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Trends and regional disparities in the diabetes burden across Asia, 1990–2021: Insights from the global burden of disease study 1990-2021年亚洲糖尿病负担的趋势和区域差异:来自全球疾病负担研究的见解
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-10-08 DOI: 10.1016/j.deman.2025.100287
Sufyan Shahid , Aya Abdulrahman Ajeel , Ali Dheyaa Marsool , Muneeb Saifullah , Hiba Mukhtar , Muhammad Umer Sattar , Anum Waseem , Zareen Shafqat , Zunaira Rehman , Raheel Ahmed , Dr. Muzammil Farhan

Background

Diabetes mellitus (DM) has emerged as a major contributor to the non-communicable disease burden in Asia. Understanding temporal, regional, and demographic patterns is essential for guiding prevention and control efforts.

Methods

We analyzed age-standardized prevalence, incidence, and mortality for DM from the Global Burden of Disease 1990–2021 dataset, encompassing both type 1 and type 2 diabetes across Asian countries and subregions. Joinpoint regression analysis (permutation tests; NCI Joinpoint v5.2.0) was applied to detect significant inflection points as well as to estimate annual percentage changes (APCs) and Average Annual Percent Changes (AAPCs) in trends.

Results

By 2021, an estimated 314 million individuals in Asia were living with DM, with an age-standardized prevalence rate (ASPR) of 6,098.31 per 100,000, incidence rate (ASIR) of 277.23, and death rate (ASDR) of 18.78. From 1990 to 2021, ASPR, ASIR, and ASDR increased with average annual percent changes (AAPCs) of 1.92%, 1.60%, and 0.35%, respectively. Central Asia demonstrated the highest increases in prevalence (AAPC: 2.73%) and mortality (1.73%), while East Asia showed slower growth and declining mortality (–0.31%). High-income Asia Pacific experienced rising prevalence but a marked decline in mortality (–2.86%). Southeast Asia recorded a sharp recent surge in prevalence (APC: 5.61% during 2019–2021). Male patients consistently had higher prevalence and mortality than females. At the national level, Brunei, Mongolia, and Malaysia had the highest prevalence, while Pakistan and the Philippines reported disproportionately high mortality.

Conclusion

The diabetes burden in Asia has risen substantially, with pronounced regional, temporal, and sex-based disparities. These findings highlight the urgent need for tailored, region-specific public health strategies to mitigate the growing impact of DM.
背景糖尿病(DM)已成为亚洲非传染性疾病负担的一个主要因素。了解时间、区域和人口模式对于指导预防和控制工作至关重要。方法:我们分析了1990-2021年全球疾病负担数据集中糖尿病的年龄标准化患病率、发病率和死亡率,包括亚洲国家和次区域的1型和2型糖尿病。应用连接点回归分析(排列测试;NCI连接点v5.2.0)来检测重要的拐点以及估计趋势中的年百分比变化(APCs)和平均年百分比变化(AAPCs)。结果到2021年,亚洲估计有3.14亿人患有糖尿病,年龄标准化患病率(ASPR)为6098.31 / 10万,发病率(ASIR)为277.23,死亡率(ASDR)为18.78。从1990年到2021年,ASPR、ASIR和ASDR分别以1.92%、1.60%和0.35%的年均变化百分比(AAPCs)增长。中亚表现出最高的患病率(AAPC: 2.73%)和死亡率(1.73%)增长,而东亚表现出较慢的增长和死亡率下降(-0.31%)。高收入亚太地区患病率上升,但死亡率显著下降(-2.86%)。东南亚的流行率最近急剧上升(2019-2021年APC: 5.61%)。男性患者的患病率和死亡率始终高于女性。在国家一级,文莱、蒙古和马来西亚的患病率最高,而巴基斯坦和菲律宾报告的死亡率高得不成比例。结论亚洲糖尿病负担显著上升,存在明显的地区、时间和性别差异。这些发现突出表明,迫切需要制定有针对性的区域公共卫生战略,以减轻糖尿病日益严重的影响。
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引用次数: 0
Trends in use of cardiorenal protective medication among people with type 2 diabetes and chronic kidney disease in Denmark 丹麦2型糖尿病和慢性肾病患者使用心肾保护药物的趋势
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-09-28 DOI: 10.1016/j.deman.2025.100286
Rasmus Rørth , Thomas A. Gerds , Vanja Kosjerina , Bendix Carstensen , Frederik Persson , Peter Rossing

Objective

Kidney- and cardiovascular complications are the main challenges in modern diabetes care. Several drugs to prevent these have emerged in recent years. A key problem is therapy implementation to ensure benefits demonstrated in trials and recommended in guidelines. We investigated time-trends in use of cardiorenal protective medication in persons with type-2 diabetes(T2D) with or without chronic kidney disease (CKD).

