Yutaka Seino, Daisuke Yabe, Kazuhiro Tsumura, Chien-Ning Huang, So Hun Kim, Weiping Jia, Altaisaikhan Khasag, Takashi Kadowaki
Many Asian countries, including Japan, China, and South Korea, continue to use terms that reference sugar and urine, contributing to ongoing stigma, while most of the rest of the world seem to use terms related to the original “Diabetes,” meaning “to pass through.” The 16th Scientific Meeting of the Asian Association for the Study of Diabetes (AASD) was held, featuring a pivotal joint symposium organized by AASD and the Japanese Association of Diabetes Education and Care where an in-depth discussion was carried out on diabetes-related terminology across various Asian countries and regions, with a particular focus on the stigma associated with existing terms. The symposium participants reached a consensus on the necessity of revising the stigmatizing diabetes terminology across Asia and agreed to continue discussions and monitor progress at the 17th AASD Scientific Meeting, scheduled to be held in 2025.
{"title":"The Ulaanbaatar agreement: Revising diabetes terminology in Asia to combat stigma","authors":"Yutaka Seino, Daisuke Yabe, Kazuhiro Tsumura, Chien-Ning Huang, So Hun Kim, Weiping Jia, Altaisaikhan Khasag, Takashi Kadowaki","doi":"10.1111/jdi.14330","DOIUrl":"10.1111/jdi.14330","url":null,"abstract":"<p>Many Asian countries, including Japan, China, and South Korea, continue to use terms that reference sugar and urine, contributing to ongoing stigma, while most of the rest of the world seem to use terms related to the original “Diabetes,” meaning “to pass through.” The 16th Scientific Meeting of the Asian Association for the Study of Diabetes (AASD) was held, featuring a pivotal joint symposium organized by AASD and the Japanese Association of Diabetes Education and Care where an in-depth discussion was carried out on diabetes-related terminology across various Asian countries and regions, with a particular focus on the stigma associated with existing terms. The symposium participants reached a consensus on the necessity of revising the stigmatizing diabetes terminology across Asia and agreed to continue discussions and monitor progress at the 17th AASD Scientific Meeting, scheduled to be held in 2025.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Imai D, Ushigome E., Sakai R., Kitagawa N., Hamaguchi M., Yamazaki M., Fukui M. Association between variation in hemoglobin A1c levels and diabetes therapy-related quality of life in patients with diabetes. J Diabetes Investig. 2024 Aug;15:1042–1046.
In the Data collection paragraph of the Method, VIM (variability independent of mean) is corrected to be MAD (mean absolute deviation). In addition, the calculation results of ARV were incorrect. The contents of Tables 1 and 2 have been partially revised accordingly.
We apologize for this error.
Imai D、Ushigome E.、Sakai R.、Kitagawa N.、Hamaguchi M.、Yamazaki M.、Fukui M. 糖尿病患者血红蛋白 A1c 水平变化与糖尿病治疗相关生活质量之间的关系。J Diabetes Investig.2024 Aug;15:1042-1046.In the Data collection paragraph of the Method, VIM (variability independent of mean) is corrected to be MAD (mean absolute deviation).此外，ARV 的计算结果有误。表 1 和表 2 的内容也做了相应的部分修改。
{"title":"Correction to “Association between variation in hemoglobin A1c levels and diabetes therapy-related quality of life in patients with diabetes”","authors":"","doi":"10.1111/jdi.14321","DOIUrl":"10.1111/jdi.14321","url":null,"abstract":"<p>Imai D, Ushigome E., Sakai R., Kitagawa N., Hamaguchi M., Yamazaki M., Fukui M. Association between variation in hemoglobin A1c levels and diabetes therapy-related quality of life in patients with diabetes. J Diabetes Investig. 2024 Aug;15:1042–1046.</p><p>In the Data collection paragraph of the Method, VIM (variability independent of mean) is corrected to be MAD (mean absolute deviation). In addition, the calculation results of ARV were incorrect. The contents of Tables 1 and 2 have been partially revised accordingly.</p><p>We apologize for this error.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We aimed to explore the associations between income/employment status and diabetes care processes, health behaviors and health outcomes.
Materials and Methods
This cross-sectional study used health insurance claims data between April 2021 and March 2022, and a questionnaire survey between December 2022 and January 2023 in Tsukuba City. The study analyzed the participants with diabetes (other than type 1) from those selected by stratified random sampling. We evaluated diabetes care processes, health behaviors and health outcomes by calculating weighted proportions among the groups. We also assessed the associations between income/employment status and these variables using multivariable modified Poisson regression models.
Results
Of the 264 identified participants, 161 (64.2%) were men and 168 (72.8%) were aged ≥65 years old. Compared with the low-income groups, the high-income group had a higher proportion of sodium–glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists use (adjusted risk ratio [aRR] 1.70, 95% confidence interval (CI) 1.07–2.72), a higher proportion of attendance to annual health checkups for ≥2 years (aRR 1.68, 95% CI 1.07–2.64) and a lower proportion of all-cause hospitalization (aRR 0.15, 95% CI 0.04–0.48); additionally, the middle-income group had a lower proportion of high total outpatient medical expenses (aRR 0.57, 95% CI 0.35–0.92). Compared to the no work time group, the full-time work group had a lower proportion of exercise habits (aRR 0.59, 95% CI 0.35–0.99) and a higher proportion of good self-reported health (aRR 2.08, 95% CI 1.22–3.55).
