Pub Date : 2025-10-01Epub Date: 2025-07-16DOI: 10.1016/j.pcd.2025.07.003
Anne Sofie Baymler Lundberg , Claus Høgstrup Vestergaard , Annelli Sandbæk , Anders Prior
{"title":"Corrigendum to “Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark” [Prim. Care Diabetes 19 (2025) 261–269]","authors":"Anne Sofie Baymler Lundberg , Claus Høgstrup Vestergaard , Annelli Sandbæk , Anders Prior","doi":"10.1016/j.pcd.2025.07.003","DOIUrl":"10.1016/j.pcd.2025.07.003","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 556-560"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651675","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 : 2025-10-01Epub Date: 2025-08-05DOI: 10.1016/j.pcd.2025.07.009
Miguel-Angel Muñoz , Victoria Cendrós , Elena Navas , Jose-Maria Verdú-Rotellar , Joan Barrot , Josep Franch
Objectives
To analyse the incidence of first hospitalization for heart failure (HF) in a cohort of patients newly diagnosed with type 2 diabetes mellitus (T2DM) compared with those without T2DM, attended in primary care.
Participants
Retrospective cohort study including both the entire adult population of Catalonia who developed T2DM (N = 518,232), and three paired controls for each of them (N = 1503,812), followed between January 2010 and December 2023. Patients’ characteristics and diagnostics were drawn from the System for the Development of Research in Primary Care (SIDIAP) database. Information on the first hospitalization was obtained from the hospital discharge database (CMBD).
Primary and secondary outcome measures
We analysed the incidence of first hospitalization for HF.
Results
Over the 13-year period of the study, there were 24,565 (4.7 %) and 25,886 (1.7 %) episodes of first hospitalization for HF among those with and without T2DM, respectively. In patients with incident T2DM we found that hypertension (HR 8.59; 95 % CI 7.41 – 9.96), atrial fibrillation (HR 2.30; 95 % CI 2.15 – 2.45) and ischemic heart disease (HR 1.61; 95 %CI 1.50 – 1.72) were the main predictors of first hospitalization for HF. Chronic kidney disease, age, male sex, obesity, dyslipidemia, and global comorbidity, also contributed to the risk of incident heart failure.
Conclusions
Incidence of first hospitalization for HF in patients newly diagnosed with T2DM, attended in primary care is three-fold higher than in those without T2DM. This Incidence remains stable in spite of new therapeutic approaches.
{"title":"Incidence of first hospitalization for heart failure in type 2 diabetes mellitus: A population-based cohort study in primary care","authors":"Miguel-Angel Muñoz , Victoria Cendrós , Elena Navas , Jose-Maria Verdú-Rotellar , Joan Barrot , Josep Franch","doi":"10.1016/j.pcd.2025.07.009","DOIUrl":"10.1016/j.pcd.2025.07.009","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyse the incidence of first hospitalization for heart failure (HF) in a cohort of patients newly diagnosed with type 2 diabetes mellitus (T2DM) compared with those without T2DM, attended in primary care.</div></div><div><h3>Participants</h3><div>Retrospective cohort study including both the entire adult population of Catalonia who developed T2DM (N = 518,232), and three paired controls for each of them (N = 1503,812), followed between January 2010 and December 2023. Patients’ characteristics and diagnostics were drawn from the System for the Development of Research in Primary Care (SIDIAP) database. Information on the first hospitalization was obtained from the hospital discharge database (CMBD).</div><div>Primary and secondary outcome measures</div><div>We analysed the incidence of first hospitalization for HF.</div></div><div><h3>Results</h3><div>Over the 13-year period of the study, there were 24,565 (4.7 %) and 25,886 (1.7 %) episodes of first hospitalization for HF among those with and without T2DM, respectively. In patients with incident T2DM we found that hypertension (HR 8.59; 95 % CI 7.41 – 9.96), atrial fibrillation (HR 2.30; 95 % CI 2.15 – 2.45) and ischemic heart disease (HR 1.61; 95 %CI 1.50 – 1.72) were the main predictors of first hospitalization for HF. Chronic kidney disease, age, male sex, obesity, dyslipidemia, and global comorbidity, also contributed to the risk of incident heart failure.</div></div><div><h3>Conclusions</h3><div>Incidence of first hospitalization for HF in patients newly diagnosed with T2DM, attended in primary care is three-fold higher than in those without T2DM. This Incidence remains stable in spite of new therapeutic approaches.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 471-477"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791065","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 : 2025-10-01Epub Date: 2025-06-11DOI: 10.1016/j.pcd.2025.06.001
Dalia Al-Abdulrazzaq , Mohammed T. Hudda , Doaa Khalifa Hussein , Hessa Alkandari
Introduction
This study aimed to determine prevalence of Familial FT1D children in type 1 diabetes in Kuwait and compare their characteristics at time of diagnosis including clinical phenotype, and biochemical/immunological profile in comparison to children with non-familial type 1 diabetes (NFT1D).
