Pub Date : 2025-07-10DOI: 10.1016/j.pcd.2025.05.005
Eugene E. Wright , Ana Cebrian , Daniel Ngui
This paper reports the expert opinions and recommendations made by primary care physicians (PCPs) to optimize screening and management of chronic kidney disease (CKD) associated with diabetes and presents algorithms to provide a practical and simplified guide for PCPs. Individuals living with type 2 diabetes (T2D) should be screened early and at regular intervals for CKD using both estimated glomerular filtration rate and urinary albumin-to-creatinine ratio testing. The risk of CKD assessed using the Kidney Disease: Improving Global Outcomes heatmap should be reviewed at least annually to optimize treatment to slow progression of CKD. Lifestyle modifications form the foundation of reducing CKD risk in individuals with T2D. A pillared approach to pharmacotherapy (renin–angiotensin system inhibitors, sodium-glucose cotransporter 2 inhibitors, a nonsteroidal mineralocorticoid receptor antagonist [finerenone], and glucagon-like peptide-1 receptor agonists) is recommended in individuals with CKD and T2D.
{"title":"A primary care guide to the screening and pharmacologic management of chronic kidney disease in people living with type 2 diabetes","authors":"Eugene E. Wright , Ana Cebrian , Daniel Ngui","doi":"10.1016/j.pcd.2025.05.005","DOIUrl":"10.1016/j.pcd.2025.05.005","url":null,"abstract":"<div><div>This paper reports the expert opinions and recommendations made by primary care physicians (PCPs) to optimize screening and management of chronic kidney disease (CKD) associated with diabetes and presents algorithms to provide a practical and simplified guide for PCPs. Individuals living with type 2 diabetes (T2D) should be screened early and at regular intervals for CKD using both estimated glomerular filtration rate and urinary albumin-to-creatinine ratio testing. The risk of CKD assessed using the Kidney Disease: Improving Global Outcomes heatmap should be reviewed at least annually to optimize treatment to slow progression of CKD. Lifestyle modifications form the foundation of reducing CKD risk in individuals with T2D. A pillared approach to pharmacotherapy (renin–angiotensin system inhibitors, sodium-glucose cotransporter 2 inhibitors, a nonsteroidal mineralocorticoid receptor antagonist [finerenone], and glucagon-like peptide-1 receptor agonists) is recommended in individuals with CKD and T2D.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 411-421"},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922522","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 : 2025-07-08DOI: 10.1016/j.pcd.2025.07.002
Ashley Anjali Singh , Katie M. Babbott , Simon Young , Zhenqiang Wu , Anna Serlachius
Aim
The present study sought to explore if engagement with a commercially available diabetes app, mySugr, could facilitate improvement in glycaemic outcomes, diabetes self-care behaviours and psychological wellbeing compared to standard care among adults with type 1 diabetes (T1D).
Methods
Participants were randomised to the intervention (n = 31) or control group (n = 32) and assessed at 12 weeks after baseline. Changes to blood glucose levels (HbA1c) was the primary outcome of interest in the present study. Secondary outcomes included diabetes self-care behaviours, diabetes self-efficacy, diabetes distress, psychological well-being and general stress. These outcomes were quantitatively assessed via self-report questionnaires. Qualitative accounts of user engagement with the app were also explored.
Results
Fifty-five participants completed the 12-week follow-up questionnaires. The intervention group demonstrated a lower HbA1c than the control group at 12-weeks, however this change was not statistically significant (adjusted mean difference 4.20 mmol/mol, 95 % CI [-0.39,8.79], p = 0.072). Additionally, no significant changes across time or between-group differences were observed for secondary outcomes at 12 weeks. However, close to 80 % of participants in the intervention group reported using the app daily for 12 weeks, suggesting good user engagement. Further, users scored the app on average favourably on the uMARS scale (objective quality M=3.93, SD=0.55, subjective quality M=3.31, SD=0.99, perceived impact M=3.15, SD=1.25).
