Diabetic Medicine[JOURNAL]
Sun
200 papers
Psychosocial care and experiences in young adults living with early-onset type 2 diabetes: A narrative review.
Caba M, Carvalho M, Forbes A … +7 more , Forde R, Gill K, Khalifa M, Parsons J, Speight J, Trief PM, Hadjiconstantinou M
Diabet Med · 2026 Jul · PMID 42104849 · Full text
AIMS: To review the literature on psychosocial care and experiences of young adults with early-onset type 2 diabetes (EOT2D), to identify what is known, current gaps and to develop recommendations to help advance psychos...
AIMS: To review the literature on psychosocial care and experiences of young adults with early-onset type 2 diabetes (EOT2D), to identify what is known, current gaps and to develop recommendations to help advance psychosocial care and support for the population. METHODS: We searched Medline (Ovid), Google Scholar and diabetes-specific journals for English-language articles focused on psychosocial aspects in young adults (aged 18-45 years) with EOT2D. Two people with lived experience reviewed and commented on the review findings. RESULTS: Growing evidence indicates that a diagnosis of EOT2D is associated with an increased risk of developing diabetes-related psychological comorbidities. Experiences of diabetes-related stigma, compounded by age-related negative preconceptions, contribute to heightening the psychosocial impact of EOT2D. Some population sub-groups appear to be more likely to experience adverse psychological effects. However, the evidence base is limited by a dearth of diverse research specifically focused on the psychosocial experiences and needs of this population (e.g., longitudinal and qualitative studies). Adults with EOT2D also experience unmet education, care and support needs relevant to optimising their psychosocial well-being and diabetes management. Overall, they require enhanced, tailored care and support that is age-appropriate, person-centred and responsive to their psychosocial needs. Digital technology and support-based strategies may help to address current gaps and improve the psychological well-being of this group, but these require further exploration. CONCLUSIONS: Despite the importance of psychosocial factors in young adults' diabetes management and outcomes, there remain gaps in research and practice and the need for further research, alongside changes in practice.
The burden of COVID-19 in hospitalized people with diabetes mellitus in Brazil: Insights from four years of the pandemic.
Camargo TM, Siqueira BA, Marques LFA … +2 more , Mello LS, Marson FAL
Diabet Med · 2026 May · PMID 42085590 · Publisher ↗
AIMS: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is more severe in people with diabetes mellitus due to immune dysfunction, exacerbated inflammation and i...
AIMS: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is more severe in people with diabetes mellitus due to immune dysfunction, exacerbated inflammation and increased risk of co-morbidities and mortality. In this context, this study aims to analyse the epidemiological profile of hospitalized people with diabetes mellitus and COVID-19 in Brazil over 4 years of the pandemic. METHODS: The epidemiological analysis was conducted using data from the Open-Data-SUS (Sistema Único de Saúde, Brazilian Unified Health System) platform (Brazilian Ministry of Health) covering the period from March 2020 to March 2024. Data were processed in Statistical Package for the Social Sciences software, with missing values imputed using XLSTAT. Variables included demographic profile, viral infection, co-morbidities, clinical signs and symptoms, intensive care unit (ICU) admission and mechanical ventilation, and outcomes. Statistical analyses comprised bivariate and multivariable logistic regression with a 5% significance level, focusing on two primary comparisons: the risk of death and the likelihood of classification as diabetes mellitus. The study protocol was approved by the institutional ethics committee. RESULTS: Among 2,078,062 people hospitalized with SARS-CoV-2 in Brazil, 22.2% (N = 461,647) had diabetes mellitus, with marked regional heterogeneity in both prevalence and mortality. Overall mortality was 32.9% (N = 683,088). Diabetes mellitus was not only highly prevalent but also emerged as an independent risk factor for in-hospital death, significantly increasing mortality odds (OR = 1.178; 95% confidence interval [95% CI] = 1.168-1.188), as well as higher likelihood of ICU admission (OR = 1.102; 95% CI = 1.093-1.112) and invasive mechanical ventilation (OR = 1.102; 95% CI = 1.087-1.118). Older age, female sex and self-identification as Black, mixed-race or Asian were also strongly associated with diabetes mellitus. The presence of co-morbidities, such as cardiopathy (heart disease), kidney disease, obesity, liver disease, and neurological disorders further amplified the risk of poor outcomes. Regarding vaccination, most people were unvaccinated, and while COVID-19 vaccination showed a modest association with DM diagnosis, it consistently reduced the risk of death (OR = 0.588; 95% CI = 0.583-0.594). Conversely, nosocomial infection substantially increased mortality risk, despite presenting a divergent pattern in relation to diabetes mellitus in adjusted models. Clinical symptoms most strongly associated with death included dyspnoea, respiratory discomfort and peripheral oxygen saturation below 95%. Hospital management variables were decisive: ICU admission and ventilatory support, especially invasive mechanical ventilation (OR = 12.933; 95% CI = 12.752-13.115), markedly increased mortality. Overall, advanced age remained the strongest predictor, with individuals older than 85 years experiencing more than a 30-fold increased risk of death compared with younger groups (OR = 32.840; 95% CI = 30.840-34.969). CONCLUSIONS: Diabetes mellitus is an independent predictor of worse outcomes in hospitalized people with COVID-19 in Brazil. Mortality is strongly influenced by age, co-morbidities and severity markers, while vaccination provides substantial protection.
