Diabetes epidemiology and management最新文献_第4页

Prevalence of diabetes-related sarcopenia and its defining components within primary care: A cross-sectional study 初级保健中糖尿病相关肌肉减少症的患病率及其定义成分：一项横断面研究

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-04-01 Epub Date: 2025-01-23 DOI: 10.1016/j.deman.2025.100252

Rubén Silva-Tinoco , Lilia Castillo-Martínez , Berenice Cabrera-Victoria , Eileen Guzmán-Olvera , Christian Hinojosa-Segura , Alejandro Avalos-Bracho , Cira Santillán-Díaz

Background

Diabetes-related sarcopenia is a significant contributor to the global prevalence of sarcopenia. Both conditions become more prevalent with age and amplify the risk of adverse outcomes. This study aimed to assess the prevalence of sarcopenia and at-risk morphofunctional (MF) phenotypes and to identify the factors associated in patients with type 2 diabetes (T2D), including non-elderly adults, in primary care settings

Methods

This cross-sectional study included 261 individuals managed in primary care units in Mexico City, between July 2022 and May 2024. Assessments followed the guidelines of the European Working Group on Sarcopenia in Older Adults (EWGSOP2) to identify isolated low muscle mass, low muscle strength, and sarcopenia or severe sarcopenia

Results

The mean age of the participants (57.1 % female) was 51.1 ± 12.1 years, with a median diabetes duration of 7 (1–15) years. An altered MF assessment was observed in 159 participants, with 14.1 % exhibiting sarcopenia, 5.4 % isolated low muscle strength, and 41.4 % isolated low muscle mass. Univariate logistic regression analysis identified that age, educational level, diabetes duration, weight, body mass index, waist circumference, hip circumference, fat mass, use, and insulin dose were associated with altered MF assessment. Multivariable analyses showed that hip circumference and hypertriglyceridemia were associated with a lower risk of altered MF assessment, whereas the interactions between age and fat mass increased the risk.

Conclusions

This primary care study, which included elderly and non-elderly adults with T2D, revealed a relatively high prevalence of altered MF assessments, including sarcopenia, low muscle strength, and low muscle mass. Early recognition of sarcopenia spectrum disorders is essential for the timely prevention of adverse outcomes related to diabetic sarcopenia in primary care settings.

背景：糖尿病相关的肌肉减少症是全球肌肉减少症流行的重要因素。这两种情况都随着年龄的增长而变得更加普遍，并增加了不良后果的风险。本研究旨在评估骨骼肌减少症和高危形态功能（MF）表型的患病率，并确定2型糖尿病（T2D）患者（包括非老年人）在初级保健机构中的相关因素。方法本横断面研究包括2022年7月至2024年5月期间在墨西哥城初级保健单位管理的261名患者。评估遵循欧洲老年人肌肉减少症工作组（EWGSOP2）的指导方针，以确定孤立的低肌肉质量，低肌肉力量和肌肉减少症或严重的肌肉减少症。结果参与者的平均年龄（57.1%为女性）为51.1±12.1岁，中位糖尿病持续时间为7（1-15）年。在159名参与者中观察到改变的MF评估，其中14.1%表现为肌肉减少症，5.4%表现为低肌肉力量，41.4%表现为低肌肉质量。单变量logistic回归分析发现，年龄、受教育程度、糖尿病病程、体重、体重指数、腰围、臀围、脂肪量、使用情况和胰岛素剂量与MF评估的改变有关。多变量分析显示，臀围和高甘油三酯血症与MF评估改变的风险较低相关，而年龄和脂肪量之间的相互作用增加了风险。结论：这项初级保健研究，包括老年和非老年T2D患者，揭示了MF评估改变的相对较高的患病率，包括肌肉减少症、低肌肉力量和低肌肉质量。早期识别肌少症谱系障碍对于及时预防初级保健机构中与糖尿病性肌少症相关的不良后果至关重要。