Conclusions
Several variables were associated with income/employment status. Policy intervention should focus on high-risk groups identified by considering these associations.
{"title":"Associations between income/employment status and diabetes care processes, health behaviors, and health outcomes in Japan: A cross-sectional study using claims data linked to a questionnaire survey","authors":"Takuya Yamaoka, Takehiro Sugiyama, Noriko Ihana-Sugiyama, Akiko Kimura, Kouko Yamamoto, Kenjiro Imai, Naoaki Kuroda, Mitsuru Ohsugi, Kohjiro Ueki, Toshimasa Yamauchi, Nanako Tamiya","doi":"10.1111/jdi.14301","DOIUrl":"10.1111/jdi.14301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>We aimed to explore the associations between income/employment status and diabetes care processes, health behaviors and health outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This cross-sectional study used health insurance claims data between April 2021 and March 2022, and a questionnaire survey between December 2022 and January 2023 in Tsukuba City. The study analyzed the participants with diabetes (other than type 1) from those selected by stratified random sampling. We evaluated diabetes care processes, health behaviors and health outcomes by calculating weighted proportions among the groups. We also assessed the associations between income/employment status and these variables using multivariable modified Poisson regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 264 identified participants, 161 (64.2%) were men and 168 (72.8%) were aged ≥65 years old. Compared with the low-income groups, the high-income group had a higher proportion of sodium–glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists use (adjusted risk ratio [aRR] 1.70, 95% confidence interval (CI) 1.07–2.72), a higher proportion of attendance to annual health checkups for ≥2 years (aRR 1.68, 95% CI 1.07–2.64) and a lower proportion of all-cause hospitalization (aRR 0.15, 95% CI 0.04–0.48); additionally, the middle-income group had a lower proportion of high total outpatient medical expenses (aRR 0.57, 95% CI 0.35–0.92). Compared to the no work time group, the full-time work group had a lower proportion of exercise habits (aRR 0.59, 95% CI 0.35–0.99) and a higher proportion of good self-reported health (aRR 2.08, 95% CI 1.22–3.55).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Several variables were associated with income/employment status. Policy intervention should focus on high-risk groups identified by considering these associations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shujun Zhang, Fen Wang, Lei Xie, Jialu Xu, Xiaoqing Song, Jing Tao, Juan Chen, Delin Ma, Xuefeng Yu, Xiaoli Shi, Yan Yang
Aims/Introduction
To assess whether the sodium–glucose cotransporter 2 inhibitor, henagliflozin, improves cognitive impairment in patients with type 2 diabetes.
Materials and Methods
We carried out a prospective study on 290 patients with type 2 diabetes and cognitive impairment. Montreal Cognitive Assessment scores and plasma phosphorylated tau181 levels were used to assess cognition. The association between henagliflozin use and changes in cognition was examined using multivariable logistic regression analysis.
Results
Montreal Cognitive Assessment scores at enrollment and after 6 months were 21 (interquartile range [IQR]19–23) versus 22 (IQR 20–25; P < 0.0001) in all patients, 21 (IQR 19–23) versus 24 (IQR 22–26; P < 0.0001) in the henagliflozin group and 21 (IQR 19–22) versus 21 (IQR 19–23; P > 0.05) in the non-sodium–glucose cotransporter 2 inhibitor group. Logistic regression analysis showed that henagliflozin treatment was associated with Montreal Cognitive Assessment score improvement independent of potential confounders (odds ratio [OR] 3.670, 95% confidence interval [CI] 2.224–6.056, P < 0.0001). Additionally, plasma phosphorylated tau181 levels significantly decreased at 6-month follow up in all patients (OR 11.5, 95% CI 9.9–13.7 vs OR 10.1, 95% CI 7.8–12.9, P < 0.0001) and in the henagliflozin group (OR 11.5, 95% CI 10.3–13.0 vs OR 9.2, 95% CI 7.1–10.7, P < 0.0001), but not in the non-sodium–glucose cotransporter 2 inhibitor group. Henagliflozin treatment was independently associated with decreased phosphorylated tau181 levels (OR 3.670, 95% CI 1.598–4.213, P < 0.0001).
Conclusions
Henagliflozin treatment was independently associated with improvements in Montreal Cognitive Assessment scores and plasma phosphorylated tau181 levels, indicating significant beneficial effects on cognitive impairment in patients with type 2 diabetes.
