The relationship between economic disadvantages and the risk of developing gestational diabetes mellitus (GDM), as well as its impact on birth outcomes, remains uncertain.
Materials and Methods
From the Taiwan Maternal and Child Health Database, we identified 984,712 pregnant women between 1 January 2007 and 31 December 2018. Using propensity score matching, we selected 5,068 pairs of women across four income levels: very low, low, middle and high. We used a multivariable Cox regression model to assess the risk of GDM in these pregnant women and analyzed the birth outcomes.
Results
The mean age of the pregnant women was 30.89 years. We found no significant difference in GDM risk among pregnant women with different family income. However, newborns of women with GDM and very low-income were at higher risk for several adverse conditions, such as small for gestational age (adjusted odds ratio (aOR) 1.17, 95% confidence interval (CI) 1.04–1.31), large for gestational age (aOR 1.27, 95% CI 1.08–1.51), hypoxic–ischemic encephalopathy (aOR 3.19, 95% CI 1.15–8.86), respiratory distress (aOR 1.58, 95% CI 1.14–2. 19), congenital anomalies (aOR 1.32, 95% CI 1.08–1.62), jaundice requiring phototherapy or exchange transfusion (aOR 1.14, 95% CI 1.05–1.24) and so on.
Conclusions
This study found that low family income alone was not associated with GDM development. However, for a GDM pregnancy, pregnant women with lower income had worse birth outcomes. Improving maternal health and nutrition among low-income pregnant women with GDM might be critical to improving birth outcomes.
{"title":"Impact of family income on the development of gestational diabetes mellitus and the associated birth outcomes: A nationwide study","authors":"Fu-Shun Yen, James Cheng-Chung Wei, Yi-Ling Wu, Yu-Ru Lo, Chih-Ming Chen, Chii-Min Hwu, Chih-Cheng Hsu","doi":"10.1111/jdi.14288","DOIUrl":"10.1111/jdi.14288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>The relationship between economic disadvantages and the risk of developing gestational diabetes mellitus (GDM), as well as its impact on birth outcomes, remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>From the Taiwan Maternal and Child Health Database, we identified 984,712 pregnant women between 1 January 2007 and 31 December 2018. Using propensity score matching, we selected 5,068 pairs of women across four income levels: very low, low, middle and high. We used a multivariable Cox regression model to assess the risk of GDM in these pregnant women and analyzed the birth outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the pregnant women was 30.89 years. We found no significant difference in GDM risk among pregnant women with different family income. However, newborns of women with GDM and very low-income were at higher risk for several adverse conditions, such as small for gestational age (adjusted odds ratio (aOR) 1.17, 95% confidence interval (CI) 1.04–1.31), large for gestational age (aOR 1.27, 95% CI 1.08–1.51), hypoxic–ischemic encephalopathy (aOR 3.19, 95% CI 1.15–8.86), respiratory distress (aOR 1.58, 95% CI 1.14–2. 19), congenital anomalies (aOR 1.32, 95% CI 1.08–1.62), jaundice requiring phototherapy or exchange transfusion (aOR 1.14, 95% CI 1.05–1.24) and so on.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found that low family income alone was not associated with GDM development. However, for a GDM pregnancy, pregnant women with lower income had worse birth outcomes. Improving maternal health and nutrition among low-income pregnant women with GDM might be critical to improving birth outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 1","pages":"51-59"},"PeriodicalIF":3.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613112","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}
Ying Liu, Lei Gao, Mengfei Wu, Boyang Yang, Dongxue Ren, Zekun Zhang, Wei Zhang, Yan Wang
Objective
To explore the relationship between adipose tissue deposition and triglyceride-glucose (TyG) index, an indicator clinically used to assess insulin resistance (IR), in middle-aged and elderly women using quantitative computed tomography (QCT) and MRI mDIXON-Quant sequence.
