PURPOSE OF REVIEW: Care guidelines recommend screening and intervention for diabetes distress (DD) as part of standard type 1 diabetes (T1D) care. The variability in how individuals with diabetes experience distress, alo...PURPOSE OF REVIEW: Care guidelines recommend screening and intervention for diabetes distress (DD) as part of standard type 1 diabetes (T1D) care. The variability in how individuals with diabetes experience distress, alongside the range of treatment options, underscores the value of tailoring approaches for addressing diabetes distress. Our objective was to summarize contemporary clinical trials addressing DD directly in adults with T1D, focusing on evidence of heterogenous treatment effects. RECENT FINDINGS: We reviewed five studies testing diverse intervention strategies, including emotional support, telehealth, digital health platforms, and patient-centered communication. All studies were effective in reducing DD. Four studies examined the variation in treatment effects or outcomes in relation to observable participant characteristics and demonstrated heterogeneity both in the factors associated with changes in DD and factors associated with the differential impact of specific interventions. This review uncovered preliminary evidence of heterogeneous treatment effects across a range of DD-focused interventions. Gaining a deeper, more comprehensive understanding of the individuals or subgroups for whom evidence-based DD strategies are particularly effective versus less effective is needed to advance data-driven personalized treatment for DD. Future studies should prioritize diversity in enrolled individuals and advanced analytic approaches that can empirically match individuals with elevated DD to their optimal treatment approach.
PURPOSE OF REVIEW: To highlight various preventive and therapeutic strategies via health care delivery system to minimize sight-threatening diabetic retinopathy. RECENT FINDINGS: Diabetic retinopathy (DR) is a common and...PURPOSE OF REVIEW: To highlight various preventive and therapeutic strategies via health care delivery system to minimize sight-threatening diabetic retinopathy. RECENT FINDINGS: Diabetic retinopathy (DR) is a common and specific microvascular complication of diabetes and is a common cause of blindness among economic age groups or the working population of the country. Clinically, DR can be graded as non-sight-threatening diabetic retinopathy (NSTDR), including mild and moderate non-proliferative abnormalities and sight-threatening diabetic retinopathy (STDR), which comprises of severe non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), or clinically significant macular edema (CSME). In STDR, the disease progresses to the proliferative phase which is characterized by the formation of new blood vessels and macular edema owing to the accumulation of fluid within the retina, producing severe and often irreversible vision loss. With the influx of artificial intelligence in the medical arena, there is a continuous rise in the demand for the development of automated analysis software for the analysis of retinal images in people with diabetes. Nowadays, Smartphone-based retinal imaging has emerged as one of the most cost-effective ways of screening for DR in the community, which even non-ophthalmologists can do. Understanding the factors associated with STDR can help to develop primary and secondary prevention strategies. Spreading awareness regarding STDR at the community level is crucial. All diabetic patients need regular and repetitive follow-ups with the ophthalmologist for screening and timely treatment of DR, particularly STDR. Preservation of sight in STDR can be achieved through effective screening, timely laser treatment, intraocular injection of steroids and anti-vascular endothelial growth-factor agents and intraocular surgery.
PURPOSE OF REVIEW: The "obesity paradox" describes the counterintuitive observation that overweight and mildly obese individuals with cardiovascular disease (CVD) may have better outcomes than those with normal weight. T...PURPOSE OF REVIEW: The "obesity paradox" describes the counterintuitive observation that overweight and mildly obese individuals with cardiovascular disease (CVD) may have better outcomes than those with normal weight. This paradox is particularly intriguing in patients with type-2 diabetes (T2D), where obesity is a well-established risk factor for cardiometabolic complications. RECENT FINDINGS: Evidence from some epidemiological studies suggested an obesity paradox in mortality risk among patients with T2D. However, confounding factors may influence this association, including reverse causality, differences in risk factor profiles, and adipose tissue distribution. Recent research also questions the reliance on body mass index as an accurate measure of metabolic health, emphasizing the role of alternative anthropometric indices. This review critically evaluates the evidence for the obesity paradox in T2D, explores potential mechanistic explanations, and discusses clinical implications. Understanding the complex interaction between diabetes and obesity in CVD risk is essential for refining obesity management strategies in individuals with T2D and CVD.