Methods
This is a population-based observational study of children registered in the Kuwait Childhood-Onset Diabetes electronic Registry (CODeR) between 2011 and 2022 at the time of T1D diagnosis. FT1D was defined as those reporting a first-degree relative with T1D.
Results
Out of 3494 diagnosed with T1D, 391 (11.2 %) had FT1D. The most common first degree relative affected were siblings (5.2 %). Children with FT1D had 49.6 % lower odds of presenting with DKA (p-value<0.001) and 33.4 % lower odds of PICU admission (p = 0.044). Levels of HbA1c were higher and C-peptides lower amongst children with FT1D (both p < 0.001). Children born to a mother with T1D had lower HbA1C (p < 0.001). Children with siblings with T1D lower odds of IAA (p = 0.003).
Conclusion
Children with FT1D in Kuwait had less likelihood of decompensation with a different pancreatic autoimmune profile according to the first degree relative in comparison to the literature. Future studies are required to study the course and outcomes of the disease in children with FT1D.
{"title":"Are children with familial type 1 diabetes from Kuwait different? Report on prevalence, clinical, biochemical, and immunological characteristics","authors":"Dalia Al-Abdulrazzaq , Mohammed T. Hudda , Doaa Khalifa Hussein , Hessa Alkandari","doi":"10.1016/j.pcd.2025.06.001","DOIUrl":"10.1016/j.pcd.2025.06.001","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to determine prevalence of Familial FT1D children in type 1 diabetes in Kuwait and compare their characteristics at time of diagnosis including clinical phenotype, and biochemical/immunological profile in comparison to children with non-familial type 1 diabetes (NFT1D).</div></div><div><h3>Methods</h3><div>This is a population-based observational study of children registered in the Kuwait Childhood-Onset Diabetes electronic Registry (CODeR) between 2011 and 2022 at the time of T1D diagnosis. FT1D was defined as those reporting a first-degree relative with T1D.</div></div><div><h3>Results</h3><div>Out of 3494 diagnosed with T1D, 391 (11.2 %) had FT1D. The most common first degree relative affected were siblings (5.2 %). Children with FT1D had 49.6 % lower odds of presenting with DKA (p-value<0.001) and 33.4 % lower odds of PICU admission (p = 0.044). Levels of HbA1c were higher and C-peptides lower amongst children with FT1D (both p < 0.001). Children born to a mother with T1D had lower HbA1C (p < 0.001). Children with siblings with T1D lower odds of IAA (p = 0.003).</div></div><div><h3>Conclusion</h3><div>Children with FT1D in Kuwait had less likelihood of decompensation with a different pancreatic autoimmune profile according to the first degree relative in comparison to the literature. Future studies are required to study the course and outcomes of the disease in children with FT1D.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 533-539"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287687","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 : 2025-10-01Epub 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":"2025-10-01","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 : 2025-10-01Epub Date: 2025-07-15DOI: 10.1016/j.pcd.2025.06.003
Mike Stedman , Mark Davies , Adam Robinson , John Warner-Levy , Martin Whyte , Martin Gibson , Ritwika Mallik , Adrian Heald
Aims
Public Health England mortality data shows that most deaths are associated with underlying longer-term health issues and could potentially be mitigated by more effective preventive and planned healthcare. General practitioner practices (GPPs) are the provider and gatekeeper to most NHS healthcare services and there are no direct publications of deaths at GPP level Our aim here was to determine how estimated mortality rate at GPP level may associate with the effectiveness of local services in delivering healthcare outcomes.
Methods
We used Office of National Statistics (ONS) data for January 2018-January 2020 (inclusive). From this an estimated Age Standardised Mortality Rate (SMR) for that Layer Super Output Areas (LSOA) was calculated. A linear link between local LSOA SMR and IMD was established so that the SMR_D could be calculated which assumes the practice was at median deprivation.