Conclusion
Results suggest that mySugr is an engaging diabetes app. Preliminary findings suggest that the mySugr app may assist users in improving glycaemic levels over 12 weeks, but the trends found in the present study did not reach statistical significance. Thus, the study needs to be replicated in a larger sample size with a longer follow-up period to more robustly ascertain the effects of mySugr on glycaemic outcomes and diabetes self-management
目的：本研究旨在探索与标准治疗相比，使用市售糖尿病应用程序mysugar是否可以促进1型糖尿病（T1D）成人血糖结局、糖尿病自我护理行为和心理健康的改善。方法：参与者被随机分为干预组（n = 31）或对照组（n = 32），并在基线后12周进行评估。血糖水平（HbA1c）的变化是本研究的主要目的。次要结局包括糖尿病自我护理行为、糖尿病自我效能、糖尿病困扰、心理健康和一般压力。这些结果通过自我报告问卷进行定量评估。我们还探讨了用户粘性的定性描述。结果：55名参与者完成了为期12周的随访问卷。干预组在12周时HbA1c低于对照组，但差异无统计学意义（调整后平均差异4.20 mmol/mol, 95 % CI [-0.39,8.79], p = 0.072）。此外，在12周时，次要结果在时间上或组间没有显著变化。然而，在干预组中，接近80% %的参与者报告说，他们在12周内每天都使用该应用程序，这表明用户粘性很好。此外，用户在uMARS量表上对该应用的平均评分为好评（客观质量M=3.93， SD=0.55，主观质量M=3.31， SD=0.99，感知影响M=3.15， SD=1.25）。结论：结果表明mysugar是一款引人关注的糖尿病应用程序。初步研究结果表明，mysugar应用程序可以帮助用户在12周内改善血糖水平，但本研究中发现的趋势没有达到统计学意义。因此，该研究需要在更大的样本量和更长的随访期内进行重复，以更有力地确定mysugar对血糖结局和糖尿病自我管理的影响。
{"title":"Evaluating the mySugr diabetes app: A randomised controlled trial exploring changes in HbA1c and psychological outcomes in adults with type 1 diabetes","authors":"Ashley Anjali Singh , Katie M. Babbott , Simon Young , Zhenqiang Wu , Anna Serlachius","doi":"10.1016/j.pcd.2025.07.002","DOIUrl":"10.1016/j.pcd.2025.07.002","url":null,"abstract":"<div><h3>Aim</h3><div>The present study sought to explore if engagement with a commercially available diabetes app, mySugr, could facilitate improvement in glycaemic outcomes, diabetes self-care behaviours and psychological wellbeing compared to standard care among adults with type 1 diabetes (T1D).</div></div><div><h3>Methods</h3><div>Participants were randomised to the intervention (<em>n</em> = 31) or control group (<em>n</em> = 32) and assessed at 12 weeks after baseline. Changes to blood glucose levels (HbA1c) was the primary outcome of interest in the present study. Secondary outcomes included diabetes self-care behaviours, diabetes self-efficacy, diabetes distress, psychological well-being and general stress. These outcomes were quantitatively assessed via self-report questionnaires. Qualitative accounts of user engagement with the app were also explored.</div></div><div><h3>Results</h3><div>Fifty-five participants completed the 12-week follow-up questionnaires. The intervention group demonstrated a lower HbA1c than the control group at 12-weeks, however this change was not statistically significant (adjusted mean difference 4.20 mmol/mol, 95 % CI [-0.39,8.79], <em>p</em> = 0.072). Additionally, no significant changes across time or between-group differences were observed for secondary outcomes at 12 weeks. However, close to 80 % of participants in the intervention group reported using the app daily for 12 weeks, suggesting good user engagement. Further, users scored the app on average favourably on the uMARS scale (objective quality <em>M</em>=3.93, <em>SD</em>=0.55, subjective quality <em>M</em>=3.31, <em>SD</em>=0.99, perceived impact <em>M</em>=3.15, SD=1.25).</div></div><div><h3>Conclusion</h3><div>Results suggest that mySugr is an engaging diabetes app. Preliminary findings suggest that the mySugr app may assist users in improving glycaemic levels over 12 weeks, but the trends found in the present study did not reach statistical significance. Thus, the study needs to be replicated in a larger sample size with a longer follow-up period to more robustly ascertain the effects of mySugr on glycaemic outcomes and diabetes self-management</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 446-452"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602700","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 : 2025-07-08DOI: 10.1016/j.pcd.2025.06.009
Emma Victoria Shiel , Steve Hemingway , Rajeeb Kumar Sah , Kim Burton
Aims
To interpret the available qualitative research findings on people’s experiences of managing type 1 diabetes at work.
Methods
A qualitative meta-synthesis was conducted using constant comparative methods, reciprocal analysis, and a line of argument synthesis, which were expressed narratively.
