首页 > 最新文献

Primary care diabetes最新文献

英文 中文
Level of interprofessionalism in the management of T2D in primary care: All-cause and cause-specific mortality. 初级保健中t2dm管理的跨专业水平:全因死亡率和病因特异性死亡率。
IF 2.3 Pub Date : 2026-02-09 DOI: 10.1016/j.pcd.2026.02.002
Eero Mellanen, Timo Kauppila, Hannu Kautiainen, Mika Lehto, Ossi Rahkonen, Kaisu H Pitkälä, Merja K Laine

Aims: This study aimed to examine the association of the level of nurse and general practitioner (GP) interprofessional care on all-cause and cause-specific mortality in patients aged 60 years or more with T2D.

Methods: This cohort study was conducted between January 2002 and December 2018 in the public primary health care of Vantaa, Finland. An index was created to measure the level of interprofessional care. Mortality was measured with standardized mortality ratio (SMR). Analyzed causes of death included cardiovascular diseases, dementia, digestive system diseases, cancer and respiratory diseases.

Results: 11 020 patients were followed for 71 598 person years. Mean follow-up time was 7.3 years. The group with slightly nurse-centred care had the lowest mortality (SMR 0.92, 95 % CI 0.87 - 0.97) and the group with the most GP-centred care had the highest mortality (SMR 2.69: 95 % CI 2.27 - 3.19). Cardiovascular diseases were the leading cause of death in all groups followed by cancer and dementia varying in rank.

Conclusions: Slightly nurse-centred interprofessional care might reduce mortality in patients with T2D. Common causes of death in general population were prevalent in patients with T2D.

目的:本研究旨在探讨60岁及以上T2D患者的护士和全科医生(GP)跨专业护理水平与全因和病因特异性死亡率的关系。方法:本队列研究于2002年1月至2018年12月在芬兰万塔市的公共初级卫生保健中心进行。创建了一个指数来衡量跨专业护理的水平。采用标准化死亡率(SMR)测定死亡率。分析的死亡原因包括心血管疾病、痴呆、消化系统疾病、癌症和呼吸系统疾病。结果:随访11 020例,随访时间为71 598人年。平均随访时间7.3年。稍微以护士为中心的护理组死亡率最低(SMR 0.92, 95 % CI 0.87 ~ 0.97),而最以gp为中心的护理组死亡率最高(SMR 2.69: 95 % CI 2.27 ~ 3.19)。在所有人群中,心血管疾病是导致死亡的主要原因,其次是癌症和痴呆,排名各不相同。结论:稍微以护士为中心的跨专业护理可能降低T2D患者的死亡率。一般人群中常见的死亡原因在T2D患者中普遍存在。
{"title":"Level of interprofessionalism in the management of T2D in primary care: All-cause and cause-specific mortality.","authors":"Eero Mellanen, Timo Kauppila, Hannu Kautiainen, Mika Lehto, Ossi Rahkonen, Kaisu H Pitkälä, Merja K Laine","doi":"10.1016/j.pcd.2026.02.002","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.02.002","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to examine the association of the level of nurse and general practitioner (GP) interprofessional care on all-cause and cause-specific mortality in patients aged 60 years or more with T2D.</p><p><strong>Methods: </strong>This cohort study was conducted between January 2002 and December 2018 in the public primary health care of Vantaa, Finland. An index was created to measure the level of interprofessional care. Mortality was measured with standardized mortality ratio (SMR). Analyzed causes of death included cardiovascular diseases, dementia, digestive system diseases, cancer and respiratory diseases.</p><p><strong>Results: </strong>11 020 patients were followed for 71 598 person years. Mean follow-up time was 7.3 years. The group with slightly nurse-centred care had the lowest mortality (SMR 0.92, 95 % CI 0.87 - 0.97) and the group with the most GP-centred care had the highest mortality (SMR 2.69: 95 % CI 2.27 - 3.19). Cardiovascular diseases were the leading cause of death in all groups followed by cancer and dementia varying in rank.</p><p><strong>Conclusions: </strong>Slightly nurse-centred interprofessional care might reduce mortality in patients with T2D. Common causes of death in general population were prevalent in patients with T2D.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159690","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
Translation and validation of the Chinese version of Type 2 Diabetes Distress Assessment System (C-T2-DDAS). 2型糖尿病痛苦评估系统(C-T2-DDAS)中文版的翻译与验证
IF 2.3 Pub Date : 2026-02-02 DOI: 10.1016/j.pcd.2026.01.008
Hau Yi Ngan, Cho Lee Wong, Kai Chow Choi, Kit Man Loo, Hon Lon Tam

Aims: This study aimed to translate the Type 2 Diabetes Distress Assessment System (T2-DDAS) into Traditional Chinese (C-T2-DDAS) and evaluate its psychometric properties among individuals with type 2 diabetes in Hong Kong. T2-DDAS is a comprehensive tool designed to assess diabetes-related core emotional distress and the sources contributing to the distress.

Methods: A two-phase approach was employed. Phase 1 involved translation and cultural adaptation through forward and backward translation, expert panel review, and pilot testing. Phase 2 comprised a cross-sectional validation study with 292 participants recruited from a public hospital outpatient clinic. Psychometric evaluation included assessments of reliability (internal consistency and test-retest), content validity, structural validity via confirmatory factor analysis, and convergent validity through correlations with the Chinese Diabetes Distress Scale.

Results: The C-T2-DDAS demonstrated good internal consistency (0.95 for CORE scale; 0.76-0.88 for seven SOURCE scales) and moderate test-retest reliability (ICC = 0.63). Content validity indices were high (S-CVI = 1.00 for CORE; 0.96 for seven SOURCE scales). Confirmatory factor analysis supported the original eight-factor structure, indicating a strong model fit (RMSEA = 0.045; SRMR = 0.041; CFI/NNFI = 1.00). Convergent validity was confirmed through strong correlations with the Chinese Diabetes Distress Scale (CORE scale: r = 0.78, p < 0.001).

Conclusions: The C-T2-DDAS is a reliable and culturally appropriate tool for assessing diabetes-related distress in Chinese adults with type 2 diabetes. Its multidimensional structure facilitates targeted psychosocial interventions, supporting routine screening and improved diabetes management in both clinical and research contexts. Future research should explore its longitudinal responsiveness and applicability across broader Chinese-speaking populations.