'Dancing with diabetes': Family coping strategies to promote psychological and behavioural adaptation in older children and adolescents with type 1 diabetes-A qualitative study.
Zhang H, Li K, Luo D … +2 more , Wu Y, Li M
Diabet Med · 2026 May · PMID 42083125 · Publisher ↗
AIMS: To explore how families facilitate psychological and behavioural adaptation among older children and adolescents with T1D from the perspective of parents, children and families. METHODS: A qualitative descriptive s...
AIMS: To explore how families facilitate psychological and behavioural adaptation among older children and adolescents with T1D from the perspective of parents, children and families. METHODS: A qualitative descriptive study was conducted using maximum variance sampling method. Seventeen families in China, including 16 parents and 10 older children/adolescents with T1D, participated in semi-structured online interviews via phone or social software. Conventional content analysis was employed for data analysis. RESULTS: Three interrelated themes emerged: (1) emotional adjustment through support and compensation; (2) positive belief formation through transcendence and identity; and (3) enhanced self-management through cooperation and development. Emotional exchange, verbal support, companionship and practical compensation were identified from parents or children for regulating children's emotions. Parents fostered positive self-identity and set role models to encourage children's resilience and optimism. Shared responsibility, cognitive-behavioural adjustments, expansion of supportive environments and avoiding unhealthy behaviors were shown to be effective strategies for improving children's diabetes management. CONCLUSIONS: Perspectives on psychological and behavioural adaptation differed among parents, children and families, underscoring the need for family-centred approaches that address diverse emotional needs and align behavioural goals. Interventions should strengthen emotional connections, foster positive beliefs and enhance collaborative self-management within families to support children's adaptation to diabetes.
A qualitative study exploring and understanding the experiences and unmet needs of adults with type 2 diabetes and diabetes-related foot ulcers.
Caba M, Speight J, Glab A … +3 more , Highton P, Khunti K, Hadjiconstantinou M
Diabet Med · 2026 May · PMID 42083124 · Publisher ↗
AIMS: Diabetes-related foot ulcers (DFUs) are associated with depression, impaired health-related quality of life, an increased risk of cardiovascular disease and early mortality. To inform holistic care pathways, this q...
AIMS: Diabetes-related foot ulcers (DFUs) are associated with depression, impaired health-related quality of life, an increased risk of cardiovascular disease and early mortality. To inform holistic care pathways, this qualitative study explored the experiences and unmet needs of adults living with type 2 diabetes mellitus (T2DM) and DFUs. METHODS: Semi-structured interviews were conducted with 25 adults with T2DM and current or previous DFUs, and 20 healthcare professionals with experience treating DFUs. Topic guides were underpinned by the Theoretical Domains Framework. Data were analysed using reflexive thematic analysis. RESULTS: Four themes and three sub-themes were created relating to the impact of DFUs. DFUs were perceived as a 'wake-up call'; the experience often came as a shock, prompting individuals to consider what was responsible for their development. DFUs impacted individuals' behaviours in multiple ways: for some, they were a catalyst for positive change; for others, they fostered behaviours that were unhealthful and/or discordant with professionals' advice. DFUs negatively affected the physical and psychosocial well-being of individuals with DFU; sedentary behaviours instigated by DFUs led to changes in mood and mental health, in addition to increased weight, mobility problems and an amplified risk of health complications. Regarding the unmet needs of people with T2DM and DFUs, three themes were developed, capturing the need for treatment plans created through shared decision making and improving access to physical well-being and psychological support. CONCLUSIONS: These findings identify several important areas of unmet need regarding care for adults with T2DM and DFUs, which can help inform improved support for this population.
Associations between diabetic retinopathy and modifiable risk factors: Correction based on updated information.
Trott M, Pardhan S
Diabet Med · 2026 May · PMID 42083114 · Publisher ↗
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Unravelling dialysis-related dysglycaemia: Longitudinal insights from continuous glucose monitoring.