Results
The study included thirteen articles, revealing a complex relationship between type 1 diabetes and work. People with type one diabetes want minimal interference in their daily routines while balancing health and work responsibilities. The concept of 'containment' emerged as a key strategy, where self-management is integrated alongside work demands. However, this approach may inadvertently lead to psychosocial conflicts and detrimental health outcomes.
Conclusions
The findings highlight the importance of creating supportive and empowering workplaces to reduce the tensions between type one diabetes and work. Enabling people with type one diabetes to self-manage effectively while maintaining autonomy requires support that both fosters self-management and avoids isolation. This sort of supportive and empowering work environment for workers with type one diabetes could contribute to facilitating [re]entry and retention in the workforce. This synthesis adds to contemporary knowledge, particularly in qualitative areas, yet further study is needed to identify specific actions that can create more accommodating workplaces for people with type one diabetes.
{"title":"Managing type 1 diabetes at work – A qualitative meta-synthesis","authors":"Emma Victoria Shiel , Steve Hemingway , Rajeeb Kumar Sah , Kim Burton","doi":"10.1016/j.pcd.2025.06.009","DOIUrl":"10.1016/j.pcd.2025.06.009","url":null,"abstract":"<div><h3>Aims</h3><div>To interpret the available qualitative research findings on people’s experiences of managing type 1 diabetes at work.</div></div><div><h3>Methods</h3><div>A qualitative meta-synthesis was conducted using constant comparative methods, reciprocal analysis, and a line of argument synthesis, which were expressed narratively.</div></div><div><h3>Results</h3><div>The study included thirteen articles, revealing a complex relationship between type 1 diabetes and work. People with type one diabetes want minimal interference in their daily routines while balancing health and work responsibilities. The concept of 'containment' emerged as a key strategy, where self-management is integrated alongside work demands. However, this approach may inadvertently lead to psychosocial conflicts and detrimental health outcomes.</div></div><div><h3>Conclusions</h3><div>The findings highlight the importance of creating supportive and empowering workplaces to reduce the tensions between type one diabetes and work. Enabling people with type one diabetes to self-manage effectively while maintaining autonomy requires support that both fosters self-management and avoids isolation. This sort of supportive and empowering work environment for workers with type one diabetes could contribute to facilitating [re]entry and retention in the workforce. This synthesis adds to contemporary knowledge, particularly in qualitative areas, yet further study is needed to identify specific actions that can create more accommodating workplaces for people with type one diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 426-433"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593292","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 : 2025-07-08DOI: 10.1016/j.pcd.2025.07.001
Andishe Hamedi , Mozhgan Seif , Mohammad Hossein Sharifi , Abbas Rezaianzadeh , Jafar Hassanzadeh
Aims
To evaluate the effectiveness of the Finnish Diabetes Risk Score (FINDRISC) as a potentially valuable tool for diabetes screening and prevention.
Methods
This study utilized data from the Kharameh Cohort Study, which included 10,663 participants. Of these, 1600 individuals with known diabetes were excluded. Participants were assessed using the FINDRISC questionnaire and a fasting blood glucose test to determine their glucose metabolism status. Receiver Operating Characteristic curves evaluated the effectiveness of FINDRISC in identifying Undiagnosed Diabetes Mellitus (UDM).
Results
The prevalence of individuals with UDM was 2.2 %. The FINDRISC score was 14.18 ± 4.46 for those with UDM, compared to 9.51 ± 4.69 for those without. Women had a mean FINDRISC score of 10.99 ± 4.42, significantly higher than the mean score of 8.07 ± 4.60 for men. The overall AUC-ROC curve for diagnosing UDM was 0.767 (95 % CI: 0.735–0.800). For men, it was 0.809 (95 % CI: 0.764–0.853), while for women, it was 0.737 (95 % CI: 0.689–0.785).
Conclusions
The FINDRISC score demonstrates good accuracy in identifying individuals with UDM, making it a valuable and simple screening tool, especially in resource-limited settings. Significant gender differences were observed in the risk scores between women and men. Therefore, we recommend that screening tools be adapted to account for these gender differences, with particular attention to individuals with a family history of diabetes to improve early detection and prevention strategies.