Methods
All participants underwent quantitative computed tomography (QCT) and MRI mDIXON-Quant examination and calculated the TyG index based on the fasting blood glucose and triacylglycerol. Bounded by the median TyG index, all participants were divided into low TyG group and high TyG group. Visceral fat mass (VFM) and subcutaneous fat mass (SFM) were measured on QCT images. Hepatic proton density fat fraction (H-PDFF), pancreatic proton density fat fraction (P-PDFF), and lumbar bone marrow fat fraction (L-BMFF) were measured on MRI mDIXON-Quant images.
Results
Adjusting for age and body mass index (BMI), TyG was moderately positively correlated with H-PDFF, and r/P was 0.416/<0.001, TyG index was weakly positively correlated with VFM and P-PDFF, and r/P were 0.385/<0.001 and 0.221/0.030. There was a difference of VFM, H-PDFF, and P-PDFF between low TyG group and high TyG group (P < 0.05). Adjusting for age and BMI, VFM, and H-PDFF were the risk factors of high TyG, and H-PDFF was the independent risk factor of high TyG.
Conclusions
VFM and H-PDFF were the risk factors of IR, and H-PDFF was the independent risk factor. Early identification and active treatment of adipose tissue deposition, especially hepatic fat deposition, may reserve and delay the progression of IR and even metabolic syndrome.
{"title":"Effect of adipose tissue deposition on insulin resistance in middle-aged and elderly women: Based on QCT and MRI mDIXON-Quant","authors":"Ying Liu, Lei Gao, Mengfei Wu, Boyang Yang, Dongxue Ren, Zekun Zhang, Wei Zhang, Yan Wang","doi":"10.1111/jdi.14352","DOIUrl":"10.1111/jdi.14352","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the relationship between adipose tissue deposition and triglyceride-glucose (TyG) index, an indicator clinically used to assess insulin resistance (IR), in middle-aged and elderly women using quantitative computed tomography (QCT) and MRI mDIXON-Quant sequence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All participants underwent quantitative computed tomography (QCT) and MRI mDIXON-Quant examination and calculated the TyG index based on the fasting blood glucose and triacylglycerol. Bounded by the median TyG index, all participants were divided into low TyG group and high TyG group. Visceral fat mass (VFM) and subcutaneous fat mass (SFM) were measured on QCT images. Hepatic proton density fat fraction (H-PDFF), pancreatic proton density fat fraction (P-PDFF), and lumbar bone marrow fat fraction (L-BMFF) were measured on MRI mDIXON-Quant images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adjusting for age and body mass index (BMI), TyG was moderately positively correlated with H-PDFF, and <i>r</i>/<i>P</i> was 0.416/<0.001, TyG index was weakly positively correlated with VFM and P-PDFF, and <i>r</i>/<i>P</i> were 0.385/<0.001 and 0.221/0.030. There was a difference of VFM, H-PDFF, and P-PDFF between low TyG group and high TyG group (<i>P</i> < 0.05). Adjusting for age and BMI, VFM, and H-PDFF were the risk factors of high TyG, and H-PDFF was the independent risk factor of high TyG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VFM and H-PDFF were the risk factors of IR, and H-PDFF was the independent risk factor. Early identification and active treatment of adipose tissue deposition, especially hepatic fat deposition, may reserve and delay the progression of IR and even metabolic syndrome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 2","pages":"292-297"},"PeriodicalIF":3.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613110","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}
GIP is a multifaceted hormone whose role in metabolism is highly context-dependent. Pharmacological GIP receptor activation promotes weight loss and improves insulin sensitivity, contrasting sharply with the lipogenic and insulin-resistant effects of endogenous GIP. However, it remains unclear whether these effects simply amplify endogenous GIP's actions or represent distinct mechanisms.
{"title":"Which is the real nature of glucose-dependent insulinotropic peptide?: Endogenous vs pharmacological","authors":"Yuji Yamazaki, Yutaka Seino","doi":"10.1111/jdi.14357","DOIUrl":"10.1111/jdi.14357","url":null,"abstract":"<p>GIP is a multifaceted hormone whose role in metabolism is highly context-dependent. Pharmacological GIP receptor activation promotes weight loss and improves insulin sensitivity, contrasting sharply with the lipogenic and insulin-resistant effects of endogenous GIP. However, it remains unclear whether these effects simply amplify endogenous GIP's actions or represent distinct mechanisms.\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":"16 2","pages":"173-175"},"PeriodicalIF":3.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613191","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 early detection of high-risk individuals is crucial to delay and reduce the incidence of type 2 diabetes. In this study, we aimed to explore the performance of a novel subgroup-specific biomarker strategy in the prediction of incident diabetes.
