Primary Care Diabetes最新文献_第4页

A structured education program for improving cardiovascular risk and glycaemic control in type 2 diabetes mellitus (the SUGAR study) 一项改善2型糖尿病心血管风险和血糖控制的结构化教育计划（SUGAR研究）。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-10-01 DOI: 10.1016/j.pcd.2025.09.008

Mark P. Ranasinghe , Marly Ranasinghe , Mayurathan Balachandran , Vinay Goel , Sulochi Subasinghe , Shane Nanayakkara

Aims

Structured community-based diabetes education programs may improve cardiometabolic outcomes, yet objective evidence remains limited. We evaluated the efficacy of a multidisciplinary education program in improving glycaemic control and cardiovascular risk factors in adults with type 2 diabetes mellitus (T2DM).

Methods

Adults with T2DM participated in a four-week program comprising weekly two-hour sessions on diabetes and cardiovascular disease, nutrition, exercise, and mental health. HbA1c, body mass index (BMI), weight, blood pressure, and lipid profile were assessed at baseline and at 3, 6, and 12 months. Outcomes were analysed using pooled linear mixed-effects models with multiple imputation, with sensitivity analyses excluding participants requiring pharmacotherapy escalation.

Results

Fifty participants (median age 49 years; 38 % female) completed the program. HbA1c improved significantly and was sustained at 12 months (−1.57 % (95 %CI(-1.96, −1.17), p < 0.001). LDL cholesterol (-0.51 mmol/L (95 %CI(-0.71,-0.30), p < 0.001), triglycerides (-0.86 mmol/L (95 %CI(-1.34,-0.39), p = 0.001), and BMI (−1.45 kg/m², 95 %CI(-1.99,-0.91), p < 0.001) also improved at 12 months. These findings were supported by sensitivity analysis for HbA1c, but attenuated for other cardiometabolic parameters at 12 months.

Conclusions

A structured, multidisciplinary community-based education program was associated with significant improvements in glycaemic control and key parameters of cardiometabolic risk. As a cost-efficient model, it offers a scalable strategy for T2DM management in primary care, warranting further evaluation of interactions with pharmacotherapy.

目的：有组织的社区糖尿病教育项目可能改善心脏代谢结果，但客观证据仍然有限。我们评估了多学科教育项目在改善成人2型糖尿病（T2DM）患者血糖控制和心血管危险因素方面的效果。方法：成年T2DM患者参加了一个为期四周的项目，包括每周两小时的糖尿病和心血管疾病、营养、运动和心理健康会议。在基线、3个月、6个月和12个月时评估HbA1c、体重指数（BMI）、体重、血压和血脂。结果分析使用多重归因的合并线性混合效应模型，并进行敏感性分析，排除需要增加药物治疗的参与者。结果：50名参与者（中位年龄49岁；38% %女性）完成了该计划。HbA1c显著改善并持续12个月(-1.57 %（95 %CI(-1.96, -1.17), p ）结论：一个结构化的、多学科的社区教育项目与血糖控制和心脏代谢风险关键参数的显著改善有关。作为一种具有成本效益的模式，它为初级保健中的T2DM管理提供了一种可扩展的策略，值得进一步评估与药物治疗的相互作用。

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引用次数: 0

Assessment of urological complications in male patients with diabetes: Insights from a survey of healthcare providers 男性糖尿病患者泌尿系统并发症的评估：来自医疗保健提供者调查的见解。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-09-30 DOI: 10.1016/j.pcd.2025.09.007

Mesut Altan , Emre Albayrak , Müjdat Ayva , Uğur Ünlütürk , Tomris Erbas

Objective

This study aimed to investigate healthcare professionals’ practices, attitudes, and challenges in assessing and managing urological complications, including lower urinary tract symptoms (LUTSs) and erectile dysfunction (ED), in male patients with diabetes.

Methods

A 12-question online survey, distributed between April 2023 and January 2024, gathered responses from 370 physicians in Turkey. Participants represented various specialties, including endocrinology, internal medicine, family medicine, and general practice. The survey evaluated how frequently physicians inquired about symptoms, their use of validated assessment tools, and their management strategies for ED and LUTSs in male patients with diabetes.

