Diabetic Medicine[JOURNAL]
Sun
200 papers
Acute pancreatitis following sleeve gastrectomy with transit bipartition: A case report.
Jiang Y, Pang X, Zhang Z … +4 more , Xie S, Yang H, He M, Zhang Y
Diabet Med · 2026 Jul · PMID 42010450 · Publisher ↗
INTRODUCTION: Sleeve gastrectomy with transit bipartition (SG-TB) is an emerging metabolic and bariatric surgery (MBS) procedure for obesity and type 2 diabetes. Acute pancreatitis (AP) is a rare complication of other me...
INTRODUCTION: Sleeve gastrectomy with transit bipartition (SG-TB) is an emerging metabolic and bariatric surgery (MBS) procedure for obesity and type 2 diabetes. Acute pancreatitis (AP) is a rare complication of other metabolic and bariatric surgery (MBS) procedures (incidence: 0.27%-3.6%), including Roux-en-Y Gastric Bypass (RYGB) and occurs after other MBS procedures such as Roux-en-Y Gastric Bypass (RYGB) and standard Laparoscopic Sleeve Gastrectomy (LSG), while no AP cases following SG-TB have been reported to date. CASE PRESENTATION: We describe a 41-year-old female patient with obesity and type 2 diabetes (BMI 30.6 kg/m) who developed AP on the 3rd day after an uncomplicated laparoscopic SG-TB. She presented with epigastric pain radiating to the back, mild elevation of serum amylase and lipase and magnetic resonance imaging findings consistent with the diagnosis of mild AP according to the 2012 Revised Atlanta Criteria. DISCUSSION: The patient had moderately elevated preoperative triglycerides (5.0 mmol/L), which was below the classical threshold of 11.3 mmol/L for hypertriglyceridemia-induced AP, thus serving as a background risk factor for the onset, with no other definite etiological factors. Conservative treatment resolved symptoms, pancreatic enzyme levels normalized on the 7th postoperative day, and she was discharged uneventfully. CONCLUSION: This case highlights that AP should be included in the differential diagnosis of patients with abdominal pain in the early postoperative period after SG-TB. Biliogastric reflux-induced pancreatic duct hypertension following gastrojejunal anastomosis in SG-TB and iatrogenic mechanical/thermal injury may be the main pathogenic mechanisms, with the patient's metabolic status acting as a synergistic factor for early-onset AP.
Health, hope and worry: A qualitative study of people with diabetes' experiences with anti-VEGF treatment.
Leksell JK, Granstam E, Granström T … +1 more , Nerpin E
Diabet Med · 2026 Apr · PMID 42008767 · Publisher ↗
AIMS: Diabetic macular edema (DME) is a leading cause of vision loss among individuals with diabetes. While anti-VEGF therapy is a widely used and effective treatment, limited research has explored participants' lived ex...
AIMS: Diabetic macular edema (DME) is a leading cause of vision loss among individuals with diabetes. While anti-VEGF therapy is a widely used and effective treatment, limited research has explored participants' lived experiences throughout the treatment process. METHODS: This qualitative study summarizes findings from longitudinal interviews conducted at 4 and 12 months after initiating intravitreal anti-VEGF therapy. The analysis focused on participants' emotional, physical and psychosocial responses to treatment. RESULTS: An overarching theme, 'health, hope, and worry', captured the ambivalent experiences of participants. Two main categories were identified: 'hope and anxiety during injection treatment' and 'uncertainty and variation in visual outcomes'. Participants described a spectrum of physical discomfort and emotional reactions, influenced by expectations, bodily sensitivity and clinical context. Trust in healthcare providers, consistent care and adequate information were crucial for emotional resilience. Perceived treatment effectiveness varied, with some experiencing significant visual improvement and regained independence, while others reported little or no change, leading to frustration and anxiety about future vision. CONCLUSIONS: Anti-VEGF treatment for DME is experienced not only as a clinical intervention but as an emotionally and physically complex journey. Participants' navigate fluctuating levels of hope and worry, shaped by their bodily experiences, emotional responses and expectations of outcomes. These findings highlight the need for empathetic communication, consistent care and individualized support to promote adherence and mitigate emotional distress. The insights from this study are especially relevant for multidisciplinary diabetes care teams.
Reverse innovation in diabetic foot disease prevention: Rethinking family and community roles.
Suglo JN, Winkley K, Abeasi DA … +1 more , Sturt J
Diabet Med · 2026 Jun · PMID 41999662 · Full text
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When the system fails: Barriers to type 1 diabetes medication access and the emergent role of social media support.
Sklar J, Harel S, Lipska KJ … +6 more , Lukasik J, Wilcox A, Flynn A, Weinzimer SA, Suttiratana SC, Nally LM
Diabet Med · 2026 Jun · PMID 41996632 · Publisher ↗
AIMS: People with type 1 diabetes (T1D) often face systemic failures in healthcare delivery. As a result, some turn to social media to seek assistance from others within the T1D community. This study explores the challen...