Materials and Methods
In the Taiwan Lifestyle Cohort Study, adult subjects without diabetes were included and followed for the incidence of diabetes in 2006–2019. The biomarkers measured included blood secretogranin III (SCG3), vascular adhesion protein-1 (VAP-1), fibrinogen-like protein 1 (FGL1), angiopoietin-like protein 6 (ANGPTL6), and angiopoietin-like protein 4 (ANGPTL4).
Results
Among the 1,287 subjects, 12.2% developed diabetes during a 6 year follow-up. Blood VAP-1 was significantly associated with incident diabetes in the overall population (HR = 0.724, P < 0.05), participants under 65 years old (HR = 0.685, P < 0.05), those with a BMI of ≥24 kg/m2 (HR = 0.673, P < 0.05), and females (HR = 0.635, P < 0.05). Blood ANGPTL6 was significantly correlated with incident diabetes in participants aged 65 and older (HR = 0.314, P < 0.05), and blood SCG3 was associated with incident diabetes in those with a BMI of <24 kg/m2 (HR = 1.296, P < 0.05). Two subgroup-specific biomarker strategies were developed. The gender and BMI-specific biomarker strategy, using traditional risk factors and blood SCG3 or VAP-1 in different subgroups, could improve prediction performance, especially the specificity and positive prediction value, compared with the whole-population strategy using only traditional risk factors or traditional risk factors plus blood VAP-1.
Conclusion
Gender- and BMI-specific biomarker strategy can improve the prediction of incident diabetes. A subgroup-specific biomarker strategy is a novel approach in the prediction of incident diabetes.
{"title":"Precision medicine in diabetes prediction: Exploring a subgroup-specific biomarker strategy for risk stratification","authors":"I-Weng Yen, Szu-Chi Chen, Chia-Hung Lin, Kang-Chih Fan, Chung-Yi Yang, Chih-Yao Hsu, Chun-Heng Kuo, Mao-Shin Lin, Ya-Pin Lyu, Hsien-Chia Juan, Lin Heng-Huei, Hung-Yuan Li","doi":"10.1111/jdi.14311","DOIUrl":"10.1111/jdi.14311","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The early detection of high-risk individuals is crucial to delay and reduce the incidence of type 2 diabetes. In this study, we aimed to explore the performance of a novel subgroup-specific biomarker strategy in the prediction of incident diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In the Taiwan Lifestyle Cohort Study, adult subjects without diabetes were included and followed for the incidence of diabetes in 2006–2019. The biomarkers measured included blood secretogranin III (SCG3), vascular adhesion protein-1 (VAP-1), fibrinogen-like protein 1 (FGL1), angiopoietin-like protein 6 (ANGPTL6), and angiopoietin-like protein 4 (ANGPTL4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 1,287 subjects, 12.2% developed diabetes during a 6 year follow-up. Blood VAP-1 was significantly associated with incident diabetes in the overall population (HR = 0.724, <i>P</i> < 0.05), participants under 65 years old (HR = 0.685, <i>P</i> < 0.05), those with a BMI of ≥24 kg/m<sup>2</sup> (HR = 0.673, <i>P</i> < 0.05), and females (HR = 0.635, <i>P</i> < 0.05). Blood ANGPTL6 was significantly correlated with incident diabetes in participants aged 65 and older (HR = 0.314, <i>P</i> < 0.05), and blood SCG3 was associated with incident diabetes in those with a BMI of <24 kg/m<sup>2</sup> (HR = 1.296, <i>P</i> < 0.05). Two subgroup-specific biomarker strategies were developed. The gender and BMI-specific biomarker strategy, using traditional risk factors and blood SCG3 or VAP-1 in different subgroups, could improve prediction performance, especially the specificity and positive prediction value, compared with the whole-population strategy using only traditional risk factors or traditional risk factors plus blood VAP-1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gender- and BMI-specific biomarker strategy can improve the prediction of incident diabetes. A subgroup-specific biomarker strategy is a novel approach in the prediction of incident diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 1","pages":"43-50"},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613189","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}
Mari Watanabe, Shu Meguro, Kaiken Kimura, Michiaki Furukoshi, Tsuyoshi Masuda, Makoto Enomoto, Hiroshi Itoh
Background and Aims
To prevent end-stage renal disease caused by diabetic kidney disease, we created a predictive model for high-risk patients using machine learning.