PURPOSE OF REVIEW: To assess the current literature on iron intake in relation to obesity and its comorbidities. Specifically, to evaluate the potential mechanisms and the strength of the evidence linking heme iron intak...PURPOSE OF REVIEW: To assess the current literature on iron intake in relation to obesity and its comorbidities. Specifically, to evaluate the potential mechanisms and the strength of the evidence linking heme iron intake to these conditions, highlight methodological challenges in assessing iron intake, and identify gaps that warrant further investigation. RECENT FINDINGS: Studies were mostly prospective cohorts. Across studies, total, heme and non-heme iron intakes were associated with both increased and decreased risk in relation to outcomes, which may be due to differences in the population being investigated and methods used to estimate the heme iron content of foods. The evidence concerning total, heme and non-heme dietary iron is inconclusive when evaluating its associations with obesity and comorbidities. Well-designed clinical trials are needed to better inform nutrition guidelines. Additionally, quantification of total, heme and non-heme iron in foods is essential to improve dietary assessments and strengthen research on their potential impact on health.
Curr Diab Rep
· 2025 May · PMID 40366501
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PURPOSE OF REVIEW: The rates of diabetes in pregnancy (type 1, type 2, and gestational diabetes) are increasing. Diabetes in pregnancy is associated with increased risk for maternal and neonatal complications. Certain gr...PURPOSE OF REVIEW: The rates of diabetes in pregnancy (type 1, type 2, and gestational diabetes) are increasing. Diabetes in pregnancy is associated with increased risk for maternal and neonatal complications. Certain groups are disproportionately affected by these complications and this paper reviews the data about disparities in diabetes in pregnancy and explores the social determinants of health (SDoH) underlying these disparities. RECENT FINDINGS: Rates of diagnosis of gestational diabetes and pregestational diabetes are higher in racial and ethnic minority groups and people with socioeconomic disadvantage. There is higher all cause maternal mortality for Black people compared to White people. Emerging data suggests higher risk for adverse pregnancy outcomes for Black, American Indian, and Hispanic/Latina subjects with diabetes compared to White subjects. Individuals living in neighborhoods with higher poverty and less educational attainment also have higher rates of pregnancy and neonatal complications with diabetes. Diabetes in pregnancy is a complex condition which requires specialty care that can be time-consuming and costly. Individuals with disadvantages in income and employment, food security, social protection and support, and access to affordable and quality health services may be particularly susceptible to adverse outcomes of diabetes in pregnancy. Providers can reduce disparities by recognizing individuals with vulnerabilities in SDoH and tailoring treatment to social context. Equitable access to diabetes technology and postpartum care can also reduce disparities in outcomes.
Curr Diab Rep
· 2025 May · PMID 40358737
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PURPOSE OF REVIEW: This systematic examination quantifies financial toxicity- the economic burden and related financial distress experienced by patients due to medical costs- in diabetes management globally, analyzing pr...PURPOSE OF REVIEW: This systematic examination quantifies financial toxicity- the economic burden and related financial distress experienced by patients due to medical costs- in diabetes management globally, analyzing prevalence, mechanisms, and interventions across diverse healthcare systems and geographic contexts. RECENT FINDINGS: Data indicates 30-60% of diabetes patients experience financial toxicity, with household expenditures ranging from 5 to 40% of income on disease management, and demographic disparities evident. Current intervention strategies demonstrate limited efficacy, particularly in resource-constrained settings, while policy approaches show mixed results across economic contexts. Financial toxicity operates through four identified pathways: direct expenses, indirect costs (productivity/caregiver burden), insurance coverage limitations, and structural access barriers. Research priorities include developing validated measurement instruments for diabetes financial toxicity, implementing contextually appropriate interventions, and establishing causative relationships between financial burden and clinical outcomes through longitudinal studies.