目的/简介评估钠-葡萄糖共转运体 2 抑制剂希格列嗪是否能改善 2 型糖尿病患者的认知功能障碍。材料与方法我们对 290 名患有认知功能障碍的 2 型糖尿病患者进行了一项前瞻性研究。蒙特利尔认知评估评分和血浆磷酸化 tau181 水平用于评估认知能力。结果蒙特利尔认知评估得分在入组时和 6 个月后分别为 21（四分位间范围 [IQR]19-23）与 22（IQR 20-25；P < 0.0001），希格列嗪组为21（IQR 19-23）对24（IQR 22-26；P <；0.0001），非葡萄糖钠共转运体2抑制剂组为21（IQR 19-22）对21（IQR 19-23；P >；0.05）。逻辑回归分析表明，独立于潜在的混杂因素，希格列净治疗与蒙特利尔认知评估评分的改善相关（比值比 [OR] 3.670，95% 置信区间 [CI] 2.224-6.056，P <0.0001）。此外，随访6个月时，所有患者血浆磷酸化tau181水平均显著下降（OR 11.5，95% CI 9.9-13.7 vs OR 10.1，95% CI 7.8-12.9，P < 0.0001），而非葡萄糖钠共转运体2抑制剂组患者血浆磷酸化tau181水平显著下降（OR 11.5，95% CI 10.3-13.0 vs OR 9.2，95% CI 7.1-10.7，P < 0.0001）。结论Henagliflozin治疗与蒙特利尔认知评估评分和血浆磷酸化tau181水平的改善独立相关，表明对2型糖尿病患者的认知障碍有显著的益处。
{"title":"Sodium–glucose cotransporter 2 inhibition through henagliflozin ameliorates cognitive impairment in patients with type 2 diabetes","authors":"Shujun Zhang, Fen Wang, Lei Xie, Jialu Xu, Xiaoqing Song, Jing Tao, Juan Chen, Delin Ma, Xuefeng Yu, Xiaoli Shi, Yan Yang","doi":"10.1111/jdi.14306","DOIUrl":"10.1111/jdi.14306","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>To assess whether the sodium–glucose cotransporter 2 inhibitor, henagliflozin, improves cognitive impairment in patients with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We carried out a prospective study on 290 patients with type 2 diabetes and cognitive impairment. Montreal Cognitive Assessment scores and plasma phosphorylated tau181 levels were used to assess cognition. The association between henagliflozin use and changes in cognition was examined using multivariable logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Montreal Cognitive Assessment scores at enrollment and after 6 months were 21 (interquartile range [IQR]19–23) versus 22 (IQR 20–25; <i>P</i> < 0.0001) in all patients, 21 (IQR 19–23) versus 24 (IQR 22–26; <i>P</i> < 0.0001) in the henagliflozin group and 21 (IQR 19–22) versus 21 (IQR 19–23; <i>P</i> > 0.05) in the non-sodium–glucose cotransporter 2 inhibitor group. Logistic regression analysis showed that henagliflozin treatment was associated with Montreal Cognitive Assessment score improvement independent of potential confounders (odds ratio [OR] 3.670, 95% confidence interval [CI] 2.224–6.056, <i>P</i> < 0.0001). Additionally, plasma phosphorylated tau181 levels significantly decreased at 6-month follow up in all patients (OR 11.5, 95% CI 9.9–13.7 vs OR 10.1, 95% CI 7.8–12.9, <i>P</i> < 0.0001) and in the henagliflozin group (OR 11.5, 95% CI 10.3–13.0 vs OR 9.2, 95% CI 7.1–10.7, <i>P</i> < 0.0001), but not in the non-sodium–glucose cotransporter 2 inhibitor group. Henagliflozin treatment was independently associated with decreased phosphorylated tau181 levels (OR 3.670, 95% CI 1.598–4.213, <i>P</i> < 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Henagliflozin treatment was independently associated with improvements in Montreal Cognitive Assessment scores and plasma phosphorylated tau181 levels, indicating significant beneficial effects on cognitive impairment in patients with type 2 diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adherence and treatment continuation rates of the glucagon-like peptide-1 receptor agonist (GLP-1RA) semaglutide for both oral (O-SEMA) and subcutaneous injection (SEMA-SC) remain unknown in real-world clinical practice. This retrospective observational study compared the 12 month adherence and treatment discontinuation of O-SEMA and once-weekly SEMA-SC in patients with type 2 diabetes using a real-world claims database. SEMA-SC initiators were 1:1 propensity score-matched to O-SEMA initiators. Non-adherence was defined as <0.8 of the proportion of days covered. SEMA-SC had a significantly higher odds ratio (OR) for non-adherence than O-SEMA (OR: 1.39). The hazard ratio for treatment discontinuation, using O-SEMA as the reference, was 1.45 for SEMA-SC, although the discontinuation rate of O-SEMA was higher during the early stage. O-SEMA initiators showed significantly higher adherence and greater persistence in therapy than SEMA-SC initiators at 12 months, which could lead to earlier initiation of GLP-1RA treatment.