Methods and Results
The reference point was the time at which each patient's estimated glomerular filtration rate (eGFR) first fell below 60 mL/min/1.73 m2. The input period spanned the reference point to 1 year prior. The primary endpoint was a 50% decrease in eGFR from the mean of the input period over the 3 year evaluation period. We created predictive models for patients’ primary endpoints using time series data of various variables over the input period. Among 2,533 total patients, 1,409 had reference points, 31 had records for their input and evaluation periods and had reached their primary endpoints, and 317 patients had not. The area under the curve (AUC) of the predictive model peaked (0.81) when the minimum eGFR, the difference between maximum and minimum eGFR, and both maximum and minimum urinary protein values were included in the features.
Conclusion
The accuracy of prognosis prediction can be improved by considering the variable components of urinary protein and eGFR levels. This model will allow us to identify patients whose renal functions are relatively preserved with eGFR of more than 60 mL/min/1.73 m2 and are likely to benefit clinically from immediate treatment intensification.
{"title":"A machine learning model for predicting worsening renal function using one-year time series data in patients with type 2 diabetes","authors":"Mari Watanabe, Shu Meguro, Kaiken Kimura, Michiaki Furukoshi, Tsuyoshi Masuda, Makoto Enomoto, Hiroshi Itoh","doi":"10.1111/jdi.14309","DOIUrl":"10.1111/jdi.14309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>To prevent end-stage renal disease caused by diabetic kidney disease, we created a predictive model for high-risk patients using machine learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>The reference point was the time at which each patient's estimated glomerular filtration rate (eGFR) first fell below 60 mL/min/1.73 m<sup>2</sup>. The input period spanned the reference point to 1 year prior. The primary endpoint was a 50% decrease in eGFR from the mean of the input period over the 3 year evaluation period. We created predictive models for patients’ primary endpoints using time series data of various variables over the input period. Among 2,533 total patients, 1,409 had reference points, 31 had records for their input and evaluation periods and had reached their primary endpoints, and 317 patients had not. The area under the curve (AUC) of the predictive model peaked (0.81) when the minimum eGFR, the difference between maximum and minimum eGFR, and both maximum and minimum urinary protein values were included in the features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The accuracy of prognosis prediction can be improved by considering the variable components of urinary protein and eGFR levels. This model will allow us to identify patients whose renal functions are relatively preserved with eGFR of more than 60 mL/min/1.73 m<sup>2</sup> and are likely to benefit clinically from immediate treatment intensification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 1","pages":"93-99"},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613097","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}
Glucagon-like peptide-1 (GLP-1) receptor agonists are antidiabetic drugs that possess a suppressive effect on the progression of atherosclerosis, and it has been thought that their anti-inflammatory effect is involved in their effect, but the detailed mechanism was unknown. Recently, Ben Nasr and colleagues have proposed easily understood mechanism for the anti-inflammatory effect of GLP-1 receptor agonists. They discovered that some normal T cells express GLP-1 receptors on their cell membranes and showed that GLP-1 has an inhibitory effect on T-cell function.