Research design and Methods

By use of data from Danish health registers we were able to identify individuals with diabetes and stratify them by CKD status. We assessed the medication use in individuals with T2D with and without CKD on a national level between 2011-2022.

Results

By 2022, 312,990 persons had T2D and 102,216 (33 %) of these had CKD. Use of SGLT2i and GLP-1RA increased over time and was more abundant among persons with T2D without CKD, whereas the use of ACE-inhibitors, ARBs, MRA, antiplatelet - and lipid lowering drugs was more frequent among people with diabetes and CKD. The use of cardiorenal protective medication across age and sex was similar for persons with T2D with or without CKD with men having marginally higher degree of exposure than women for most medication classes except GLP-1RA and ARB.

Conclusion

Exposure to SGLT2i and GLP-1RA increased over time but was, in contrast to current guideline recommendations, more pronounced among individuals with diabetes without CKD and contrary to the other cardiorenal protective medications. The cardiorenal protective benefits of these agents can only be achieved with continued focus on implementation of guideline recommendations for high-risk individuals with complications.
目的肾脏和心血管并发症是现代糖尿病护理的主要挑战。近年来出现了几种预防这些疾病的药物。一个关键问题是治疗的实施,以确保在试验中证明和指南中推荐的益处。我们调查了伴有或不伴有慢性肾脏疾病(CKD)的2型糖尿病(T2D)患者使用心肾保护药物的时间趋势。研究设计和方法通过使用来自丹麦健康登记的数据,我们能够识别糖尿病患者并根据CKD状态对他们进行分层。我们评估了2011-2022年全国范围内伴有和不伴有CKD的T2D患者的药物使用情况。结果到2022年,有312,990人患有T2D,其中102,216人(33%)患有CKD。SGLT2i和GLP-1RA的使用随着时间的推移而增加,在没有CKD的T2D患者中更为丰富,而在糖尿病和CKD患者中,ace抑制剂、arb、MRA、抗血小板和降脂药物的使用更为频繁。对于合并或不合并CKD的T2D患者,不同年龄和性别的心肾保护药物的使用情况相似,除了GLP-1RA和ARB外,男性对大多数药物类别的暴露程度略高于女性。结论:SGLT2i和GLP-1RA的暴露随着时间的推移而增加,但与目前的指南建议相反,在没有CKD的糖尿病患者中更为明显,与其他心肾保护药物相反。这些药物的心肾保护作用只有在持续关注高危并发症患者指南建议的实施时才能实现。
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引用次数: 0
Longitudinal analysis of diabetes risk factors in HIV-positive patients in a 15-year cohort study 15年队列研究中hiv阳性患者糖尿病危险因素的纵向分析
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-07-26 DOI: 10.1016/j.deman.2025.100275
Tra Thu Doan , Cuong Duy Do
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引用次数: 0
Participation of individuals with type 2 diabetes in a behavioural e-health lifestyle intervention in Denmark: A feasibility study 丹麦2型糖尿病患者参与行为电子健康生活方式干预:可行性研究
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-09-24 DOI: 10.1016/j.deman.2025.100285
Fereshteh Baygi , Carl J. Brandt , Kathrine Kjær-Hansen , Anders Grøntved , Jan C. Brønd , Sia K. Nicolaisen , Jacob V. Stidsen , Reimar W. Thomsen , Jens Søndergaard , Jens S. Nielsen

Background

Behavioural lifestyle interventions can support type 2 diabetes (T2D) self-management; however, participation and adherence rates are often low. This feasibility study examined characteristics of individuals with T2D who were willing or unwilling to participate in, complete, and adhere to a personalised e-health behavioural lifestyle intervention in a general practitioner (GP) setting.

Method

Nurses at two Danish GP setting invited patients with T2D to participate in a one-year smartphone-based intervention. Patient characteristics were obtained from Danish health registers, GP records, and previously collected data. The personalized intervention included three face-to-face consultations (at baseline, 2 months, and 12 months) to set personal goals and measure weight, height, waist, and hip circumferences. Physical and mental health were assessed using the SF-12v1 survey. All other support and interactions occurred via app. Adherence to the app usage was evaluated by tracking logins, messages sent, and response times during the first and final three months of the intervention.

