Primary Care Diabetes最新文献

英文中文

The association between Ramadan, pre-Ramadan diabetes education (PRE) and metabolic parameters in people with type 2 diabetes: A longitudinal study using routine primary care data 2型糖尿病患者斋月、斋月前糖尿病教育（PRE）与代谢参数之间的关系：一项使用常规初级保健数据的纵向研究

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-05-05 DOI: 10.1016/j.pcd.2025.04.002

Siham Bouchareb , Peter P. Harms , Mohamed Hassanein , Giel Nijpels , Petra J.M. Elders

Aims

To assess the impact of Ramadan and pre-Ramadan diabetes education (PRE) on metabolic parameters in people with type 2 diabetes (T2D). Additionally, we described the proportion of Ramadan-related adverse events.

Methods

A retrospective longitudinal study utilising Dutch routine primary care data from 133 people with T2D who participated in a PRE session. Linear Generalized Estimating Equations models were used to assess the association of metabolic parameters with Ramadan and PRE. We analysed free-text notes and a questionnaire to identify Ramadan-related adverse events.

Results

Ramadan was associated with modest reductions in HbA1c (β −1.07 mmol/mol; p = 0.07), systolic blood pressure (β −1.89 mmHg; p = 0.04), weight (β −0.81 kg; p < 0.01), BMI (β −0.29 kg/m²; p < 0.01), and a slight increase in triglycerides (β 0.27 mmol/l; p = 0.04) compared to non-Ramadan periods. PRE demonstrated no significant impact on metabolic parameters. The number of medical notes regarding Ramadan was small, with the mentioning of some physical complaints and medication errors.

Conclusions

In our study, Ramadan is associated with temporary and marginal metabolic improvements in people with T2D. A single PRE session had no substantial impact on metabolic control. Healthcare professionals should more often discuss Ramadan and medication adjustments with their patients.

目的：评估斋月及斋月前糖尿病教育（PRE）对2型糖尿病（T2D）患者代谢参数的影响。此外，我们描述了斋月相关不良事件的比例。方法：一项回顾性纵向研究，利用荷兰常规初级保健数据，来自133名参加PRE会议的T2D患者。使用线性广义估计方程模型评估代谢参数与斋月和PRE的关系。我们分析了自由文本注释和问卷调查，以确定斋月相关的不良事件。结果：斋月与HbA1c适度降低相关(β -1.07 mmol/mol；p = 0.07)，收缩压(β -1.89 mmHg；P = 0.04)，体重(β -0.81 kg；p 2;p 结论：在我们的研究中，斋月与T2D患者的暂时和边际代谢改善有关。单次PRE训练对代谢控制没有实质性影响。医疗保健专业人员应该更经常地与患者讨论斋月和药物调整。

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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 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-06-25 DOI: 10.1016/S1751-9918(25)00120-2

引用次数: 0

Evaluating risk stratification according to Type 2 diabetes guidelines in primary care – Insights from the Danish DIAGRAM project 根据初级保健2型糖尿病指南评估风险分层——来自丹麦图表项目的见解。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-05-07 DOI: 10.1016/j.pcd.2025.05.002

Morten H. Charles , Karoline Schousboe , Tanja Thybo , Esben Krogh Hall-Andersen , Søren Tang Knudsen

Aims

To evaluate how Danish General Practitioners (GPs) apply Type 2 diabetes guideline recommendations for risk stratification and management across patient subgroups defined by existing chronic kidney disease (CKD), heart failure (HF), cardiovascular disease (CVD), or elevated risk of incident CVD.

Methods

131 GPs responded to a questionnaire on guideline usage and reviewed randomised patient electronic medical records (EMRs), noting demographics, treatment, comorbidities, and presence of six prespecified CVD risk factors. Patients without comorbidities but with ≥ 3 risk factors were deemed at Higher CVD Risk. When missing data prevented allocation to risk groups, CVD risk was Undefined.

Results

Of 1964 EMRs meeting inclusion criteria, 641 (33 %) had ≥ 1 cardiorenal comorbidity. Of 1307 without comorbidities, 513 (26 %) were at Higher CVD Risk; risk was Undefined for 668 (34 %). Organ-protective antihyperglycaemic agents were used in 1114/1964 (57 %), and more frequently (61–68 %) across comorbidity subgroups, while CVD risk group status did not correlate with guideline-directed organ-protective treatment. Finally, whereas GPs allocated 379 (19 %) patients to CKD, 596 (30 %) EMRs included laboratory data suggesting presence of CKD.

Conclusions

Organ-protective treatment patterns suggest that GPs distinguish patients by comorbidity status but find guideline-defined CVD risk challenging to apply. Additionally, CKD may be underdiagnosed in T2D patients.