{"title":"Adherence and treatment discontinuation of oral semaglutide and once-weekly semaglutide injection at 12 month follow-up: Japanese real-world data","authors":"Takeshi Horii, Chikako Masudo, Yui Takayanagi, Yoichi Oikawa, Akira Shimada, Kiyoshi Mihara","doi":"10.1111/jdi.14265","DOIUrl":"10.1111/jdi.14265","url":null,"abstract":"<p>Adherence and treatment continuation rates of the glucagon-like peptide-1 receptor agonist (GLP-1RA) semaglutide for both oral (O-SEMA) and subcutaneous injection (SEMA-SC) remain unknown in real-world clinical practice. This retrospective observational study compared the 12 month adherence and treatment discontinuation of O-SEMA and once-weekly SEMA-SC in patients with type 2 diabetes using a real-world claims database. SEMA-SC initiators were 1:1 propensity score-matched to O-SEMA initiators. Non-adherence was defined as <0.8 of the proportion of days covered. SEMA-SC had a significantly higher odds ratio (OR) for non-adherence than O-SEMA (OR: 1.39). The hazard ratio for treatment discontinuation, using O-SEMA as the reference, was 1.45 for SEMA-SC, although the discontinuation rate of O-SEMA was higher during the early stage. O-SEMA initiators showed significantly higher adherence and greater persistence in therapy than SEMA-SC initiators at 12 months, which could lead to earlier initiation of GLP-1RA treatment.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to investigate the factors associated with the exacerbation of the severity of atherothrombotic brain infarction at discharge in patients with type 2 diabetes using a large-scale claims database.
Materials and Methods
This retrospective cross-sectional study utilized the Medical Data Vision administrative claims database, a nationwide database in Japan using acute care hospital data, and the Diagnosis Procedure Combination system. Diagnosis Procedure Combination data collected between April 1, 2008, and December 31, 2022, were extracted. Patients with type 2 diabetes were included. Severe atherothrombotic brain infarction was defined as a modified Rankin scale score of ≥3.
Results
Severe atherothrombotic brain infarction occurred in 43,916/99,864 (44.0%) patients with type 2 diabetes. The odds ratio for severe atherothrombotic brain infarction increased significantly per 10 year increments in age (odds ratio: 1.69, 95% confidence interval: 1.66–1.71). A body mass index of <25 kg/m2, with a body mass index of ≥25 kg/m2 as reference, also increased the risk for severe atherothrombotic brain infarction (odds ratio: 1.11, 95% confidence interval: 1.08–1.15). The odds ratios in insulin and dipeptidyl peptidase 4 inhibitor use were significantly higher than 1. In particular, statin use (odds ratio: 0.85, 95% confidence interval: 0.83–0.88), fibrate use (odds ratio: 0.68, 95% confidence interval: 0.59–0.78), aspirin use (odds ratio: 0.78, 95% confidence interval: 0.75–0.80), and P2Y12 inhibitor use (odds ratio: 0.88, 95% confidence interval: 0.85–0.91) were associated with a lower odds ratio for severe atherothrombotic brain infarction.
Conclusions
The active management of lipid levels using statins and fibrates may be beneficial in preventing the exacerbation of atherothrombotic brain infarction in type 2 diabetes patients.
{"title":"Factor affecting severe atherothrombotic cerebral infarction in patients with type 2 diabetes mellitus: Large-scale claim database analysis of Japan","authors":"Takeshi Horii, Yoichi Oikawa, Kasumi Kidowaki, Akira Shimada, Kiyoshi Mihara","doi":"10.1111/jdi.14284","DOIUrl":"10.1111/jdi.14284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to investigate the factors associated with the exacerbation of the severity of atherothrombotic brain infarction at discharge in patients with type 2 diabetes using a large-scale claims database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study utilized the Medical Data Vision administrative claims database, a nationwide database in Japan using acute care hospital data, and the Diagnosis Procedure Combination system. Diagnosis Procedure Combination data collected between April 1, 2008, and December 31, 2022, were extracted. Patients with type 2 diabetes were included. Severe atherothrombotic brain infarction was defined as a modified Rankin scale score of ≥3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Severe atherothrombotic brain infarction occurred in 43,916/99,864 (44.0%) patients with type 2 diabetes. The odds ratio for severe atherothrombotic brain infarction increased significantly per 10 year increments in age (odds ratio: 1.69, 95% confidence interval: 1.66–1.71). A body mass index of <25 kg/m<sup>2</sup>, with a body mass index of ≥25 kg/m<sup>2</sup> as reference, also increased the risk for severe atherothrombotic brain infarction (odds ratio: 1.11, 95% confidence interval: 1.08–1.15). The odds ratios in insulin and dipeptidyl peptidase 4 inhibitor use were significantly higher than 1. In particular, statin use (odds ratio: 0.85, 95% confidence interval: 0.83–0.88), fibrate use (odds ratio: 0.68, 95% confidence interval: 0.59–0.78), aspirin use (odds ratio: 0.78, 95% confidence interval: 0.75–0.80), and P2Y12 inhibitor use (odds ratio: 0.88, 95% confidence interval: 0.85–0.91) were associated with a lower odds ratio for severe atherothrombotic brain infarction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The active management of lipid levels using statins and fibrates may be beneficial in preventing the exacerbation of atherothrombotic brain infarction in type 2 diabetes patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The ongoing debate about the optimal types of carbohydrates for reducing the risk of type 2 diabetes and related conditions remains a central topic in medical and nutritional research. The ongoing uncertainty about whether glycemic index (GI) and glycemic load (GL) should be considered significant dietary factors in the prevention of chronic diseases in the general population. Understanding the relationship between dietary GI and GL and type 2 diabetes mellitus is important, especially in Asian populations where carbohydrate-rich diets are prevalent.