Results

Of the 63 eligible individuals with T2D, 20 (31.7 %) agreed to participate. Those who were willing to participate were predominantly men (75 %), younger (median age 57 years [IQR 52; 66] vs. 65 years [IQR: 57; 73]), had a longer duration of diabetes (6.6 years [2.9; 8.2] vs. 5.5 years [3.7; 7.0], higher fasting glucose levels (8.5 mmol/L [6.8; 10.4] vs. 7.9 mmol/L [7.1; 9.3]), and lower mental component scores (48.8 [38.5; 52.0] vs. 54.7 [47.3; 58.7]) compared to those unwilling. Of 20 individuals who were willing to participate, 13 (65 %) completed the intervention. After 2 months their mental component scores were 47.4 (40.6; 50.5), compared to 31.5 (31.5; 45.8) among those who dropped out. Additionally, completers demonstrated more consistent app usage, whereas app engagement among dropouts declined significantly over the first two months.

Conclusion

Willingness to participate in the behavioural intervention among individual with T2D was modest. Those willing to participate and completed the intervention were more often men, had better mental health, and showed higher app engagement than dropouts. These findings underscore the need for personalized strategies to improve participation and adherence in e-health lifestyle interventions.
行为生活方式干预可以支持2型糖尿病(T2D)的自我管理;然而,参与和坚持率往往很低。这项可行性研究考察了愿意或不愿意在全科医生(GP)环境中参与、完成并坚持个性化电子健康行为生活方式干预的T2D患者的特征。方法丹麦两家全科医生机构的护士邀请T2D患者参加为期一年的智能手机干预。从丹麦健康登记、全科医生记录和先前收集的数据中获得患者特征。个性化干预包括三次面对面咨询(基线、2个月和12个月),以设定个人目标并测量体重、身高、腰围和臀围。采用SF-12v1问卷评估身心健康状况。所有其他支持和互动都是通过应用程序进行的。在干预的前三个月和最后三个月,通过跟踪登录、发送的消息和响应时间来评估应用程序使用的依从性。结果63例符合条件的t2dm患者中,有20例(31.7%)同意参与。愿意参加的主要是男性(75%),年龄较小(中位年龄57岁[IQR 52; 66]对65岁[IQR: 57; 73]),糖尿病持续时间较长(6.6年[2.9;8.2]对5.5年[3.7;7.0]),空腹血糖水平较高(8.5 mmol/L[6.8; 10.4]对7.9 mmol/L[7.1; 9.3]),智力成分评分较低(48.8[38.5;52.0]对54.7[47.3;58.7])。在20名愿意参与的个人中,13人(65%)完成了干预。2个月后,他们的心理成分得分为47.4(40.6;50.5),而辍学者的得分为31.5(31.5;45.8)。此外,完成者更稳定地使用应用,而辍学者的应用粘性在前两个月显著下降。结论T2D患者参与行为干预的意愿不高。那些愿意参与并完成干预的人往往是男性,他们的心理健康状况更好,与辍学者相比,他们对应用程序的参与度更高。这些发现强调了个性化策略的必要性,以提高电子健康生活方式干预措施的参与度和依从性。
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引用次数: 0
Type 1 and type 2 diabetes mellitus among people with intellectual disability in comparison to the general population: A register study (IDcare) 智障人群中1型和2型糖尿病与普通人群的比较:一项登记研究(IDcare)
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-11-07 DOI: 10.1016/j.deman.2025.100290
Karin Engström , Magnus Sandberg , Anna Axmon

Aims

To assess the prevalence and prevalence relative risk (PRR) of Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) among people with intellectual disabilities (ID) compared to the general population using a register-based cohort in Sweden.

Methods

The study included 14,716 people with ID and 1226,955 people from the general population in Skåne, Sweden, on January 1st, 2014. Data on health care contacts were collected from the Skåne Healthcare Register for the entire study period (2014–2021). PRRs with 95 % confidence intervals (CIs) were estimated using Poisson regression, with the general population serving as the reference group.