AIMS: People with type 1 diabetes (T1D) often face systemic failures in healthcare delivery. As a result, some turn to social media to seek assistance from others within the T1D community. This study explores the challenges people with T1D face in accessing insulin and diabetes devices, the resulting health consequences, and the strategies they use to navigate these obstacles. METHODS: Thirty adults with TID or caregivers of youth with T1D (25 adults, 5 caregivers) who had sought support through social media for diabetes medications and supplies participated in semi-structured telephone interviews. Qualitative thematic analysis generated themes about the types of barriers encountered, how individuals responded and the health consequences of barriers to medication and supply access. RESULTS: Themes reflected multilevel barriers to diabetes care, including system-wide failures in access, coordination and delivery; difficulties affording insulin and diabetes devices; personal sacrifices and rationing behaviours in response to access challenges; and serious health consequences resulting from delayed or disrupted care. People encountered challenges with coverage, benefits, and approvals from insurers, pharmacies and durable medical equipment companies, and overlapping problems with affordability. Some experienced life-threatening situations, such as diabetic ketoacidosis, when unable to get needed medicines or supplies. The accessibility of the T1D community through social media was seen as a valuable resource during emergencies when no other options were available. CONCLUSIONS: This study underscores the substantial barriers individuals with T1D encounter when accessing essential medications and supplies within the healthcare system. The findings highlight the pivotal role of social media in facilitating rapid support from the T1D community during times of urgent need. Addressing these systemic challenges is essential for enhancing healthcare access and improving health outcomes for individuals with T1D.
The insulin-like growth factor system and the progression of renal complications of type 2 diabetes.
Heald A, Lllangasekera Y, Matheou A … +11 more , Narayanan RP, White S, Habte-Asres H, Lay A, Shalamanova L, Ollier W, Hitman GA, Mallik R, Kalra PA, Whyte M, Gibson JM
Diabet Med · 2026 Apr · PMID 41996599 · Publisher ↗
AIMS: Chronic kidney disease is associated with dysregulation of the insulin-like growth factor (IGF) system. Alterations in IGF bioavailability, driven by IGF binding proteins (IGFBPs), may influence the decline in rena...
AIMS: Chronic kidney disease is associated with dysregulation of the insulin-like growth factor (IGF) system. Alterations in IGF bioavailability, driven by IGF binding proteins (IGFBPs), may influence the decline in renal function. However, the longitudinal relationship between baseline IGF-I, IGF-II, IGFBPs and progression of kidney dysfunction remains unclear. We evaluated how IGF/IGFBP profile relates to longitudinal changes in urinary albumin/creatinine ratio (ACR) and serum creatinine level in people with type 2 diabetes (T2D). METHODS: Individuals' measurements were performed in 436 individuals with T2D recruited from primary and secondary care (2002-2004), from the Salford and Manchester Integrated Care Record (GMCR), for laboratory and clinical data, as well as date of death. Baseline IGF/IGFBP profile was related to 2 primary outcomes: (i) change in albumin-to-creatinine ratio over time (urine ACR trend slope) and (ii) change in serum creatinine over time (creatinine trend slope). Trend slopes were derived for each participant, using repeated measures throughout follow-up for up to 24 years. Associations between IGF axis proteins and outcomes were evaluated with multivariate regression models. Cox proportional hazards models were constructed to determine mortality risk associated with the IGF system proteins studied. RESULTS: At baseline, 59.3% of participants were men. Age at baseline was 56.6 ± 9.4 years. Mean follow-up duration was 17.4 ± 5.2 years. IGF-II and IGFBP-3 were strongly correlated (Spearman rho = 0.80), and were therefore not included simultaneously in the multi-variate linear regression model to avoid co-linearity. Higher circulating IGFBP-2 was independently associated with faster rate of ACR progression (normalised beta (Β) = 0.007, p = 0.002), while IGFBP-1 showed an inverse association (B = -0.057, p = 0.009). IGF-II also remained positively associated with ACR trend (B = 0.005, p = 0.013), whereas IGF-I showed no association. IGFBP-1 showed a significant inverse association with creatinine change when adjusted for effects of covariates (unstandardised B = -0.038, p = 0.04). Survival analysis revealed that higher IGFBP-2 levels were independently associated with higher all-cause mortality (hazard ratio [HR] per 1 standard deviation increase 1.306, 95% CI 1.151-1.483 p = 0.0001). CONCLUSION: This longitudinal study indicated that higher baseline IGF-II, lower IGFBP-1 and higher IGFBP-2 are associated with a greater likelihood of albuminuria progression, independent of standard risk factors; lower IGBFP-1 also associated with greater increase in serum creatinine. Higher circulating IGFBP-2 level was also associated with relatively higher mortality. This study demonstrated the relevance of the IGF system to our understanding of renal complications in diabetes and strongly suggests that further exploration of mechanisms underlying these associations is merited.
Gestational diabetes mellitus and disordered eating behaviours: A qualitative study of online forum discussions.
Noori Y, Cote E, Clark S … +2 more , Chambers H, Benton M
Diabet Med · 2026 Apr · PMID 41995724 · Publisher ↗
AIMS: To explore how gestational diabetes mellitus (GDM) and disordered eating behaviours (DEBs) in pregnancy and postpartum are discussed on an online forum. METHODS: A qualitative reflexive thematic analysis of threads...