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引用次数: 0

The rise in incidence of pediatric type 2 diabetes during the COVID-19 pandemic and the virus as a potential causative factor COVID-19大流行期间儿童2型糖尿病发病率的上升以及该病毒作为潜在的致病因素

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-04-01 Epub Date: 2025-01-24 DOI: 10.1016/j.deman.2025.100258

Andrew Kanouse , Joanna S. Fishbein , Parissa Salemi

Aim

The prevalence of type 2 diabetes continues to rise across multiple demographics but there was an especially large increase in incidence during the COVID-19 pandemic. A pre-existing diagnosis of type 2 diabetes is generally associated with more difficulties with viral infections, as seen with COVID-19, but it is less clear if a reverse causal association exists between the development of type 2 diabetes and infection with the COVID-19 virus. Our aim was to determine if an association exists between the COVID-19 virus and new diagnoses of pediatric type 2 diabetes.

Methods

We examined 130 new patients in our pediatric endocrinology practice diagnosed with type 2 diabetes immediately before and just after the emergence of the pandemic to determine if there was a change in presenting characteristics between these two periods.

Results

Our data showed an increase in the incidence of type 2 diabetes (p < 0.0001) and a lower mean presenting age (p = 0.03) during the COVID-19 pandemic without differences in other parameters.

Conclusion

We believe these results suggest that the development of type 2 diabetes following COVID-19 infection is due to mechanisms inherent to the virus itself and that younger patients are especially at an increased risk.

多种人口统计数据显示，2型糖尿病的患病率持续上升，但在2019冠状病毒病大流行期间，发病率增幅尤其大。如COVID-19所示，先前的2型糖尿病诊断通常与病毒感染的更多困难相关，但2型糖尿病的发展与COVID-19病毒感染之间是否存在反向因果关系尚不清楚。我们的目的是确定COVID-19病毒与儿童2型糖尿病的新诊断之间是否存在关联。方法我们在小儿内分泌科的实践中检查了130例新诊断为2型糖尿病的患者，这些患者在大流行出现之前和之后不久被诊断为2型糖尿病，以确定这两个时期之间的表现特征是否有变化。结果我们的数据显示2型糖尿病的发病率增加(p <；0.0001)和较低的平均呈现年龄（p = 0.03），在COVID-19大流行期间，其他参数无差异。结论我们认为，这些结果表明，COVID-19感染后2型糖尿病的发展是由于病毒本身固有的机制，特别是年轻患者的风险增加。

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引用次数: 0

Prevalence of various psychotic disorders among patients with type 2 diabetes: Real-world evidence from Shanghai, China 2型糖尿病患者中各种精神障碍的患病率：来自中国上海的真实世界证据

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-04-01 Epub Date: 2025-04-17 DOI: 10.1016/j.deman.2025.100259

Yunxi Ji , Ping He , Yingxia Zhou , Huayan Yao , Yanbin Xue , Renjie Jing , Tingyu Zhang , Wen Sun , Ping Lu , Bin Cui , Weiqing Wang

Aims

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that significantly impacts psychotic health, leading to increased incidence and mortality. We aim to explore the status of patients with T2DM and the issue of comorbid psychotic disorders.

Methods

Our study estimated the characteristics of 836,120 patients with T2DM from 2019 to 2023 based on electronic health records from the Shanghai Link Database (SHLD). We calculated the prevalence of the four major psychotic disorders in patients with T2DM, including depression, anxiety, dementia, and schizophrenia. The data was also stratified by age, sex, and other factors. Additionally, the association between diabetes complications and various psychotic disorders was investigated.

Results

We observed that the age group of 55-80 counted for about 68.15% of the total population with T2DM. There were more male patients with T2DM than females, but females exhibited a higher overall prevalence of psychotic disorders compared to males. For patients with T2DM, anxiety had the highest prevalence (3.97%), followed by depression (2.33%), dementia (2.04%), and schizophrenia (0.16%). There was a significant relationship between psychotic disorders and various diabetes complications.