目的:本研究旨在将2型糖尿病困扰评估系统(T2-DDAS)翻译成中文(C-T2-DDAS),并评估其在香港2型糖尿病患者中的心理测量特性。T2-DDAS是一个综合性的工具,旨在评估糖尿病相关的核心情绪困扰和造成困扰的来源。方法:采用两阶段方法。第一阶段涉及翻译和文化适应,包括前向和后向翻译、专家小组评审和试点测试。第二阶段包括一项横断面验证研究,从一家公立医院门诊招募了292名参与者。心理测量评估包括信度评估(内部一致性和重测)、内容效度评估、验证性因子分析的结构效度评估以及与中国糖尿病困扰量表相关的收敛效度评估。结果:C-T2-DDAS具有良好的内部一致性(CORE量表为0.95,SOURCE量表为0.76-0.88 )和中等的重测信度(ICC = 0.63)。内容效度指标较高(CORE的S-CVI = 1.00, 7个SOURCE量表的S-CVI = 0.96)。验证性因子分析支持原始的八因子结构,表明模型拟合较强(RMSEA = 0.045; SRMR = 0.041; CFI/NNFI = 1.00)。通过与中国糖尿病困扰量表(CORE量表:r = 0.78,p )的强相关性证实了收敛效度:结论:C-T2-DDAS是评估中国成人2型糖尿病患者糖尿病相关困扰的可靠且文化上合适的工具。它的多维结构有助于有针对性的社会心理干预,支持常规筛查和改善临床和研究背景下的糖尿病管理。未来的研究应探索其在更广泛的汉语人群中的纵向响应性和适用性。
{"title":"Translation and validation of the Chinese version of Type 2 Diabetes Distress Assessment System (C-T2-DDAS).","authors":"Hau Yi Ngan, Cho Lee Wong, Kai Chow Choi, Kit Man Loo, Hon Lon Tam","doi":"10.1016/j.pcd.2026.01.008","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.01.008","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to translate the Type 2 Diabetes Distress Assessment System (T2-DDAS) into Traditional Chinese (C-T2-DDAS) and evaluate its psychometric properties among individuals with type 2 diabetes in Hong Kong. T2-DDAS is a comprehensive tool designed to assess diabetes-related core emotional distress and the sources contributing to the distress.</p><p><strong>Methods: </strong>A two-phase approach was employed. Phase 1 involved translation and cultural adaptation through forward and backward translation, expert panel review, and pilot testing. Phase 2 comprised a cross-sectional validation study with 292 participants recruited from a public hospital outpatient clinic. Psychometric evaluation included assessments of reliability (internal consistency and test-retest), content validity, structural validity via confirmatory factor analysis, and convergent validity through correlations with the Chinese Diabetes Distress Scale.</p><p><strong>Results: </strong>The C-T2-DDAS demonstrated good internal consistency (0.95 for CORE scale; 0.76-0.88 for seven SOURCE scales) and moderate test-retest reliability (ICC = 0.63). Content validity indices were high (S-CVI = 1.00 for CORE; 0.96 for seven SOURCE scales). Confirmatory factor analysis supported the original eight-factor structure, indicating a strong model fit (RMSEA = 0.045; SRMR = 0.041; CFI/NNFI = 1.00). Convergent validity was confirmed through strong correlations with the Chinese Diabetes Distress Scale (CORE scale: r = 0.78, p < 0.001).</p><p><strong>Conclusions: </strong>The C-T2-DDAS is a reliable and culturally appropriate tool for assessing diabetes-related distress in Chinese adults with type 2 diabetes. Its multidimensional structure facilitates targeted psychosocial interventions, supporting routine screening and improved diabetes management in both clinical and research contexts. Future research should explore its longitudinal responsiveness and applicability across broader Chinese-speaking populations.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115542","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
Sex-specific associations of lipid profiles with type 2 diabetes: Insights from the Shiraz University employees cohort. 脂质谱与2型糖尿病的性别特异性关联:来自设拉子大学员工队列的见解
IF 2.3 Pub Date : 2026-01-30 DOI: 10.1016/j.pcd.2026.01.001
Saeid Zare, Seyed Jalil Masoumi, Andishe Hamedi, Atefeh Torabi Ardekani, Jafar Hassanzadeh

Aims: Type 2 diabetes (T2D) is a growing global health concern, with its prevalence rising rapidly in Iran. Dysregulation of lipid metabolism has been implicated in the development of T2D, yet potential differences between men and women remain underexplored. Lipid markers, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and the TG/HDL-C ratio, may serve as early predictors of metabolic dysfunction. This study investigates the sex-specific associations between lipid profiles and T2D within the Shiraz University Employees Cohort.

Methods: Data from 7100 participants of the Shiraz University Employees Cohort, with type 2 diabetes at baseline, were analyzed. Demographic, anthropometric, and biochemical data, including lipid profiles (TG, HDL-C, TC, LDL-C) and derived ratios (TG/HDL-C, TC/HDL-C), were collected. Sex-specific logistic regression and ROC analyses were used to evaluate the association between lipid indices and type 2 diabetes and to determine optimal cut-off points RESULTS: The study included 3035 men and 4047 women. Higher TG and TG/HDL-C ratios were observed in person with diabetes, with 1-SD increases in TG/HDL-C raising diabetes odds (men: OR=1.28, 95 % CI 1.12-1.45; women: OR=1.35, 95 % CI 1.19-1.52), while HDL-C was protective (men: OR=0.80, 95 % CI 0.66-0.98; women: OR=0.81, 95 % CI 0.67-0.97). TG/HDL-C cut-offs of 3.72 (men) and 2.73 (women) showed the best predictive performance.

Conclusion: TG and TG/HDL-C ratios are simple, accessible, and independent predictors of type 2 diabetes, especially in women, and can help identify high-risk individuals for targeted preventive interventions in clinical settings.