AIMS: To explore how gestational diabetes mellitus (GDM) and disordered eating behaviours (DEBs) in pregnancy and postpartum are discussed on an online forum. METHODS: A qualitative reflexive thematic analysis of threads and comments from publicly accessible Reddit forums. Posts were included if they referred to current or previous GDM and described experiences related to DEBs. Only English-language posts were analysed, with no geographical restrictions. RESULTS: A total of 144 posts referring to DEBs in the context of current or previous GDM were analysed. Three overarching themes were developed: (1) GDM management as a trigger for DEBs, capturing how clinical demands around diet and glucose monitoring intensified preoccupations with food and control; (2) Multilayered distress impacting on relationship with food and disordered eating, highlighting how feelings of shame, unpredictability of GDM, and perceived blame compounded food-related anxiety and DEBs; (3) Reclaiming agency-disclosure, coping, and adaptive strategies, capturing how some women regained feelings of control by sharing experiences, using adaptive coping strategies, and engaging with online peer support. CONCLUSIONS: GDM care protocols may exacerbate or precipitate DEBs due to their focus on dietary surveillance, glucose control and fear-based messaging. Individualised, evidence-informed care that considers psychological experiences across pregnancy and postpartum could improve both clinical and psychological outcomes for women.
Risk of progression to type 2 diabetes or regression to normoglycaemia among Ghanaians with prediabetes living in Ghana and the Netherlands: The RODAM prospective study.
Bannerman-Williams E, Atiase Y, van den Born BH … +6 more , Chilunga FP, van der Linden E, Meeks KAC, Beune E, Agyemang C, Hayfron-Benjamin CF
Diabet Med · 2026 Apr · PMID 41986987 · Publisher ↗
INTRODUCTION: Evidence shows that ethnicity affects the risk of progression of prediabetes to type 2 diabetes(T2D) or regression to normoglycaemia However, little is known about progression rates among sub-Saharan Africa...
INTRODUCTION: Evidence shows that ethnicity affects the risk of progression of prediabetes to type 2 diabetes(T2D) or regression to normoglycaemia However, little is known about progression rates among sub-Saharan African populations or whether geographical context affects risk variations. We compared the risk of progression to T2D or regression to normoglycemia in West Africans with prediabetes living in Africa and their migrant compatriots living in Europe. METHODS: We analysed data from 615 Ghanaians with prediabetes at baseline (245 in Ghana/370 in Amsterdam) in the prospective RODAM cohort with an average follow-up of 6.7 years. Prediabetes was defined according to the WHO criteria. Incidence risk ratios for progression to T2D and regression to normoglycaemia were calculated with adjustment for age, sex, follow-up duration, socioeconomic status and baseline BMI and fasting plasma glucose. RESULTS: Overall, the cumulative incidences of T2D and normoglycaemia from prediabetes were 12.6% and 28.9%, respectively. While the proportions of individuals who progressed to T2D did not differ between non-migrants and migrants (16.0% vs. 10.9%, p-value = 0.108), the proportion who regressed to normoglycaemia was higher in non-migrants (51.5% vs. 17.1%, p < 0.001) with an incident risk ratio of 3.48 (95% CI 2.39-5.05, p < 0.001) in the fully adjusted model. However, the risk of progression of prediabetes to T2D remained similar in the two groups after full adjustment [1.20 (0.71-2.05), 0.498]. CONCLUSIONS: Among Ghanaians with prediabetes, regression to normoglycaemia was more frequent than progression to T2D, and more likely in non-migrants than in migrants. Future studies could identify factors underlying the higher rates of regression to normoglycaemia in non-migrants to improve outcomes in individuals with prediabetes.
Safety and efficacy of intermittent fasting with or without exercise in people living with overweight or obesity and type 2 diabetes-The INTERFAST-3 study design.
Sourij C, Müller A, Al-Baghdadi A … +8 more , Aziz F, Tripolt NJ, Pferschy PN, Andritz E, Kojzar H, Stadlbauer V, Garcia SL, Sourij H
Diabet Med · 2026 Jul · PMID 41986966 · Full text
AIMS: Lifestyle modification, including caloric restriction and exercise, is fundamental in the treatment of people living with overweight and type 2 diabetes mellitus (T2D). The overall aim of lifestyle intervention sch...