Egede LE, Campbell JA, Walker RJ
… +2 more, Fraser RA, Ekwunife O
Curr Diab Rep
· 2025 May · PMID 40307503
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PURPOSE OF REVIEW: To evaluate the evidence on the relationship between fatalism, self-efficacy, and clinical and behavioral diabetes outcomes among African American adults with type 2 diabetes and to recommend areas for...PURPOSE OF REVIEW: To evaluate the evidence on the relationship between fatalism, self-efficacy, and clinical and behavioral diabetes outcomes among African American adults with type 2 diabetes and to recommend areas for future work. RECENT FINDINGS: Evidence suggests that psychosocial factors including fatalism and self-efficacy are essential for optimizing diabetes outcomes and may be important considerations for reducing health disparities in type 2 diabetes. A reproducible search using OVID Medline, PubMed, and EBSCOHost was conducted from database creation up to February 2025. Medical Subject Heading terms and key words representing fatalism, self-efficacy, and diabetes were used. Outcomes included: hemoglobin A1c, LDL, Blood Pressure, Self-Care, and Quality of Life. A total of 17 studies were identified, 5 examining fatalism and 12 examining self-efficacy. All 5 fatalism studies demonstrated that fatalism is statistically significantly related to self-care behaviors and HbA1c, however this relationship may be impacted by other psychosocial and social risk factors. Among the self-efficacy studies, 11 demonstrated statistically significant relationships between self-efficacy and one or more clinical and behavioral outcomes including HbA1c, diet, physical activity, medication adherence, blood glucose testing, and quality of life. All studies were cross-sectional analyses. Given the small number of studies focused on fatalism and the largely correlational results for self-efficacy, there is a need for more targeted research to understand contributors to and moderators of the influence of the factors on outcomes.
Brunner K, Linder T, Klaritsch P
… +3 more, Tura A, Windsperger K, Göbl C
Curr Diab Rep
· 2025 Apr · PMID 40257685
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BACKGROUND: While substantial literature exists on the intersection of overweight/obesity (OWO) and pregnancy, much of it focuses on specific aspects, making it difficult to maintain an overview of clinically relevant fa...BACKGROUND: While substantial literature exists on the intersection of overweight/obesity (OWO) and pregnancy, much of it focuses on specific aspects, making it difficult to maintain an overview of clinically relevant factors for optimal care of OWO women throughout pregnancy. OBJECTIVES: To provide a comprehensive synthesis of the existing literature, covering the full spectrum of clinically relevant information needed to manage OWO women from preconception to birth. METHODS: For this narrative review a literature search was conducted on PubMed in January 2025. Eligible studies included full-text English articles with data from human subjects, with no restrictions on publication date. FINDINGS: The impact of OWO on pregnancy is multifaceted, encompassing four interrelated themes: physiological consequences, emerging risks, challenges in prenatal care, and intervention strategies. OWO women exhibit differences in metabolic and inflammatory pathways compared to normal-weight women, reflected in altered laboratory tests. When managing gestational diabetes and preeclampsia, obesity-related characteristics must be considered. Clinicians need to be alert of obesity-mediated fetal complications, including overgrowth, malformations, stillbirth, and preterm birth, while navigating challenges in ultrasound measurements. Interventions during the preconception and prenatal periods provide key opportunities to optimize maternal weight and reduce the risk of long-term disease development. CONCLUSION: The review's insights enhance clinical practice and call on researchers and policymakers to prioritize strategies that offer early counseling for obese pregnant women. These initiatives aim to optimize outcomes for both mother and child and contribute to combating the global obesity crisis.