目的:2型糖尿病(T2D)是一个日益严重的全球健康问题,其患病率在伊朗迅速上升。脂质代谢失调与T2D的发展有关,但男性和女性之间的潜在差异仍未得到充分探讨。脂质标志物,包括甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和TG/HDL-C比值,可以作为代谢功能障碍的早期预测指标。本研究调查了设拉子大学员工队列中脂质谱和T2D之间的性别特异性关联。方法:对来自设拉子大学雇员队列的7100名基线时患有2型糖尿病的参与者的数据进行分析。收集了人口统计学、人体测量学和生化数据,包括脂质谱(TG、HDL-C、TC、LDL-C)和衍生比率(TG/HDL-C、TC/HDL-C)。使用性别特异性logistic回归和ROC分析来评估脂质指数与2型糖尿病之间的关系,并确定最佳分界点。结果:该研究包括3035名男性和4047名女性。在糖尿病患者中观察到较高的TG和TG/HDL-C比值,TG/HDL-C升高1-SD会增加患糖尿病的几率(男性:OR=1.28, 95 % CI 1.12-1.45;女性:OR=1.35, 95 % CI 1.19-1.52),而HDL-C具有保护作用(男性:OR=0.80, 95 % CI 0.66-0.98;女性:OR=0.81, 95 % CI 0.67-0.97)。TG/HDL-C的临界值分别为3.72(男性)和2.73(女性),表现出最好的预测效果。结论:TG和TG/HDL-C比值是2型糖尿病的简单、可及、独立的预测指标,特别是在女性中,可以帮助识别高危人群,在临床环境中进行有针对性的预防干预。
{"title":"Sex-specific associations of lipid profiles with type 2 diabetes: Insights from the Shiraz University employees cohort.","authors":"Saeid Zare, Seyed Jalil Masoumi, Andishe Hamedi, Atefeh Torabi Ardekani, Jafar Hassanzadeh","doi":"10.1016/j.pcd.2026.01.001","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.01.001","url":null,"abstract":"<p><strong>Aims: </strong>Type 2 diabetes (T2D) is a growing global health concern, with its prevalence rising rapidly in Iran. Dysregulation of lipid metabolism has been implicated in the development of T2D, yet potential differences between men and women remain underexplored. Lipid markers, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and the TG/HDL-C ratio, may serve as early predictors of metabolic dysfunction. This study investigates the sex-specific associations between lipid profiles and T2D within the Shiraz University Employees Cohort.</p><p><strong>Methods: </strong>Data from 7100 participants of the Shiraz University Employees Cohort, with type 2 diabetes at baseline, were analyzed. Demographic, anthropometric, and biochemical data, including lipid profiles (TG, HDL-C, TC, LDL-C) and derived ratios (TG/HDL-C, TC/HDL-C), were collected. Sex-specific logistic regression and ROC analyses were used to evaluate the association between lipid indices and type 2 diabetes and to determine optimal cut-off points RESULTS: The study included 3035 men and 4047 women. Higher TG and TG/HDL-C ratios were observed in person with diabetes, with 1-SD increases in TG/HDL-C raising diabetes odds (men: OR=1.28, 95 % CI 1.12-1.45; women: OR=1.35, 95 % CI 1.19-1.52), while HDL-C was protective (men: OR=0.80, 95 % CI 0.66-0.98; women: OR=0.81, 95 % CI 0.67-0.97). TG/HDL-C cut-offs of 3.72 (men) and 2.73 (women) showed the best predictive performance.</p><p><strong>Conclusion: </strong>TG and TG/HDL-C ratios are simple, accessible, and independent predictors of type 2 diabetes, especially in women, and can help identify high-risk individuals for targeted preventive interventions in clinical settings.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097710","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
Understanding insulin dose deviations in people with type 2 diabetes receiving telemonitoring: Comment. 了解接受远程监测的2型糖尿病患者的胰岛素剂量偏差:评论。
IF 2.3 Pub Date : 2026-01-27 DOI: 10.1016/j.pcd.2026.01.007
Jiajia Tong
{"title":"Understanding insulin dose deviations in people with type 2 diabetes receiving telemonitoring: Comment.","authors":"Jiajia Tong","doi":"10.1016/j.pcd.2026.01.007","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.01.007","url":null,"abstract":"","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069312","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
Semaglutide and tirzepatide in prediabetes: Evidence for diabetes prevention and cardiovascular protection. 西马鲁肽和替西帕肽用于糖尿病前期:糖尿病预防和心血管保护的证据。
IF 2.3 Pub Date : 2026-01-20 DOI: 10.1016/j.pcd.2026.01.003
Anastasios Tentolouris, Christos Siafarikas, Ioannis Ntanasis-Stathopoulos, Ioanna A Anastasiou, Eirini Kalara, Alexandros Briasoulis

Background: Prediabetes represents an intermediate stage in the dysglycemia continuum, associated with increased cardiometabolic risk but also substantial opportunity for prevention. The aim of this review was to summarize and critically evaluate the available evidence on the effects of semaglutide and tirzepatide in individuals with prediabetes, focusing on diabetes prevention and cardiovascular (CV) outcomes.

Methods: A narrative synthesis of data from randomized controlled trials, meta-analyses, and real-world studies assessing semaglutide and tirzepatide in people with prediabetes.

Results: Across the STEP 1, STEP 5, and SELECT trials, semaglutide 2.4 mg significantly increased regression to normoglycemia (up to 84 %) and reduced the risk of progression to diabetes compared with placebo. In the SURMOUNT-1 trial, tirzepatide reduced the incidence of diabetes by nearly 90 % (Hazard Ratio: 0.07; p < 0.001), an effect largely mediated by substantial weight loss. Regarding CV outcomes, the SELECT trial, of which 66.4 % of participants had prediabetes, demonstrated a significant reduction in the primary composite endpoint of CV death, nonfatal myocardial infarction, or nonfatal stroke with semaglutide versus placebo (hazard ratio 0.80; 95 % CI: 0.72-0.90). A prespecified analysis showed that CV risk reduction was independent of baseline HbA1c, supporting CV benefit in people with prediabetes. The ongoing SURMOUNT-MMO trial will further clarify the CV effects of tirzepatide in individuals with obesity without diabetes.

Conclusion: Semaglutide and tirzepatide markedly increase regression to normoglycemia and reduce progression to diabetes in people with obesity and prediabetes. Semaglutide has also demonstrated CV benefit in SELECT, including among participants with prediabetes. Ongoing outcome data, particularly from SURMOUNT-MMO, will further define the cardioprotective potential of GLP-1-based medicines across the dysglycemia spectrum.