Conclusions

The high prevalence of psychotic disorders among patients with T2DM highlights the importance of considering the impact of their comorbid psychotic illnesses when treating T2DM. Developing high-quality diabetes healthcare and implementing targeted treatment and management plans are essential in addressing these issues.

目的：2型糖尿病（T2DM）是一种慢性代谢紊乱，严重影响精神健康，导致发病率和死亡率增加。我们的目的是探讨T2DM患者的状况和共病性精神障碍的问题。方法基于上海Link数据库（SHLD）的电子健康记录，对2019 - 2023年836,120例T2DM患者的特征进行估计。我们计算了T2DM患者中四种主要精神障碍的患病率，包括抑郁、焦虑、痴呆和精神分裂症。数据还按年龄、性别和其他因素分层。此外，还研究了糖尿病并发症与各种精神障碍之间的关系。结果55 ~ 80岁年龄组占T2DM患者总数的68.15%。男性2型糖尿病患者多于女性，但女性精神障碍的总体患病率高于男性。在T2DM患者中，焦虑患病率最高（3.97%），其次是抑郁（2.33%）、痴呆（2.04%）和精神分裂症（0.16%）。精神障碍与各种糖尿病并发症之间存在显著相关性。结论T2DM患者中精神疾病的高发突出了在治疗T2DM时考虑其合并症精神疾病影响的重要性。发展高质量的糖尿病保健和实施有针对性的治疗和管理计划对于解决这些问题至关重要。

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引用次数: 0

Autoantibodies in type 1 diabetes: Prevalence and clinical profiles 1 型糖尿病的自身抗体：发病率和临床特征

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-01-01 Epub Date: 2024-10-29 DOI: 10.1016/j.deman.2024.100246

Raja Hazime , Saad Lamjadli , Morad Guennouni , Mounir Belkrachni , Fatima-Ezzohra Eddehbi , Ider Oujamaa , Lahcen Elmoumou , Aicha Bourrahouate , Imane Ait Sab , Hicham Baizri , Nawal El Ansari , Brahim Admou

Type 1 diabetes mellitus (T1D) is one of the most common chronic diseases in children and is associated with acute and serious chronic complications. T1D is characterized by the destruction of insulin-producing beta cells in the pancreas, with the emergence of circulating autoantibodies (a-Abs) targeting β cell antigens. Identifying autoantibodies can help predict the onset of T1D and associated autoimmune disorders, enhancing patient management strategies.

We aimed to determine the prevalence of T1D autoantibodies and their clinical significance in the pediatric and adult populations. A multicenter cross-sectional study was carried out on 276 patient-first with T1D, including 167 pediatric (60.5 %) and 109 adult (39.5 %) cases, of which 144 were female and 132 were male (sex ratio= 0.91),with an average age of 14.1 ± 8.0 years. The immunological investigation was based on the detection of T1D related a-Abs, including anti-insulin, anti-glutamic acid decarboxylase (GAD65), anti-insulinoma-associated antigen 2 (IA2), and anti-zinc transporter 8 (ZnT8) specificities. The results revealed an overall autoantibody seropositivity rate of 75.36 % (n= 208). Among the positive cases, GAD65 antibodies were the most prevalent at 37.31 %, followed by anti-insulin and anti-ZnT8 antibodies, each at 36.59 %, and anti-IA2 at 28.62 %. Additionally, 45,67 % of patients had one a-Abs, 28.36 % had a two, 21.15 % had three, and 4.8 % had all four a-Abs.

A statistically significant difference was observed between the seropositive and seronegative groups regarding the presence of associated autoimmune diseases (p = 0.005). These findings align with the existing literature, highlighting the importance and scientific value of detecting a-Abs in patients with T1D.