{"title":"Performance of the finnish diabetes risk score in screening for undiagnosed type 2 diabetes among adults without prior diagnosis: A Kharameh Cohort Study, Iran","authors":"Andishe Hamedi , Mozhgan Seif , Mohammad Hossein Sharifi , Abbas Rezaianzadeh , Jafar Hassanzadeh","doi":"10.1016/j.pcd.2025.07.001","DOIUrl":"10.1016/j.pcd.2025.07.001","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the effectiveness of the Finnish Diabetes Risk Score (FINDRISC) as a potentially valuable tool for diabetes screening and prevention.</div></div><div><h3>Methods</h3><div><span>This study utilized data from the Kharameh Cohort Study, which included 10,663 participants. Of these, 1600 individuals with known diabetes were excluded. Participants were assessed using the FINDRISC questionnaire and a fasting blood </span>glucose test<span> to determine their glucose metabolism status. Receiver Operating Characteristic curves evaluated the effectiveness of FINDRISC in identifying Undiagnosed Diabetes Mellitus (UDM).</span></div></div><div><h3>Results</h3><div>The prevalence of individuals with UDM was 2.2 %. The FINDRISC score was 14.18 ± 4.46 for those with UDM, compared to 9.51 ± 4.69 for those without. Women had a mean FINDRISC score of 10.99 ± 4.42, significantly higher than the mean score of 8.07 ± 4.60 for men. The overall AUC-ROC curve for diagnosing UDM was 0.767 (95 % CI: 0.735–0.800). For men, it was 0.809 (95 % CI: 0.764–0.853), while for women, it was 0.737 (95 % CI: 0.689–0.785).</div></div><div><h3>Conclusions</h3><div>The FINDRISC score demonstrates good accuracy in identifying individuals with UDM, making it a valuable and simple screening tool, especially in resource-limited settings. Significant gender differences were observed in the risk scores between women and men. Therefore, we recommend that screening tools be adapted to account for these gender differences, with particular attention to individuals with a family history of diabetes to improve early detection and prevention strategies.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 517-521"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602701","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 : 2025-07-04DOI: 10.1016/j.pcd.2025.06.007
Jacob W. Harland , Zoe Shih-Jung Liu , Kimberly Cukier , Spiros Fourlanos , Courtney Swinton , Briana Spolding , Mark A. Kotowicz , Julie A. Pasco , Kara L. Holloway-Kew
Aims
To determine the prevalence of the novel diabetes subgroups in a population-based study, and investigate clinical characteristics and mortality in these subgroups compared to participants without diabetes.
Methods
Men from the Geelong Osteoporosis study (n = 895) were categorised according to diabetes status. Men with diabetes (n = 105) were categorised into the severe auto-immune diabetes (SAID) subgroup based on islet antibody seropositivity. The remaining men were then classified into the other subgroups using k-means clustering. ANOVA and chi-squared tests were used to determine differences in demographics, lifestyle factors and comorbidities between the novel diabetes subgroups and normoglycaemia (n = 790). Cox proportional hazard models were used to compare mortality over a median of 11.8 years (IQR 9.7–11.3). A p-value< 0.05 was considered significant, models were adjusted for age, physical activity, and systolic blood pressure.
Results
Compared to men with normoglycaemia, mean blood pressure and cardiovascular comorbidities were higher in the mild obesity-related diabetes (MOD), mild age-related diabetes (MARD), and severe insulin-resistant diabetes (SIRD) subgroups. The MARD subgroup was associated with higher mortality in unadjusted models (HR 5.5, 95 %CI 3.6–8.4); although this was attenuated after adjustment. In unadjusted models, mortality was not different in the SIRD subgroup, however, after adjustment this subgroup had higher mortality (HR 2.0; 95 %CI 1.0–3.9).
Conclusions
These data may influence choice of antihyperglycaemic medication and management of cardiovascular risk factors in men with type 2 diabetes particularly in the SIRD subgroup which is associated with cardiovascular-related comorbidities, and mortality.