目的：评估丹麦全科医生（gp）如何应用2型糖尿病指南建议，对现有慢性肾脏疾病（CKD）、心力衰竭（HF）、心血管疾病（CVD）或心血管疾病发生率升高的患者亚组进行风险分层和管理。方法：131名全科医生回答了一份关于指南使用的问卷，并回顾了随机患者电子病历（emr），注意到人口统计学、治疗、合并症和六种预先指定的心血管疾病危险因素的存在。无合并症但危险因素≥ 3的患者被认为是高CVD风险。当缺少数据无法分配给风险组时，CVD风险为未定义。结果：在符合纳入标准的1964例emr中，641例（33 %）有≥ 1例心肾合并症。在1307名无合并症的患者中，513名（26% %）心血管疾病风险较高；668例（34% %）风险未确定。在1114/1964中（57 %）使用了器官保护抗高血糖药物，在合并症亚组中使用的频率更高（61-68 %），而CVD危险组状态与指南指导的器官保护治疗无关。最后，尽管全科医生将379例（19% %）患者分配为CKD，但596例（30 %）emr包含提示CKD存在的实验室数据。结论：器官保护治疗模式提示全科医生根据合并症状况区分患者，但发现指南定义的心血管疾病风险难以应用。此外，慢性肾病在T2D患者中可能未被充分诊断。

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Using glucometers to assess lifestyle-mediated prediabetes remission in health examinations for students and workers 使用血糖仪评估学生和工人健康检查中生活方式介导的前驱糖尿病缓解。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-05-27 DOI: 10.1016/j.pcd.2025.05.008

Olaf Chresten Jensen , Nailet Delgado Mujica , Bishal Gyawali , Finn Gyntelberg

One-third to one-half of seafarers and other transport workers have prediabetes. The initiative described herein aims to incorporate glucometer tests into the routine health examinations and offers a structured 16-week intervention plan. Gold-standard diagnostic techniques such as A1c testing are often excluded from routine health examinations, which leads to missed opportunities to prevent diabetes. Using affordable glucometer technology, by comparison, would enable early diagnosis and the initiation of prediabetes remission coaching programmes. Regularly monitoring fitness and dietary health plans, along with the self-monitoring of blood glucose, is both feasible and beneficial for long-term health management.

三分之一到一半的海员和其他运输工人患有前驱糖尿病。本文所述的倡议旨在将血糖仪测试纳入常规健康检查，并提供一个结构化的16周干预计划。糖化血红蛋白检测等金标准诊断技术经常被排除在常规健康检查之外，这导致错过了预防糖尿病的机会。相比之下，使用负担得起的血糖仪技术将有助于早期诊断和启动糖尿病前期缓解指导计划。定期监测健身和饮食健康计划，以及自我监测血糖，对长期健康管理既可行又有益。

引用次数: 0

The association between ethnicity and complications in individuals with early-onset type 2 diabetes: A systematic review 早发性2型糖尿病患者的种族与并发症之间的关系：一项系统综述

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-05-14 DOI: 10.1016/j.pcd.2025.05.006

Jonathan Goldney , Eka Melson , Ansh Verma , Kamlesh Khunti , Francesco Zaccardi , Melanie J. Davies , Samuel Seidu

It remains unclear whether the prevalence and incidence of complications varies with ethnicity in individuals with early-onset type 2 diabetes. We undertook a systematic review to investigate. We identified sparse published data, with no clear findings. More prospective studies are needed. Epidemiological studies should routinely stratify by ethnicity.

目前尚不清楚早发性2型糖尿病患者并发症的患病率和发生率是否因种族而异。我们进行了系统的调查。我们确定了稀疏的已发表数据，没有明确的发现。需要更多的前瞻性研究。流行病学研究应按常规按种族分层。

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The German Diabetes Risk Score (GDRS) in action: Bridging risk stratification with cognitive behavioral lifestyle counseling 德国糖尿病风险评分（GDRS）在行动：连接风险分层与认知行为生活方式咨询。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-05-24 DOI: 10.1016/j.pcd.2025.05.009

Riza Amalia, Ronal Surya Aditya, Rizka Apriani, Salmiati

Type 2 diabetes mellitus is a growing global health challenge, particularly in low- and middle-income countries. The recent study by Seidel-Jacobs et al. highlights the effectiveness of the German Diabetes Risk Score (GDRS) in enhancing lifestyle counseling and shared decision-making in primary care. This letter emphasizes the importance of integrating risk assessment tools with cognitive behavioral therapy (CBT) approaches in counseling to address both behavior and the underlying negative thought patterns that contribute to diabetes risk. Adapting such models to diverse populations, especially in regions like Southeast Asia, could improve early intervention and diabetes prevention efforts globally.