Habte-Asres HH, Agbabiaka A, Rehan R … +2 more , Wheeler DC, Rosenthal M
Diabet Med · 2026 May · PMID 42081714 · Publisher ↗
AIM: To characterise CGM-derived glycaemic trajectories over 12months in people receiving maintenance haemodialysis, with a particular focus on hypoglycaemia burden and composite glycaemic risk. METHODS: We conducted a l...
AIM: To characterise CGM-derived glycaemic trajectories over 12months in people receiving maintenance haemodialysis, with a particular focus on hypoglycaemia burden and composite glycaemic risk. METHODS: We conducted a longitudinal observational study. CGM data were collected at baseline, 6 and 12 months. Descriptive statistics summarised characteristics. Outcomes included time in range (TIR), time below range (TBR), time above range (TAR), glycaemic variability (GV), hypoglycaemia burden and glycaemic risk index (GRI). Metrics were summarised using means or medians, and changes between timepoints were assessed using paired t-tests or Wilcoxon signed-rank tests. RESULTS: In 125 participants (mean age 63.7 years; 54.5% men), TIR increased from 51.6% at baseline to 56.6% at 6 months (mean difference 5.09%, 95% CI 1.06 to 9.12; p = 0.014) but was not sustained at 12 months (50.5%; p = 0.568), with a decline between 6 and 12 months (-6.11%, 95% CI -9.03 to -3.19; p < 0.001). TBR remained low, with a small increase between 6 and 12 months (1.61%, 95% CI 0.59-2.64; p = 0.002). TAR and GV were unchanged across timepoints. Hypoglycaemia burden increased over follow-up (p < 0.001), while GRI showed no change. HbA1c showed moderate concordance with CGM-derived glucose at baseline (ρ = 0.39; p = 0.0001) and 12 months (ρ = 0.59; p < 0.0001). CONCLUSIONS: CGM revealed evolving glycaemic patterns. Early improvements in TIR were not sustained, hypoglycaemia increased modestly and the overall GRI remained unchanged. These findings support CGM-informed, individualised diabetes management, prioritising safety and stability.
Protective effects of 23-valent pneumococcal polysaccharide vaccination against mortality among elder patients with type 2 diabetes mellitus.
Peng X, Gu S, Liu J … +9 more , Kong D, Yang G, Guo R, Xu C, Hu X, Li Q, Yang H, Zhang N, Dong C
Diabet Med · 2026 Apr · PMID 42060856 · Publisher ↗
BACKGROUND: Older adults with type 2 diabetes mellitus are at elevated risk for severe pneumococcal disease, experiencing higher rates of complications and mortality. However, the evidence for the protective benefits of...
BACKGROUND: Older adults with type 2 diabetes mellitus are at elevated risk for severe pneumococcal disease, experiencing higher rates of complications and mortality. However, the evidence for the protective benefits of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) against mortality in this demographic remains limited. METHODS: This retrospective study included 8649 elderly people with type 2 diabetes mellitus in Soochow, China, comprising 3247 PPSV23-vaccinated individuals and 5402 unvaccinated patients. Cox proportional hazards analyses were performed to calculate the adjusted hazard ratios (HRs) of the association between PPSV23 vaccination and the risk of all cause mortality, pneumonia-related mortality, cardiovascular disease-related mortality and cancer mortality. Inverse probability weighting (IPW) was applied to estimate the average treatment effect (ATE) of universal PPSV23 vaccination compared to unvaccinated. RESULTS: During the follow-up period, a total of 1557 deaths were recorded. Compared to unvaccinated elderly people with type 2 diabetes mellitus, those receiving PPSV23 vaccine exhibited significantly lower risks of all-cause mortality (HR: 0.47; 95% CI: 0.42-0.53), with reductions also observed in deaths related to cardiovascular disease (HR: 0.50; 95% CI: 0.41-0.62), pneumonia (HR: 0.62; 95% CI: 0.43-0.89) and cancer (HR: 0.54; 95% CI: 0.42-0.70). Furthermore, IPW estimates indicated that universal PPSV23 vaccination among the elderly people with type 2 diabetes mellitus could prevent an average of 11.4% of all-cause deaths (p < 0.001), 4.0% of cardiovascular disease-related deaths (p < 0.001), 0.8% of pneumonia-related deaths (p = 0.005) and 1.9% of cancer deaths (p < 0.001). CONCLUSIONS: PPSV23 vaccination is associated with a reduced risk of all cause mortality, cardiovascular disease-related mortality, pneumonia-related mortality and cancer mortality in elderly people with type 2 diabetes mellitus.