胰高血糖素样肽-1（GLP-1）受体激动剂是一种抗糖尿病药物，对动脉粥样硬化的进展具有抑制作用，人们一直认为其抗炎作用与该药物的抗炎作用有关，但具体机制尚不清楚。最近，Ben Nasr 及其同事提出了易于理解的 GLP-1 受体激动剂抗炎作用机制。他们发现一些正常 T 细胞的细胞膜上表达 GLP-1 受体，并证明 GLP-1 对 T 细胞功能有抑制作用。
{"title":"One step closer to solving the mystery of the anti-inflammatory effects of glucagon-like peptide-1 receptor agonists","authors":"Hirotaka Watada","doi":"10.1111/jdi.14346","DOIUrl":"10.1111/jdi.14346","url":null,"abstract":"<p>Glucagon-like peptide-1 (GLP-1) receptor agonists are antidiabetic drugs that possess a suppressive effect on the progression of atherosclerosis, and it has been thought that their anti-inflammatory effect is involved in their effect, but the detailed mechanism was unknown. Recently, Ben Nasr and colleagues have proposed easily understood mechanism for the anti-inflammatory effect of GLP-1 receptor agonists. They discovered that some normal T cells express GLP-1 receptors on their cell membranes and showed that GLP-1 has an inhibitory effect on T-cell function.\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":"16 2","pages":"180-182"},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613113","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}
Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non-insulin-dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase. Dipeptidyl peptidase-4 inhibitors and biguanides might be the treatment of choice for SPIDDM (probable), but no evidence exists for other hypoglycemic agents. In any case, careful monitoring of the endogenous insulin secretion capacity should be carried out, and if a decrease in insulin secretion capacity is suspected, a change in treatment should be considered to prevent progression to an insulin-dependent state.
{"title":"Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)","authors":"Akira Shimada, Eiji Kawasaki, Norio Abiru, Takuya Awata, Yoichi Oikawa, Haruhiko Osawa, Hiroshi Kajio, Junji Kozawa, Kazuma Takahashi, Daisuke Chujo, Shinsuke Noso, Tomoyasu Fukui, Junnosuke Miura, Kazuki Yasuda, Hisafumi Yasuda, Akihisa Imagawa, Hiroshi Ikegami","doi":"10.1111/jdi.14267","DOIUrl":"10.1111/jdi.14267","url":null,"abstract":"<p>Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non-insulin-dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase. Dipeptidyl peptidase-4 inhibitors and biguanides might be the treatment of choice for SPIDDM (probable), but no evidence exists for other hypoglycemic agents. In any case, careful monitoring of the endogenous insulin secretion capacity should be carried out, and if a decrease in insulin secretion capacity is suspected, a change in treatment should be considered to prevent progression to an insulin-dependent state.</p>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 1","pages":"163-168"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613174","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 investigated the association between the ankle reflex and the estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes.
Materials and Methods
This was a single-center, retrospective, observational cohort study. A total of 1,387 patients who underwent an ankle reflex examination between January 2005 and December 2015 were included in the analysis for the primary outcome. The findings of the ankle reflex examination were classified into three groups: normal, decreased, or absent. The primary outcome was defined as the incidence of a 40% loss of eGFR from baseline. A survival time analysis using the Kaplan–Meier method and a regression analysis using a Cox proportional hazards model were conducted to evaluate the association between the ankle reflex test results and loss of eGFR.
Results
The ankle reflex test results were as follows: normal, n = 678 (48.9%); decreased, n = 270 (19.5%); and absent, n = 439 (31.6%) patients. The median follow-up period was 5.6 years in the observational period. In the univariate regression analysis, decreased and absent ankle reflexes were significantly associated with loss of eGFR. Moreover, decreased ankle reflex (hazard ratio: 1.83, 95% confidence interval: 1.16–2.87) and absent ankle reflex (hazard ratio: 2.57, 95% confidence interval: 1.76–3.76) were independently associated with loss of eGFR after adjusting for prognostic risk factors.
Conclusions
Decreased and absent ankle reflexes are closely and independently associated with loss of eGFR in patients with type 2 diabetes.