Results

Of the participants, 40.3 % frequently asked about LUTSs, whereas 42.4 % reported rarely or never addressing these symptoms. More than 20 years of experience was significantly associated with higher inquiry rates (p = 0.001). Only 0.8 % of participants used validated symptom assessment tools. Concerning ED, 89.5 % of physicians noted that male patients with diabetes seldom reported related complaints, and only 20.3 % routinely asked about ED. Endocrinologists were significantly more likely to inquire about ED, with 36.2 % reporting such inquiries compared to 10.5 % among other specialties (p < 0.001). Most participants (53.5 %) preferred referring patients with ED to urology specialists for further management.

Conclusion

Urological complications in male patients with diabetes are under-assessed, with significant gaps in the use of validated tools and structured approaches. The study underscores the importance of raising awareness and implementing multidisciplinary strategies, such as regular symptom screening and timely interventions, to enhance patient outcomes.

目的：本研究旨在调查医疗保健专业人员在评估和管理泌尿系统并发症（包括下尿路症状（LUTSs）和勃起功能障碍（ED））方面的做法、态度和挑战。方法：在2023年4月至2024年1月期间进行了一项包含12个问题的在线调查，收集了土耳其370名医生的回复。参与者代表了不同的专业，包括内分泌学、内科、家庭医学和全科医学。该调查评估了医生询问症状的频率，他们对有效评估工具的使用，以及他们对男性糖尿病患者ED和LUTSs的管理策略。结果：在参与者中，40.3% %经常询问LUTSs，而42.4 %报告很少或从未处理这些症状。超过20年的经验与较高的问询率显著相关（p = 0.001）。只有0.8 %的参与者使用有效的症状评估工具。关于ED， 89.5% %的医生注意到男性糖尿病患者很少报告相关的抱怨，只有20.3% %的医生经常询问ED。内分泌科医生更有可能询问ED， 36.2% %的医生报告了这一问题，而其他专科的这一比例为10.5% % （p ）结论：男性糖尿病患者的泌尿系统并发症被低估，在使用有效的工具和结构化方法方面存在显著差距。该研究强调了提高认识和实施多学科战略的重要性，如定期症状筛查和及时干预，以提高患者的预后。

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引用次数: 0

Predicting the future risk of developing type 2 diabetes in women with a history of gestational diabetes mellitus using machine learning and explainable artificial intelligence 使用机器学习和可解释的人工智能预测有妊娠糖尿病史的妇女未来发展为2型糖尿病的风险

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-09-25 DOI: 10.1016/j.pcd.2025.09.006

Jenifar Prashanthan , Amirthanathan Prashanthan

Background and aim

It is essential to identify the risk of developing Type 2 Diabetes Mellitus (T2DM) in women with a history of Gestational Diabetes Mellitus (GDM). This study seeks to create a machine learning (ML) model combined with explainable artificial intelligence (XAI) to predict and explain the risk of Type 2 Diabetes Mellitus (T2DM) in women with a history of Gestational Diabetes Mellitus (GDM).

Methods

A literature review found 28 risk factors, including pregnancy-related clinical risk factors, maternal characteristics, genetic risk factors, and lifestyle and modifiable risk factors. A synthetic dataset was generated utilizing subject expertise and clinical experience through Python programming. Various machine learning classification techniques were employed on the data to identify the optimal model, which integrates interpretability approaches (SHAP) to guarantee the transparency of model predictions.

Results

The developed machine learning model exhibited superior accuracy in predicting the risk of T2DM relative to conventional clinical risk scores, with notable contributions from factors such as insulin treatment during pregnancy, physical inactivity, obesity, breastfeeding, a history of recurrent GDM, an unhealthy diet, and ethnicity. Integrated XAI assists clinicians in comprehending the relevant risk factors and their influence on certain predictive outcomes.

Conclusions

Machine learning and explainable artificial intelligence provide a comprehensive methodology for individualized risk evaluation in women with a history of gestational diabetes mellitus. This methodology, by integrating extensive real-world data, offers healthcare clinicians actionable insights for early intervention.