背景:前驱糖尿病是血糖异常连续体的中间阶段,与心脏代谢风险增加有关,但也有大量预防机会。本综述的目的是总结和批判性评价关于西马鲁肽和替西帕肽对糖尿病前期个体影响的现有证据,重点关注糖尿病预防和心血管(CV)结局。方法:对随机对照试验、荟萃分析和现实世界研究的数据进行叙述性综合,评估西马鲁肽和替西帕肽在糖尿病前期患者中的作用。结果:在step1、step5和SELECT试验中,与安慰剂相比,semaglutide 2.4 mg显著增加了正常血糖的回归(高达84 %),并降低了进展为糖尿病的风险。在SURMOUNT-1试验中,替西帕肽将糖尿病的发病率降低了近90% %(危险比:0.07;p )结论:西马鲁肽和替西帕肽显著增加了肥胖和糖尿病前期患者向正常血糖的回归,并减少了糖尿病的进展。Semaglutide在SELECT中也显示出CV益处,包括糖尿病前期患者。正在进行的结果数据,特别是来自SURMOUNT-MMO的数据,将进一步确定基于glp -1的药物在血糖异常谱中的心脏保护潜力。
{"title":"Semaglutide and tirzepatide in prediabetes: Evidence for diabetes prevention and cardiovascular protection.","authors":"Anastasios Tentolouris, Christos Siafarikas, Ioannis Ntanasis-Stathopoulos, Ioanna A Anastasiou, Eirini Kalara, Alexandros Briasoulis","doi":"10.1016/j.pcd.2026.01.003","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.01.003","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes represents an intermediate stage in the dysglycemia continuum, associated with increased cardiometabolic risk but also substantial opportunity for prevention. The aim of this review was to summarize and critically evaluate the available evidence on the effects of semaglutide and tirzepatide in individuals with prediabetes, focusing on diabetes prevention and cardiovascular (CV) outcomes.</p><p><strong>Methods: </strong>A narrative synthesis of data from randomized controlled trials, meta-analyses, and real-world studies assessing semaglutide and tirzepatide in people with prediabetes.</p><p><strong>Results: </strong>Across the STEP 1, STEP 5, and SELECT trials, semaglutide 2.4 mg significantly increased regression to normoglycemia (up to 84 %) and reduced the risk of progression to diabetes compared with placebo. In the SURMOUNT-1 trial, tirzepatide reduced the incidence of diabetes by nearly 90 % (Hazard Ratio: 0.07; p < 0.001), an effect largely mediated by substantial weight loss. Regarding CV outcomes, the SELECT trial, of which 66.4 % of participants had prediabetes, demonstrated a significant reduction in the primary composite endpoint of CV death, nonfatal myocardial infarction, or nonfatal stroke with semaglutide versus placebo (hazard ratio 0.80; 95 % CI: 0.72-0.90). A prespecified analysis showed that CV risk reduction was independent of baseline HbA1c, supporting CV benefit in people with prediabetes. The ongoing SURMOUNT-MMO trial will further clarify the CV effects of tirzepatide in individuals with obesity without diabetes.</p><p><strong>Conclusion: </strong>Semaglutide and tirzepatide markedly increase regression to normoglycemia and reduce progression to diabetes in people with obesity and prediabetes. Semaglutide has also demonstrated CV benefit in SELECT, including among participants with prediabetes. Ongoing outcome data, particularly from SURMOUNT-MMO, will further define the cardioprotective potential of GLP-1-based medicines across the dysglycemia spectrum.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021214","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
Incidence and predictors of diabetic foot ulcers in newly diagnosed type 2 diabetes without complications: A prospective longitudinal cohort study. 新诊断的无并发症的2型糖尿病患者糖尿病足溃疡的发病率和预测因素:一项前瞻性纵向队列研究
IF 2.3 Pub Date : 2026-01-19 DOI: 10.1016/j.pcd.2026.01.006
Carmine Gazzaruso, Pietro Gallotti, Carmelo Pujia, Alberto Castagna, Colomba Falcone, Adriana Coppola

Aims: Diabetic foot ulcers (DFU) are a major cause of morbidity and mortality, but data on incidence and predictors in newly diagnosed, uncomplicated type 2 diabetes mellitus (T2DM) are limited. Aim of this longitudinal study was to quantify the incidence of first-ever DFU in newly diagnosed, complication-free T2DM and to identify predictors.

Methods: A total of 937 newly diagnosed, uncomplicated T2DM patients were enrolled between July 2013 and February 2019 and followed prospectively for 62.7 ± 21.5 months. The primary outcome was the first incident DFU.

Results: During follow-up, 48 patients (5.1 %) developed DFU (incidence 0.99/100 person-years). Multivariable Cox regression identified four independent predictors of incident DFU: baseline TcPO₂≤ 46 mmHg (Hazard Ratio -HR-=5.09, 95 %Confidence Interval -95 %CI-:2.68-9.65, p < 0.001), incident retinopathy (HR=6.11, 95 %CI=3.39-11.00, p < 0.001), incident polyneuropathy (HR=7.05, 95 %CI:3.94-12.62, p < 0.001), and incident micro-/macroalbuminuria (HR=2.67, 95 %CI:1.47-4.85, p < 0.001). Sexual dysfunction was more frequent in DFU patients (47.9 % vs. 31.3 %, p = 0.016) but was not an independent predictor.

Conclusions: In newly diagnosed, uncomplicated T2DM, reduced tissue oxygenation and early microvascular complications strongly predict DFU. TcPO₂ measurement at diagnosis may help identify high-risk patients who could benefit from targeted foot surveillance and preventive interventions. However, our findings cannot be applied to all T2DM patients due to the specific characteristics of our study population.