{"title":"Deterioration in ankle reflex is associated with a reduced estimated glomerular filtration rate in patients with type 2 diabetes: A retrospective observational cohort study","authors":"Taichi Muramatsu, Daisuke Yamamuro, Akifumi Kushiyama, Takako Kikuchi","doi":"10.1111/jdi.14348","DOIUrl":"10.1111/jdi.14348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>We investigated the association between the ankle reflex and the estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This was a single-center, retrospective, observational cohort study. A total of 1,387 patients who underwent an ankle reflex examination between January 2005 and December 2015 were included in the analysis for the primary outcome. The findings of the ankle reflex examination were classified into three groups: normal, decreased, or absent. The primary outcome was defined as the incidence of a 40% loss of eGFR from baseline. A survival time analysis using the Kaplan–Meier method and a regression analysis using a Cox proportional hazards model were conducted to evaluate the association between the ankle reflex test results and loss of eGFR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The ankle reflex test results were as follows: normal, <i>n</i> = 678 (48.9%); decreased, <i>n</i> = 270 (19.5%); and absent, <i>n</i> = 439 (31.6%) patients. The median follow-up period was 5.6 years in the observational period. In the univariate regression analysis, decreased and absent ankle reflexes were significantly associated with loss of eGFR. Moreover, decreased ankle reflex (hazard ratio: 1.83, 95% confidence interval: 1.16–2.87) and absent ankle reflex (hazard ratio: 2.57, 95% confidence interval: 1.76–3.76) were independently associated with loss of eGFR after adjusting for prognostic risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Decreased and absent ankle reflexes are closely and independently associated with loss of eGFR in patients with type 2 diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 2","pages":"225-235"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613105","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 evaluated the effect of the MiniMed™ 770G, an insulin pump using hybrid closed-loop technology, on blood glucose management and quality of life in Japanese people with type 1 diabetes.
Materials and Methods
This was a 52-week, prospective, observational study. Fifty Japanese people with type 1 diabetes switched from the MiniMed™ 640G to 770G, and we analyzed the continuous glucose monitoring data of 24 subjects who used auto mode throughout the study. We also analyzed the scores of the Diabetes Therapy-Related Quality of Life questionnaire completed by 26 auto-mode users before and after the treatment change.
Results
The baseline time in range 70–180 mg/dL was 67.3 (54.8–78.4)%, with a significant improvement beginning 8 weeks after the switch and lasting until 52 weeks. The baseline time below range <70 mg/dL was 1.9 (0.6–3.6)%, with a significant increase at week 8; however, the mean value was less than 4% throughout the study period. On the other hand, the number of blood glucose measurements significantly increased. While there was no significant difference in the overall change in the total Diabetes Therapy-Related Quality of Life score, there was a significant decrease in the treatment satisfaction score.
Conclusions
Use of the MiniMed™ 770G improved continuous glucose monitoring metrics. However, treatment satisfaction decreased, probably due to the increased frequency of blood glucose monitoring necessary to maintain auto mode.
{"title":"Effects of switching from MiniMed™ 640G to 770G on continuous glucose monitoring metrics and DTR-QOL scores: An observational study of Japanese people with type 1 diabetes mellitus","authors":"Toshiki Kogai, Junko Sato, Haruna Yasuda, Tatsuhiro Ayame, Azusa Ozaki, Eri Takagi, Mami Koshibu, Yuya Nishida, Fuki Ikeda, Hirotaka Watada","doi":"10.1111/jdi.14350","DOIUrl":"10.1111/jdi.14350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>We evaluated the effect of the MiniMed™ 770G, an insulin pump using hybrid closed-loop technology, on blood glucose management and quality of life in Japanese people with type 1 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This was a 52-week, prospective, observational study. Fifty Japanese people with type 1 diabetes switched from the MiniMed™ 640G to 770G, and we analyzed the continuous glucose monitoring data of 24 subjects who used auto mode throughout the study. We also analyzed the scores of the Diabetes Therapy-Related Quality of Life questionnaire completed by 26 auto-mode users before and after the treatment change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The baseline time in range 70–180 mg/dL was 67.3 (54.8–78.4)%, with a significant improvement beginning 8 weeks after the switch and lasting until 52 weeks. The baseline time below range <70 mg/dL was 1.9 (0.6–3.6)%, with a significant increase at week 8; however, the mean value was less than 4% throughout the study period. On the other hand, the number of blood glucose measurements significantly increased. While there was no significant difference in the overall change in the total Diabetes Therapy-Related Quality of Life score, there was a significant decrease in the treatment satisfaction score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Use of the MiniMed™ 770G improved continuous glucose monitoring metrics. However, treatment satisfaction decreased, probably due to the increased frequency of blood glucose monitoring necessary to maintain auto mode.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 2","pages":"326-333"},"PeriodicalIF":3.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602636","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 assess the correlation between hip circumference (HC) and the risk of cardiovascular disease (CVD) and type 2 diabetes mellitus using Mendelian randomization (MR) to overcome observational study limitations.