Iregbu S, Dawson AZ, Walker RJ
… +1 more, Egede LE
Curr Diab Rep
· 2025 Apr · PMID 40186848
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PURPOSE OF REVIEW: Homebound older adults with type 2 diabetes (T2DM) have worse outcomes compared to older adults with diabetes who are not homebound. This systematic review aimed to summarize evidence on interventions...PURPOSE OF REVIEW: Homebound older adults with type 2 diabetes (T2DM) have worse outcomes compared to older adults with diabetes who are not homebound. This systematic review aimed to summarize evidence on interventions aimed to improve outcomes in homebound older adults with T2DM. The PRISMA guidelines for reporting of systematic reviews were followed. PubMed, CINAHL, SCOPUS, and PsycINFO databases were searched. To be included, studies were published from database inception until November 6, 2023. Eligible studies included Participants who were older adults with a mean age of 60 or older; Interventions of any type; Comparators of any type; Outcomes of hemoglobin A1c (HbA1c), blood pressure, cholesterol, quality of life (QOL), healthcare utilization, depression, anxiety, psychological distress, or mortality; Study designs of clinical trials. RECENT FINDINGS: There were 2,280 articles identified by the search, with nine articles included in the final review. Eight studies were conducted in the United States and one in Japan. Seven used pre-post designs and two were randomized controlled trials. Sample sizes ranged from 11 to 8,318,291. Study participants had a mean age of 60-82 years. Interventions included telehealth, home-based health care with in-home primary care visits, nutrition counseling, and meal delivery programs. We found a paucity of studies tailored to homebound older adults with T2DM. Results suggest that interventions provided to homebound older adults with T2DM in the home, including home-based primary care, case management/care coordination, joint patient and caregiver/family education, and home telemonitoring integrated into electronic medical systems, hold promise for improving clinical outcomes.
PURPOSE OF REVIEW: This review aims to highlight the evolution and multifaceted benefits of modern sulfonylureas (SUs) in managing Type 2 Diabetes Mellitus (T2DM). It discusses their enhanced glycemic control, pleiotropi...PURPOSE OF REVIEW: This review aims to highlight the evolution and multifaceted benefits of modern sulfonylureas (SUs) in managing Type 2 Diabetes Mellitus (T2DM). It discusses their enhanced glycemic control, pleiotropic advantages, usage with other antidiabetic agents, safety, and tolerability, supporting their persistent relevance and effectiveness in diabetes care. RECENT FINDINGS: Recent findings indicate that modern SUs, like glimepiride, offer significant cardioprotective and renoprotective benefits along with their primary role in glycemic control. Additionally, they have also shown their anti-inflammatory effects, lipid-lowering properties, testosterone-enhancing effects, and neuroprotective effects in recent years. These findings support the broader therapeutic advantages of modern SUs beyond glucose lowering. Hence, many guidelines now recommend modern SUs as an add-on therapy to metformin. Modern sulfonylureas remain a vital component in T2DM management strategy due to their efficacy, safety profile, and cost-effectiveness. Their pleiotropic benefits, like cardiovascular, renal, anti-inflammatory, neuroprotective effects, etc., make them a comprehensive therapeutic option. Considering their efficacy and safety profile, SUs are expected to remain vital components of antidiabetic therapy, providing valuable benefits in managing T2DM in the long run.
Idrees T, Castro-Revoredo I, Kantipudi S
… +1 more, Umpierrez G
Curr Diab Rep
· 2025 Mar · PMID 40138097
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PURPOSE OF REVIEW: This narrative review aims to explore the literature on advancements in diabetes management within long-term care facilities (LTCFs). Managing chronic diseases like diabetes in LTCFs is particularly ch...PURPOSE OF REVIEW: This narrative review aims to explore the literature on advancements in diabetes management within long-term care facilities (LTCFs). Managing chronic diseases like diabetes in LTCFs is particularly challenging due to the dynamic nature of these environments and the significant changes they have undergone over the past decade. Various factors, including rising care costs and government regulations, influence the quality-of-care residents receive in these settings. RECENT FINDINGS: Many diabetes medications have not been extensively studied in LTCFs, and high-risk medications such as sulfonylureas and sliding scale insulin are still in use, potentially increasing the risk of morbidity and mortality among residents. Additionally, the adoption of diabetes technologies, such as continuous glucose monitors (CGMs) and insulin pumps, remains limited in LTCFs. Despite the high prevalence of diabetes, significant research gaps persist. Diabetes technologies have the potential to greatly improve diabetes management and outcomes for residents. However, more research is needed to evaluate their efficacy and safety in long-term care settings. Furthermore, there is a pressing need to address the gap in staff training on the use of these technologies. Closing these research gaps is essential for developing evidence-based guidelines and improving the quality of diabetes care in LTCFs.