1 型糖尿病（T1D）是儿童最常见的慢性疾病之一，并伴有急性和严重的慢性并发症。T1D的特征是胰腺中产生胰岛素的β细胞遭到破坏，同时出现针对β细胞抗原的循环自身抗体（a-Abs）。识别自身抗体有助于预测 T1D 和相关自身免疫性疾病的发病，从而改善患者管理策略。我们的目的是确定 T1D 自身抗体在儿童和成人人群中的流行率及其临床意义。我们对276名T1D患者进行了多中心横断面研究，包括167名儿童（60.5%）和109名成人（39.5%），其中女性144名，男性132名（性别比= 0.91），平均年龄为（14.1 ± 8.0）岁。免疫学调查的基础是检测与 T1D 相关的 a-抗体，包括抗胰岛素、抗谷氨酸脱羧酶（GAD65）、抗胰岛素瘤相关抗原 2（IA2）和抗锌转运体 8（ZnT8）特异性抗体。结果显示，总体自身抗体血清阳性率为 75.36%（n= 208）。在阳性病例中，GAD65 抗体最普遍，占 37.31%，其次是抗胰岛素抗体和抗 ZnT8 抗体，各占 36.59%，抗 IA2 抗体占 28.62%。此外，45.67% 的患者有一种 a 抗体，28.36% 的患者有两种，21.15% 的患者有三种，4.8% 的患者有四种 a 抗体。这些研究结果与现有文献一致，强调了在 T1D 患者中检测 a-Abs 的重要性和科学价值。

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引用次数: 0

Reply to increase in diabetic deaths during COVID-19 pandemic. Some comments 对 COVID-19 大流行期间糖尿病死亡人数增加的答复。一些评论

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-01-01 Epub Date: 2024-10-15 DOI: 10.1016/j.deman.2024.100240

Camilla Mattiuzzi, Giuseppe Lippi

引用次数: 0

Innovative immunotherapies and emerging treatments in type 1 diabetes management 1 型糖尿病管理中的创新免疫疗法和新兴疗法

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-01-01 Epub Date: 2024-11-13 DOI: 10.1016/j.deman.2024.100247

Malek Zarei , Mohammad Abbas Sheikholeslami , Masoud Mozaffari , Yassar Mortada

Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease characterized by the selective destruction of pancreatic insulin-producing beta cells, primarily mediated by CD4+ and CD8+ T cells. This review comprehensively examines the latest advances in immunotherapeutic approaches to T1D, categorizing current strategies into four main groups: antigen-independent therapies, antigen-dependent therapies, beta cell therapies, and stem cell therapies. Antigen-independent strategies, such as antibody-based therapies (e.g., Abatacept and Teplizumab) and cytokine inhibitors (e.g., Anakinra and Etanercept), have shown potential in preserving beta cell function by modulating immune responses. Antigen-dependent strategies focus on inducing immune tolerance to specific beta cell antigens, with mixed results from clinical trials involving autoantigen vaccines like GAD65. Beta cell therapies, including islet transplantation, offer promising outcomes but face challenges related to immunosuppression and donor availability. Stem cell therapies, particularly using mesenchymal stem cells (MSCs) and autologous hematopoietic stem cells (HSCs), demonstrate potential in immune modulation and beta cell regeneration. Novel approaches, such as Chimeric Antigen Receptor (CAR)–Tregs therapy and JAK-STAT pathway inhibition, represent exciting areas of ongoing research. This comprehensive overview underscores the necessity of personalized therapeutic approaches and continued research to optimize existing therapies and explore new targets, ultimately aiming to improve outcomes and achieve a potential cure for T1D.