AIMS: Lifestyle modification, including caloric restriction and exercise, is fundamental in the treatment of people living with overweight and type 2 diabetes mellitus (T2D). The overall aim of lifestyle intervention schemes is to reduce body weight and improve glycaemic control to reduce the future risk of diabetes-associated complications. The aim of this study is to determine whether intermittent energy restriction, exercise or their combination is best suited for reaching these targets in individuals with T2D not treated with insulin. METHODS: This randomized, controlled, monocentric parallel-group trial is designed to investigate participants living with T2D, body mass index >27 kg/m, HbA1c ≥53 mmol/mol (≥7.0%) and ≤86 mmol/mol (≤10.0%) and without insulin therapy. Participants are equally and randomly allocated to one of four study groups: (1) intermittent energy restriction group, (2) exercise group, (3) combined intermittent energy restriction and exercise group and (4) control group. The intervention phase lasts 12 weeks, followed by a two-year follow-up phase. In addition to assessing body weight and glycaemic parameters, resting energy expenditure (REE) and body composition are measured. An oral glucose tolerance test is carried out at baseline and at the end of the intervention. Additionally, stool samples for microbiome analyses and individual-related outcomes are collected, and all participants are equipped with continuous glucose monitoring (CGM). The primary outcome measure is the change in bodyweight from baseline to day 84. TRIAL REGISTRATION: The study was registered at DRKS (Deutsches Register Klinischer Studien-German Clinical Trial Register DRKS-ID: DRKS00032036)-Date of registration: 11.10.2023.
Does faster aspart improve time in range in children with type 1 diabetes with glycaemia close to target on insulin pump therapy?
Emilia KK, Magdalena D, Lidia G … +1 more , Agnieszka S
Diabet Med · 2026 Apr · PMID 41968383 · Publisher ↗
AIMS: To evaluate whether faster insulin aspart (FIA) improves time in range (TIR) compared with standard insulin aspart (SIA) in children and adolescents with type 1 diabetes achieving glycaemia close to target treated...
AIMS: To evaluate whether faster insulin aspart (FIA) improves time in range (TIR) compared with standard insulin aspart (SIA) in children and adolescents with type 1 diabetes achieving glycaemia close to target treated with continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM). METHODS: This prospective, open-label, randomized, 1:1 crossover trial included participants aged 6-17 years with T1D duration of ≥1 year, CSII use ≥3 months, CGM use ≥1 month, and HbA1c 64 mmol/mol (<8%). After a 2-week run-in period, they then crossed over to the alternate insulin for another 4 weeks. All participants used the same CGM system. Assessments were performed at the end of each treatment phase. The primary endpoint was the between-treatment difference in TIR (3.9-10.0 mmol/L, 70-180 mg/dL). RESULTS: Seventy-seven children were enrolled (mean T1D duration approximately 7 years; 66% male; mean HbA1c 53 mmol/mol, 7%). Mean TIR was 68.5% (SD 12.3%) with SIA and 67.6% (SD 12.1%) with FIA, with no statistically significant difference (mean difference -0.9%; 95% CI -2.60 to 0.86; P = 0.322). Similar patterns were observed for additional glycaemic metrics. Time in tight range was also similar between treatments: 46.3% for SIA versus 45.4% for FIA (P = 0.674). CONCLUSIONS: In this randomised crossover study of children and adolescents with T1D achieving glycaemia close to target on CSII, switching from SIA to FIA does not improve TIR. The absence of improvement across CGM-derived metrics suggests that FIA does not meaningfully enhance glycaemic outcomes in this clinical setting.
A multi-omics risk score enables early and personalized screening for type 2 diabetes: A population-based cohort study.
Bu F, Fang C, Zheng X … +7 more , Yu XJ, Yuan SJ, Liu CJ, Song ZT, Shen YP, Zhang L, Pei YF
Diabet Med · 2026 Apr · PMID 41964949 · Publisher ↗
OBJECTIVE: This study aims to develop a multi-omics model to predict type 2 diabetes onset using multi-omics data, beyond established clinical and genetic factors. METHODS: In the UK Biobank cohort (N = 21,312,893 incide...
OBJECTIVE: This study aims to develop a multi-omics model to predict type 2 diabetes onset using multi-omics data, beyond established clinical and genetic factors. METHODS: In the UK Biobank cohort (N = 21,312,893 incident type 2 diabetes cases), Ridge Cox regression models were constructed based on clinical factors defined by the Finnish Diabetes Risk Score (CliS), plasma metabolomics (MetS), proteomics (ProS) and polygenic risk score (PRS). Model performance was evaluated by C-index and net reclassification improvement (NRI). Clinical utility was assessed through net benefit, risk stratification and screening initiation ages. Independent validation of protein markers was performed in the Liyang Cohort (N = 10,056). RESULTS: The ProS was the top-performing single-omics predictor (C-index: 0.80). ComS (Combined risk score) achieved the highest discriminative ability (C-index: 0.84), significantly outperforming the CliS (C-index: 0.76, NRI: 0.328, p < 0.001). ComS reclassified 73 additional type 2 diabetes cases per 1000 participants not receiving intervention, without increasing false positives. Kaplan-Meier analysis confirmed superior risk stratification of ComS (Log-rank p < 0.0001). Critically, both MetS and ProS identified high-risk individuals missed by the conventional CliS. Screening initiation before age 40 was warranted for individuals in the top risk quintile of MetS, ProS, or ComS. In the Liyang Cohort, plasma FGF23 levels were significantly elevated in type 2 diabetes cases (p < 0.05), corroborating its role as a key proteomic contributor to risk prediction. CONCLUSION: The combined multi-omics model enables more precise, earlier type 2 diabetes risk stratification, supporting personalized screening strategies years before clinical onset.
Changing trends and variation in service delivery for inpatient diabetes care in England: A national survey.