</p><p>The meta-analysis published in <i>The Lancet</i> in 2019 extensively reviewed the impact of carbohydrate quality on health. It highlighted that while low GI and low GL diets are linked to a reduced incidence of diabetes, cardiovascular mortality, stroke mortality, and breast cancer incidence, these findings were accompanied by inconsistent benefits on overall mortality and the incidence of non-communicable diseases. The study also noted variable reductions in the risk for different health outcomes based on the quality of carbohydrate intake, particularly emphasizing the significant health benefits associated with high dietary fiber and whole grain intakes<span><sup>1</sup></span>.</p><p>In 2024, a new meta-analysis was published in <i>The Lancet Diabetes & Endocrinology</i>, examining the associations between the GI and GL with major health outcomes such as the incidence of type 2 diabetes, cardiovascular disease, diabetes-related cancers, and all-cause mortality. The study analyzed large prospective cohorts with at least 100,000 participants and assessed the lowest and highest quantiles of GI and GL, as well as fiber and whole grain diets within these cohorts<span><sup>2</sup></span>. The meta-analysis identified ten large cohorts from the Richard Doll Consortium and analyzed 48 studies examining the effects of GI and GL on the outcomes of interest.</p><p>The results are summarized in Table 1, showing a positive correlation between high GI/GL diets and the incidence of type 2 diabetes, cardiovascular disease, and diabetes-related cancers<span><sup>2</sup></span>. Additionally, low GI/GL diets were associated with a reduced risk of diabetes, cardiovascular mortality, and all-cause mortality. The article also compared the effects of high fiber and whole grain intake on health outcomes with the effects of low GI/GL diets, providing a new perspective on the potential value of these dietary characteristics in preventing chronic diseases.</p><p>Recruiting large cohorts with a very high number of cases, this study enhances the reliability of its conclusions. It covers not only GI/GL but also fiber and whole grains, and is more comprehensive in many aspects, especially including the addition of cancer and all-cause mortality.</p><p>The Shanghai Women's Health Study (SWHS) observed that high dietary GI/GL significantly increased the risk of diabetes, with a multivariable-adjusted relative risk (
我们需要更加客观和精确的膳食评估方法，以确保其有效性和可靠性。此外，GI 和 GL 值因食物来源、品种和制作方法等因素而存在差异，这也会使结果的解释变得复杂10。这种复杂性使得普通消费者很难实际应用这些概念，尤其是在食品标签上没有 GI 和 GL 指标的情况下。这些见解表明，与依赖 GI 和 GL 值（GI 和 GL 值可能变化很大，且取决于具体情况）相比，关注食品质量（如包含高膳食纤维和全谷物）和整体膳食模式可能更有效地为公众健康提供指导11。此外，该研究侧重于观察性数据，虽然很有价值，但却限制了得出确定因果推论的能力，突出表明需要更多的随机对照试验来验证这些关联。未来，下一项研究可能会探讨如何量化临床实践中的各个方面，如饮食变化的时间和份量及其对餐后血糖水平的影响。此外，还需要更详细地了解相关机制，包括对自由基和胰岛素抵抗的影响。总之，詹金斯等人进行的荟萃分析2 表明，低 GI 膳食的临床优势与高纤维全谷物膳食相当。这些研究结果支持将 GI 和 GL 作为衡量碳水化合物质量的重要指标纳入膳食指南。
{"title":"Commentary on association of glycemic index and glycemic load with type 2 diabetes, cardiovascular disease, cancer, and all-cause mortality","authors":"Yi-Ting Hsieh, Ting-An Chou, Yi-Der Jiang","doi":"10.1111/jdi.14280","DOIUrl":"10.1111/jdi.14280","url":null,"abstract":"<p>The ongoing debate about the optimal types of carbohydrates for reducing the risk of type 2 diabetes and related conditions remains a central topic in medical and nutritional research. The ongoing uncertainty about whether glycemic index (GI) and glycemic load (GL) should be considered significant dietary factors in the prevention of chronic diseases in the general population. Understanding the relationship between dietary GI and GL and type 2 diabetes mellitus is important, especially in Asian populations where carbohydrate-rich diets are prevalent.</p><p>The meta-analysis published in <i>The Lancet</i> in 2019 extensively reviewed the impact of carbohydrate quality on health. It highlighted that while low GI and low GL diets are linked to a reduced incidence of diabetes, cardiovascular mortality, stroke mortality, and breast cancer incidence, these findings were accompanied by inconsistent benefits on overall mortality and the incidence of non-communicable diseases. The study also noted variable reductions in the risk for different health outcomes based on the quality of carbohydrate intake, particularly emphasizing the significant health benefits associated with high dietary fiber and whole grain intakes<span><sup>1</sup></span>.