1 型糖尿病（T1D）是一种慢性自身免疫性疾病，主要由 CD4+ 和 CD8+ T 细胞介导，以选择性破坏胰岛分泌胰岛素的 beta 细胞为特征。本综述全面探讨了治疗 T1D 的免疫疗法的最新进展，并将目前的疗法分为四大类：抗原依赖性疗法、抗原依赖性疗法、β 细胞疗法和干细胞疗法。抗原依赖型疗法，如抗体疗法（如阿巴他赛普和替普利珠单抗）和细胞因子抑制剂（如阿纳金拉和依那西普），已显示出通过调节免疫反应保护β细胞功能的潜力。抗原依赖性策略侧重于诱导对特定β细胞抗原的免疫耐受，涉及自身抗原疫苗（如 GAD65）的临床试验结果喜忧参半。β细胞疗法（包括胰岛移植）的疗效很好，但也面临着免疫抑制和供体供应方面的挑战。干细胞疗法，特别是使用间充质干细胞（MSCs）和自体造血干细胞（HSCs）的疗法，在免疫调节和β细胞再生方面显示出潜力。嵌合抗原受体（CAR）-Tregs疗法和JAK-STAT通路抑制等新方法是令人兴奋的研究领域。这一全面概述强调了个性化治疗方法和持续研究的必要性，以优化现有疗法并探索新的靶点，最终改善治疗效果并实现治愈 T1D 的可能。

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引用次数: 0

High prevalence of prediabetes and type 2 diabetes, and identification of associated factors, in high-risk adults in Vietnam: A cross-sectional study 越南高危成年人中糖尿病前期和 2 型糖尿病的高发病率以及相关因素的识别：横断面研究

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-01-01 Epub Date: 2024-10-09 DOI: 10.1016/j.deman.2024.100239

Tran Bao Vuong , Triet Minh Tran , Nam Quang Tran

Objectives

The prevalences of diabetes and prediabetes have increased rapidly in recent years in emerging nations such as Vietnam, particularly in the population at high risk of diabetes. This study aimed to investigate the prevalence of prediabetes and undiagnosed diabetes in individuals at high risk of type 2 diabetes (T2D), as well as the related risk factors.

Methods

This cross-sectional study at the clinics of the University Medical Center in Ho Chi Minh City included 360 patients who were 18 years of age or older, and were at risk of developing T2D. The diagnosis of prediabetes and diabetes relied on measurements of fasting plasma glucose, HbA1c, and 2-hour plasma glucose after a 75 g oral glucose tolerance test.

Results

The prevalence of prediabetes was 60.6 % (95 % CI: 55.3–65.6 %), and the prevalence of diabetes was 18.3 % (95 % CI: 14.6–22.8 %). Older age (OR = 1.06), obesity (OR = 3.89), hypertension (OR = 5.71), and dyslipidemia (OR = 2.01) were factors associated with increasing frequencies of undiagnosed T2D and prediabetes.

Conclusion

The prevalences of prediabetes and undiagnosed diabetes were significantly higher among people with a high-risk of dysglycemia in Vietnam. There is a need for screening programs for such high-risk individuals.

目的近年来，在越南等新兴国家，糖尿病和糖尿病前期的发病率迅速上升，尤其是在糖尿病高危人群中。本研究旨在调查 2 型糖尿病（T2D）高风险人群中糖尿病前期和未确诊糖尿病的患病率，以及相关风险因素。方法这项横断面研究在胡志明市大学医疗中心诊所进行，共纳入 360 名年龄在 18 岁或以上、有患 T2D 风险的患者。糖尿病前期和糖尿病的诊断依赖于空腹血浆葡萄糖、HbA1c 和 75 克口服葡萄糖耐量试验后 2 小时血浆葡萄糖的测量结果。结果糖尿病前期的患病率为 60.6%（95 % CI：55.3-65.6%），糖尿病的患病率为 18.3%（95 % CI：14.6-22.8%）。高龄（OR = 1.06）、肥胖（OR = 3.89）、高血压（OR = 5.71）和血脂异常（OR = 2.01）是未确诊 T2D 和糖尿病前期发病率增加的相关因素。有必要针对此类高危人群开展筛查计划。

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引用次数: 0

The role of clinical pharmacists in improving diabetic care of hospitalized heart patients 临床药师在改善住院心脏病患者糖尿病护理中的作用

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-01-01 Epub Date: 2024-11-30 DOI: 10.1016/j.deman.2024.100248

Sanaa Mekdad, Leenah Alsayed, Susan Alkhulaif

Introduction

Globally, diabetes is becoming an increasingly prevalent chronic illness. Managing glucose levels in patients with diabetes presents a significant challenge that requires collaboration with medical specialists. Clinical pharmacists play a crucial role in diabetes management, positively influencing patient outcomes and improving overall quality of care.