2型糖尿病是一个日益严重的全球健康挑战，特别是在低收入和中等收入国家。Seidel-Jacobs等人最近的研究强调了德国糖尿病风险评分（GDRS）在加强初级保健生活方式咨询和共同决策方面的有效性。这封信强调了将风险评估工具与认知行为疗法（CBT）方法整合在咨询中的重要性，以解决导致糖尿病风险的行为和潜在的消极思维模式。将这些模式适用于不同的人群，特别是东南亚等地区，可以改善全球的早期干预和糖尿病预防工作。

引用次数: 0

Impact on diabetes-related health outcomes using a digitally-enabled diabetes self-management platform in Somerset, UK: An interrupted time-series analysis 在英国萨默塞特使用数字化糖尿病自我管理平台对糖尿病相关健康结果的影响：中断时间序列分析。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-05-14 DOI: 10.1016/j.pcd.2025.05.003

Mats Baxter , Nicholas Conway , Alex Bickerton , Scott Cunningham , Scott C. MacKenzie , Jane Dickson , Doogie Brodie , Christopher Sainsbury , Deborah J. Wake

Background

The MyWay Diabetes (MWD) digital platform aims to improve diabetes management through personalised access to health records, structured education, and other self-management features.

Purpose

We aimed to assess health outcomes in MWD users with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) over 6 years of use.

Methods

An interrupted time-series analysis in MWD users with T1DM or T2DM in Somerset, UK, compared pre- and post-MWD registration trends to estimate differences in health outcomes (HbA1c, blood pressure, lipids, BMI, weight). Generalised estimating equations modelling adjusted for participant baseline characteristics and identified significant predictors.

Results

A total of 7207 people (T1DM: n = 750 (52.3 % female, mean age 51.2 (SD15.8)), T2DM: n = 6457 (58.1 % male, mean age 64.7 (SD12.0))) were included in the analysis. The study showed some health outcomes improved significantly for T2DM between pre- and post-MWD registration. HbA1c reduced by 8.6 mmol/mol at 24 months post-MWD registration, with greatest improvements observed in users who were younger, had shorter diabetes durations and who were frequent MWD users. All health outcomes for T1DM were unchanged.

Conclusion

The large HbA1c reduction for T2DM is notable for a scalable digitally-enabled self-management intervention and adds to the evidence base for digital interventions for diabetes self-management.

背景：MyWay Diabetes （MWD）数字平台旨在通过个性化访问健康记录、结构化教育和其他自我管理功能来改善糖尿病管理。目的：我们旨在评估合并1型糖尿病（T1DM）和2型糖尿病（T2DM）的MWD使用者使用6年以上的健康结果。方法：对英国萨默塞特（Somerset）患有1型糖尿病或2型糖尿病的MWD患者进行中断时间序列分析，比较MWD前后登记趋势，以估计健康结局（HbA1c、血压、血脂、BMI、体重）的差异。广义估计方程模型调整了参与者基线特征并确定了重要的预测因子。结果：共纳入7207人(T1DM: n = 750（女性52.3 %，平均年龄51.2 （SD15.8)）， T2DM: n = 6457（男性58.1 %，平均年龄64.7 (SD12.0)））。研究显示，在mwd登记前后，T2DM患者的一些健康结果显著改善。在MWD登记后24个月，HbA1c降低了8.6 mmol/mol，在年轻、糖尿病持续时间较短和频繁使用MWD的用户中观察到最大的改善。T1DM的所有健康结果没有变化。结论：T2DM患者HbA1c的大幅降低对于可扩展的数字化自我管理干预是值得注意的，并为数字化糖尿病自我管理干预提供了证据基础。

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引用次数: 0

Back Matter 2 : Society News 时事2：社会新闻

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-06-25 DOI: 10.1016/S1751-9918(25)00126-3

引用次数: 0

Effectiveness of AI-driven interventions in glycemic control: A systematic review and meta-analysis of randomized controlled trials 人工智能驱动的血糖控制干预措施的有效性：随机对照试验的系统回顾和荟萃分析。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-05-12 DOI: 10.1016/j.pcd.2025.05.004