Design
MR analysis utilized genetic variation from the MR Base in a two-sample analysis. Three methods were employed: MR-Egger regression, weighted median estimator, and inverse variance weighting (IVW).
Setting
Data was acquired from MR Base, a platform summarizing genome-wide association study (GWAS) data for MR research.
Main Outcome Measures
Publicly available summary statistics datasets from GWAS meta-analyses were used, with HC and HC adjusted for body mass index (BMI) as exposures. Data for CVD and type 2 diabetes mellitus were obtained as outcomes.
Results
Results indicated a positive causal relationship between HC and CVD (IVW: P = 1.84e-07, OR: 1.37, 95% CI: 1.22–1.54) as well as type 2 diabetes mellitus (IVW: P = 0.04, OR: 1.62, 95% CI: 1.02–2.56), independent of BMI. However, HC after BMI adjustment showed no significant causal relationship with CVD (IVW: P = 0.05, OR: 1.09, 95% CI: 1.00–1.19) and exhibited a negative association with type 2 diabetes mellitus (IVW: P = 0.00, OR: 0.76, 95% CI: 0.66–0.88), suggesting a protective effect against type 2 diabetes mellitus.
Conclusions
After adjusting for BMI, adipose tissue concentrated in the hip region showed a protective effect against type 2 diabetes mellitus but not against CVD. These findings offer insights into diabetes prevention and treatment strategies, and may inform plastic surgery procedures. Further research is needed to validate these findings and explore underlying mechanisms.
{"title":"Investigating the correlation of hip circumference to cardiovascular disease and type-2 diabetes using Mendelian randomization","authors":"Hongtao Liu, Zhaoyu Li, Su Yan, Shaopeng Ming","doi":"10.1111/jdi.14344","DOIUrl":"10.1111/jdi.14344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to assess the correlation between hip circumference (HC) and the risk of cardiovascular disease (CVD) and type 2 diabetes mellitus using Mendelian randomization (MR) to overcome observational study limitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>MR analysis utilized genetic variation from the MR Base in a two-sample analysis. Three methods were employed: MR-Egger regression, weighted median estimator, and inverse variance weighting (IVW).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Data was acquired from MR Base, a platform summarizing genome-wide association study (GWAS) data for MR research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Publicly available summary statistics datasets from GWAS meta-analyses were used, with HC and HC adjusted for body mass index (BMI) as exposures. Data for CVD and type 2 diabetes mellitus were obtained as outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results indicated a positive causal relationship between HC and CVD (IVW: <i>P</i> = 1.84e-07, OR: 1.37, 95% CI: 1.22–1.54) as well as type 2 diabetes mellitus (IVW: <i>P</i> = 0.04, OR: 1.62, 95% CI: 1.02–2.56), independent of BMI. However, HC after BMI adjustment showed no significant causal relationship with CVD (IVW: <i>P</i> = 0.05, OR: 1.09, 95% CI: 1.00–1.19) and exhibited a negative association with type 2 diabetes mellitus (IVW: <i>P</i> = 0.00, OR: 0.76, 95% CI: 0.66–0.88), suggesting a protective effect against type 2 diabetes mellitus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>After adjusting for BMI, adipose tissue concentrated in the hip region showed a protective effect against type 2 diabetes mellitus but not against CVD. These findings offer insights into diabetes prevention and treatment strategies, and may inform plastic surgery procedures. Further research is needed to validate these findings and explore underlying mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 2","pages":"265-271"},"PeriodicalIF":3.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589940","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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