Risk Factors that were then included into the Analysis these included: demographic, medical conditions, local use of preventive Medication (prescriptions) and impact of local area health services, including diabetes. Stepwise (removing factors with p value > 0.05) multifactorial linear regression was applied to derive the impact of these factors on the SMR_D
Results
The analysis covered 5792 GPP where all the data was available, and where more than 2000 patients were on the practice list. There were 22 factors taken into consideration for the model, of which 17 remained significant. If all practices achieved at least the median level there might be as many as 30,000 (7 %) fewer deaths/year. IMD even after adjustment within the LSOA SMR continued to have a strong effect. The association of Cancer QOF registration rates was associated with a lower mortality rate. A higher rate of diabetes case identification did not associate with reduced mortality rate, rather with higher mortality rate. Practice size was not a factor. Practices with higher percentage of older patients had relative lower mortality rates as did those with higher rates of antihypertensive prescribing.
Conclusions
We here describe associations that suggest that there are underlying themes to understanding the drivers to mortality in England. Our model can be applied to local practices to highlight those that have the largest gap. The association of general practice percentage identification of diabetes cases with increased practice mortality rate likely relates to the reality of type 2 diabetes being associated with many other conditions that can shorten life. The association of higher rates of prescription of antihypertensive agents in individuals over 65 years old with lower practice mortality, highlights the importance of effective identification and effective treatment of hypertension in this group.
{"title":"The Influence of Local Service Configuration on All-Cause Mortality: An Age- and Sex-Standardised Analysis","authors":"Mike Stedman , Mark Davies , Adam Robinson , John Warner-Levy , Martin Whyte , Martin Gibson , Ritwika Mallik , Adrian Heald","doi":"10.1016/j.pcd.2025.06.003","DOIUrl":"10.1016/j.pcd.2025.06.003","url":null,"abstract":"<div><h3>Aims</h3><div>Public Health England mortality data shows that most deaths are associated with underlying longer-term health issues and could potentially be mitigated by more effective preventive and planned healthcare. General practitioner practices (GPPs) are the provider and gatekeeper to most NHS healthcare services and there are no direct publications of deaths at GPP level Our aim here was to determine how estimated mortality rate at GPP level may associate with the effectiveness of local services in delivering healthcare outcomes.</div></div><div><h3>Methods</h3><div>We used Office of National Statistics (ONS) data for January 2018-January 2020 (inclusive). From this an estimated Age Standardised Mortality Rate (SMR) for that Layer Super Output Areas (LSOA) was calculated. A linear link between local LSOA SMR and IMD was established so that the SMR_D could be calculated which assumes the practice was at median deprivation.</div><div>Risk Factors that were then included into the Analysis these included: demographic, medical conditions, local use of preventive Medication (prescriptions) and impact of local area health services, including diabetes. Stepwise (removing factors with p value > 0.05) multifactorial linear regression was applied to derive the impact of these factors on the SMR_D</div></div><div><h3>Results</h3><div>The analysis covered 5792 GPP where all the data was available, and where more than 2000 patients were on the practice list. There were 22 factors taken into consideration for the model, of which 17 remained significant. If all practices achieved at least the median level there might be as many as 30,000 (7 %) fewer deaths/year. IMD even after adjustment within the LSOA SMR continued to have a strong effect. The association of Cancer QOF registration rates was associated with a lower mortality rate. A higher rate of diabetes case identification did not associate with reduced mortality rate, rather with higher mortality rate. Practice size was not a factor. Practices with higher percentage of older patients had relative lower mortality rates as did those with higher rates of antihypertensive prescribing.</div></div><div><h3>Conclusions</h3><div>We here describe associations that suggest that there are underlying themes to understanding the drivers to mortality in England. Our model can be applied to local practices to highlight those that have the largest gap. The association of general practice percentage identification of diabetes cases with increased practice mortality rate likely relates to the reality of type 2 diabetes being associated with many other conditions that can shorten life. The association of higher rates of prescription of antihypertensive agents in individuals over 65 years old with lower practice mortality, highlights the importance of effective identification and effective treatment of hypertension in this group.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 540-544"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651676","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 : 2025-10-01Epub Date: 2025-06-13DOI: 10.1016/j.pcd.2025.06.002
Ivan Berlin , Romain Guignard , Sandrine Fosse-Edorh , Guillemette Quatremère , Emmanuel Lahaie , Viêt Nguyen-Thanh
Aims
To evaluate the prevalence of tobacco smoking, electronic cigarette, alcohol and cannabis use among individuals diagnosed with diabetes mellitus (wD) compared to those who were not (woD).