目的:糖尿病足溃疡(DFU)是发病和死亡的主要原因,但关于新诊断的无并发症2型糖尿病(T2DM)的发病率和预测因素的数据有限。这项纵向研究的目的是量化新诊断的无并发症T2DM患者首次DFU的发生率,并确定预测因素。方法:在2013年7月至2019年2月期间,共纳入937例新诊断的无并发症T2DM患者,前瞻性随访62.7 ± 21.5个月。主要结局是第一次事件DFU。结果:随访期间,48例(5.1% %)发生DFU(发病率0.99/100人年)。多变量Cox回归确定了4个独立的预测因素:基线TcPO₂≤ 46 mmHg(危险比- hr -=5.09, 95% %可信区间-95 %CI-:2.68-9.65, p )结论:在新诊断的无并发症T2DM中,组织氧合降低和早期微血管并发症强烈预测DFU。诊断时测量TcPO₂可能有助于识别高危患者,这些患者可能受益于有针对性的足部监测和预防性干预。然而,由于我们研究人群的特定特征,我们的研究结果不能适用于所有T2DM患者。
{"title":"Incidence and predictors of diabetic foot ulcers in newly diagnosed type 2 diabetes without complications: A prospective longitudinal cohort study.","authors":"Carmine Gazzaruso, Pietro Gallotti, Carmelo Pujia, Alberto Castagna, Colomba Falcone, Adriana Coppola","doi":"10.1016/j.pcd.2026.01.006","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.01.006","url":null,"abstract":"<p><strong>Aims: </strong>Diabetic foot ulcers (DFU) are a major cause of morbidity and mortality, but data on incidence and predictors in newly diagnosed, uncomplicated type 2 diabetes mellitus (T2DM) are limited. Aim of this longitudinal study was to quantify the incidence of first-ever DFU in newly diagnosed, complication-free T2DM and to identify predictors.</p><p><strong>Methods: </strong>A total of 937 newly diagnosed, uncomplicated T2DM patients were enrolled between July 2013 and February 2019 and followed prospectively for 62.7 ± 21.5 months. The primary outcome was the first incident DFU.</p><p><strong>Results: </strong>During follow-up, 48 patients (5.1 %) developed DFU (incidence 0.99/100 person-years). Multivariable Cox regression identified four independent predictors of incident DFU: baseline TcPO₂≤ 46 mmHg (Hazard Ratio -HR-=5.09, 95 %Confidence Interval -95 %CI-:2.68-9.65, p < 0.001), incident retinopathy (HR=6.11, 95 %CI=3.39-11.00, p < 0.001), incident polyneuropathy (HR=7.05, 95 %CI:3.94-12.62, p < 0.001), and incident micro-/macroalbuminuria (HR=2.67, 95 %CI:1.47-4.85, p < 0.001). Sexual dysfunction was more frequent in DFU patients (47.9 % vs. 31.3 %, p = 0.016) but was not an independent predictor.</p><p><strong>Conclusions: </strong>In newly diagnosed, uncomplicated T2DM, reduced tissue oxygenation and early microvascular complications strongly predict DFU. TcPO₂ measurement at diagnosis may help identify high-risk patients who could benefit from targeted foot surveillance and preventive interventions. However, our findings cannot be applied to all T2DM patients due to the specific characteristics of our study population.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013971","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
SGLT-2 inhibitors and GLP-1 receptor agonists in primary care pharmacotherapy of type 2 diabetes in people living with HIV versus HIV-negative controls: Findings from a multicenter study in Germany. SGLT-2抑制剂和GLP-1受体激动剂在HIV感染者与HIV阴性对照的2型糖尿病初级保健药物治疗中的应用:来自德国一项多中心研究的结果
IF 2.3 Pub Date : 2026-01-16 DOI: 10.1016/j.pcd.2026.01.005
L Hilgefort, A Potthoff, S Nambiar, R Schlottmann, B Kaup, A Ebigbo, W E Schmidt, H Nonseid-Jansen, W A Jansen, A Skaletz-Rorowski, D R Quast

Aims: Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve glycemic control and reduce cardiovascular (CV) mortality. However, evidence regarding their real-world utilization in people living with HIV (PLWH) receiving primary care remains limited.

Methods: The present study evaluates the real-world diabetes management, prescription patterns and outcomes in PLWH with type 2 diabetes (T2D) compared to HIV-negative controls in primary care, using retrospective and prospective data from multiple outpatient healthcare facilities from urban outpatient clinics in Germany.

Results: No significant difference was found for treatment with either SGLT-2i or GLP-1 RA (PLWH [30.0 %] vs. controls [28.3 %], p = 0.86) or the combined therapy (p = 0.34). Among participants with established CV disease, only a third received an SGLT-2i and/or a GLP-1 RA (p = 0.63). Regarding quality of life, PLWH had more difficulties with self-care (p = 0.038) and there was a trend towards a greater burden of anxiety and depression (p = 0.051).

Conclusions: PLWH and T2D in primary care received similar evidence-based therapies as controls, however, prescription rates in participants with CV disease were relatively low. Future studies with a larger sample size and longitudinal follow-up are needed to confirm the present findings.