Results

The PRR for T1DM was higher among people with ID (PRR 1.63, 95 % CI 1.36–1.95), particularly among children and adolescents. The PRR for T2DM was also higher (PRR 1.53, 95 % CI 1.43–1.63) across all age groups, except for children. Women had higher PRRs (T1DM: PRR 1.88, 95 % CI 1.42–2.47; T2DM: PRR 1.80, 95 % CI 1.63–1.99) than men (T1DM: PRR 1.44, 95 % CI 1.13–1.82; T2DM: PRR 1.34, 95 % CI 1.22–1.48). The PRR increased with ID severity for T1DM, whereas a higher PRR was observed among people with mild or moderate ID for T2DM, but not among those with severe/profound ID.

Conclusions

People with ID have higher prevalence relative risks for both T1DM and T2DM, indicating a higher diabetes burden than in the general population. Differences in PRR between T1DM and T2DM, according to age, sex, and ID severity, underscore the need for targeted interventions.
目的:通过瑞典的一项基于登记的队列研究,评估智力残疾(ID)人群中1型糖尿病(T1DM)和2型糖尿病(T2DM)的患病率和患病率相对危险度(PRR)。方法选取2014年1月1日在瑞典sk内的14716名ID人群和1226955名普通人群为研究对象。在整个研究期间(2014-2021年),从skamatne医疗保健登记册收集医疗保健接触者的数据。使用泊松回归估计95%置信区间(ci)的PRRs,以一般人群作为参照组。结果ID患者T1DM的PRR较高(PRR为1.63,95% CI为1.36-1.95),尤其是儿童和青少年。除儿童外,T2DM的PRR在所有年龄组中也较高(PRR 1.53, 95% CI 1.43-1.63)。女性的PRR (T1DM: PRR 1.88, 95% CI 1.42-2.47; T2DM: PRR 1.80, 95% CI 1.63-1.99)高于男性(T1DM: PRR 1.44, 95% CI 1.13-1.82; T2DM: PRR 1.34, 95% CI 1.22-1.48)。T1DM患者的PRR随着ID严重程度的增加而增加,而T2DM轻度或中度ID患者的PRR更高,而重度/重度ID患者的PRR则不高。结论ID患者患T1DM和T2DM的相对风险较高,表明其糖尿病负担高于一般人群。根据年龄、性别和ID严重程度,T1DM和T2DM之间PRR的差异强调了有针对性干预的必要性。
{"title":"Type 1 and type 2 diabetes mellitus among people with intellectual disability in comparison to the general population: A register study (IDcare)","authors":"Karin Engström ,&nbsp;Magnus Sandberg ,&nbsp;Anna Axmon","doi":"10.1016/j.deman.2025.100290","DOIUrl":"10.1016/j.deman.2025.100290","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the prevalence and prevalence relative risk (PRR) of Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) among people with intellectual disabilities (ID) compared to the general population using a register-based cohort in Sweden.</div></div><div><h3>Methods</h3><div>The study included 14,716 people with ID and 1226,955 people from the general population in Skåne, Sweden, on January 1st, 2014. Data on health care contacts were collected from the Skåne Healthcare Register for the entire study period (2014–2021). PRRs with 95 % confidence intervals (CIs) were estimated using Poisson regression, with the general population serving as the reference group.</div></div><div><h3>Results</h3><div>The PRR for T1DM was higher among people with ID (PRR 1.63, 95 % CI 1.36–1.95), particularly among children and adolescents. The PRR for T2DM was also higher (PRR 1.53, 95 % CI 1.43–1.63) across all age groups, except for children. Women had higher PRRs (T1DM: PRR 1.88, 95 % CI 1.42–2.47; T2DM: PRR 1.80, 95 % CI 1.63–1.99) than men (T1DM: PRR 1.44, 95 % CI 1.13–1.82; T2DM: PRR 1.34, 95 % CI 1.22–1.48). The PRR increased with ID severity for T1DM, whereas a higher PRR was observed among people with mild or moderate ID for T2DM, but not among those with severe/profound ID.</div></div><div><h3>Conclusions</h3><div>People with ID have higher prevalence relative risks for both T1DM and T2DM, indicating a higher diabetes burden than in the general population. Differences in PRR between T1DM and T2DM, according to age, sex, and ID severity, underscore the need for targeted interventions.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100290"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comorbidity depression – diabetes in Eastern DR Congo: insights from a cross-sectional study 刚果民主共和国东部抑郁症-糖尿病的合并症:来自横断面研究的见解
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-10-29 DOI: 10.1016/j.deman.2025.100289
Roland Muhindo Muyisa (Laros) M.D. , Jacques Katsuva Wahangire M.D. , Célestin Kaputu Malu M.D., Ph.D.