背景和目的：有妊娠期糖尿病（GDM）病史的妇女发生2型糖尿病（T2DM）的风险至关重要。本研究旨在创建一个结合可解释人工智能（XAI）的机器学习（ML）模型，以预测和解释有妊娠糖尿病（GDM）史的女性患2型糖尿病（T2DM）的风险。方法：通过文献回顾，发现28个危险因素，包括妊娠相关临床危险因素、孕产妇特征、遗传危险因素、生活方式及可改变的危险因素。通过Python编程，利用学科专业知识和临床经验生成合成数据集。采用多种机器学习分类技术对数据进行分类，并结合可解释性方法（SHAP）来确定最优模型，保证模型预测的透明性。结果：与传统临床风险评分相比，开发的机器学习模型在预测T2DM风险方面表现出更高的准确性，其中包括怀孕期间胰岛素治疗、缺乏运动、肥胖、母乳喂养、复发性GDM史、不健康饮食和种族等因素的显著贡献。集成的XAI帮助临床医生理解相关的风险因素及其对某些预测结果的影响。结论：机器学习和可解释的人工智能为妊娠期糖尿病患者的个体化风险评估提供了一种全面的方法。该方法通过整合广泛的真实世界数据，为早期干预提供了医疗保健临床医生可操作的见解。

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引用次数: 0

Intervention fidelity and behaviour change mechanisms in a health promotion intervention for women following gestational diabetes mellitus: Secondary analysis of the Face-it RCT 妊娠期糖尿病妇女健康促进干预中的干预保真度和行为改变机制：Face-it随机对照试验的二次分析

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-09-23 DOI: 10.1016/j.pcd.2025.09.003

Nanna Husted Jensen , Inger Katrine Dahl-Petersen , Karoline Kragelund Nielsen , Dorte Møller Jensen , Peter Damm , Per Ovesen , Elisabeth R. Mathiesen , Ulla Kampmann , Christina Anne Vinter , Sharleen O’Reilly , Helle Terkildsen Maindal , On behalf of the Face-it Study Group

Aims

We evaluated the fidelity of the Face-it intervention and its impact on behaviour change mechanisms among women with recent gestational diabetes mellitus (GDM).

Methods

In this randomised controlled trial, 277 women were allocated to usual care or an intervention comprising three home visits, digital platform health coaching and cross-sectoral communication to support health behaviour change during the first year after delivery. Behaviour change mechanisms included social support, motivation, self-efficacy, risk perception and health literacy. High fidelity was defined as completing three home visits and ≥ 9 coaching contacts.

Results

Within the intervention group, 86.4 % completed ≥ 2 home visits, 88.6 % registered digitally with a median (IQR) of 10.0 (3.0–20.0) contacts. At one-year after delivery, the high-fidelity group (n = 73; 39.7 %) had higher odds of perceiving moderate/high diabetes risk (OR 2.42; 95 % CI 1.06–5.51) and higher health literacy (adjusted difference 0.20; 95 % CI 0.04–0.35), whereas no difference was found for social support, motivation and self-efficacy compared with usual care. No difference was observed between the low fidelity and the usual care group in behaviour change mechanisms.

Conclusions

The Face-it intervention achieved acceptable fidelity. High fidelity appears essential for improving risk perception, health literacy and supporting behaviour change mechanisms among women with recent GDM.

目的：我们评估Face-it干预的保真度及其对近期妊娠期糖尿病（GDM）妇女行为改变机制的影响。方法：在这项随机对照试验中，277名妇女被分配到常规护理或干预措施，包括三次家访、数字平台健康指导和跨部门沟通，以支持分娩后第一年的健康行为改变。行为改变机制包括社会支持、动机、自我效能、风险认知和卫生知识。高保真度定义为完成3次家访和≥ 9次辅导接触。结果：在干预组中，86.4%完成了≥ 2次家访，88.6% %进行了数字登记，中位数（IQR）为10.0（3.0-20.0）个接触者。在分娩后一年，高保真组（n = 73;39.7 %）有更高的察觉中度/高度糖尿病风险的几率（OR 2.42; 95 % CI 1.06-5.51）和更高的健康知识（调整差值0.20;95 % CI 0.04-0.35），而与常规护理相比，社会支持、动机和自我效能感没有差异。低保真度组和常规护理组在行为改变机制上没有差异。结论：Face-it干预达到了可接受的保真度。高保真度对于提高新近患GDM妇女的风险认知、健康知识和支持行为改变机制至关重要。

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引用次数: 0

Effectiveness of structured distance education on metabolic control, self-care, and health literacy in newly diagnosed type 2 diabetes: A randomized controlled trial 结构化远程教育对新诊断2型糖尿病患者代谢控制、自我保健和健康素养的影响：一项随机对照试验

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-09-22 DOI: 10.1016/j.pcd.2025.09.002

Nurten Terkes , Hicran Bektas , Mustafa Aydemir

Aim

This study aimed to evaluate the effectiveness of a structured distance education program on metabolic control, self-care activities, and health literacy in patients with newly diagnosed type 2 diabetes mellitus.