{"title":"Clinical characteristics and mortality in novel subgroups of adult-onset diabetes in an Australian population-based cohort of men","authors":"Jacob W. Harland , Zoe Shih-Jung Liu , Kimberly Cukier , Spiros Fourlanos , Courtney Swinton , Briana Spolding , Mark A. Kotowicz , Julie A. Pasco , Kara L. Holloway-Kew","doi":"10.1016/j.pcd.2025.06.007","DOIUrl":"10.1016/j.pcd.2025.06.007","url":null,"abstract":"<div><h3>Aims</h3><div>To determine the prevalence of the novel diabetes subgroups in a population-based study, and investigate clinical characteristics and mortality in these subgroups compared to participants without diabetes.</div></div><div><h3>Methods</h3><div>Men from the Geelong Osteoporosis study (n = 895) were categorised according to diabetes status. Men with diabetes (n = 105) were categorised into the severe auto-immune diabetes (SAID) subgroup based on islet antibody seropositivity. The remaining men were then classified into the other subgroups using k-means clustering. ANOVA and chi-squared tests were used to determine differences in demographics, lifestyle factors and comorbidities between the novel diabetes subgroups and normoglycaemia (n = 790). Cox proportional hazard models were used to compare mortality over a median of 11.8 years (IQR 9.7–11.3). A p-value< 0.05 was considered significant, models were adjusted for age, physical activity, and systolic blood pressure.</div></div><div><h3>Results</h3><div>Compared to men with normoglycaemia, mean blood pressure and cardiovascular comorbidities were higher in the mild obesity-related diabetes (MOD), mild age-related diabetes (MARD), and severe insulin-resistant diabetes (SIRD) subgroups. The MARD subgroup was associated with higher mortality in unadjusted models (HR 5.5, 95 %CI 3.6–8.4); although this was attenuated after adjustment. In unadjusted models, mortality was not different in the SIRD subgroup, however, after adjustment this subgroup had higher mortality (HR 2.0; 95 %CI 1.0–3.9).</div></div><div><h3>Conclusions</h3><div>These data may influence choice of antihyperglycaemic medication and management of cardiovascular risk factors in men with type 2 diabetes particularly in the SIRD subgroup which is associated with cardiovascular-related comorbidities, and mortality.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 545-551"},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568290","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 : 2025-07-03DOI: 10.1016/j.pcd.2025.06.008
Fereshteh Baygi, Peter Haastrup, Helene Støttrup Andersen, Sonja Wehberg, Jens Søndergaard
Aims
This study aims to analyze recent trends in managing major metabolic risk factors among type 2 diabetes patients (T2D) over time.
Methods
We used data from the Danish Adult Diabetes Registry (DVDD) on health indicators in 2018 and 2021. Information about medication was found using Danish National Prescription Registry (DNPR). Cut points for abnormal values of the included health indicators were identified from the revised National Cholesterol Education Program Adult Treatment Panel III criteria. Correspondingly, reached target levels were defined. A logistic regression model based on generalized estimating equations was fitted to evaluate the difference between 2018 and 2021.
Results
We included 24,343 and 18,027 observations in 2018 and 2021, respectively. Longitudinal analyses showed statistically significant improvement in Low density lipoprotein, Blood pressure, triglycerides, and Glycated hemoglobin control overtime. The use of glucose-lowering and lipid-lowering medications, and antihypertensive medication increased. Obesity declined significantly overtime. Subgroup analyses highlighted improvement in metabolic control across age groups, with TG control declining in T2D patients over 60 years.
Conclusions
We found statistically significant improvement in metabolic risk factor control and medication use over time. Despite progress in managing LDL, BP, and HbA1c, challenges remain in Blood pressure and triglycerides control.
{"title":"Trends in metabolic risk factors control among adults with type 2 diabetes: A comparative study of 2018 and 2021","authors":"Fereshteh Baygi, Peter Haastrup, Helene Støttrup Andersen, Sonja Wehberg, Jens Søndergaard","doi":"10.1016/j.pcd.2025.06.008","DOIUrl":"10.1016/j.pcd.2025.06.008","url":null,"abstract":"<div><h3>Aims</h3><div>This study aims to analyze recent trends in managing major metabolic risk factors among type 2 diabetes patients (T2D) over time.</div></div><div><h3>Methods</h3><div>We used data from the Danish Adult Diabetes Registry (DVDD) on health indicators in 2018 and 2021. Information about medication was found using Danish National Prescription Registry (DNPR). Cut points for abnormal values of the included health indicators were identified from the revised National Cholesterol Education Program Adult Treatment Panel III criteria. Correspondingly, reached target levels were defined. A logistic regression model based on generalized estimating equations was fitted to evaluate the difference between 2018 and 2021.</div></div><div><h3>Results</h3><div>We included 24,343 and 18,027 observations in 2018 and 2021, respectively. Longitudinal analyses showed statistically significant improvement in Low density lipoprotein, Blood pressure, triglycerides, and Glycated hemoglobin control overtime. The use of glucose-lowering and lipid-lowering medications, and antihypertensive medication increased. Obesity declined significantly overtime. Subgroup analyses highlighted improvement in metabolic control across age groups, with TG control declining in T2D patients over 60 years.</div></div><div><h3>Conclusions</h3><div>We found statistically significant improvement in metabolic risk factor control and medication use over time. Despite progress in managing LDL, BP, and HbA1c, challenges remain in Blood pressure and triglycerides control.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 486-496"},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562494","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}
To evaluate the correlation between continuous glucose monitoring (CGM)-derived metrics such as time in range (TIR) and time below range (TBR) and clinical parameters in Indian patients with type 2 diabetes mellitus (T2DM), providing insights into the effectiveness of CGM in this population.