</p><p>In 2024, a new meta-analysis was published in <i>The Lancet Diabetes & Endocrinology</i>, examining the associations between the GI and GL with major health outcomes such as the incidence of type 2 diabetes, cardiovascular disease, diabetes-related cancers, and all-cause mortality. The study analyzed large prospective cohorts with at least 100,000 participants and assessed the lowest and highest quantiles of GI and GL, as well as fiber and whole grain diets within these cohorts<span><sup>2</sup></span>. The meta-analysis identified ten large cohorts from the Richard Doll Consortium and analyzed 48 studies examining the effects of GI and GL on the outcomes of interest.</p><p>The results are summarized in Table 1, showing a positive correlation between high GI/GL diets and the incidence of type 2 diabetes, cardiovascular disease, and diabetes-related cancers<span><sup>2</sup></span>. Additionally, low GI/GL diets were associated with a reduced risk of diabetes, cardiovascular mortality, and all-cause mortality. The article also compared the effects of high fiber and whole grain intake on health outcomes with the effects of low GI/GL diets, providing a new perspective on the potential value of these dietary characteristics in preventing chronic diseases.</p><p>Recruiting large cohorts with a very high number of cases, this study enhances the reliability of its conclusions. It covers not only GI/GL but also fiber and whole grains, and is more comprehensive in many aspects, especially including the addition of cancer and all-cause mortality.</p><p>The Shanghai Women's Health Study (SWHS) observed that high dietary GI/GL significantly increased the risk of diabetes, with a multivariable-adjusted relative risk (","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coefficient of variation (CV) is an indicator for glucose variability in continuous glucose monitoring (CGM), and the target threshold of %CV in type 1 diabetes is proposed to be ≤36%. This study aimed to evaluate the clinical significance of CV in children and adolescents with type 1 diabetes.
Materials and Methods
Participants included 66 children with type 1 diabetes. A total of 48 participants were treated with multiple daily injections of insulin, and 18 with continues subcutaneous insulin infusion, using intermittently scanned CGM. The frequencies of the CGM metrics and glycosylated hemoglobin values were examined, and the significance of a threshold %CV of 36% was evaluated.
Results
The mean frequencies in time in range (TIR), time below range, %CV and the mean glycosylated hemoglobin value were 59.3 ± 16.1, 4.0 ± 3.5, 39.3 ± 6.2 and 7.3 ± 0.8%, respectively. The frequencies of participants who achieved a TIR >70% and a %CV of ≤36% were 24.1 and 27.3%, respectively. A total of 18 participants with a %CV of ≤36% had significantly higher TIR, lower time below range and lower glycosylated hemoglobin than the 48 with a %CV of >36% (72.6 ± 12.6 vs 52.4 ± 13.6, 2.4 ± 1.9 vs 4.6 ± 3.6, 6.9 ± 0.8 vs 7.4 ± 0.7%, respectively).
Conclusions
Children and adolescents with type 1 diabetes using intermittently scanned CGM had difficulties in achieving the recommended targets of TIR and CV. However, the target %CV of ≤36% seems to be an appropriate indicator for assessing glycemic control and risk of hypoglycemia in pediatric patients with type 1 diabetes with any treatment.
{"title":"Clinical significance of coefficient of variation in continuous glucose monitoring for glycemic management in children and adolescents with type 1 diabetes","authors":"Tatsuhiko Urakami, Hiroki Terada, Satomi Tanabe, Yusuke Mine, Masako Aoki, Ryoji Aoki, Junichi Suzuki, Ichiro Morioka","doi":"10.1111/jdi.14303","DOIUrl":"10.1111/jdi.14303","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Coefficient of variation (CV) is an indicator for glucose variability in continuous glucose monitoring (CGM), and the target threshold of %CV in type 1 diabetes is proposed to be ≤36%. This study aimed to evaluate the clinical significance of CV in children and adolescents with type 1 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Participants included 66 children with type 1 diabetes. A total of 48 participants were treated with multiple daily injections of insulin, and 18 with continues subcutaneous insulin infusion, using intermittently scanned CGM. The frequencies of the CGM metrics and glycosylated hemoglobin values were examined, and the significance of a threshold %CV of 36% was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean frequencies in time in range (TIR), time below range, %CV and the mean glycosylated hemoglobin value were 59.3 ± 16.1, 4.0 ± 3.5, 39.3 ± 6.2 and 7.3 ± 0.8%, respectively. The frequencies of participants who achieved a TIR >70% and a %CV of ≤36% were 24.1 and 27.3%, respectively. A total of 18 participants with a %CV of ≤36% had significantly higher TIR, lower time below range and lower glycosylated hemoglobin than the 48 with a %CV of >36% (72.6 ± 12.6 vs 52.4 ± 13.6, 2.4 ± 1.9 vs 4.6 ± 3.6, 6.9 ± 0.8 vs 7.4 ± 0.7%, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children and adolescents with type 1 diabetes using intermittently scanned CGM had difficulties in achieving the recommended targets of TIR and CV. However, the target %CV of ≤36% seems to be an appropriate indicator for assessing glycemic control and risk of hypoglycemia in pediatric patients with type 1 diabetes with any treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The study aim was to investigate sulfonylurea prescription patterns in elderly patients (age ≥65 years) with type 2 diabetes mellitus in Japan. Sulfonylurea use among older adults has been insufficiently examined, despite the associated risks of hypoglycemia.