Curr Diab Rep
· 2025 Mar · PMID 40128490
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PURPOSE OF REVIEW: Neonatal and syndromic diabetes are rare but important conditions. These conditions often result in severe insulin deficiency or insulin resistance. In this review, we aim to discuss the clinical chara...PURPOSE OF REVIEW: Neonatal and syndromic diabetes are rare but important conditions. These conditions often result in severe insulin deficiency or insulin resistance. In this review, we aim to discuss the clinical characteristics and genetics of neonatal and syndromic forms of diabetes. RECENT FINDINGS: Beyond the development of diabetes mellitus, many other organ systems are affected. Understanding the pathophysiology of these conditions have improved our collective understanding of the genetics and developmental biology related to glucose metabolism and beyond. This review will provide new information for researchers and provide a helpful resource for clinicians when evaluating a patient for neonatal and syndromic forms of diabetes.
PURPOSEOF REVIEW: Prediabetes poses a significant risk of developing diabetes and it's complications. Africa faces specific challenges, hindering early recognition and management of prediabetes. We aimed to understand un...PURPOSEOF REVIEW: Prediabetes poses a significant risk of developing diabetes and it's complications. Africa faces specific challenges, hindering early recognition and management of prediabetes. We aimed to understand unique, ethnicity specific aspects of the burden, pathogenesis and management of prediabetes in Africa. RECENT FINDINGS: The rate of progression from prediabetes to diabetes is higher in African, compared to European populations. Prediabetes in Africans is driven mainly by hyperinsulinemia and reduced hepatic clearance causing obesity and insulin resistance, rather than impaired insulin sensitivity. High risk, difficult to reach individuals in lower socioeconomic strata, benefited from community versus facility-based screening. Intensive lifestyle changes with low calorie or low fat-high fiber diet provide longer lasting effect versus drug monotherapy. Using structured community-based screening, early detection of prediabetes is achievable, requiring dedicated stakeholder engagement. Further research into the etiology and sequencing of pathogenetic anomalies and preventive strategies in African populations is needed.
PURPOSE OF REVIEW: Type 2 diabetes (T2D) disproportionately impacts minority populations. The National Institute on Minority Health and Health Disparities (NIMHD) developed a research framework to encourage health dispar...PURPOSE OF REVIEW: Type 2 diabetes (T2D) disproportionately impacts minority populations. The National Institute on Minority Health and Health Disparities (NIMHD) developed a research framework to encourage health disparities research that considers a multi-level, multi-domain perspective. The purpose of this review was to describe evidence on the levels and domains that influence T2D disparities among minority populations and use this information to adapt the NIMHD Research Framework for T2D. RECENT FINDINGS: Screening identified 108 articles published between 2017 and 2023 covering 74,354,597 participants. Articles were classified under the following domains, Biological (18), Behavioral (22), Physical/Built Environment (19), Sociocultural Environment (42), and Health Care System (31). Article levels of influence included Individual (73), Interpersonal (18), Community (36), and Societal (10). Findings were used to adapt the NIMHD Research Framework with an eye towards advancing T2D-related health equity. The results of this review confirm the complex nature of T2D-related disparities and support the notion that drivers operate within and between multiple levels and multiple domains to influence T2D-related outcomes across the lifespan.