Methods
This is a single-center, retrospective-observational study of T2DM patients aged 18 or older years using the Freestyle Libre/Libre Pro CGM system. Demographic and clinical data of these patients were extracted from medical records, and glycemic metrics from CGM profiles.
Results
The study included 248 T2DM patients, of whom 72.98 % were male, with a mean age of 60.48 years and a mean HbA1c value of 8.319 %. Linear regression analysis revealed that TIR was significantly negatively associated with HbA1c values (coefficient=-6.746) and duration of diabetes (coefficient=-0.425). The body mass index (BMI) showed a positive association with TIR (coefficient=0.649; P = 0.032). For TBR, only HbA1c values showed a significant negative association (coefficient=-1.051; P = 0.009), whereas age, duration of diabetes, and BMI were not significant predictors.
Conclusion
The study highlights the significant relationships between CGM-derived metrics (TIR and TBR), and clinical parameters in Indian patients with T2DM, and their effectiveness in identifying patients at risk of inadequate glycemic control.
背景：评估印度2型糖尿病（T2DM）患者连续血糖监测（CGM）衍生指标（如范围内时间（TIR）和范围下时间（TBR））与临床参数之间的相关性，为CGM在该人群中的有效性提供见解。方法：这是一项使用Freestyle Libre/Libre Pro CGM系统的18岁及以上T2DM患者的单中心、回顾性观察研究。这些患者的人口学和临床数据从医疗记录中提取，血糖指标从CGM档案中提取。结果：研究纳入T2DM患者248例，其中男性72.98 %，平均年龄60.48岁，平均HbA1c值8.319 %。线性回归分析显示，TIR与HbA1c值（系数=-6.746）和糖尿病病程（系数=-0.425）呈显著负相关。体质指数（BMI）与TIR呈正相关(系数=0.649； = 0.032页)。对于TBR，只有HbA1c值呈显著负相关(系数=-1.051；P = 0.009)，而年龄、糖尿病病程和BMI不是显著的预测因子。结论：该研究强调了cgm衍生指标（TIR和TBR）与印度T2DM患者临床参数之间的显著关系，以及它们在识别血糖控制不足风险患者方面的有效性。
{"title":"Association between continuous glucose monitoring derived metrics and clinical parameters in Indian people living with type 2 diabetes","authors":"Purvi Chawla , Alpana Sowani , Rakesh Parikh , Amit Gupta , Jothydev Kesavadev , Rutul Gokalani , Banshi Saboo , Manoj Chawla","doi":"10.1016/j.pcd.2025.06.004","DOIUrl":"10.1016/j.pcd.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the correlation between continuous glucose monitoring (CGM)-derived metrics such as time in range (TIR) and time below range (TBR) and clinical parameters in Indian patients with type 2 diabetes mellitus (T2DM), providing insights into the effectiveness of CGM in this population.</div></div><div><h3>Methods</h3><div>This is a single-center, retrospective-observational study of T2DM patients aged 18 or older years using the Freestyle Libre/Libre Pro CGM system. Demographic and clinical data of these patients were extracted from medical records, and glycemic metrics from CGM profiles.</div></div><div><h3>Results</h3><div>The study included 248 T2DM patients, of whom 72.98 % were male, with a mean age of 60.48 years and a mean HbA1c value of 8.319 %. Linear regression analysis revealed that TIR was significantly negatively associated with HbA1c values (coefficient=-6.746) and duration of diabetes (coefficient=-0.425). The body mass index (BMI) showed a positive association with TIR (coefficient=0.649; <em>P</em> = 0.032). For TBR, only HbA1c values showed a significant negative association (coefficient=-1.051; <em>P</em> = 0.009), whereas age, duration of diabetes, and BMI were not significant predictors.</div></div><div><h3>Conclusion</h3><div>The study highlights the significant relationships between CGM-derived metrics (TIR and TBR), and clinical parameters in Indian patients with T2DM, and their effectiveness in identifying patients at risk of inadequate glycemic control.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 453-461"},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512962","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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