目的:钠-葡萄糖共转运蛋白-2抑制剂(SGLT-2i)和胰高血糖素样肽-1受体激动剂(GLP-1 RA)改善血糖控制并降低心血管(CV)死亡率。然而,关于在接受初级保健的艾滋病毒感染者(PLWH)中实际使用这些药物的证据仍然有限。方法:本研究利用来自德国城市门诊诊所的多个门诊医疗机构的回顾性和前瞻性数据,评估了与初级保健中hiv阴性对照相比,PLWH合并2型糖尿病(T2D)的现实世界糖尿病管理、处方模式和结局。结果:SGLT-2i或GLP-1 RA治疗无显著差异(PLWH[30.0 %]vs对照组[28.3 %],p = 0.86)或联合治疗(p = 0.34)。在已确诊心血管疾病的参与者中,只有三分之一的人接受了SGLT-2i和/或GLP-1 RA (p = 0.63)。在生活质量方面,PLWH在自我照顾方面有更多的困难(p = 0.038),焦虑和抑郁负担有更大的趋势(p = 0.051)。结论:初级保健中的PLWH和T2D接受了与对照组相似的循证治疗,然而,心血管疾病参与者的处方率相对较低。未来的研究需要更大的样本量和纵向随访来证实目前的发现。
{"title":"SGLT-2 inhibitors and GLP-1 receptor agonists in primary care pharmacotherapy of type 2 diabetes in people living with HIV versus HIV-negative controls: Findings from a multicenter study in Germany.","authors":"L Hilgefort, A Potthoff, S Nambiar, R Schlottmann, B Kaup, A Ebigbo, W E Schmidt, H Nonseid-Jansen, W A Jansen, A Skaletz-Rorowski, D R Quast","doi":"10.1016/j.pcd.2026.01.005","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.01.005","url":null,"abstract":"<p><strong>Aims: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve glycemic control and reduce cardiovascular (CV) mortality. However, evidence regarding their real-world utilization in people living with HIV (PLWH) receiving primary care remains limited.</p><p><strong>Methods: </strong>The present study evaluates the real-world diabetes management, prescription patterns and outcomes in PLWH with type 2 diabetes (T2D) compared to HIV-negative controls in primary care, using retrospective and prospective data from multiple outpatient healthcare facilities from urban outpatient clinics in Germany.</p><p><strong>Results: </strong>No significant difference was found for treatment with either SGLT-2i or GLP-1 RA (PLWH [30.0 %] vs. controls [28.3 %], p = 0.86) or the combined therapy (p = 0.34). Among participants with established CV disease, only a third received an SGLT-2i and/or a GLP-1 RA (p = 0.63). Regarding quality of life, PLWH had more difficulties with self-care (p = 0.038) and there was a trend towards a greater burden of anxiety and depression (p = 0.051).</p><p><strong>Conclusions: </strong>PLWH and T2D in primary care received similar evidence-based therapies as controls, however, prescription rates in participants with CV disease were relatively low. Future studies with a larger sample size and longitudinal follow-up are needed to confirm the present findings.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994427","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
Understanding factors influencing medication adherence in Type 2 diabetes guided by the COM-B behaviour change model and assessed using the Morisky scale: A systematic review. COM-B行为改变模型指导和Morisky量表评估的2型糖尿病患者药物依从性影响因素的系统评价
IF 2.3 Pub Date : 2026-01-13 DOI: 10.1016/j.pcd.2026.01.002
Marian Archer, Sofia Llahana

Background: Type 2 Diabetes Mellitus (T2DM) requires a multifaceted management approach involving lifestyle modifications, education, and pharmacological treatments. Medication adherence is critical for achieving glycaemic control; however, up to 45 % of patients fail to meet HbA1c targets. The Morisky Medication Adherence Scale (MMAS) is a validated tool widely used in clinical practice to assess self-reported medication adherence, offering valuable insights into patient behaviours affecting treatment outcomes.

Aim: This systematic review evaluates medication adherence in adults with T2DM using the MMAS and to identify modifiable factors influencing non-adherence. The COM-B model was used to structure the analysis by mapping barriers and enablers to the Capability, Opportunity, and Motivation components that underpin medication-taking Behaviour.

Method: A systematic review was conducted following the PRISMA framework. MEDLINE, EMBASE, EMCARE, and Ovid Nursing databases were searched for cross-sectional studies published between January 2013 and December 2024 that utilised the MMAS scale to assess adherence in adults with T2DM receiving oral or injectable anti-glycaemic therapies. A narrative synthesis was conducted using the COM-B model to identify key barriers and enablers influencing adherence.

Results: Of 9990 records screened, 30 studies from 17 countries, involving 8405 participants, met the inclusion criteria. Overall, 40.9 % of participants demonstrated high adherence, while 42.6 % had low adherence. Key barriers included poor diabetes knowledge, depression, polypharmacy, side effects, inadequate patient-provider communication, and lack of continuity in care. Enablers encompassed patient education, family support, effective patient-provider communication, and structured diabetes education programmes.

Conclusions: The MMAS remains a reliable tool for assessing self-reported medication adherence in T2DM. However, adherence levels remain suboptimal. Addressing modifiable factors, such as depression, enhancing diabetes education, and improving healthcare communication, may improve adherence, glycaemic control, and overall T2DM management outcomes.

Registration: Registered with PROSPERO (CRD42022359969).

背景:2型糖尿病(T2DM)需要多方面的治疗方法,包括改变生活方式、教育和药物治疗。药物依从性是实现血糖控制的关键;然而,高达45% %的患者未能达到HbA1c目标。莫里斯基药物依从性量表(MMAS)是一种经过验证的工具,广泛应用于临床实践,用于评估自我报告的药物依从性,为患者影响治疗结果的行为提供有价值的见解。目的:本系统综述使用MMAS评估成人T2DM患者的药物依从性,并确定影响不依从性的可改变因素。COM-B模型通过将障碍和推动因素映射到支持服药行为的能力、机会和动机组件来构建分析。方法:根据PRISMA框架进行系统评价。我们检索了MEDLINE、EMBASE、EMCARE和Ovid护理数据库,检索了2013年1月至2024年12月间发表的横断面研究,这些研究利用MMAS量表评估接受口服或注射降糖治疗的成年T2DM患者的依从性。使用COM-B模型进行叙事综合,以确定影响依从性的关键障碍和促成因素。结果:在筛选的9990条记录中,来自17个国家的30项研究,涉及8405名参与者,符合纳入标准。总体而言,40.9 %的参与者表现出高依从性,而42.6 %的参与者表现出低依从性。主要障碍包括糖尿病知识贫乏、抑郁、多种药物、副作用、医患沟通不足以及护理缺乏连续性。促成因素包括患者教育、家庭支持、有效的患者-提供者沟通和结构化的糖尿病教育计划。结论:MMAS仍然是评估T2DM患者自我报告服药依从性的可靠工具。然而,依从性水平仍然不是最佳的。解决可改变的因素,如抑郁症、加强糖尿病教育和改善医疗保健沟通,可能会改善依从性、血糖控制和总体T2DM管理结果。注册:在普洛斯彼罗注册(CRD42022359969)。
{"title":"Understanding factors influencing medication adherence in Type 2 diabetes guided by the COM-B behaviour change model and assessed using the Morisky scale: A systematic review.","authors":"Marian Archer, Sofia Llahana","doi":"10.1016/j.pcd.2026.01.002","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.01.002","url":null,"abstract":"<p><strong>Background: </strong>Type 2 Diabetes Mellitus (T2DM) requires a multifaceted management approach involving lifestyle modifications, education, and pharmacological treatments. Medication adherence is critical for achieving glycaemic control; however, up to 45 % of patients fail to meet HbA1c targets. The Morisky Medication Adherence Scale (MMAS) is a validated tool widely used in clinical practice to assess self-reported medication adherence, offering valuable insights into patient behaviours affecting treatment outcomes.</p><p><strong>Aim: </strong>This systematic review evaluates medication adherence in adults with T2DM using the MMAS and to identify modifiable factors influencing non-adherence. The COM-B model was used to structure the analysis by mapping barriers and enablers to the Capability, Opportunity, and Motivation components that underpin medication-taking Behaviour.</p><p><strong>Method: </strong>A systematic review was conducted following the PRISMA framework. MEDLINE, EMBASE, EMCARE, and Ovid Nursing databases were searched for cross-sectional studies published between January 2013 and December 2024 that utilised the MMAS scale to assess adherence in adults with T2DM receiving oral or injectable anti-glycaemic therapies. A narrative synthesis was conducted using the COM-B model to identify key barriers and enablers influencing adherence.</p><p><strong>Results: </strong>Of 9990 records screened, 30 studies from 17 countries, involving 8405 participants, met the inclusion criteria. Overall, 40.9 % of participants demonstrated high adherence, while 42.6 % had low adherence. Key barriers included poor diabetes knowledge, depression, polypharmacy, side effects, inadequate patient-provider communication, and lack of continuity in care. Enablers encompassed patient education, family support, effective patient-provider communication, and structured diabetes education programmes.</p><p><strong>Conclusions: </strong>The MMAS remains a reliable tool for assessing self-reported medication adherence in T2DM. However, adherence levels remain suboptimal. Addressing modifiable factors, such as depression, enhancing diabetes education, and improving healthcare communication, may improve adherence, glycaemic control, and overall T2DM management outcomes.</p><p><strong>Registration: </strong>Registered with PROSPERO (CRD42022359969).</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985910","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
Defining quality in type 2 diabetes primary care: A multistakeholder modified Delphi consensus indicator set. 定义2型糖尿病初级保健的质量:多利益相关者修改的德尔菲共识指标集。
IF 2.3 Pub Date : 2026-01-09 DOI: 10.1016/j.pcd.2026.01.004
Philippe-Richard Domeyer, Xavier Cos, Manel Mata-Cases