PURPOSE OF REVIEW: This review highlights the impact of weight loss on metabolic dysfunction associated steatotic liver disease (MASLD), formally known as nonalcoholic fatty liver disease (NAFLD), and its progressive for...PURPOSE OF REVIEW: This review highlights the impact of weight loss on metabolic dysfunction associated steatotic liver disease (MASLD), formally known as nonalcoholic fatty liver disease (NAFLD), and its progressive form of metabolic dysfunction associated steatohepatitis (MASH), formally known as nonalcoholic steatohepatitis (NASH). The effects of weight loss, as achieved through lifestyle modification, pharmacotherapy, bariatric surgery or endobariatric procedures on MASLD/MASH and hepatic fibrosis are discussed. RECENT FINDINGS: Although foundational in the treatment of MASLD/MASH, weight loss through life-style modification is challenging for most patients to achieve and sustain long-term. In patients with MASLD/MASH, a multidisciplinary approach may facilitate success with lifestyle modification, individualized consideration of pharmacotherapies and/or surgical approaches that have potential to lend an improvement in MASLD/MASH. Effective and sustained weight loss improves hepatic steatosis, steatohepatitis and potentially hepatic fibrosis. Improvement in hepatic fibrosis can improve patient-related outcomes associated with complications of advanced hepatic fibrosis or cirrhosis in patients with MASLD/MASH. Identifying risk factors that influence MASLD/MASH and early implementation of therapeutic weight loss strategies may improve chronic liver injury and decrease risk for adverse clinical outcomes related to progressive hepatic fibrosis attributable to MASLD/MASH.
PURPOSE OF REVIEW: To review the genetics of type 1 diabetes (T1D) and T1D genetic risk scores, focusing on their development, research and clinical applications, and future directions. RECENT FINDINGS: More than 90 gene...PURPOSE OF REVIEW: To review the genetics of type 1 diabetes (T1D) and T1D genetic risk scores, focusing on their development, research and clinical applications, and future directions. RECENT FINDINGS: More than 90 genetic loci have been linked to T1D risk, with approximately half of the genetic risk attributable to the human leukocyte antigen (HLA) locus, along with non-HLA loci that have smaller effects to disease risk. The practical use of T1D genetic risk scores simplifies the complex genetic information, within the HLA and non-HLA regions, by combining the additive effect and interactions of single nucleotide polymorphisms (SNPs) associated with risk. Genetic risk scores have proven to be useful in various aspects, including classifying diabetes (e.g., distinguishing between T1D vs. neonatal, type 2 or other diabetes types), predicting the risk of developing T1D, assessing the prognosis of the clinical course (e.g., determining the risk of developing insulin dependence and glycemic control), and research into the heterogeneity of diabetes (e.g., atypical diabetes). However, there are gaps in our current knowledge including the specific sets of genes that regulate transition between preclinical stages of T1D, response to disease modifying therapies, and other outcomes of interest such as persistence of beta cell function. Several T1D genetic risk scores have been developed and shown to be valuable in various contexts, from classification of diabetes to providing insights into its etiology and predicting T1D risk across different stages of T1D. Further research is needed to develop and validate T1D genetic risk scores that are effective across all populations and ancestries. Finally, barriers such as cost, and training of medical professionals have to be addressed before the use of genetic risk scores can be incorporated into routine clinical practice.
DeLacey S, Papadakis J, James S
… +10 more, Cudizio L, Ng SM, Lyons SK, Maruthur NM, Araszkiewicz A, Gomber A, Snoek FJ, Toft E, de Beaufort C, Weissberg-Benchell J
Curr Diab Rep
· 2025 Feb · PMID 39890661
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PURPOSE OF REVIEW: The transition to adult healthcare is difficult for young adults with diabetes, with declining glycemic control and reduced healthcare utilization. Efforts are needed to facilitate an effective transfe...PURPOSE OF REVIEW: The transition to adult healthcare is difficult for young adults with diabetes, with declining glycemic control and reduced healthcare utilization. Efforts are needed to facilitate an effective transfer of care. Our study aimed to systematically review the literature and identify studies evaluating the effectiveness of interventions designed to improve transition readiness and/or the transfer to adult care, describe their characteristics and outcomes, and identify areas for future research. RECENT FINDINGS: Twenty-six studies were included with one randomized control trial and many pre-post studies observing the impact of transition programs. Generally, interventions had no clear benefit on metabolic outcomes, with variable improvement in care satisfaction and transition readiness. Studies often did not satisfy quality metrics, report important contextual factors (e.g. race, ethnicity) or involve family members. The current literature on interventions to improve transition readiness and transfer of care outcomes in young adults with diabetes is relatively limited with few studies applying rigorous methods. Future studies should apply formal methodology, include both medical and psychosocial outcomes and account for patient and health system context.