Methods
Data of the French Health Barometer 2021 were analyzed.
Results
A total of 24,496 individuals completed the survey; of whom 1772 (8.0 %) reported living with diabetes. There were significantly fewer smokers among individuals wD (22.1 % vs. 30.6 %), but more former and fewer never smokers. Smoking more than 15 cigarettes/day was more common among those wD and they were more tobacco dependent than those woD. 28.7 % of persons wD and 39.5 % woD reported having already tried electronic cigarettes. Current or daily electronic cigarette use was similar. Among those who had tried e-cigarettes, 5.7 % of respondents wD were never smokers (vs. 10.1 % of those woD). Alcohol consumption and cannabis use were significantly less common among respondents wD than those woD, but the prevalence of daily alcohol consumption was similar.
Conclusions
Although smoking prevalence is lower among persons wD compared to those without, smokers wD smoke more and are more tobacco dependent. Tobacco smoking should be assessed and all smokers wD should be enrolled in a smoking cessation program. More data are needed regarding other substance use and its association with diabetes characteristics and self-management.
目的：评估被诊断为糖尿病（wD）的个体与未被诊断为糖尿病（wD）的个体相比，吸烟、电子烟、酒精和大麻使用的流行程度。方法：对法国健康晴雨表2021的数据进行分析。结果：共有24496人完成调查；其中1772人（8.0 %）报告患有糖尿病。在wD个体中，吸烟者明显减少（22.1% % vs. 30.6% %），但吸烟者较多，从不吸烟者较少。d组每天吸烟超过15支更为普遍，他们比d组更依赖烟草。28.7% %的wD和39.5% %的wD报告已经尝试过电子烟。目前或每天使用电子烟的情况相似。在那些尝试过电子烟的人中，5.7% %的wD受访者从未吸烟（10.1% %的wD受访者从未吸烟）。在答复者wD中，酒精消费和大麻使用明显低于wD，但每日酒精消费的流行程度相似。结论：尽管糖尿病患者的吸烟率低于非糖尿病患者，但糖尿病吸烟者吸烟更多，更依赖烟草。应该对吸烟进行评估，所有吸烟者都应该参加戒烟计划。需要更多关于其他物质使用及其与糖尿病特征和自我管理的关系的数据。
{"title":"Tobacco, electronic cigarette, alcohol and cannabis use among individuals diagnosed with diabetes. A national survey in France","authors":"Ivan Berlin , Romain Guignard , Sandrine Fosse-Edorh , Guillemette Quatremère , Emmanuel Lahaie , Viêt Nguyen-Thanh","doi":"10.1016/j.pcd.2025.06.002","DOIUrl":"10.1016/j.pcd.2025.06.002","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the prevalence of tobacco smoking, electronic cigarette, alcohol and cannabis use among individuals diagnosed with diabetes mellitus (wD) compared to those who were not (woD).</div></div><div><h3>Methods</h3><div>Data of the French Health Barometer 2021 were analyzed.</div></div><div><h3>Results</h3><div>A total of 24,496 individuals completed the survey; of whom 1772 (8.0 %) reported living with diabetes. There were significantly fewer smokers among individuals wD (22.1 % vs. 30.6 %), but more former and fewer never smokers. Smoking more than 15 cigarettes/day was more common among those wD and they were more tobacco dependent than those woD. 28.7 % of persons wD and 39.5 % woD reported having already tried electronic cigarettes. Current or daily electronic cigarette use was similar. Among those who had tried e-cigarettes, 5.7 % of respondents wD were never smokers (vs. 10.1 % of those woD). Alcohol consumption and cannabis use were significantly less common among respondents wD than those woD, but the prevalence of daily alcohol consumption was similar.</div></div><div><h3>Conclusions</h3><div>Although smoking prevalence is lower among persons wD compared to those without, smokers wD smoke more and are more tobacco dependent. Tobacco smoking should be assessed and all smokers wD should be enrolled in a smoking cessation program. More data are needed regarding other substance use and its association with diabetes characteristics and self-management.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 478-485"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295539","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 : 2025-10-01Epub 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":"2025-10-01","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 : 2025-10-01Epub Date: 2025-07-22DOI: 10.1016/j.pcd.2025.07.004
Farnaz Khatami , Pien Rawee , Vlada Hanchar , Martin H. de Borst , Stephan J.L. Bakker , Milton Severo , Henrique Barros , Michele F. Eisenga , Taulant Muka , Pedro Marques-Vidal
Aims
We investigated whether adding iron biomarkers into existing type 2 diabetes risk models improves risk prediction.