Aims: Type 2 diabetes mellitus (T2DM) is a growing public‑health challenge in Greece, yet validated tools to assess care quality in primary settings are lacking. We aimed to develop a context‑specific set of consensus‑based quality indicators (QIs) for T2DM in Greek primary care, with an eye toward broader applicability in comparable European and low‑ and middle‑income country (LMIC) systems.

Methods: A two-phase study was conducted: (1) a focused bibliographic search (Medline/PubMed and Scopus; January 2019-August 2020) to identify existing T2DM QI sets suitable for primary care; and (2) a three-round modified Delphi survey with 10 stakeholders (general practitioners, diabetologist, dietician, health policy expert, patients) to evaluate indicator importance and feasibility and reach consensus. Candidate indicators were contextually adapted for European relevance prior to Delphi rating.

Results: The bibliographic search identified 16 records; only one study met eligibility criteria and provided 43 candidate QIs. The Delphi process yielded 39 QIs across nine domains: access (2), monitoring (13), health counseling (3), treatment and prevention (2), patient safety (3), records (1), health status (11), patient satisfaction (2), and self-management (2).

Conclusions: We present the first context-adapted, consensus-based T2DM QI set for Greek primary care, covering clinical, organizational, and patient-reported aspects of care. This framework lays the groundwork for wider implementation, electronic health record integration, and international benchmarking.

目的:2型糖尿病(T2DM)在希腊是一个日益严重的公共卫生挑战,但缺乏有效的工具来评估初级医疗机构的护理质量。我们的目的是为希腊初级保健中的2型糖尿病制定一套基于共识的质量指标(QIs),并着眼于在可比较的欧洲和中低收入国家(LMIC)系统中更广泛的适用性。方法:进行了一项两阶段的研究:(1)进行重点文献检索(Medline/PubMed和Scopus; 2019年1月- 2020年8月),以确定适合初级保健的现有T2DM QI集;(2)对10名利益相关者(全科医生、糖尿病专家、营养师、卫生政策专家、患者)进行3轮修正德尔菲调查,评价指标的重要性和可行性,并达成共识。候选指标在德尔菲评级之前根据欧洲相关情况进行调整。结果:检索到文献记录16条;只有一项研究符合资格标准,提供了43个候选QIs。德尔菲过程产生了九个领域的39个QIs:准入(2)、监测(13)、健康咨询(3)、治疗和预防(2)、患者安全(3)、记录(1)、健康状况(11)、患者满意度(2)和自我管理(2)。结论:我们提出了希腊初级保健的第一个基于共识的T2DM QI集,涵盖临床、组织和患者报告的护理方面。该框架为更广泛的实施、电子健康记录集成和国际基准测试奠定了基础。
{"title":"Defining quality in type 2 diabetes primary care: A multistakeholder modified Delphi consensus indicator set.","authors":"Philippe-Richard Domeyer, Xavier Cos, Manel Mata-Cases","doi":"10.1016/j.pcd.2026.01.004","DOIUrl":"https://doi.org/10.1016/j.pcd.2026.01.004","url":null,"abstract":"<p><strong>Aims: </strong>Type 2 diabetes mellitus (T2DM) is a growing public‑health challenge in Greece, yet validated tools to assess care quality in primary settings are lacking. We aimed to develop a context‑specific set of consensus‑based quality indicators (QIs) for T2DM in Greek primary care, with an eye toward broader applicability in comparable European and low‑ and middle‑income country (LMIC) systems.</p><p><strong>Methods: </strong>A two-phase study was conducted: (1) a focused bibliographic search (Medline/PubMed and Scopus; January 2019-August 2020) to identify existing T2DM QI sets suitable for primary care; and (2) a three-round modified Delphi survey with 10 stakeholders (general practitioners, diabetologist, dietician, health policy expert, patients) to evaluate indicator importance and feasibility and reach consensus. Candidate indicators were contextually adapted for European relevance prior to Delphi rating.</p><p><strong>Results: </strong>The bibliographic search identified 16 records; only one study met eligibility criteria and provided 43 candidate QIs. The Delphi process yielded 39 QIs across nine domains: access (2), monitoring (13), health counseling (3), treatment and prevention (2), patient safety (3), records (1), health status (11), patient satisfaction (2), and self-management (2).</p><p><strong>Conclusions: </strong>We present the first context-adapted, consensus-based T2DM QI set for Greek primary care, covering clinical, organizational, and patient-reported aspects of care. This framework lays the groundwork for wider implementation, electronic health record integration, and international benchmarking.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949464","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
A systematic review of structured weight loss programs and their association with HbA1c reduction in adults with prediabetes managed in primary care. 对初级保健管理的成人糖尿病前期患者的结构化减肥计划及其与HbA1c降低的关系的系统回顾。
IF 2.3 Pub Date : 2025-11-21 DOI: 10.1016/j.pcd.2025.11.007
Ayokunle Osonuga, Gloria Okoye, Adewoyin Osonuga, Serge Engamba, Nicholas Aderinto