Introduction

Depression among patients with diabetes is a major public health problem, but it is not well described in our region. The objective of this survey was to determine the prevalence and identify predictive factors of depression in individuals with diabetes in our region.

Method

It was a cross-sectional and analytic study of patients under regular medical consultations at Matanda Hospital. Data collection involved a structured questionnaire covering socio-demographic parameters, clinical characteristics, depression assessment using the PHQ-9, and glycemic control through HbA1c levels.

Results

Among 294 diabetic patients, 170 (57.8 %) exhibited depressive symptoms. Major risk factors for depression included age ≥45 years, illiteracy, unemployment, low income (<30 USD/month), alcohol use, tobacco use, diabetes duration <5 years, hygiene measures-only therapy, acute complications, and hypertension. Protective factors included age 30–44 years, marriage, university education, employment, diabetes duration 5–9 years, and combined hygiene measures plus oral antidiabetic therapy. Depression was significantly associated with poor glycemic control (HbA1c >6.5 %; p = 0.0043).

Conclusion

There is a high prevalence of depression among patients with diabetes in our region. The implementation of routine screening for depression is necessary to improve the quality of life of patients with diabetes.
糖尿病患者的抑郁症是一个重大的公共卫生问题,但在我们地区并没有得到很好的描述。本调查的目的是确定患病率,并确定抑郁症的预测因素,个人糖尿病在我们的地区。方法对在马坦达医院定期就诊的患者进行横断面分析研究。数据收集包括一份结构化问卷,包括社会人口统计学参数、临床特征、使用PHQ-9进行抑郁评估以及通过HbA1c水平进行血糖控制。结果294例糖尿病患者中有170例(57.8%)出现抑郁症状。抑郁症的主要危险因素包括年龄≥45岁、文盲、失业、低收入(每月30美元)、饮酒、吸烟、糖尿病病程≥5年、仅采取卫生措施的治疗、急性并发症和高血压。保护因素包括年龄30-44岁、婚姻、大学教育、就业、糖尿病病程5-9年、综合卫生措施加口服降糖治疗。抑郁与血糖控制不良显著相关(HbA1c > 6.5%; p = 0.0043)。结论我区糖尿病患者抑郁患病率较高。实施抑郁症的常规筛查对改善糖尿病患者的生活质量是必要的。
{"title":"Comorbidity depression – diabetes in Eastern DR Congo: insights from a cross-sectional study","authors":"Roland Muhindo Muyisa (Laros) M.D. ,&nbsp;Jacques Katsuva Wahangire M.D. ,&nbsp;Célestin Kaputu Malu M.D., Ph.D.","doi":"10.1016/j.deman.2025.100289","DOIUrl":"10.1016/j.deman.2025.100289","url":null,"abstract":"<div><h3>Introduction</h3><div>Depression among patients with diabetes is a major public health problem, but it is not well described in our region. The objective of this survey was to determine the prevalence and identify predictive factors of depression in individuals with diabetes in our region.</div></div><div><h3>Method</h3><div>It was a cross-sectional and analytic study of patients under regular medical consultations at Matanda Hospital. Data collection involved a structured questionnaire covering socio-demographic parameters, clinical characteristics, depression assessment using the PHQ-9, and glycemic control through HbA1c levels.</div></div><div><h3>Results</h3><div>Among 294 diabetic patients, 170 (57.8 %) exhibited depressive symptoms. Major risk factors for depression included age ≥45 years, illiteracy, unemployment, low income (&lt;30 USD/month), alcohol use, tobacco use, diabetes duration &lt;5 years, hygiene measures-only therapy, acute complications, and hypertension. Protective factors included age 30–44 years, marriage, university education, employment, diabetes duration 5–9 years, and combined hygiene measures plus oral antidiabetic therapy. Depression was significantly associated with poor glycemic control (HbA1c &gt;6.5 %; p = 0.0043).</div></div><div><h3>Conclusion</h3><div>There is a high prevalence of depression among patients with diabetes in our region. The implementation of routine screening for depression is necessary to improve the quality of life of patients with diabetes.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100289"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insulin therapy adherence and associated factors among diabetes mellitus patients in Southern Ethiopia 埃塞俄比亚南部糖尿病患者胰岛素治疗依从性及相关因素
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-08-31 DOI: 10.1016/j.deman.2025.100284
Mulualem Gete Feleke, Tadele Lankrew Ayalew, Kidist Ashager, Bizuayehu Atinafu Ataro, Hailu Asmare Beyene

Introduction

Diabetes mellitus is a major global public health challenge. Insulin adherence is crucial to prevent complications, yet poor adherence remains common. This study assessed insulin adherence and associated factors among diabetic patients in Wolaita Zone Hospitals, Southern Ethiopia.