Expert considerations to guide the development and delivery of an exercise intervention in people with type 2 diabetes-related foot ulcer disease.
Johnson VL, Hall V, Berrington R … +15 more , Burdon J, Schreder S, McCarthy M, Brough C, Highton PJ, Hadjiconstantinou M, Game FL, Keogh LJ, Tesfaye S, Valabhji J, Petrie JR, Dhatariya KK, Yates T, Davies MJ, Khunti K
Diabet Med · 2026 Apr · PMID 42060833 · Publisher ↗
OBJECTIVE: Engaging in exercise presents unique challenges for those with type 2 diabetes (T2D) and diabetes-related foot ulcer disease (DFUD). This brief report describes the development of practical considerations aimi...
OBJECTIVE: Engaging in exercise presents unique challenges for those with type 2 diabetes (T2D) and diabetes-related foot ulcer disease (DFUD). This brief report describes the development of practical considerations aiming to support exercise in people with T2D and DFUD. RESEARCH DESIGN AND METHODS: An expert group of multidisciplinary healthcare professionals (HCPs), researchers and individuals with DFUD reviewed available evidence and developed practical considerations for the assessment, prescription and monitoring of exercise within an ongoing randomised controlled trial. RESULTS: Key considerations include screening for contraindications, individualising exercise prescription, determining weight-bearing status and initial supervision by HCPs. Self monitoring of exercise and appropriate foot protection advice and care are also encouraged. CONCLUSIONS: We have developed practical considerations to use when delivering an exercise intervention within a study aiming to improve cardiovascular health for people with T2D and DFUD. For this specific population, these recommendations include prescribing non-weight bearing physical activity (such as arm ergometry or chair-based upper limb exercises) for those with active foot ulcers, educating and encouraging footcare self-management (including how to check feet and when to seek advice), monitoring glucose levels in participants at high risk of hypoglycaemia or hyperglycaemia and reducing the barriers to exercise. Pragmatic measures aimed at maintaining safety include determining the level of pre-assessment and individualised monitoring based on clinical presentation and/or risk as well as equipment and staff resource. This approach may also be helpful when supporting exercise in a wider population.
Evaluation of a secondary care multidisciplinary clinic for adults with early-onset type 2 diabetes at high risk in Leicester, Leicestershire and Rutland.
Goldney J, Hamza M, Sarkar P … +12 more , Morgan H, Green N, Ridgeway J, Alabraba V, Willcocks L, Chandracant K, Javed K, O'Callaghan R, Turner F, Seidu S, Meek CL, Davies MJ
Diabet Med · 2026 Apr · PMID 42060257 · Publisher ↗
BACKGROUND: Clinical services for adults with early-onset type 2 diabetes (EOT2D) are in urgent need of improvement. METHODS: We evaluated a multi-disciplinary clinic for individuals with EOT2D at high risk (HbA1c >9%/tr...
BACKGROUND: Clinical services for adults with early-onset type 2 diabetes (EOT2D) are in urgent need of improvement. METHODS: We evaluated a multi-disciplinary clinic for individuals with EOT2D at high risk (HbA1c >9%/triglyceride >20 mmol/L), providing 2-3 flexibly arranged consultations per individual between March 2024 and September 2025. Nurse-led case-finding in primary care supported identification and targeted referral of high-risk individuals. On 3 November 2025, electronic medical records were used to evaluate change in cardiometabolic outcomes at 6- and 12-months from baseline and evaluate service activity, including proportions with recorded health information and prescriptions. The paired t-test (continuous) and McNemar's test (proportions) were used to assess change in outcomes. Patient feedback was obtained using questionnaires. RESULTS: In total, 159 individuals received an appointment (45% women; median age 34 years). At both 6- and 12-months post-baseline, HbA1c (at 12-months: -2.53% [95% CI: -3.13, -1.93]/-28 mmol/mol [-34, 21]), systolic (-5.89 mmHg [-9.88, -1.91]) and diastolic (-2.72 mmHg [-5.34, -0.10]) blood pressure, body mass index (BMI; -1.49 kg/m [-2.31, -0.67]) and weight (-3.52 kg [-6.32, -0.72]) were significantly lower. Triglycerides were lower at 12-months only (-1.12 mmol/L [-1.89, -0.34]). The proportion with BMI or smoking status recorded, and with a glucagon-like peptide-1 receptor-based treatment, was higher at 12-months than at baseline, whereas creatinine and retinal screening measurements were less frequent. A limited amount of patient feedback was positive. DISCUSSION: Case-finding and invitation to flexibly run multidisciplinary clinics were associated with improvements in cardiometabolic outcomes and positive patient feedback. Similar services are immediately required given the rising prevalence of EOT2D and associated complications.