Rayman G, Johnston P, Earnshaw F … +3 more , Kar P, Briggs TWR, Gray WK
Diabet Med · 2026 Jul · PMID 41964120 · Publisher ↗
BACKGROUND: The Getting It Right First Time (GIRFT) programme national report was published in 2020 with recommendations on how inpatient diabetes care could be improved. To determine whether there have been changes in s...
BACKGROUND: The Getting It Right First Time (GIRFT) programme national report was published in 2020 with recommendations on how inpatient diabetes care could be improved. To determine whether there have been changes in service provision of inpatient diabetes care since the GIRFT report and to gather feedback from staff on current diabetes care, we conducted a survey of NHS hospitals in England. METHODS: A national survey of inpatient diabetes service provision and diabetes staff opinion was conducted across NHS hospital trusts in England between 1 July 2024 and 31 March 2025. The survey assessed inpatient diabetes prevalence, workforce staffing, infrastructure and information technology, care pathways (including perioperative care) and systems to improve patient safety. Findings were compared with previous national audits, including the National Diabetes Inpatient Audit (NaDIA; 2010-2019) and the 2024 National Diabetes Audit - Integrated Specialist Services (NDA ISS) survey. RESULTS: Responses were received from 136 hospitals, representing 102 (77%) of 132 NHS hospital trusts in England with a diabetes service. Most hospitals reported a continued increase in inpatient numbers since 2019. Although approximately 85% of hospitals reported access to Diabetes Inpatient Specialist Nurses (DISNs), nearly two-thirds had no weekend DISN service. Access to diabetes physician support and out-of-hours specialist advice was limited. The use of networked glucose monitoring systems was widespread, but their use for quality improvement was inconsistent. Trusts with higher specialist staffing levels demonstrated shorter lengths of stay and fewer 30-day emergency readmissions. CONCLUSIONS: Despite improvements in inpatient diabetes service provision since 2019, substantial variation remains, with workforce capacity failing to match rising demand and increasing clinical complexity. The absence of a national bedside inpatient diabetes audit since 2019 represents a critical gap. Reinstating a national bedside audit and integrating service-level evaluation with patient-level outcomes should be prioritised to support safe, effective and equitable inpatient diabetes care in England.
Acute kidney injury in hospitalised patients with type 2 diabetes: Associations with continuous glucose monitoring-based glucose levels, mortality, and ICU admission.
Olsen MT, Nørgaard K, Jensen SH … +10 more , Rasmussen LM, Klarskov CK, Lindegaard B, Andersen JA, Gottlieb H, Lunding S, Pedersen-Bjergaard U, Hansen KB, Kristensen PL, Brøsen JMB
Diabet Med · 2026 Jun · PMID 41964006 · Publisher ↗
AIMS: Acute kidney injury (AKI) may increase the risk of hypoglycaemia in patients with diabetes due to reduced insulin clearance and altered glucose metabolism. However, the impact of AKI on glycaemic status in non-crit...
AIMS: Acute kidney injury (AKI) may increase the risk of hypoglycaemia in patients with diabetes due to reduced insulin clearance and altered glucose metabolism. However, the impact of AKI on glycaemic status in non-critically ill hospitalised patients with diabetes is not well understood. METHODS: We included 166 hospitalised patients with type 2 diabetes on basal-bolus insulin monitored by continuous glucose monitoring (CGM). Kidney function was measured daily via plasma creatinine levels, and AKI was staged per Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Multivariate models assessed associations between kidney function and CGM-based glycaemic outcomes. RESULTS: AKI correlated with a 7.3%-point (95% CI 0.3-14.2) reduction in time in range (TIR, 3.9-10.0 mmol/L), driven by increased time above range (TAR, >10.0 mmol/L), with no significant change in time below range (TBR, <3.9 mmol/L). AKI was also associated with approximately a tenfold increase in the risk of in-hospital mortality and intensive care unit (ICU) admission, and the risk of being readmitted within 30 days was twice as high. TIR decreased by 7.6%-point (95% CI 2.6-12.5) for each 100 μmol/L increase in plasma creatinine levels. CONCLUSION: AKI and high plasma creatinine are associated with hyperglycemia, in-hospital mortality, referral to ICU, and 30-day unscheduled readmissions in hospitalised patients with type 2 diabetes. These findings challenge the prevailing focus on hypoglycemia prevention during AKI, emphasising the importance of addressing hyperglycemia as well.
Receipt of postpartum diabetes screening after gestational diabetes mellitus in the United States, 2016-2022.
Boege HL, Berube LT, Ryan RA … +1 more , Deierlein AL
Diabet Med · 2026 Apr · PMID 41963768 · Publisher ↗
AIMS: To examine temporal trends in, as well as social and clinical factors associated with, the prevalence of postpartum diabetes screening after gestational diabetes mellitus (GDM) in the United States (U.S.). METHODS:...