Methods

A multicenter cross-sectional study was conducted from November 2023 to January 2024 among 394 diabetic patients. Participants were selected using proportional allocation and systematic random sampling. Logistic regression was used to identify factors associated with insulin adherence, with results reported as adjusted odds ratios (AORs) and 95 % confidence intervals (CIs).

Results

The prevalence of insulin adherence was 40.1 % (95 % CI: 35.5–44.9 %). Higher adherence was associated with college education or above (AOR=3.03; 95 % CI: 1.36–7.18), owning a glucometer (AOR=2.79; 95 % CI: 1.35–5.75), good knowledge (AOR=3.14; 95 % CI: 1.71–5.77), positive attitude toward insulin (AOR=6.12; 95 % CI: 3.38–11.09), and regular monthly follow-up (AOR=3.81; 95 % CI: 1.73–8.40). Conversely, having comorbidities (AOR=0.42; 95 % CI: 0.23–0.77) and diabetes duration ≥15 years (AOR=0.27; 95 % CI: 0.11–0.67) were negatively associated with adherence.

Conclusion

Insulin adherence was low. Patient-centered interventions focusing on education, attitude improvement, and promote regular follow-up are vital to enhance adherence and reduce complications.
糖尿病是一项重大的全球公共卫生挑战。坚持使用胰岛素对预防并发症至关重要,但不坚持使用胰岛素仍然很常见。本研究评估了埃塞俄比亚南部Wolaita区医院糖尿病患者的胰岛素依从性及其相关因素。方法于2023年11月至2024年1月对394例糖尿病患者进行多中心横断面研究。采用比例分配和系统随机抽样的方法选择研究对象。使用逻辑回归来确定与胰岛素依从性相关的因素,结果报告为调整优势比(AORs)和95%置信区间(CIs)。结果胰岛素依从率为40.1% (95% CI: 35.5 ~ 44.9%)。高依从性与大学及以上学历(AOR=3.03; 95% CI: 1.36-7.18)、拥有血糖仪(AOR=2.79; 95% CI: 1.35-5.75)、良好的知识(AOR=3.14; 95% CI: 1.71-5.77)、对胰岛素的积极态度(AOR=6.12; 95% CI: 3.38-11.09)、每月定期随访(AOR=3.81; 95% CI: 1.73-8.40)相关。相反,合并症(AOR=0.42; 95% CI: 0.23-0.77)和糖尿病病程≥15年(AOR=0.27; 95% CI: 0.11-0.67)与依从性呈负相关。结论胰岛素依从性低。以患者为中心的干预措施侧重于教育、态度改善和促进定期随访,对于提高依从性和减少并发症至关重要。
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引用次数: 0
Comments on the impact of oral health on fasting blood sugar levels in diabetic individuals 口腔健康对糖尿病患者空腹血糖水平的影响
IF 1 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-06-02 DOI: 10.1016/j.deman.2025.100271
Shu Yuan , Zi-Lin Li , Jing Hu
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引用次数: 0
Relationship between canagliflozin use and sarcopenia: Real-world data from the United States 卡格列净使用与肌肉减少症之间的关系:来自美国的真实世界数据
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-08-06 DOI: 10.1016/j.deman.2025.100280
Zhong Yuan , Jill Hardin , James P. Gilbert , Jordy Mehawej , Saberi Rana Ali , Carolyn Jeffcoat , Sergio Fonseca

Aims

Real-world data were analyzed to evaluate the incidence and risk of sarcopenia for canagliflozin compared with other antihyperglycemic agents (AHAs) including dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), empagliflozin, and dapagliflozin.

Materials and methods

This retrospective cohort analysis of patients with type 2 diabetes mellitus (T2DM) included new users of canagliflozin or the AHAs (2016 to 2023) in 7 United States healthcare databases. Large-scale regularized regression generated propensity scores (PS) were used for matching and controlling confounding. A conditional Cox proportional hazards model assessed the treatment effect, presented as hazard ratios (HR). A self-controlled case series (SCCS) analysis assessed the incidence rate ratio between exposed and non-exposed periods among canagliflozin users.