Methods

A randomized controlled trial design with block randomization (1:1 allocation) was conducted at a university hospital's endocrine outpatient clinic. A total of 100 patients newly diagnosed with type 2 diabetes were randomly assigned to either an intervention group (n = 50), receiving structured weekly distance education via Zoom sessions (each 40 min) for four weeks, or a control group (n = 50) receiving routine outpatient care. Data were collected using metabolic control parameters (BMI, fasting blood sugar, HbA1c), Diabetes Self-Care Activities Questionnaire, and Health Literacy Scale at baseline and after three months.

Results

Significant improvements were observed in metabolic control parameters, self-care activities, and health literacy in the intervention group compared to the control group (p < 0.01). Positive correlations were identified between health literacy and diabetes self-care behaviors post-intervention.

Conclusion

Structured distance education significantly enhances metabolic control, self-care, and health literacy in newly diagnosed T2DM patients. The study highlights the importance and practicality of integrating telehealth technologies into routine diabetes management and patient education, offering effective strategies to overcome barriers inherent in traditional educational methods.

目的：本研究旨在评估一个结构化的远程教育项目对新诊断的2型糖尿病患者代谢控制、自我保健活动和健康素养的影响。方法：在某大学附属医院内分泌门诊采用分组随机（1:1分配）随机对照试验设计。共有100名新诊断为2型糖尿病的患者被随机分配到干预组（n = 50），通过Zoom课程（每次40 分钟）每周接受结构化的远程教育，为期四周，或对照组（n = 50）接受常规门诊治疗。在基线和三个月后使用代谢控制参数（BMI、空腹血糖、HbA1c）、糖尿病自我保健活动问卷和健康素养量表收集数据。结果：与对照组相比，干预组在代谢控制参数、自我保健活动和健康素养方面均有显著改善（p ）。结论：结构化远程教育可显著提高新诊断T2DM患者的代谢控制、自我保健和健康素养。该研究强调了将远程保健技术纳入常规糖尿病管理和患者教育的重要性和实用性，提供了克服传统教育方法固有障碍的有效战略。

{"title":"Effectiveness of structured distance education on metabolic control, self-care, and health literacy in newly diagnosed type 2 diabetes: A randomized controlled trial","authors":"Nurten Terkes , Hicran Bektas , Mustafa Aydemir","doi":"10.1016/j.pcd.2025.09.002","DOIUrl":"10.1016/j.pcd.2025.09.002","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to evaluate the effectiveness of a structured distance education program on metabolic control, self-care activities, and health literacy in patients with newly diagnosed type 2 diabetes mellitus.</div></div><div><h3>Methods</h3><div>A randomized controlled trial design with block randomization (1:1 allocation) was conducted at a university hospital's endocrine outpatient clinic. A total of 100 patients newly diagnosed with type 2 diabetes were randomly assigned to either an intervention group (n = 50), receiving structured weekly distance education via Zoom sessions (each 40 min) for four weeks, or a control group (n = 50) receiving routine outpatient care. Data were collected using metabolic control parameters (BMI, fasting blood sugar, HbA1c), Diabetes Self-Care Activities Questionnaire, and Health Literacy Scale at baseline and after three months.</div></div><div><h3>Results</h3><div>Significant improvements were observed in metabolic control parameters, self-care activities, and health literacy in the intervention group compared to the control group (p < 0.01). Positive correlations were identified between health literacy and diabetes self-care behaviors post-intervention.</div></div><div><h3>Conclusion</h3><div>Structured distance education significantly enhances metabolic control, self-care, and health literacy in newly diagnosed T2DM patients. The study highlights the importance and practicality of integrating telehealth technologies into routine diabetes management and patient education, offering effective strategies to overcome barriers inherent in traditional educational methods.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 577-583"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133213","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}

引用次数: 0

Nutrition among older adults with type 1 diabetes: Sub-optimal intakes of key dietary factors according to the Dietary Screener Questionnaire (DSQ) 老年1型糖尿病患者的营养状况：根据膳食筛选问卷（DSQ），关键饮食因素的次优摄入量

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-09-19 DOI: 10.1016/j.pcd.2025.09.005

Angelica Cristello Sarteau , Nikhita R. Gopisetty , Jessica Sprinkles , Gabriella Ercolino , Angela Fruik , Rashmi Muthukkumar , Xiaorui Qu , Elizabeth Mayer-Davis , Anna R. Kahkoska

A cross-sectional survey (September-November 2023) among a clinic-based sample of American older adults aged 65 + with type 1 diabetes (n = 77, 95 % White, HbA1c 6.8 ± 1.1 %) suggests sub-optimal intakes of fruit, vegetables, whole grain, fiber, calcium, dairy, and added sugars according to the National Cancer Institute Dietary Screener Questionnaire.