Methods
Data from three population-based cohorts were used; CoLaus|PsyCoLaus in Switzerland (5250 participants, 54.9 % females, mean age± standard deviation 51.8 ± 10.5 years, median follow-up of 14.5 years; PREVEND in the Netherlands (4784 participants, 51.8 % females, 52.2 ± 11.5 years, follow-up 7.3 years); and EPIPorto in Portugal (806 participants, 40 % females, 62 ± 13 years, follow-up 7.8 years). The effect of adding iron, ferritin, and transferrin in seven type 2 diabetes risk models was examined.
Results
486 participants (9.3 %) in the CoLaus|PsyCoLaus, 170 (3.6 %) in PREVEND, and 22 (3.4 %) in EPIPorto developed diabetes. There was a substantial association between type 2 diabetes and all risk scores. In the CoLaus|PsyCoLaus and PREVEND, ferritin levels were positively and independently associated with the incidence of diabetes and considerably enhanced its prediction. Transferrin levels were positively and independently associated with the incidence of diabetes across all risk scores in all cohorts and improved its prediction in PREVEND, EpiPorto, and certain risk models in CoLaus|PsyCoLaus. There was found to be no association between iron levels and type 2 diabetes.
Conclusions
Adding ferritin or transferrin slightly improved most diabetes risk prediction models.
{"title":"The role of iron biomarkers in predicting type 2 Diabetes: An international, multi-cohort Study","authors":"Farnaz Khatami , Pien Rawee , Vlada Hanchar , Martin H. de Borst , Stephan J.L. Bakker , Milton Severo , Henrique Barros , Michele F. Eisenga , Taulant Muka , Pedro Marques-Vidal","doi":"10.1016/j.pcd.2025.07.004","DOIUrl":"10.1016/j.pcd.2025.07.004","url":null,"abstract":"<div><h3>Aims</h3><div>We investigated whether adding iron biomarkers into existing type 2 diabetes risk models improves risk prediction.</div></div><div><h3>Methods</h3><div>Data from three population-based cohorts were used; CoLaus|PsyCoLaus in Switzerland (5250 participants, 54.9 % females, mean age± standard deviation 51.8 ± 10.5 years, median follow-up of 14.5 years; PREVEND in the Netherlands (4784 participants, 51.8 % females, 52.2 ± 11.5 years, follow-up 7.3 years); and EPIPorto in Portugal (806 participants, 40 % females, 62 ± 13 years, follow-up 7.8 years). The effect of adding iron, ferritin, and transferrin in seven type 2 diabetes risk models was examined.</div></div><div><h3>Results</h3><div>486 participants (9.3 %) in the CoLaus|PsyCoLaus, 170 (3.6 %) in PREVEND, and 22 (3.4 %) in EPIPorto developed diabetes. There was a substantial association between type 2 diabetes and all risk scores. In the CoLaus|PsyCoLaus and PREVEND, ferritin levels were positively and independently associated with the incidence of diabetes and considerably enhanced its prediction. Transferrin levels were positively and independently associated with the incidence of diabetes across all risk scores in all cohorts and improved its prediction in PREVEND, EpiPorto, and certain risk models in CoLaus|PsyCoLaus. There was found to be no association between iron levels and type 2 diabetes.</div></div><div><h3>Conclusions</h3><div>Adding ferritin or transferrin slightly improved most diabetes risk prediction models.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 462-470"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700756","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}
Diabetic sensorimotor peripheral neuropathy causes patients to have foot injuries without realizing it. This condition may progress to diabetic foot ulcer; infections can include osteomyelitis and lower limb amputations. Managing diabetes and screening diabetic neuropathy is crucial to reducing patient mortality, quality of life, functionality, and the cost burden of complications to the healthcare system. We aim to contribute to the literature by comparing diagnostic methods and examining parameters that can predict neuropathy early.
Material and methods
A total of 108 patients with a neuropathy score Douleur Neuropathique-4 (DN-4) above 4, 54 with known diabetes, and 54 with prediabetes were included. Fasting plasma glucose, oral glucose tolerance test, hemoglobin A1c (HbA1c), LDL-cholesterol, HDL-cholesterol, triglyceride, uric acid, vitamin B12, folic acid, creatinine, and complete urinalysis was performed on 108 patients included. Afterward, a monofilament test, tuning fork test, and electromyography were performed by the neurologist to prove neuropathy.
