OR 0.61, 95 %-CI 0.57–0.64; OR 0.86, 95 %-CI 0.81–0.91). Exploratory analyses demonstrated insulins to be less often prescribed to migrants.</div></div><div><h3>Conclusions</h3><div>Most migrant groups were equally or better monitored for T2D-parameters compared to non-migrants, but were less likely to meet HbA1c targets. This might partly reflect the less frequent insulin prescriptions to migrants. Further research is needed on underlying mechanisms and the specific needs of migrant groups to optimize T2D-care for all.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Pages 53-60"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.pcd.2025.11.009
Döndü Bilici , Meryem Kılıç
Background
Frailty is increasingly recognized as a condition that negatively affects self-management in individuals with type 2 diabetes. Limited evidence exists regarding its impact on diabetic foot self-care and self-efficacy, particularly in middle-aged populations.
Objectives
This study aimed to examine the effect of frailty on foot care behaviors and self-efficacy among middle-aged and older adults with type 2 diabetes.
Methods
A descriptive, cross-sectional study was conducted with 75 middle-aged (40–64 years) and 75 older (≥65 years) adults diagnosed with type 2 diabetes. Data were collected using the FRAIL Scale, the Foot Care Behavior Scale, and the Diabetic Foot Care Self-Efficacy Scale. Group comparisons were performed using independent t-tests, and regression analyses were used to evaluate the predictive role of frailty.
Results
Frailty prevalence was 22.7 % in middle-aged adults and 42.7 % in older adults. Regression analyses showed that frailty was a strong predictor of both self-efficacy and foot care behaviors. Each one-point increase in frailty score was associated with a ∼12-point decrease in self-efficacy (β=-0.876; p < 0.001) and an ∼8-point decrease in foot care behaviors (β=-0.905; p < 0.001). The explanatory power of frailty was greater in middle-aged adults compared to older adults.
Conclusion
Frailty significantly impairs foot care behaviors and self-efficacy in adults with type 2 diabetes. Routine frailty screening, even from middle age, may support the early identification of individuals at risk for diabetic foot complications and inform preventive wound care strategies.
背景：虚弱越来越被认为是对2型糖尿病患者自我管理产生负面影响的一种状况。关于它对糖尿病足自我保健和自我效能的影响，特别是在中年人群中，证据有限。目的：本研究旨在探讨虚弱对中老年2型糖尿病患者足部护理行为和自我效能感的影响。方法：对75名诊断为2型糖尿病的中年人（40-64岁）和75名老年人（≥65岁）进行描述性横断面研究。采用体弱量表、足部护理行为量表和糖尿病足部护理自我效能量表收集数据。采用独立t检验进行组间比较，并采用回归分析评估虚弱的预测作用。结果：中老年人和老年人的衰弱患病率分别为22.7% %和42.7% %。回归分析显示，虚弱是自我效能感和足部护理行为的强预测因子。虚弱评分每增加1分，自我效能感就会降低~ 12分（β=-0.876; p ）。结论：虚弱显著影响2型糖尿病成人足部护理行为和自我效能感。常规虚弱筛查，甚至从中年开始，可以支持早期识别有糖尿病足并发症风险的个体，并告知预防性伤口护理策略。
{"title":"Impact of frailty on foot care behaviors and self-efficacy in middle-aged and older adults with type 2 diabetes","authors":"Döndü Bilici , Meryem Kılıç","doi":"10.1016/j.pcd.2025.11.009","DOIUrl":"10.1016/j.pcd.2025.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is increasingly recognized as a condition that negatively affects self-management in individuals with type 2 diabetes. Limited evidence exists regarding its impact on diabetic foot self-care and self-efficacy, particularly in middle-aged populations.</div></div><div><h3>Objectives</h3><div>This study aimed to examine the effect of frailty on foot care behaviors and self-efficacy among middle-aged and older adults with type 2 diabetes.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional study was conducted with 75 middle-aged (40–64 years) and 75 older (≥65 years) adults diagnosed with type 2 diabetes. Data were collected using the FRAIL Scale, the Foot Care Behavior Scale, and the Diabetic Foot Care Self-Efficacy Scale. Group comparisons were performed using independent t-tests, and regression analyses were used to evaluate the predictive role of frailty.</div></div><div><h3>Results</h3><div>Frailty prevalence was 22.7 % in middle-aged adults and 42.7 % in older adults. Regression analyses showed that frailty was a strong predictor of both self-efficacy and foot care behaviors. Each one-point increase in frailty score was associated with a ∼12-point decrease in self-efficacy (β=-0.876; p < 0.001) and an ∼8-point decrease in foot care behaviors (β=-0.905; p < 0.001). The explanatory power of frailty was greater in middle-aged adults compared to older adults.</div></div><div><h3>Conclusion</h3><div>Frailty significantly impairs foot care behaviors and self-efficacy in adults with type 2 diabetes. Routine frailty screening, even from middle age, may support the early identification of individuals at risk for diabetic foot complications and inform preventive wound care strategies.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Pages 115-119"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is still no complete agreement on the best anthropometric index for identifying type 2 diabetes. This study aims to evaluate the predictive power of the novel indices compared with traditional and to better understand how gender influences this association.