一项横断面调查（2023年9月至11月）在美国65岁老年1型糖尿病患者（n = 77,95 % White, HbA1c 6.8 ± 1.1 %）的临床样本中显示，根据美国国家癌症研究所饮食筛查问卷，水果、蔬菜、全谷物、纤维、钙、乳制品和添加糖的摄入量不是最佳的。

引用次数: 0

Comparison of resistance training among individuals living with diabetes, prediabetes, and without diabetes: 2017–2023 BRFSS 糖尿病、前驱糖尿病和非糖尿病患者抗阻训练的比较：2017-2023 BRFSS

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-09-09 DOI: 10.1016/j.pcd.2025.09.001

Anthony Figueroa , Ariella Palmieri , Lu Shi , Willie Leung

Aim

This study aims to compare the weekly resistance training (RT) frequency between people with diabetes, prediabetes, and without diabetes.

Methods

A total of 536,703 participants from 2017 to 2023 Behavioral Risk Factors Surveillance System were included in the analysis. Unadjusted and adjusted Poisson regression was performed to compare weekly resistance training frequency among participants with different diabetes statuses (without diabetes, prediabetes, and with diabetes).

Results

89.28 % (95 % CI [89.11, 89.45]) of participants did not have diabetes, 1.67 % (95 % CI [1.59, 1.73]) had prediabetes, and 9.10 % (95 % CI [8.91, 9.22]) had diabetes. Across the sample, the averages weekly RT frequency among the sample was 1.73 times (95 % CI [1.71, 1.74]). Participants without diabetes had the highest weekly RT frequency of 1.79 (95 % CI [1.71, 1.74]) times. Participants with prediabetes had the weekly RT frequency of 1.38 (95 % CI [1.26, 1.50]) times and participants with diabetes had the lowest average frequency between the three groups with 1.19 (95 % CI [1.15, 1.23]) times per week. The unadjusted and adjusted linear regression found that people with diabetes had less weekly RT frequency than participants without diabetes (β=-.60, p < .01; αβ=-.23, p < .01). Participants with prediabetes also had lower weekly RT frequency in the unadjusted regression compared to participants without diabetes (β=-.41, p < .01).

Conclusion

People with prediabetes and diabetes might face personal and environmental barriers in engaging in RT, leading to lower weekly RT frequency compared to those without diabetes. There is a need to overcome barriers and continue promote RT among people with and without diabetes.

目的：本研究旨在比较糖尿病患者、前驱糖尿病患者和非糖尿病患者每周阻力训练（RT）的频率。方法：将2017 - 2023年行为危险因素监测系统共536703名参与者纳入分析。采用未经调整和调整的泊松回归来比较不同糖尿病状态（无糖尿病、糖尿病前期和糖尿病）的参与者每周阻力训练频率。结果：89.28 %（95 % CI[89.11, 89.45]）的参与者没有糖尿病，1.67 %（95 % CI[1.59, 1.73]）患有糖尿病前期，9.10 %（95 % CI[8.91, 9.22]）患有糖尿病。在整个样本中，样本的平均每周RT频率为1.73次（95 % CI[1.71, 1.74]）。无糖尿病的参与者每周RT频率最高，为1.79次（95 % CI[1.71, 1.74]）。糖尿病前期患者的每周RT频率为1.38（95 % CI[1.26, 1.50]）次，糖尿病患者的平均频率最低，为1.19（95 % CI[1.15, 1.23]）次。未经调整和调整后的线性回归发现，糖尿病患者的每周RT频率低于非糖尿病患者（β=- 0.60, p ）。结论：糖尿病前期和糖尿病患者在进行RT时可能面临个人和环境障碍，导致每周RT频率低于非糖尿病患者。有必要克服障碍，继续在糖尿病患者和非糖尿病患者中推广RT。