AIMS: To examine temporal trends in, as well as social and clinical factors associated with, the prevalence of postpartum diabetes screening after gestational diabetes mellitus (GDM) in the United States (U.S.). METHODS: Cross-sectional, population-based data were from the Pregnancy Risk Assessment Monitoring System (PRAMS) 2016-2022 from 44 U.S. states and jurisdictions. The analytic sample included postpartum individuals with self-reported GDM who attended a postpartum checkup and reported on postpartum diabetes screening (n = 21,559). Overall and annual prevalence of postpartum diabetes screening were calculated, and associations between social and clinical factors and postpartum diabetes screening were examined using multivariable modified Poisson regression (adjusted prevalence ratios [aPR] with 95% confidence intervals [CI]). RESULTS: Overall weighted prevalence of postpartum diabetes screening was 55.8% (95% CI: 54.8-56.9). Screening prevalence increased from 2016 (55.6%) to 2019 (60.3%), declined at the onset of the COVID-19 pandemic (2020: 52.6%) and subsequently increased through 2022 (55.8%). Screening prevalence was 6%-38% higher among individuals who were ≥30 years of age; identified as racial or ethnic minoritized groups; did not graduate from high school; had public prenatal health insurance; had pre-pregnancy overweight or obesity and had adequate plus prenatal care. Screening prevalence was 5%-14% lower among individuals with a previous live birth, preterm birth and residents of rural areas, the South or U.S. Territories. CONCLUSIONS: While postpartum diabetes screening has increased and aligns with recognized risk factors, overall prevalence remains suboptimal. Postpartum diabetes screening represents a critical opportunity to identify individuals at elevated cardiometabolic disease risk and initiate timely interventions.
Evaluation of a novel eating disorder prevention programme (Australian diabetes body project) for young women with type 1 diabetes in a clinic setting: A randomized controlled trial protocol.
D'Silva N, Gillespie KM, Hendrieckx C … +12 more , Wisting L, Ewais T, Phillips L, Denny S, Bartlett S, White M, Mackay H, Vitanza M, Magee I, Griffin A, Jones L, Stice E
Diabet Med · 2026 Jun · PMID 41955392 · Full text
BACKGROUND: Co-occurrence of eating disorders (ED) and type 1 diabetes (T1D) can lead to deterioration in glycaemic control with reduced quality of life, microvascular complications, diabetic ketoacidosis and premature d...
BACKGROUND: Co-occurrence of eating disorders (ED) and type 1 diabetes (T1D) can lead to deterioration in glycaemic control with reduced quality of life, microvascular complications, diabetic ketoacidosis and premature death. The current trial aims to test the effectiveness of an Australian Diabetes Body Project (ADBP) programme, a cognitive dissonance-based group intervention, on ED risk factors and symptoms, psychometric analysis, quality of life and glycaemia control in young women with T1D. METHODS: Mixed methods, prospective randomized controlled trial (RCT) using an online, six-week group intervention facilitated by a clinician and a peer with T1D. A sample of 80 young women with T1D aged 15 to 30 years will be randomized to the ADBP or active control (educational videos) condition. Participants will complete assessments of body dissatisfaction, eating behaviours, quality of life and diabetes distress, at baseline, post-intervention and at three-month follow-up. Medical record data will be extracted to determine changes in glycaemia outcomes. ADBP participants will be invited to provide feedback on the benefits and acceptability of the intervention. DISCUSSION: The ADBP will be the first clinic-based RCT to examine the effectiveness of a virtual, cognitive dissonance-based intervention for reducing ED risk factors and symptoms in young women with T1D. The results of this project will have immediate implications for clinical practice in Australia and globally, given the increasing prevalence of ED in this high-risk group and limited effective prevention programmes available. TRIAL REGISTRATION: The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (Trial ID: ACTRN12624000555550); accessible at (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12624000555550).
Hypo- and hyperglycaemia following pancreas transplantation for people with type 1 diabetes.
Kozuch W, Dayan R, Ablorsu E … +4 more , Elker D, Asderakis A, Baldwin S, Dayan C
Diabet Med · 2026 Jul · PMID 41947410 · Publisher ↗
AIMS: To establish the rates of and variables associated with glycaemic disturbances in people with type 1 diabetes with a functioning pancreas transplant, and to quantify the association with graft failure. METHODS: An...
AIMS: To establish the rates of and variables associated with glycaemic disturbances in people with type 1 diabetes with a functioning pancreas transplant, and to quantify the association with graft failure. METHODS: An observational study on routinely collected data from pancreas transplant recipients at University Hospital Wales from January 2013 to April 2019 with glucose tolerance test (GTT) data. Their variables were analysed to assess rates and risk factors for glycaemic disturbance. RESULTS: Of the 96 participants in this study, 30% developed glycaemic disturbance. Hyperglycaemia was twice as common as hypoglycaemia (22% vs. 10%). Recipients who developed hypoglycaemia were predominantly women (90% vs. 26% for those who developed hyperglycaemia, p = 0.001), had a lower mean BMI (23.7 vs. 27.6 kg/m for hyperglycaemic individuals, difference: 3.89, CI: 0.77-7.0, p = 0.017). There was no increase in graft failure rates for recipients with glycaemic disturbances (normoglycaemia: 12%, hypoglycaemia: 10%, hyperglycaemia: 4.8%, p = 0.70). CONCLUSIONS: Recipients with post-transplantation hypoglycaemia were more likely to be women and of low body weight, which may be due to disordered eating with restricted calorie or carbohydrate intake. Recipients with post-transplantation hyperglycaemia had features of insulin resistance and type 2 diabetes with increased weight and men predominance. Glycaemic disturbance was not associated with graft failure, suggesting it relates to insulin-glucose mismatch rather than rejection. Further follow-up is required to identify the long-term sequelae of glycaemic disturbance after pancreas transplants and if relevant dietary counselling has the potential to attenuate these disturbances.