Methods
Baseline data of the Kharameh cohort study, which includes Iranian adults between 40 and 70 years, were used in this cross-sectional study. Anthropometric indices such as BMI, WHR, WHtR, ABSI, BRI, and BAI were evaluated for identifying type 2 diabetes. Statistical analysis was performed using independent t-tests and logistic regression to examine the association of these indices with diabetes in men and women. ROC curves were calculated to determine the sensitivity and specificity of each index.
Results
Fifteen percent of our 10,663 participants had diabetes. Anthropometric indices were significantly higher in the diabetic group than in the non-diabetic group and were significantly associated with an increased risk of type 2 diabetes. WHR performed as the best in predicting diabetes, with an optimal cutoff point of WHR > 0.95 for both sexes. BMI and BAI were the least accurate, with AUCs of less than 60 % for both sexes.
Conclusions
The findings underscore the crucial role of body fat distribution, particularly central or abdominal obesity, in predicting diabetes risk. The use of anthropometric indices like WHR could be valuable in identifying individuals at high risk for type 2 diabetes, thereby aiding the development of effective screening and prevention programs.
{"title":"Novel anthropometric indices for predicting diabetes mellitus: A population-based study","authors":"Fatemeh Baberi , Shayan Rezaeianzadeh , Abbas Rezaianzadeh , Andishe Hamedi","doi":"10.1016/j.pcd.2025.10.006","DOIUrl":"10.1016/j.pcd.2025.10.006","url":null,"abstract":"<div><h3>Aims</h3><div>There is still no complete agreement on the best anthropometric index for identifying type 2 diabetes. This study aims to evaluate the predictive power of the novel indices compared with traditional and to better understand how gender influences this association.</div></div><div><h3>Methods</h3><div>Baseline data of the Kharameh cohort study, which includes Iranian adults between 40 and 70 years, were used in this cross-sectional study. Anthropometric indices such as BMI, WHR, WHtR, ABSI, BRI, and BAI were evaluated for identifying type 2 diabetes. Statistical analysis was performed using independent t-tests and logistic regression to examine the association of these indices with diabetes in men and women. ROC curves were calculated to determine the sensitivity and specificity of each index.</div></div><div><h3>Results</h3><div>Fifteen percent of our 10,663 participants had diabetes. Anthropometric indices were significantly higher in the diabetic group than in the non-diabetic group and were significantly associated with an increased risk of type 2 diabetes. WHR performed as the best in predicting diabetes, with an optimal cutoff point of WHR > 0.95 for both sexes. BMI and BAI were the least accurate, with AUCs of less than 60 % for both sexes.</div></div><div><h3>Conclusions</h3><div>The findings underscore the crucial role of body fat distribution, particularly central or abdominal obesity, in predicting diabetes risk. The use of anthropometric indices like WHR could be valuable in identifying individuals at high risk for type 2 diabetes, thereby aiding the development of effective screening and prevention programs.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Pages 30-35"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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