Considerations for the clinical use of teplizumab in stage 2 Type 1 diabetes: A Consensus Statement from the British Society of Paediatric Endocrinology and Diabetes (BSPED) and the Association of British Clinical Diabetologists (ABCD).
Dias RP, Marcovecchio ML, Willemsen RH … +6 more , Campbell F, Ashour A, Newland-Jones P, Cooper J, Narendran P, Wright NP
Diabet Med · 2026 Jul · PMID 42051156 · Full text
INTRODUCTION: In 2025, the Medicines and Healthcare products Regulatory Agency (MHRA) approved the use of teplizumab (a monoclonal anti-CD3 antibody) to delay progression from Stage 2 to Stage 3 Type 1 diabetes in the UK...
INTRODUCTION: In 2025, the Medicines and Healthcare products Regulatory Agency (MHRA) approved the use of teplizumab (a monoclonal anti-CD3 antibody) to delay progression from Stage 2 to Stage 3 Type 1 diabetes in the UK. METHODS: To address the need for clear guidance on managing patients eligible for teplizumab therapy, the British Society of Paediatric Endocrinology and Diabetes (BSPED) Type 1 diabetes Special Interest Group (SIG) and the Association of British Clinical Diabetologists (ABCD) assembled a group to review the clinical trial data and develop expert consensus guidelines on the approach to teplizumab infusions. CONCLUSION: Here, we present recommendations on all aspects of teplizumab administration with evidence base where available. We highlight the safety considerations in individual's selection, screening, monitoring and treatment of potential common side effects.
Has the time come for a remission definition in type 1 diabetes? A functional perspective.
Popovic DS, Koufakis T
Diabet Med · 2026 Apr · PMID 42051132 · Publisher ↗
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The relationship between pre-incarceration related social determinants and glycaemic control in African Americans with criminal legal involvement and type 2 diabetes.
Akinboboye O, Walker RJ, Campbell JA … +3 more , Hawks L, Williams JS, Egede LE
Diabet Med · 2026 Jul · PMID 42036882 · Publisher ↗
AIMS: To evaluate the relationship between pre-incarceration social determinants, demographic and clinical factors, and glycaemic control in African Americans with a history of criminal legal involvement and type 2 diabe...
AIMS: To evaluate the relationship between pre-incarceration social determinants, demographic and clinical factors, and glycaemic control in African Americans with a history of criminal legal involvement and type 2 diabetes mellitus. METHODS: One hundred and seventy-one adults were recruited from medical records and community centres in the Midwestern United States. The model was estimated using stepwise regression with forward selection to evaluate the relationship between pre-incarceration factors, demographic factors, clinical factors and glycaemic control among African Americans with a history of criminal legal involvement and type 2 diabetes. RESULTS: The fully adjusted model showed that age, comorbidity count and medication were significantly associated with glycaemic control. Compared to using only oral hypoglycaemic agents, the combination of pills/oral hypoglycaemic agents and insulin (β: 1.30; 95% CI: 0.60, 1.99) and using insulin or injectables alone (β: 0.87; 95% CI: 0.07, 1.67) were associated with an increase in HbA1c. Additionally, each additional comorbidity (β: -0.22; 95% CI: -0.37, -0.08) was associated with a 0.22% decrease in HbA1c, and each unit increase in age (β: -0.05; 95% CI: -0.09, -0.01) was associated with a 0.05% decrease in HbA1c. CONCLUSION: Pre-incarceration factors were not associated with glycaemic control in African Americans with a history of criminal legal involvement and type 2 diabetes. Interventions that account for factors such as comorbidity, age and medication are essential for future research.
Interventions for binge eating disorder in adults with type 2 diabetes: A systematic review.
Nybo PF, Nielsen NV, Mouritsen JD … +2 more , Røder ME, Linnet J
Diabet Med · 2026 Apr · PMID 42036870 · Publisher ↗
AIMS: Binge eating disorder frequently co-occurs with type 2 diabetes, creating a dual burden that may complicate both psychological well-being and glycaemic management. Evidence on the effectiveness of health interventi...