Objectives

The purpose of this research is to understand how clinical pharmacists at King Fahad Medical City impact the management of hospitalized patients with diabetes and cardiac conditions.

Method

A prospective randomized study was conducted at the Cardiac Center of King Fahad Medical City, involving patients admitted between 2019 and 2023. Participants were assigned to one of two groups: one managed by clinical pharmacists (n = 500) and the other receiving standard care without clinical pharmacists (n = 500). Patients were followed up with six months following the clinical pharmacist's intervention, as well as concurrently with data collection, baseline measurements of glycosylated hemoglobin (HbAC), fasting blood glucose (FBG), and the frequency of hypoglycemic episodes. after intervention. Concurrently, included (HbA1c), after intervention. Concurrently, collection included (HbA1c), episodes following the

Results

Both groups demonstrated a decrease in HbA1c levels. The intervention group experienced a reduction in HbA1c from 10.2 % to 8.5 % (SD = 2.2, p = 0.04). In contrast, the control group showed a decrease in HbA1c from 9.95 % to 9.05 % (SD = 1.95, p = 0.05). Additionally, fasting blood glucose (FBG) levels in the intervention group decreased by 29 mg/dL, while the decline in the control group was not statistically significant, at 9 mg/dL. The difference in HbA1c levels was statistically significant, as determined by both t-tests.

Conclusions

As a member of a multidisciplinary team, a clinical pharmacist can play a crucial role in monitoring diabetes in hospitalized patients with heart conditions. Their interventions can more effectively lower HbA1c levels and fasting blood glucose (FBG) in these patients compared to standard care.

在全球范围内，糖尿病正在成为一种日益普遍的慢性疾病。管理糖尿病患者的血糖水平是一项重大挑战，需要与医学专家合作。临床药师在糖尿病管理中发挥着至关重要的作用，积极影响患者的预后，提高整体护理质量。目的了解法赫德国王医疗城的临床药师如何影响糖尿病和心脏病住院患者的管理。方法在法赫德国王医疗城心脏中心进行前瞻性随机研究，纳入2019年至2023年入院的患者。参与者被分配到两组中的一组：一组由临床药师管理（n = 500），另一组接受没有临床药师的标准治疗（n = 500）。在临床药师的干预下，对患者进行了为期6个月的随访，同时收集数据、糖化血红蛋白（HbAC）基线测量、空腹血糖（FBG）和低血糖发作频率。后干预。同时，纳入（HbA1c），干预后。同时，收集包括（HbA1c），以下事件。结果两组均显示HbA1c水平下降。干预组HbA1c从10.2%降至8.5% （SD = 2.2, p = 0.04）。对照组HbA1c由9.95%降至9.05% （SD = 1.95, p = 0.05）。此外，干预组的空腹血糖（FBG）水平下降了29 mg/dL，而对照组的下降无统计学意义，为9 mg/dL。两组HbA1c水平的差异均具有统计学意义。结论临床药师作为多学科团队的一员，对住院心脏病患者的糖尿病监测具有重要作用。与标准治疗相比，他们的干预措施可以更有效地降低这些患者的HbA1c水平和空腹血糖（FBG）。

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引用次数: 0

Increase in diabetic deaths during COVID-19 pandemic. Some comments COVID-19 大流行期间糖尿病死亡人数增加。一些评论

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-01-01 Epub Date: 2024-09-28 DOI: 10.1016/j.deman.2024.100238

Salvatore Chirumbolo

引用次数: 0

The impact of the COVID-19 pandemic on diabetes-related mortality COVID-19 大流行对糖尿病相关死亡率的影响

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management

Pub Date : 2025-01-01 Epub Date: 2024-08-03 DOI: 10.1016/j.deman.2024.100236

Camilla Mattiuzzi, Giuseppe Lippi