PURPOSE OF REVIEW: Insulin restriction is commonly studied as a form of disordered eating, but people may restrict insulin for many reasons. This systematic review examined how insulin restriction has been conceptualized...PURPOSE OF REVIEW: Insulin restriction is commonly studied as a form of disordered eating, but people may restrict insulin for many reasons. This systematic review examined how insulin restriction has been conceptualized and measured, and its associated predictors and outcomes. RECENT FINDINGS: Forty-seven unique articles measured non-specified insulin restriction (IR), insulin restriction specifically for weight control (IRWC), or both. Eight studies used non-specified measures to examine insulin restriction for a specific purpose. IR was more prevalent than IRWC, but both occurred equally among men and women across ages. Higher negative emotions were associated with both constructs, while lower self-management behaviors were examined and associated only with IR; both constructs were associated with higher HbA1c. When measured simultaneously, IR and IRWC were not correlated. There may be subtypes of insulin restriction. Future research should develop measures to assess and examine distinct subtypes, and translate findings into effective interventions for this dangerous behavior.
Plebon-Huff S, Haji-Mohamed H, Gardiner H
… +3 more, Ghanem S, Koh J, LeBlanc AG
Curr Diab Rep
· 2025 Jan · PMID 39849148
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PURPOSE OF REVIEW: The prevalence of diabetes is rising around the world and represents an important public health concern. Unlike individual-level risk and protective factors related to the etiology of diabetes, context...PURPOSE OF REVIEW: The prevalence of diabetes is rising around the world and represents an important public health concern. Unlike individual-level risk and protective factors related to the etiology of diabetes, contextual risk factors have been much less studied. Identification of contextual factors related to the risk of type 1 and type 2 diabetes in Organisation for Economic Co-operation and Development (OECD) countries may help health professionals, researchers, and policymakers to improve surveillance, develop policies and programs, and allocate funding. RECENT FINDINGS: Among 4,470 potential articles, 48 were included in this review. All reviews were published in English between 2005 and 2023 and were conducted in over 20 different countries. This review identified ten upstream contextual risk factors related to type 1 and type 2 diabetes risk, including income, employment, education, immigration, race/ethnicity, geography, rural/urban status, built environment, environmental pollution, and food security/environment. The ten upstream contextual risk factors identified this review may be integrated into diabetes research, surveillance and prevention activities to help promote better outcomes for people at risk or living with diabetes in OECD countries. Additional research is needed to better quantify the measures of associations between emerging key contextual factors and diabetes outcomes.
PURPOSE OF REVIEW: Evidence over the past few decades have proven the benefits and cost savings of diabetes self-management education and support (DSMES) and medical nutrition therapy (MNT). Yet, the benefits continue to...PURPOSE OF REVIEW: Evidence over the past few decades have proven the benefits and cost savings of diabetes self-management education and support (DSMES) and medical nutrition therapy (MNT). Yet, the benefits continue to be underutilized. Little evidence is available to definitively assess insurance coverage for both services. Strategies are presented to more efficiently assess coverage as well as Identify methods to increase referrals and more effectively bill for both services. RECENT FINDINGS: Estimated statistics for both type 1 and type 2 diabetes reveal increases globally, especially in those under 20 and over 65. Individuals meeting the current A1C guidelines are still well below current recommendations. The economic costs of diabetes continue to rise. Both DSMES and MNT are effective, cost-saving methods that are critical components to the ongoing care of people with diabetes. While insurance coverage does vary based on each specific type, billing correctly and following the requirements for NSDSMES are essential to receive appropriate reimbursement for services.