AIMS: Binge eating disorder frequently co-occurs with type 2 diabetes, creating a dual burden that may complicate both psychological well-being and glycaemic management. Evidence on the effectiveness of health interventions in this population is limited. This systematic review evaluated the effects of health interventions on binge eating outcomes and glycated haemoglobin (HbA1c) among adults with binge eating disorder and type 2 diabetes. METHODS: We systematically searched Embase, MEDLINE, APA PsycINFO, CENTRAL, ClinicalTrials.gov and WHO ICTRP in February 2026 for intervention studies evaluating pharmacological, psychological or behavioural interventions. Two reviewers independently screened studies, extracted data and assessed the risk of bias using design-appropriate risk-of-bias tools. Certainty of evidence was evaluated using GRADE. RESULTS: Two pharmacological studies evaluated glucagon-like peptide-1 receptor agonists (GLP-1RAs), and two psychological studies evaluated cognitive behavioural therapy (CBT) or digitally guided self-help. In the GLP-1RA studies, binge eating outcomes and HbA1c improved during active treatment compared with control, but relapse after treatment discontinuation was reported in one study. CBT was not superior to non-prescriptive therapy, although both groups improved over time. In a single-arm study, guided self-help was associated with within-group improvements in binge eating outcomes. The overall certainty of evidence was very low. CONCLUSIONS: Evidence on the effectiveness of health interventions for adults with binge eating disorder and type 2 diabetes is scarce and of very low certainty. Well-designed, preregistered and adequately powered trials are needed to determine whether targeted interventions can improve both binge eating outcomes and HbA1c in this population.
Implementing Diabetes Eating Problem Survey - Revised in pediatric type 1 diabetes care: Clinician reflections on systematic screening and multidisciplinary management.
Abild CB, Knudsen JH, Schødt M … +2 more , Gribsholt SB, Clausen L
Diabet Med · 2026 Apr · PMID 42036627 · Publisher ↗
AIM: Adolescents with type 1 diabetes have an increased risk of disordered eating; however, these symptoms may be underrecognized by clinicians. The aim of this study was to explore clinicians' perspectives and experienc...
AIM: Adolescents with type 1 diabetes have an increased risk of disordered eating; however, these symptoms may be underrecognized by clinicians. The aim of this study was to explore clinicians' perspectives and experiences on implementing the Diabetes Eating Problem Survey-Revised (DEPS-R) as a screening tool for disordered eating in a multidisciplinary care setting at a pediatric diabetes clinic. METHODS: A qualitative approach using Interpretive Description methodology was employed. Semistructured interviews were conducted with 10 clinicians, including pediatricians, nurses, dietitians, psychologists and psychiatrists. RESULTS: Four main themes were identified covering the relevance of DEPS-R as a supplement to the clinical expertise and intuition, enhancing conversations, interdisciplinary collaboration, engaging families and implementation challenges. Clinicians found DEPS-R valuable for detecting disordered eating, facilitating deeper patient conversations and supporting early intervention. Key challenges included time constraints and the need for further training. CONCLUSIONS: Clinicians found DEPS-R to be a valuable addition to their practice for identifying disordered eating in youths with type 1 diabetes, but effective implementation requires interdisciplinary collaboration, management support and continuous optimization for clinical use.
The burden of diabetic foot ulcers in a multi-ethnic Asian cohort.
Wee Z, Bee YM, Zainudin SB
Diabet Med · 2026 Apr · PMID 42032857 · Publisher ↗
AIMS: Diabetic foot ulcers (DFUs) are a major source of morbidity among individuals with diabetes mellitus (DM), imposing a substantial burden on healthcare systems. Our institution established a multidisciplinary servic...
AIMS: Diabetic foot ulcers (DFUs) are a major source of morbidity among individuals with diabetes mellitus (DM), imposing a substantial burden on healthcare systems. Our institution established a multidisciplinary service aiming to facilitate early specialist intervention for DFU management. This study examined demographic and cardiovascular risk profiles associated with DFU, the clinical burden of DFU in a large population, and the impact of our multidisciplinary specialist care on clinical outcomes. METHODS: We conducted a retrospective cohort study using the SingHealth Diabetes Registry on patients aged ≥18 years with DM from a tertiary centre between August 2018 and December 2023. There were 22,830 individuals with DM analysed; 2527 (11.1%) were diagnosed with DFU. Baseline demographics and clinical characteristics data were collected. Subgroup analyses were performed among patients attending the Diabetic Rapid Evaluation and lower limb Amputation Management (DREAM) clinic to evaluate differences in outcomes. RESULTS: Individuals with DFU were older, had a longer duration of DM, and had a significantly higher prevalence of cardiovascular and metabolic comorbidities compared with those without (p < 0.001). After multivariable adjustment, DFU was independently associated with increased mortality and prolonged hospitalization. Within the DFU cohort, referral to the multidisciplinary DREAM clinic in our institution was independently associated with a significantly reduced risk of major LEA, but not minor LEA, after multivariable adjustment. CONCLUSIONS: DFU represent a substantial clinical burden in Singapore and are independently associated with adverse outcomes. Beyond preventive screening, early multidisciplinary, multi-specialty management is critical to reduce amputations, hospitalization, and hence mortality.