Integrative multi-omics suggests core gene dysregulation of histidine metabolism in diabetic kidney disease.
Tan J, Chen Y, Chuan F … +3 more , Gao Y, Wu M, Hu J
Diabet Med · 2026 Jun · PMID 41947261 · Publisher ↗
AIMS: To investigate the role of histidine metabolism in diabetic kidney disease (DKD), we analysed histidine metabolism-related genes using an integrative multi-omics approach. METHODS: Untargeted metabolomics was perfo...
AIMS: To investigate the role of histidine metabolism in diabetic kidney disease (DKD), we analysed histidine metabolism-related genes using an integrative multi-omics approach. METHODS: Untargeted metabolomics was performed on serum from DKD persons and healthy controls, as well as on high glucose-treated and normal glucose-treated HK-2 cells, to assess metabolic alterations. We also analysed publicly available datasets, including GEO transcriptomes, Kidney Precision Medicine Project (KPMP), Kidney Interactive Transcriptomics single-cell data, the Human Protein Atlas (HPA) and Nephroseq, to examine the expression and function of histidine metabolism-related genes. RESULTS: Serum metabolomics confirmed alterations in histidine metabolism. Single-cell analysis revealed that five histidine metabolism-related genes were expressed in proximal tubular epithelial cells and significantly downregulated in DKD. Immunohistochemistry data from the HPA further demonstrated that the corresponding proteins are localized in the proximal tubule (PT). High-glucose treatment suppressed histidine metabolism in HK-2 cells, supporting specific metabolic reprogramming. Clinical correlation analyses using Nephroseq linked the decreased expression of these genes to renal function decline. Collectively, these findings indicate that histidine metabolic disruption is associated with tubular cell dysfunction, suggesting a mechanistic contribution to DKD progression. CONCLUSION: By integrating multi-omics analyses, we suggest that histidine metabolic reprogramming represents a PT pathological event in DKD, providing novel mechanistic insights and potential therapeutic targets.
A consensus statement on a National Competency Framework for training and assessment of knowledge and skills in diabetes technologies, including hybrid closed loop (HCL), insulin pump systems, and continuous glucose monitoring (CGM) devices.
Richardson E, Stribling B, Ridgeway J … +19 more , Kitching-Davis C, Willcocks L, Heggs L, Wakefield H, Gallen G, Jolley A, Bareford K, Williams A, Farrow D, Fletcher-Salt T, Hicks D, Higgins J, Jordan L, Kelly B, Metcalf-O'Shea C, Turner M, Walden E, Walker A, Choudhary P
Diabet Med · 2026 Jul · PMID 41943214 · Full text
AIMS: To design a national competency framework supporting the training of healthcare professionals (HCP) in the care and management of people with diabetes using diabetes technologies. METHODS: Following the release of...
AIMS: To design a national competency framework supporting the training of healthcare professionals (HCP) in the care and management of people with diabetes using diabetes technologies. METHODS: Following the release of the NICE [TA943] guidance and the NHS England 5-year implementation strategy, a working group was formed to design a four-level training framework for HCPs, identifying specific knowledge and competencies required for different roles in supporting people living with diabetes using continuous glucose monitoring (CGM) or hybrid closed-loop systems. RESULTS: We developed a four-level training and competency framework using the 'Novice to Expert' framework and identified skills and competencies for each of those levels. We then sought endorsement from leading national organisations to create this consensus document. This framework complements the delivery recommendations of the 5-year NHS implementation plan for HCL by helping HCPs develop competence and confidence to support HCL users. CONCLUSIONS: We anticipate that the national adoption of this training and competency framework will allow healthcare providers to assess and improve the care they provide. This in turn will improve access to therapies, care standards and improve clinical outcomes.
From language matters to stigma-free communication in diabetes: Evolution, challenges, and next steps.
Holmes-Truscott E, Ekpor E, Litterbach E … +13 more , Scibilia R, Kar P, Dickinson JK, Guzman S, Garza M, Asaad M, Barone MTU, Selvan C, Lathia T, McInerney A, Senior P, Skinner T, Speight J
Diabet Med · 2026 Apr · PMID 41937302 · Publisher ↗
Language profoundly shapes how diabetes is perceived, experienced and managed, with the potential to perpetuate stigma or promote dignity and respect. This expert review, conducted by an international, multidisciplinary...