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引用次数: 0

Editorial Board and Aims & Scopes 编辑委员会和目标与范围

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-09-01 DOI: 10.1016/S1751-9918(25)00170-6

引用次数: 0

Association between the weight-adjusted waist index and type 2 diabetes mellitus: Evidence from the RaNCD study 体重调整腰围指数与2型糖尿病的关系：来自rand研究的证据。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-28 DOI: 10.1016/j.pcd.2025.08.007

Hawal Lateef Fateh , Mitra Bonyani , Ebrahim Shakiba , Jafar Navabi , Yahya Pasdar

Background

The weight-adjusted-waist index (WWI) emerges as a novel metric for assessing obesity, and this study aimed to determine the association between WWI and type 2 diabetes mellitus (T2DM).

Methods

We conducted a cross-sectional analysis using data collected at the inception of the Ravansar Non-communicable Disease (RaNCD) cohort study in 2014. A total of 8901 participants aged 35–65 were included in the study. The WWI is calculated by dividing the waist circumference (WC) in centimeters by the square root of the weight in kilograms. Logistic regression analysis was performed to assess the association between WWI and T2DM, adjusting for potential confounding variables.

Results

Individuals in the second quartile demonstrate a 56 % (OR: 1.56, 95 % CI: 1.23–1.99) higher odds of T2DM compared to those in first quartile. The odds of having T2DM was elevated in the third and fourth quartiles, with odds ratios of 1.81 (95 % CI: 1.43–2.20) and 2.15 (95 % CI: 1.71–2.71) respectively. After adjusting confounder variables, it is evident that the odds of diabetes in the second, third, and fourth quartiles of WWI has increased by 38 % (95 % CI: 1.07, 1.78), 47 % (95 % CI: 1.14, 1.91), and 43 % (95 % CI: 1.08, 1.89) respectively, compared to the first quartile (P trend = 0.001).

Conclusion

The results of the current study indicate that high levels of WWI are strongly associated to a higher risk of T2DM in Iranian adults. These study findings emphasize the significance of incorporating WWI into strategies for the prevention and management of T2DM.

背景：体重调整腰围指数（WWI）是一种评估肥胖的新指标，本研究旨在确定WWI与2型糖尿病（T2DM）之间的关系。方法：我们使用2014年Ravansar非传染性疾病（randd）队列研究开始时收集的数据进行了横断面分析。共有8901名年龄在35-65岁之间的参与者参与了这项研究。第一次世界大战是用腰围（厘米）除以体重（公斤）的平方根来计算的。采用Logistic回归分析评估第一次世界大战与T2DM之间的关系，并对潜在的混杂变量进行调整。结果：与第一个四分位数的个体相比，第二个四分位数的个体表现出56 % （OR: 1.56, 95 % CI: 1.23-1.99）高的T2DM几率。在第三和第四个四分位数中，患T2DM的几率升高，比值比分别为1.81（95 % CI: 1.43-2.20）和2.15（95 % CI: 1.71-2.71）。在调整混杂变量后，很明显，与第一个四分位数（P趋势= 0.001）相比，第一次世界大战的第二、第三和第四个四分位数中糖尿病的发生率分别增加了38 %（95 % CI: 1.07, 1.78）、47 %（95 % CI: 1.14, 1.91）和43 %（95 % CI: 1.08, 1.89）。结论：目前的研究结果表明，在伊朗成年人中，高水平的WWI与较高的2型糖尿病风险密切相关。这些研究结果强调了将WWI纳入T2DM预防和管理策略的重要性。

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引用次数: 0

Identifying high glucose variability using non-glycemic factors in low continuous glucose monitoring use settings 在低连续血糖监测中使用非血糖因子识别高血糖变异性。

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-28 DOI: 10.1016/j.pcd.2025.08.008

Suresh Rama Chandran , Ming Ming Teh , Hong Chang Tan , May Zin Oo , Alcey Ang Li Chang , Daphne Gardner

Aims

Identifying non-glycemic factors associated with high Glucose variability (GV).