Obstructive sleep apnoea is associated with accelerated progression of diabetic kidney disease.
Nielsen S, Thomsen MB, Nyvad J … +7 more , Laugesen E, Grove EL, Poulsen PL, Christensen KL, Sørensen MV, Berg P, Buus NH
Diabet Med · 2026 Jun · PMID 42026935 · Full text
AIM: Persons with type 2 diabetes and diabetic kidney disease (DKD) are at high risk of end-stage kidney disease or death. We investigated the possible contribution of obstructive sleep apnoea (OSA) to decline in kidney...
AIM: Persons with type 2 diabetes and diabetic kidney disease (DKD) are at high risk of end-stage kidney disease or death. We investigated the possible contribution of obstructive sleep apnoea (OSA) to decline in kidney function and renal outcomes. METHODS: About 120 participants with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m (not on renal replacement therapy [RRT]) and elevated urine albumin-creatinine ratio (UACR) were evaluated for OSA using the apnoea-hypopnea index (AHI) determined by the portable home sleeping device ApneaLink+. Forty-one participants without OSA (AHI <5) were compared with 36 with moderate-to-severe OSA (AHI ≥15). With the date of OSA assessment defined as index, data on UACR and eGFR were sampled from 5 years prior to index and until end-of-follow-up (median 3.2 years from index). RESULTS: At index, age, eGFR (32.2 vs. 32.9 mL/min/1.73 m), medication, blood pressure, lipid levels, and glycaemic control were comparable between the two groups, but participants with OSA had higher body mass index (BMI) and UACR. The eGFR decline from -5 years to end-of-follow-up (adjusted for age, sex and UACR at -5 years) was larger in OSA than non-OSA participants (p = 0.016). Participants with OSA were at increased risk of CKD progression (eGFR decline >50% or RRT, adjusted hazard ratio 3.4, 95% CI: 1.3-9.1), robust to adjustment for age, sex, eGFR, UACR, BMI and blood pressure. The combined endpoint of CKD progression or death also occurred more often among OSA participants (adjusted hazard ratio 3.2 [1.3-7.7]). CONCLUSION: Our results suggest OSA to be an important and independent contributor to the progression of DKD.
Improved prediction of symptomatic type 1 diabetes using a luciferase-based assay to measure (pro)insulin autoantibodies.
Wyatt RC, Brigatti C, Grace SL … +14 more , Williams CL, Marzinotto I, Gillard BT, Bazzigaluppi E, Shoemark D, Chandler MA, Achenbach P, Piemonti L, BOX Study Group, AWAF, Gillespie KM, Lampasona V, Williams AJK, Long AE
Diabet Med · 2026 Apr · PMID 42026878 · Publisher ↗
INTRODUCTION: Insulin autoantibodies (IAA) are key predictors of type 1 diabetes, particularly in young children. Micro-radiobinding assays (RBA) are the gold standard for IAA measurement but have limitations. We assesse...
INTRODUCTION: Insulin autoantibodies (IAA) are key predictors of type 1 diabetes, particularly in young children. Micro-radiobinding assays (RBA) are the gold standard for IAA measurement but have limitations. We assessed whether a luciferase immunoprecipitation system (LIPS) assay improved diabetes risk assessment. METHODS: To validate LIPS compared with RBA, samples from people with new-onset type 1 diabetes (n = 150) and first-degree relatives (FDRs) (n = 619), of whom 91 had developed diabetes during follow-up, were used. This cross-sectional observational data was analysed using the area under the receiver operator characteristic curve and cox-proportional hazard models. RESULTS: In new-onset diabetes, RBA and LIPS showed 88% agreement in IAA status. Positive IAA LIPS was more common in 89 FDRs with high-moderate affinity IAA (61%) compared with 22 FDRs with low-affinity IAA (18%) (p < 0.001). In FDRs positive for multiple other islet autoantibodies, 20-year diabetes risk was 80% for those positive compared with 30% for those negative for IAA by LIPS (p = 0.013). IAA LIPS added to diabetes risk independently of status/level of IAA by RBA, other autoantibodies and sampling age (p < 0.001). CONCLUSION: The IAA LIPS low-blood-volume, high-throughput technique identifies more individuals with the highest risk of diabetes. The ability to identify high-affinity IAA makes LIPS an ideal method for future clinical trials and population screening strategies to predict the risk of diabetes.