Results

The PS-matched analyses showed no statistically significant increased risk of sarcopenia with canagliflozin versus any AHA comparator, though confidence intervals (CIs) were wide due to low event rates. The calibrated HRs (95 % CI) were 0.71 (0.26, 1.91) for canagliflozin versus empagliflozin, 1.16 (0.28, 4.70) for canagliflozin versus dapagliflozin, 8.79 (0.66, 116.96) for canagliflozin versus GLP-1RAs, and 0.88 (0.26, 2.98) for canagliflozin versus DPP-4 inhibitors. The crude incidence rates of sarcopenia (per 10,000 person-years) varied across databases: canagliflozin (0.0 to 1.0), dapagliflozin (0.4 to 7.9), empagliflozin (0.7 to 3.4), DPP-4 inhibitors (0.4 to 4.8), and GLP-1RAs (0.5 to 3.4). The SCCS analysis indicated an incidence ratio of 0.83 (0.50, 1.37).

Conclusions

The incidence rates of sarcopenia were low among patients with T2DM treated with canagliflozin or other comparator AHAs. There is no evidence suggesting an increased risk of sarcopenia associated with canagliflozin compared with other AHAs.
目的:分析真实世界的数据,比较卡格列净与其他降糖药物(包括二肽基肽酶-4 (DPP-4)抑制剂、胰高血糖素样肽-1受体激动剂(GLP-1RAs)、恩格列净和达格列净)的肌少症发生率和风险。材料和方法本回顾性队列分析包括美国7个医疗数据库中新使用卡格列净或aha的2型糖尿病(T2DM)患者(2016年至2023年)。使用大规模正则化回归生成的倾向得分(PS)进行匹配和控制混杂。条件Cox比例风险模型评估治疗效果,以风险比(HR)表示。一项自我对照病例系列(SCCS)分析评估了卡格列净使用者暴露期和非暴露期的发病率比。结果:ps匹配分析显示,与任何AHA比较药物相比,卡格列净组肌肉减少症的风险没有统计学意义上的显著增加,尽管由于事件发生率低,置信区间(ci)很宽。卡格列净与恩帕格列净的校准hr (95% CI)为0.71(0.26,1.91),卡格列净与达格列净的校准hr为1.16(0.28,4.70),卡格列净与GLP-1RAs的校准hr为8.79(0.66,116.96),卡格列净与DPP-4抑制剂的校准hr为0.88(0.26,2.98)。不同数据库中肌肉减少症的粗发生率(每10000人年)不同:canagliflozin(0.0 - 1.0)、dapagliflozin(0.4 - 7.9)、empagliflozin(0.7 - 3.4)、DPP-4抑制剂(0.4 - 4.8)和GLP-1RAs(0.5 - 3.4)。SCCS分析显示发病率为0.83(0.50,1.37)。结论用卡格列净或其他比较类aha治疗的T2DM患者肌少症发生率较低。没有证据表明与其他aha相比,卡格列净会增加肌肉减少症的风险。
{"title":"Relationship between canagliflozin use and sarcopenia: Real-world data from the United States","authors":"Zhong Yuan ,&nbsp;Jill Hardin ,&nbsp;James P. Gilbert ,&nbsp;Jordy Mehawej ,&nbsp;Saberi Rana Ali ,&nbsp;Carolyn Jeffcoat ,&nbsp;Sergio Fonseca","doi":"10.1016/j.deman.2025.100280","DOIUrl":"10.1016/j.deman.2025.100280","url":null,"abstract":"<div><h3>Aims</h3><div>Real-world data were analyzed to evaluate the incidence and risk of sarcopenia for canagliflozin compared with other antihyperglycemic agents (AHAs) including dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), empagliflozin, and dapagliflozin.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort analysis of patients with type 2 diabetes mellitus (T2DM) included new users of canagliflozin or the AHAs (2016 to 2023) in 7 United States healthcare databases. Large-scale regularized regression generated propensity scores (PS) were used for matching and controlling confounding. A conditional Cox proportional hazards model assessed the treatment effect, presented as hazard ratios (HR). A self-controlled case series (SCCS) analysis assessed the incidence rate ratio between exposed and non-exposed periods among canagliflozin users.</div></div><div><h3>Results</h3><div>The PS-matched analyses showed no statistically significant increased risk of sarcopenia with canagliflozin versus any AHA comparator, though confidence intervals (CIs) were wide due to low event rates. The calibrated HRs (95 % CI) were 0.71 (0.26, 1.91) for canagliflozin versus empagliflozin, 1.16 (0.28, 4.70) for canagliflozin versus dapagliflozin, 8.79 (0.66, 116.96) for canagliflozin versus GLP-1RAs, and 0.88 (0.26, 2.98) for canagliflozin versus DPP-4 inhibitors. The crude incidence rates of sarcopenia (per 10,000 person-years) varied across databases: canagliflozin (0.0 to 1.0), dapagliflozin (0.4 to 7.9), empagliflozin (0.7 to 3.4), DPP-4 inhibitors (0.4 to 4.8), and GLP-1RAs (0.5 to 3.4). The SCCS analysis indicated an incidence ratio of 0.83 (0.50, 1.37).</div></div><div><h3>Conclusions</h3><div>The incidence rates of sarcopenia were low among patients with T2DM treated with canagliflozin or other comparator AHAs. There is no evidence suggesting an increased risk of sarcopenia associated with canagliflozin compared with other AHAs.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"19 ","pages":"Article 100280"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between glycated hemoglobin (HbA1c) levels and hearing threshold elevation in Saudi adults with type 2 diabetes: a cross-sectional study 沙特成年2型糖尿病患者糖化血红蛋白(HbA1c)水平与听力阈值升高之间的关系:一项横断面研究
IF 1.4 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-07-01 Epub Date: 2025-08-25 DOI: 10.1016/j.deman.2025.100281
Hind Maher Alenzi , Raghad Abdullah Alsagri , Manal Alfakhri , Safa Alqudah , Margaret Zuriekat , Manal Alshareef , Aseel Hamad Alkhamees