Background: Prediabetes, marked by elevated blood glucose levels below the type 2 diabetes mellitus (T2DM) threshold, is a growing public health concern due to its rising prevalence and risk of progression to diabetes and cardiovascular issues. Structured weight loss programs in primary care show promise for improving glycemic control, yet their impact on HbA1c remains underexplored. This systematic review evaluates their effectiveness in reducing HbA1c in adults with prediabetes.

Methods: Following the 2020 PRISMA and SWiM guidelines, we searched six databases (PubMed, EMBASE, Cochrane CENTRAL, Scopus, CINAHL, Web of Science) up to July 10, 2025, for studies on structured weight loss programs in primary care. Eligible studies involved adults (≥18 years) with prediabetes, using RCTs, cohort studies, or pilot interventions with HbA1c as the primary outcome. Data were extracted, and risk of bias was assessed using Cochrane RoB 2.0 and ROBINS-I tools. A narrative synthesis was performed due to study heterogeneity.

Results: Seven studies (n = 43-2227) showed HbA1c reductions of 0.03 %-0.83 %, with high-intensity (e.g., frequent behavioral sessions) and digital interventions (e.g., low-carbohydrate apps) yielding the largest effects. Weight loss (up to 7.2 kg), BMI, and lipid profiles also improved. Adherence and intervention intensity were key factors, though inconsistent reporting limited comparisons.

Conclusion: Structured weight loss programs in primary care are consistently associated with modest-to-moderate HbA1c reductions, with high-intensity and digital interventions showing the greatest promise. However, study heterogeneity and inconsistent adherence reporting limit definitive conclusions. Future research should prioritize standardized reporting, long-term outcomes, and diverse populations to enhance generalizability.

背景:前驱糖尿病,以血糖水平升高低于2型糖尿病(T2DM)阈值为标志,由于其患病率和进展为糖尿病和心血管问题的风险不断上升,是一个日益严重的公共卫生问题。初级保健中有组织的减肥计划有望改善血糖控制,但其对HbA1c的影响仍未得到充分探讨。本系统综述评估了它们在降低成人糖尿病前期患者HbA1c方面的有效性。方法:根据2020年PRISMA和SWiM指南,我们检索了六个数据库(PubMed, EMBASE, Cochrane CENTRAL, Scopus, CINAHL, Web of Science),截至2025年7月10日,用于初级保健结构化减肥计划的研究。符合条件的研究涉及成人(≥18岁)前驱糖尿病患者,采用随机对照试验、队列研究或以HbA1c为主要结局的试点干预。提取资料,使用Cochrane RoB 2.0和ROBINS-I工具评估偏倚风险。由于研究的异质性,我们进行了叙事综合。结果:七项研究(n = 43-2227)显示,HbA1c降低0.03% %-0.83 %,高强度(如频繁的行为会话)和数字干预(如低碳水化合物应用程序)产生的效果最大。体重减轻(高达7.2 kg)、BMI和脂质谱也有所改善。依从性和干预强度是关键因素,尽管不一致的报告限制了比较。结论:初级保健中有组织的减肥计划始终与中度至中度HbA1c降低相关,高强度和数字化干预显示出最大的希望。然而,研究的异质性和不一致的依从性报告限制了明确的结论。未来的研究应优先考虑标准化报告、长期结果和多样化人群,以提高普遍性。
{"title":"A systematic review of structured weight loss programs and their association with HbA1c reduction in adults with prediabetes managed in primary care.","authors":"Ayokunle Osonuga, Gloria Okoye, Adewoyin Osonuga, Serge Engamba, Nicholas Aderinto","doi":"10.1016/j.pcd.2025.11.007","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.11.007","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes, marked by elevated blood glucose levels below the type 2 diabetes mellitus (T2DM) threshold, is a growing public health concern due to its rising prevalence and risk of progression to diabetes and cardiovascular issues. Structured weight loss programs in primary care show promise for improving glycemic control, yet their impact on HbA1c remains underexplored. This systematic review evaluates their effectiveness in reducing HbA1c in adults with prediabetes.</p><p><strong>Methods: </strong>Following the 2020 PRISMA and SWiM guidelines, we searched six databases (PubMed, EMBASE, Cochrane CENTRAL, Scopus, CINAHL, Web of Science) up to July 10, 2025, for studies on structured weight loss programs in primary care. Eligible studies involved adults (≥18 years) with prediabetes, using RCTs, cohort studies, or pilot interventions with HbA1c as the primary outcome. Data were extracted, and risk of bias was assessed using Cochrane RoB 2.0 and ROBINS-I tools. A narrative synthesis was performed due to study heterogeneity.</p><p><strong>Results: </strong>Seven studies (n = 43-2227) showed HbA1c reductions of 0.03 %-0.83 %, with high-intensity (e.g., frequent behavioral sessions) and digital interventions (e.g., low-carbohydrate apps) yielding the largest effects. Weight loss (up to 7.2 kg), BMI, and lipid profiles also improved. Adherence and intervention intensity were key factors, though inconsistent reporting limited comparisons.</p><p><strong>Conclusion: </strong>Structured weight loss programs in primary care are consistently associated with modest-to-moderate HbA1c reductions, with high-intensity and digital interventions showing the greatest promise. However, study heterogeneity and inconsistent adherence reporting limit definitive conclusions. Future research should prioritize standardized reporting, long-term outcomes, and diverse populations to enhance generalizability.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582305","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
期刊
Primary care diabetes
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1