Supplement: Abstracts of the Diabetes UK Professional Conference 2026, Exhibition Centre Liverpool, 22-24 April 2026.
Diabet Med · 2026 Apr · PMID 42011728 · Publisher ↗
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The risk of postpartum depressive symptoms in immigrant women with recent gestational diabetes mellitus.
Ahimsadasan N, Wu W, Rahman I … +3 more , Sherifali D, Lipscombe LL, ADAPT‐M steering committee
Diabet Med · 2026 Jul · PMID 42010789 · Full text
AIMS: To evaluate the impact of immigration status and sociodemographic risk factors on postpartum depressive (PPD) symptoms among women with recent gestational diabetes mellitus (GDM). METHODS: We analysed data from 327...
AIMS: To evaluate the impact of immigration status and sociodemographic risk factors on postpartum depressive (PPD) symptoms among women with recent gestational diabetes mellitus (GDM). METHODS: We analysed data from 327 women with recent GDM who participated in a postpartum diabetes prevention trial in Toronto, Canada. Multivariable logistic regression evaluated the association between self-reported immigration status (Canadian-born vs. immigrant), overall and by time since immigration (<10 years vs. ≥10 years) and PPD symptoms based on a score of ≥10 on the Edinburgh Postnatal Depression Scale. RESULTS: At a median 4 months postpartum, PPD symptoms were reported by 25.6% of immigrant women compared to 18.2% of Canadian-born women (adjusted odds ratio [AOR] 1.01, 95% CI 0.50, 2.03). Time since immigration had no significant effect. Women with low household income (<C$60,000) were significantly more likely to report PPD symptoms compared to those with income >C$100,000 (AOR 3.71, 95% CI 1.61, 8.56). Among low-income women, PPD symptom prevalence was 48%, with 52.8% in immigrant women and 35.7% in Canadian-born women. CONCLUSIONS: PPD symptoms are common in women with recent GDM, particularly those with low income. While the prevalence of PPD symptoms was not significantly higher in immigrant women, further studies are needed to explore subgroup-specific risks. CLINICAL TRIAL: Avoiding Diabetes After Pregnancy Trial in Moms (ADAPT-M), NCT01918345.
Clinically significant hypoglycaemia in hospitalised adults: A multicentre study of 1205 episodes in the United Kingdom.
Page C, Idrissi M, Sherratt-Mayhew S … +14 more , Buchipudi A, Yee ALJ, Persad K, Khatoon A, Rakkar A, Arshad A, Solomon AL, Raghavan R, Rengarajan L, Iqbal A, Choudhary P, Manta A, Kempegowda P, DEVI Collaboration
Diabet Med · 2026 Jun · PMID 42010787 · Full text
INTRODUCTION AND OBJECTIVES: Inpatient hypoglycaemia is a serious complication of diabetes therapy, yet real-world data on clinically significant episodes remain limited. The objectives of this study are (1) to describe...
INTRODUCTION AND OBJECTIVES: Inpatient hypoglycaemia is a serious complication of diabetes therapy, yet real-world data on clinically significant episodes remain limited. The objectives of this study are (1) to describe the clinical and biochemical characteristics of clinically significant inpatient hypoglycaemia across multiple NHS sites, (2) to assess adherence to Joint British Diabetes Societies hypoglycaemia management guidelines, (3) to evaluate the applicability of International Hypoglycaemia Study Group (IHSG) classifications in hospitalised people with diabetes and (4) to identify gaps in care processes amenable to quality improvement (QI) interventions. METHODS: We conducted a retrospective cohort study across 11 UK centres, including all clinically significant hypoglycaemic episodes (IHSG Levels 2 and 3) between October 2023 and December 2024. Data on demographics, precipitants, clinical features, treatment, outcomes and subsequent therapeutic adjustments were analysed. RESULTS: We identified 1205 episodes from 674 people (mean age 72 years; 54.5% male; 74.6% with type 2 diabetes; median Charlson Comorbidity Index 6). Common precipitants included intercurrent illness (44.7%), fasting/missed meals (40.7%) and medication dosing errors (16.7%). Inpatient mortality occurred in 2.9% of Level 2 and 15.2% of Level 3 episodes. Episode characteristics varied by sex, diabetes type and centre. The IHSG classification system effectively stratified the risk of adverse outcomes. CONCLUSIONS: Clinically significant inpatient hypoglycaemia is associated with high mortality and substantial variation in care. The IHSG framework reliably predicts poor outcomes and may serve as a valuable framework for standardised risk stratification and service evaluation. Identification of common, modifiable risk factors highlights opportunities for systematic QI and surveillance.
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