Results
The frequency of neuropathy in the prediabetes group was found to be 0.40 ± 0.49 % using EMG. This rate is 0.71 ± 0.45 % for diabetic neuropathy. The difference is statistically significant (p = 0.001) in the prediabetic group, the neuropathy score (DN-4 score) was 5.1 ± 0.9, the tuning fork test positivity was 0.18 ± 0.39, and p = 0.001 was statistically significant compared to the diabetic group. Also, in the monofilament test, the rate of neuropathy in the prediabetes group was again statistically significant with 0.68 ± 0.47 (p = 0.027). Total cholesterol (185.1 ± 21.8, p = 0.003), high uric acid (5.11 ± 1.27, p = 0.003), and low folic acid (4.5 ± 1.05, p = 0.026) are found to be statistically significant between diabetic and prediabetic groups.
Discussion and conclusion
In diagnosing neuropathy, monofilament, and diapason testing can be used in the clinical setting, and they have been found to be successful tests in the diagnosis of neuropathy. Also, our analysis indicates the relationship between low folic acid, high total cholesterol/uric acid levels, and prediabetic neuropathy. The role of intervening blood levels of those factors with medications in preventing neuropathy is unclear. We recommend further investigating all the patient’s dietary habits to find possible risk factors, as well as investigating patients with low folic acid and high total cholesterol/ uric acid levels much more cautiously.
Recommendation
Neuropathy should be screened in prediabetic and diabetic patients, and possible risk factors should be assessed periodically.
{"title":"The frequency of neuropathy and predictive parameters in prediabetic cases from Turkiye","authors":"Baris Emekdas , Canan Celebi , Batuhan Cakmak , Soner Duman , Ilgin Yildirim Simsir","doi":"10.1016/j.pcd.2025.05.007","DOIUrl":"10.1016/j.pcd.2025.05.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetic sensorimotor peripheral neuropathy causes patients to have foot injuries without realizing it. This condition may progress to diabetic foot ulcer; infections can include osteomyelitis and lower limb amputations. Managing diabetes and screening diabetic neuropathy is crucial to reducing patient mortality, quality of life, functionality, and the cost burden of complications to the healthcare system. We aim to contribute to the literature by comparing diagnostic methods and examining parameters that can predict neuropathy early.</div></div><div><h3>Material and methods</h3><div>A total of 108 patients with a neuropathy score Douleur Neuropathique-4 (DN-4) above 4, 54 with known diabetes, and 54 with prediabetes were included. Fasting plasma glucose, oral glucose tolerance test, hemoglobin A1c (HbA1c), LDL-cholesterol, HDL-cholesterol, triglyceride, uric acid, vitamin B12, folic acid, creatinine, and complete urinalysis was performed on 108 patients included. Afterward, a monofilament test, tuning fork test, and electromyography were performed by the neurologist to prove neuropathy.</div></div><div><h3>Results</h3><div>The frequency of neuropathy in the prediabetes group was found to be 0.40 ± 0.49 % using EMG. This rate is 0.71 ± 0.45 % for diabetic neuropathy. The difference is statistically significant (p = 0.001) in the prediabetic group, the neuropathy score (DN-4 score) was 5.1 ± 0.9, the tuning fork test positivity was 0.18 ± 0.39, and p = 0.001 was statistically significant compared to the diabetic group. Also, in the monofilament test, the rate of neuropathy in the prediabetes group was again statistically significant with 0.68 ± 0.47 (p = 0.027). Total cholesterol (185.1 ± 21.8, p = 0.003), high uric acid (5.11 ± 1.27, p = 0.003), and low folic acid (4.5 ± 1.05, p = 0.026) are found to be statistically significant between diabetic and prediabetic groups.</div></div><div><h3>Discussion and conclusion</h3><div>In diagnosing neuropathy, monofilament, and diapason testing can be used in the clinical setting, and they have been found to be successful tests in the diagnosis of neuropathy. Also, our analysis indicates the relationship between low folic acid, high total cholesterol/uric acid levels, and prediabetic neuropathy. The role of intervening blood levels of those factors with medications in preventing neuropathy is unclear. We recommend further investigating all the patient’s dietary habits to find possible risk factors, as well as investigating patients with low folic acid and high total cholesterol/ uric acid levels much more cautiously.</div></div><div><h3>Recommendation</h3><div>Neuropathy should be screened in prediabetic and diabetic patients, and possible risk factors should be assessed periodically.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 400-404"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096113","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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