Language profoundly shapes how diabetes is perceived, experienced and managed, with the potential to perpetuate stigma or promote dignity and respect. This expert review, conducted by an international, multidisciplinary team, traces the evolution of the global diabetes #LanguageMatters movement and synthesises evidence on the effects of language on diabetes management, health and wellbeing, alongside community-preferred terminology. We identified 32 language position statements/guidance documents published in more than 19 countries. Most are applicable to all diabetes types, diverse audiences and address verbal communication; many also consider non-verbal, paraverbal and, to a lesser extent, visual communication. Beyond recommendations of terms to use or avoid, these statements articulate overarching principles grounded in person-centred, strengths-based, empathic and non-judgemental communication. Evidence of uptake is emerging, including incorporation into clinical standards and research presentation guidance, alongside gradual shifts in language use within some research and media contexts. However, implementation remains uneven, and stigmatising language persists across healthcare, research, policy and public discourse. Despite growing momentum, empirical evidence on community preferences and robust evaluation of adoption and impact remain limited. Language practices are also evolving alongside new technologies, screening approaches and therapeutics, creating additional challenges and opportunities. We identify key gaps in evidence, guidance and implementation mechanisms, and highlight persistent and emerging forms of hidden stigma within systems and structures. We propose a constructive agenda centred on community partnership and system-level implementation. Treating language as foundational to person-centred, equitable and compassionate diabetes care is essential to ending diabetes stigma and discrimination across all settings.
Maternal glycaemia and child educational attainment at age 5 in the Born in Bradford cohort.
Wilson CA, Santorelli G, Simonoff E … +3 more , Howard LM, Ismail K, Reynolds RM
Diabet Med · 2026 Apr · PMID 41936124 · Publisher ↗
AIMS: There is emerging evidence that maternal hyperglycaemia may be associated with adverse offspring neuro-behavioural outcomes, which are foundational to educational success. We hypothesised that higher levels of mate...
AIMS: There is emerging evidence that maternal hyperglycaemia may be associated with adverse offspring neuro-behavioural outcomes, which are foundational to educational success. We hypothesised that higher levels of maternal glucose would be associated with poorer educational attainment in early childhood. METHODS: The sample included 13,627 children from the UK's Born in Bradford cohort. Exposures included maternal fasting glucose, 2-h post-load glucose and a clinical diagnosis of gestational diabetes. The primary outcome was failure to achieve a 'good level of development' on the Early Years Foundation Stage Profile at age five. The association was tested using multivariable Poisson regression, accounting for sibling clusters and using multiple imputation for missing data. RESULTS: Higher maternal fasting glucose (at 26-28 weeks gestation) was associated with an increased risk of failing to achieve a good level of development (adjusted RR 1.04; 95% CI 1.00, 1.08; p = 0.034). This association appeared stronger in children of Pakistani ethnicity compared to White British ethnicity. No association was found for 2-h post-load glucose or gestational diabetes diagnosis. CONCLUSIONS: These findings offer insights into the developmental origins of inequalities in child educational outcomes and highlight potential opportunities to optimise future health and learning through interventions during pregnancy.
Exploring the psychosocial implications of general population screening for paediatric type 1 diabetes in Europe: Protocol for a mixed-methods study.
Boiko O, Barnard-Kelly K, Vercauteren J … +22 more , Greenfield SM, Dias RP, Quinn LM, Litchfield I, Papanikolaou T, Dunne JL, Perego G, Gatti F, Milano F, Milazzo BM, Di Mattei V, Lange K, Mathieu C, Overbergh L, Ziegler AG, Hurtado Del Pozo C, Scarale MG, Mahieu A, Omar Alsaleh AJ, Bosi E, Narendran P, EDENT1FI Consortium
Diabet Med · 2026 Jun · PMID 41933490 · Full text
AIMS: Research and policy initiatives for type 1 diabetes (T1D) across European countries demonstrate an emergent, critical shift towards universal paediatric screening. National adaptations of screening, however, remain...
AIMS: Research and policy initiatives for type 1 diabetes (T1D) across European countries demonstrate an emergent, critical shift towards universal paediatric screening. National adaptations of screening, however, remain under-researched. The current study, as part of the EU-funded EDENT1FI programme, aimed to examine the psychosocial impact and acceptability of screening according to local contexts and regions. METHODS: The EDENT1FI screening research programme includes 27 partners involved in implementing screening across eight European countries-four countries already implementing national or local research screening programmes and four countries that are new adopters. The study consists of four sub-studies with assessments performed at five timepoints, from screening baseline to insulin-requiring T1D: (1) we examine the screening-specific psychological impact on families using a novel questionnaire for parents of screened children; (2) we further measure the psychological wellbeing of parents by administering validated questionnaires; (3) we explore parental acceptability through semi-structured interviews and (4) we explore professional stakeholder acceptability via semi-structured interviews. Data analysis will integrate questionnaire responses and thematic analysis for the interviews. RESULTS: Findings should provide a deeper understanding of the psychosocial aspects of universal paediatric screening measured longitudinally. The experience of implementation context across countries will be harmonised with the attitudes towards and practices of screening to inform best practice for scaling up universal screening. CONCLUSIONS: The study will provide essential insights into how best a general population screening program for T1D can be integrated into existing European health systems.
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