Background

Type 2 diabetes mellitus (T2DM) has been associated with sensorineural hearing loss through microvascular and neural pathways. Although T2DM prevalence is high in Saudi Arabia, limited research has examined the relationship between glycemic control and auditory function in this population.

Objective

To investigate the association between glycated hemoglobin (HbA1c) levels and hearing threshold levels (HTL) in Saudi adults with T2DM.

Methods

This retrospective cross-sectional study analyzed medical records of 41 Saudi adults with T2DM (aged 20–57 years, 27 males, 14 females) who underwent pure tone audiometry and HbA1c testing at Royal Commission Medical Center, Yanbu, between 2021–2024. Linear regression analyses examined associations between HbA1c and HTL across low-frequency (0.25–2 kHz) and high-frequency (4–8 kHz) ranges.

Results

Mean participant age was 49.1 ± 7.8 years, with mean HbA1c of 6.9 ± 1.2 %. Linear regression revealed significant positive associations between HbA1c and HTL in both low-frequency (β = 0.93, 95 % CI: 2.30–2.98, p < 0.001) and high-frequency ranges (β = 0.91, 95 % CI: 4.05–5.46, p < 0.001). Age was also significantly associated with HTL in both frequency ranges (p < 0.001).

Conclusion

Elevated HbA1c levels are significantly associated with increased hearing thresholds in Saudi adults with T2DM, suggesting that poor glycemic control may contribute to auditory dysfunction. These findings support incorporating routine audiological assessments into diabetes care protocols.
背景2型糖尿病(T2DM)通过微血管和神经通路与感音神经性听力损失相关。尽管沙特阿拉伯的2型糖尿病患病率很高,但对该人群血糖控制与听觉功能之间关系的研究有限。目的探讨沙特成年T2DM患者糖化血红蛋白(HbA1c)水平与听力阈值水平(HTL)的关系。方法本回顾性横断面研究分析了41例沙特成年T2DM患者(年龄20-57岁,男性27例,女性14例)的医疗记录,这些患者于2021-2024年间在延布皇家委员会医学中心接受了纯音听力测定和HbA1c检测。线性回归分析检验了HbA1c和HTL在低频(0.25-2 kHz)和高频(4-8 kHz)范围内的相关性。结果参与者平均年龄为49.1±7.8岁,平均HbA1c为6.9±1.2%。线性回归显示HbA1c和HTL在低频范围(β = 0.93, 95% CI: 2.30-2.98, p < 0.001)和高频范围(β = 0.91, 95% CI: 4.05-5.46, p < 0.001)均呈显著正相关。在两个频率范围内,年龄也与HTL显著相关(p < 0.001)。结论沙特成年T2DM患者HbA1c水平升高与听力阈值升高显著相关,提示血糖控制不良可能导致听力功能障碍。这些发现支持将常规听力学评估纳入糖尿病护理方案。
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Diabetes epidemiology and management
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