Khadija Elmotia, Oumaima Abouyaala, Soukaina Bougrine, Moulay Laarbi Ouahidi

This systematic review aims to assess the effectiveness of AI-Driven Decision Support Systems in improving glycemic control, measured by Time in Range (TIR) and HbA1c levels, in patients with diabetes. Included studies were randomized controlled trials (RCTs) that evaluated AI interventions in diabetes management. Exclusion criteria included non-English studies, non-peer-reviewed articles. Studies were identified by searching electronic databases including PubMed, EMBASE, and Cochrane Library up to December 2024. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs. Results were synthesized using a random-effects meta-analysis model. The review included 17 RCTs with a total of 3381 participants in the intervention group and 3176 in the control group. AI interventions were found to significantly improve TIR and reduce HbA1c levels. The meta-analysis for TIR yielded a mean difference of 0.54 (95 % CI: 0.05–1.03), and for HbA1c a standardized mean difference of –0.91 (95 % CI: –1.23 to –0.58). Evidence was limited by high heterogeneity (I² > 90 % for both outcomes) and indications of publication bias, which may overestimate the effectiveness reported. Despite limitations, the results support the potential of AI interventions in enhancing diabetes management, though variability in effectiveness suggests the need for personalized approaches.

本系统综述旨在评估人工智能驱动的决策支持系统在改善糖尿病患者血糖控制方面的有效性，通过时间范围（TIR）和HbA1c水平来衡量。纳入的研究是评估人工智能干预糖尿病管理的随机对照试验（rct）。排除标准包括非英语研究、非同行评议的文章。通过检索PubMed、EMBASE和Cochrane Library等电子数据库确定研究截止到2024年12月。使用Cochrane rct偏倚风险工具评估偏倚风险。结果采用随机效应荟萃分析模型进行综合。本综述纳入17项随机对照试验，干预组共3381名参与者，对照组3176名参与者。人工智能干预可显著改善TIR并降低HbA1c水平。TIR的荟萃分析得出的平均差异为0.54(95 % CI: 0.05-1.03)， HbA1c的标准化平均差异为-0.91（95 % CI: -1.23至-0.58）。证据受到高度异质性（两种结果均为I²bbb90 %）和发表偏倚指指的限制，这可能高估了报道的有效性。尽管存在局限性，但结果支持人工智能干预在加强糖尿病管理方面的潜力，尽管有效性的可变性表明需要个性化的方法。

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引用次数: 0

Validity and reliability of the Turkish version of the type 1 diabetes distress scale 土耳其版1型糖尿病痛苦量表的效度和信度。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-08-01 Epub Date: 2025-05-06 DOI: 10.1016/j.pcd.2025.05.001

Tuğba Bi̇lgehan , Elif Gençer Şendur , Özlem Canbolat , Emre Dünder , William H. Polonsky

Aims

This study aimed to examine the psychometric properties of the Turkish version of the Type 1 Diabetes Distress Scale

Methods

This methodological, descriptive, and correlational study was conducted with 292 individuals diagnosed with Type 1 diabetes. Data were collected between January 2024 and August 2024 using the "Information Form for Individuals with Diabetes," the "Type 1 Diabetes Distress Scale," and the "Patient Health Questionnaire." The linguistic validity and content validity of the scale were evaluated, with content validity assessed using the Davis technique. The psychometric properties of the scale were analyzed through exploratory and confirmatory factor analyses, internal consistency reliability, test–retest reliability, and parallel-form reliability.

Results

The Turkish version of the Type 1 Diabetes Distress Scale consists of 21 items and two subdimensions (Factor 1: Concerns About Diabetes Management; Factor 2: Social Diabetes Perception and Pressure). The two-factor structure explained 66 % of the total variance. The overall Cronbach’s alpha coefficient for the scale was 0.96. Test–retest reliability analysis revealed a high, positive, and statistically significant correlation (r = 0.995, p < 0.05).

Conclusions

The questionnaire was demonstrated to be a valid and reliable instrument for evaluating diabetes distress in patients with type 1 diabetes.

目的：本研究旨在检验土耳其版1型糖尿病痛苦量表的心理测量特性。方法：本方法学、描述性和相关性研究对292名诊断为1型糖尿病的个体进行了研究。数据收集于2024年1月至2024年8月，使用“糖尿病患者信息表”、“1型糖尿病痛苦量表”和“患者健康问卷”。评估量表的语言效度和内容效度，内容效度采用Davis技术评估。通过探索性因子分析和验证性因子分析、内部一致性信度、重测信度和平行形式信度对量表的心理测量特性进行分析。结果：土耳其版1型糖尿病困扰量表包括21个条目和两个子维度(因素1：对糖尿病管理的担忧；因素2：社会糖尿病认知与压力)。双因素结构解释了66% %的总方差。量表的总体Cronbach's alpha系数为0.96。重测信度分析显示高、正、有统计学意义的相关（r = 0.995,p ）。结论：该问卷是评估1型糖尿病患者糖尿病窘迫的有效、可靠的工具。

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