Materials and Methods
This retrospective cross-sectional survey entailed analysis of Japanese pharmacy data, extracted from the Musubi database, for patients (age 20–100 years) prescribed sulfonylureas between November 2022 and October 2023. Dose distribution, adherence to the Diabetes Treatment Guidelines for the Elderly 2023 and coprescription of other diabetes medications were investigated.
Results
Of the total 91,229 patients, 80.1% were prescribed glimepiride, 16.3% gliclazide and 3.6% glibenclamide. In patients aged ≥65 years, exceeding the recommended dose (>1 mg/day for glimepiride, >40 mg/day for gliclazide) was numerically higher for glimepiride (25.0%) than for gliclazide (7.8%). The most common prescribing patterns were quadruple therapy with a sulfonylurea, a dipeptidyl peptidase-4 inhibitor, an sodium–glucose transporter 2 inhibitor and a biguanide in patients aged 65 to <75 years, and dual therapy with a sulfonylurea and a dipeptidyl peptidase-4 inhibitor in patients aged ≥75 years. Unfortunately, glinide was coprescribed for 338 (0.5%) of elderly patients. Insulin was coprescribed for 3,682 (5.6%) of elderly patients.
Conclusions
Analysis of real-world sulfonylurea prescription data found guideline non-adherence, namely, excessive prescription of glimepiride, use of glibenclamide in elderly patients, and common coprescription with dipeptidyl peptidase-4 inhibitors. These findings might provide an opportunity to reconsider the treatment of patients with type 2 diabetes mellitus who are over-prescribed sulfonylureas to reduce residual risks, such as hypoglycemia.
{"title":"Sulfonylurea prescription patterns in elderly patients with type 2 diabetes mellitus: A comprehensive analysis of real-world data from pharmacies in Japan","authors":"Michiko Yamazaki, Tohru Takebe, Masaya Hosokawa, Tomoya Saika, Yutaka Nakao, Shunya Ikeda, Masaya Sakamoto","doi":"10.1111/jdi.14302","DOIUrl":"10.1111/jdi.14302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>The study aim was to investigate sulfonylurea prescription patterns in elderly patients (age ≥65 years) with type 2 diabetes mellitus in Japan. Sulfonylurea use among older adults has been insufficiently examined, despite the associated risks of hypoglycemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional survey entailed analysis of Japanese pharmacy data, extracted from the <i>Musubi</i> database, for patients (age 20–100 years) prescribed sulfonylureas between November 2022 and October 2023. Dose distribution, adherence to the Diabetes Treatment Guidelines for the Elderly 2023 and coprescription of other diabetes medications were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the total 91,229 patients, 80.1% were prescribed glimepiride, 16.3% gliclazide and 3.6% glibenclamide. In patients aged ≥65 years, exceeding the recommended dose (>1 mg/day for glimepiride, >40 mg/day for gliclazide) was numerically higher for glimepiride (25.0%) than for gliclazide (7.8%). The most common prescribing patterns were quadruple therapy with a sulfonylurea, a dipeptidyl peptidase-4 inhibitor, an sodium–glucose transporter 2 inhibitor and a biguanide in patients aged 65 to <75 years, and dual therapy with a sulfonylurea and a dipeptidyl peptidase-4 inhibitor in patients aged ≥75 years. Unfortunately, glinide was coprescribed for 338 (0.5%) of elderly patients. Insulin was coprescribed for 3,682 (5.6%) of elderly patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Analysis of real-world sulfonylurea prescription data found guideline non-adherence, namely, excessive prescription of glimepiride, use of glibenclamide in elderly patients, and common coprescription with dipeptidyl peptidase-4 inhibitors. These findings might provide an opportunity to reconsider the treatment of patients with type 2 diabetes mellitus who are over-prescribed sulfonylureas to reduce residual risks, such as hypoglycemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Riccardo Calafiore, Giovanni Luca, Francesco Gaggia, Giuseppe Basta
<p>Many years ago, we reported on a pilot clinical trial of alginate-poly-L-ornithine (AG/PLO) microencapsulated human islet treatment (TX) into four nonimmunosuppressed patients with long-standing type 1 diabetes (file 19382, PRE 805, September 2003) under intensive exogenous insulin therapy, throughout 3 years post-TX follow up<span><sup>1, 2</sup></span>. The four recipients were selected from patients with long-standing type 1 diabetes (≥25 years), with no significant secondary complications of the disease, but unfair metabolic control, and out-of-range glycated hemoglobin levels. Under local anesthesia, and using ecography guidance, the microencapsulated human islets were delivered by gravity into the peritoneal cavity. No adverse effects during and after the procedure were observed. The clinical outcome was consistent with successful graft function, as assessed as by: (1) serum C-peptide levels, that were undetectable before the graft, and appeared and were sustained in all patients, rising to 2 ng/dL in one recipient (high sensitivity C-reactive protein assay); (2) significant improvement of several biochemical parameters, such as fasting and post-prandial blood glucose