Methods

A cross-sectional observational study recruited people with type 2 diabetes, who wore a Freestyle Libre Pro CGM. Independent variables: Age, sex, BMI, diabetes medication, diabetes duration, HbA1c and estimated glomerular filtration rate (eGFR). CGM-derived variables calculated included Time-in-Range (TIR, 70–180 mg/dl), below-range 1 (TBR1, <70 mg/dl), -below-range 2 (TBR2, <54 mg/dl) and -above-range (TAR, >180 mg/dl), coefficient of variation (%CV). A logistic regression model examined independent variables associated with high GV (CV ≥36 %). All analysis was done on R version 4.3.1

Results

T2D cohort (n = 403), 46 % women, had median age of 61 y, BMI of 26.5 kg/m², diabetes duration 14 y, HbA1c 7.8 %(62 mmol/mol) and creatinine of 75 µmol/L. Using sulphonylurea, premixed or basal-bolus insulin had an odds ratio (OR) of 4.7 – 5.2 for CV ≥ 36 %. Longer diabetes duration [OR 1.2], and lower eGFR [OR 1.2] were associated with higher odds and older age [OR 0.8]and higher BMI [0.8] were associated with lower odds of CV≥ 36 %. Sex and HbA1c had no association with high GV.

Conclusion

Nonglycemic-factors like medication type, diabetes duration and eGFR can aid in identification of high GV even in low-CGM use settings.

目的：确定与高葡萄糖变异性（GV）相关的非血糖因子。方法：一项横断面观察性研究招募了2型糖尿病患者，他们佩戴了Freestyle Libre Pro CGM。自变量：年龄、性别、BMI、糖尿病药物、糖尿病病程、HbA1c和估计的肾小球滤过率（eGFR）。计算的cgm衍生变量包括Time-in-Range (TIR, 70-180 mg/dl)，低于范围1 (TBR1, 180 mg/dl)，变异系数（%CV）。logistic回归模型检验了与高GV相关的自变量（CV≥36 %）。结果：T2D队列（n = 403），46 %女性，中位年龄61 y， BMI 26.5 kg/m2，糖尿病病程14 y， HbA1c 7.8 %(62 mmol/mol)，肌酐75µmol/L。当CV≥ 36 %时，使用磺脲、预混胰岛素或基础胰岛素的比值比（or）为4.7 - 5.2。较长的糖尿病病程[OR 1.2]和较低的eGFR [OR 1.2]与较高的几率相关，年龄较大[OR 0.8]和较高的BMI[0.8]与CV≥ 36 %的较低几率相关。性别和HbA1c与高GV无关。结论：非血糖因素如药物类型、糖尿病病程和eGFR可以帮助识别高GV，即使在低cgm使用环境中。

{"title":"Identifying high glucose variability using non-glycemic factors in low continuous glucose monitoring use settings","authors":"Suresh Rama Chandran , Ming Ming Teh , Hong Chang Tan , May Zin Oo , Alcey Ang Li Chang , Daphne Gardner","doi":"10.1016/j.pcd.2025.08.008","DOIUrl":"10.1016/j.pcd.2025.08.008","url":null,"abstract":"<div><h3>Aims</h3><div>Identifying non-glycemic factors associated with high Glucose variability (GV).</div></div><div><h3>Methods</h3><div>A cross-sectional observational study recruited people with type 2 diabetes, who wore a Freestyle Libre Pro CGM. Independent variables: Age, sex, BMI, diabetes medication, diabetes duration, HbA1c and estimated glomerular filtration rate (eGFR). CGM-derived variables calculated included Time-in-Range (TIR, 70–180 mg/dl), below-range 1 (TBR1, <70 mg/dl), -below-range 2 (TBR2, <54 mg/dl) and -above-range (TAR, >180 mg/dl), coefficient of variation (%CV). A logistic regression model examined independent variables associated with high GV (CV ≥36 %). All analysis was done on R version 4.3.1</div></div><div><h3>Results</h3><div>T2D cohort (n = 403), 46 % women, had median age of 61 y, BMI of 26.5 kg/m<sup>2</sup>, diabetes duration 14 y, HbA1c 7.8 %(62 mmol/mol) and creatinine of 75 µmol/L. Using sulphonylurea, premixed or basal-bolus insulin had an odds ratio (OR) of 4.7 – 5.2 for CV ≥ 36 %. Longer diabetes duration [OR 1.2], and lower eGFR [OR 1.2] were associated with higher odds and older age [OR 0.8]and higher BMI [0.8] were associated with lower odds of CV≥ 36 %. Sex and HbA1c had no association with high GV.</div></div><div><h3>Conclusion</h3><div>Nonglycemic-factors like medication type, diabetes duration and eGFR can aid in identification of high GV even in low-CGM use settings.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 624-628"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984238","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}

引用次数: 0