levels, stabilization of glycated hemoglobin values ≤7%, and 50–75% reduction of the exogenous insulin daily dose (with 1/4 patients going off insulin, although transiently), throughout 400 days post-transplant, when the graft function was lost; (3) disappearance of nocturnal hypoglycemia unawareness in all recipients; and (4) no immune sensitization to islet cell antigens (negative ICA, anti-GAD65 and anti-HLA I–II antibodies) at 3 years post-TX in all recipients, which confirmed the immunobarrier competence associated with the AG/PLO microcapsules. Retrieval of a fraction of microcapsules from patient 1 at 3 years of TX showed almost still intact microspheres, containing no longer viable islets<span><sup>2</sup></span>. During the subsequent years, all four patients reverted back to their usual daily insulin schedule.</p><p>Currently, at 20 years of the TX, we wished to clinically re-evaluate the four patients. All of them are disease-free, except for type 1 diabetes, and enjoy fair metabolic control, on intensive exogenous insulin therapy. The four patients have undertaken clinical chemistry profile testing, as well as chest and abdominal imaging procedures (Table 1). Neither side-effects, related to the intraperitoneal microencapsulated islet grafting procedure, nor abnormalities at the level of either internal organs or clinical chemistry parameters, were detected.</p><p>In conclusion, intraperitoneal AG/PLO microencapsulated islet allografts have been proven to represent a safe procedure, virtually free of any unwanted sequelae, at 20 years post-TX, despite the finite functional lifespan of the graft. Although a search for better-performing graft sites, as well as alternative sources of insulin-producing cells, are actively being pursued, the AG/PLO-based microcapsule
{"title":"Long-term safety of alginate-poly-L-ornithine microcapsules, enveloping human islet allografts, into nonimmunosuppressed patients with type 1 diabetes mellitus","authors":"Riccardo Calafiore, Giovanni Luca, Francesco Gaggia, Giuseppe Basta","doi":"10.1111/jdi.14300","DOIUrl":"10.1111/jdi.14300","url":null,"abstract":"<p>Many years ago, we reported on a pilot clinical trial of alginate-poly-L-ornithine (AG/PLO) microencapsulated human islet treatment (TX) into four nonimmunosuppressed patients with long-standing type 1 diabetes (file 19382, PRE 805, September 2003) under intensive exogenous insulin therapy, throughout 3 years post-TX follow up<span><sup>1, 2</sup></span>. The four recipients were selected from patients with long-standing type 1 diabetes (≥25 years), with no significant secondary complications of the disease, but unfair metabolic control, and out-of-range glycated hemoglobin levels. Under local anesthesia, and using ecography guidance, the microencapsulated human islets were delivered by gravity into the peritoneal cavity. No adverse effects during and after the procedure were observed. The clinical outcome was consistent with successful graft function, as assessed as by: (1) serum C-peptide levels, that were undetectable before the graft, and appeared and were sustained in all patients, rising to 2 ng/dL in one recipient (high sensitivity C-reactive protein assay); (2) significant improvement of several biochemical parameters, such as fasting and post-prandial blood glucose levels, stabilization of glycated hemoglobin values ≤7%, and 50–75% reduction of the exogenous insulin daily dose (with 1/4 patients going off insulin, although transiently), throughout 400 days post-transplant, when the graft function was lost; (3) disappearance of nocturnal hypoglycemia unawareness in all recipients; and (4) no immune sensitization to islet cell antigens (negative ICA, anti-GAD65 and anti-HLA I–II antibodies) at 3 years post-TX in all recipients, which confirmed the immunobarrier competence associated with the AG/PLO microcapsules. Retrieval of a fraction of microcapsules from patient 1 at 3 years of TX showed almost still intact microspheres, containing no longer viable islets<span><sup>2</sup></span>. During the subsequent years, all four patients reverted back to their usual daily insulin schedule.</p><p>Currently, at 20 years of the TX, we wished to clinically re-evaluate the four patients. All of them are disease-free, except for type 1 diabetes, and enjoy fair metabolic control, on intensive exogenous insulin therapy. The four patients have undertaken clinical chemistry profile testing, as well as chest and abdominal imaging procedures (Table 1). Neither side-effects, related to the intraperitoneal microencapsulated islet grafting procedure, nor abnormalities at the level of either internal organs or clinical chemistry parameters, were detected.</p><p>In conclusion, intraperitoneal AG/PLO microencapsulated islet allografts have been proven to represent a safe procedure, virtually free of any unwanted sequelae, at 20 years post-TX, despite the finite functional lifespan of the graft. Although a search for better-performing graft sites, as well as alternative sources of insulin-producing cells, are actively being pursued, the AG/PLO-based microcapsule","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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