Diabetes Research And Clinical Practice[JOURNAL]
Sun
200 papers
Kidney measures and cerebral white matter hyperintensity severity in chronic kidney disease stratified by type 2 diabetes mellitus status.
Chang YM, Shen FC, Wu PH … +10 more , Yu PS, Lin MY, Huang TH, Chen WC, Shen JH, Chuang YS, Kuo MC, Chiu YW, Hwang SJ, Lin YT
Diabetes Res Clin Pract · 2026 Jun · PMID 42288174 · Publisher ↗
AIM: To investigate the association of kidney measures with Fazekas-defined white matter hyperintensity (WMH) severity in adults with chronic kidney disease (CKD), stratified by type 2 diabetes mellitus (T2DM) status. ME...
AIM: To investigate the association of kidney measures with Fazekas-defined white matter hyperintensity (WMH) severity in adults with chronic kidney disease (CKD), stratified by type 2 diabetes mellitus (T2DM) status. METHODS: This retrospective cross-sectional study analyzed 1085 adults with CKD from the Taiwan Kidney Outcome (TAKO) cohort who underwent brain MRI between 2007 and 2021. WMH burden was assessed using the Fazekas scale. Multivariable proportional odds regression evaluated associations of eGFR, albuminuria category, and KDIGO risk category with WMH severity. Sensitivity analyses confirmed result robustness. RESULTS: Among 1085 participants (615 with T2DM, 470 without), adjusted models revealed that albuminuria A3 was associated with higher periventricular WMH severity in both T2DM (OR, 2.46; 95 % CI, 1.49-4.10; P < 0.001) and non-T2DM groups (OR, 2.11; 95 % CI, 1.27-3.51; P = 0.004). Very high KDIGO risk also correlated with greater periventricular WMH severity in both groups. Lower eGFR was associated with higher periventricular and deep WMH severity specifically among participants with T2DM. CONCLUSION: Albuminuria and KDIGO risk category are associated with greater periventricular WMH severity regardless of T2DM status. Lower eGFR is more consistently linked to WMH severity in T2DM patients. Longitudinal studies are required to clarify the clinical implications of these findings.
GLP-1 receptor agonist adjunct therapy stabilises Ramadan dysglycaemia in insulin-treated diabetes: a CGM-based study.
Ashraf T, Lessan N
Diabetes Res Clin Pract · 2026 Jun · PMID 42269776 · Publisher ↗
BACKGROUND: Patients with type 1 and insulin-treated type 2 diabetes are at higher risk of hypo- and hyperglycaemia during Ramadan fasting. The role of incretin-based add-on therapy (GLP-1 receptor agonist semaglutide an...
BACKGROUND: Patients with type 1 and insulin-treated type 2 diabetes are at higher risk of hypo- and hyperglycaemia during Ramadan fasting. The role of incretin-based add-on therapy (GLP-1 receptor agonist semaglutide and the GLP-1/GIP dual agonist tirzepatide) in attenuating Ramadan dysglycaemia in insulin-treated type 2 diabetes has not been characterised using continuous glucose monitoring. Emerging evidence indicates that exaggerated post-iftar hyperglycaemia, drives Ramadan dysglycaemia in insulin-treated individuals. AIMS: To use continuous glucose monitoring (CGM) to characterise glycaemic control in patients with type 1 and type 2 diabetes on intensive insulin during Ramadan fasting, and to evaluate the role of add-on semaglutide or tirzepatide in attenuating post-iftar hyperglycaemia. METHODS: Adults with type 1 or type 2 diabetes using FreeStyle Libre CGM who completed ≥ 14 full fasting days during Ramadan 2025 were included. Of 140 participants screened pre-Ramadan, 54 met all inclusion criteria and were analysed: type 2 diabetes on basal-bolus insulin alone (BB, n = 18), type 2 diabetes on basal-bolus plus tirzepatide or semaglutide (BB+, n = 18) - matched 1:1 by age, baseline HbA1c and BMI - and type 1 diabetes on basal-bolus insulin (T1DM, n = 18). CGM metrics were collected over 28 days pre-Ramadan (1-28 February 2025) and 29 days during Ramadan (1-29 March 2025) and compared within and between groups, and across fasting versus non-fasting windows. RESULTS: Dysglycaemia was driven predominantly by the post-iftar period. BB participants showed marked deterioration during non-fasting hours. Adjunctive therapy attenuated this effect: time in range 74.4 % vs 36.8 % (p = 0.007), glucose management indicator 6.9 % vs 8.3 % (p = 0.004), and > 2-fold (≈61 %) reduction in incremental post-iftar area under the curve (102,014 vs 260,578 mg/dL·min over the 4-h post-iftar window). CONCLUSION: In matched insulin-treated type 2 diabetes cohorts, add-on semaglutide or tirzepatide stabilised Ramadan glycaemia and reduced post-iftar hyperglycaemia without increasing hypoglycaemia, and was well tolerated with no treatment discontinuations during Ramadan.
Association of glycemic control with arterial stiffness and hemodynamic function in type 2 diabetes mellitus.
Lin X, Sun J, Zhang J … +3 more , Gan Q, Huang Z, Bi X
Diabetes Res Clin Pract · 2026 Jun · PMID 42264392 · Publisher ↗
AIMS: Vascular complications are the leading cause of mortality, with poor glycemic control accelerating progression. This study investigated the association between multidimensional vascular ultrasound and glycemic cont...
AIMS: Vascular complications are the leading cause of mortality, with poor glycemic control accelerating progression. This study investigated the association between multidimensional vascular ultrasound and glycemic control in type 2 diabetes mellitus (T2DM). METHODS: This study enrolled 228 patients with T2DM stratified by glycated hemoglobin (HbA1c) levels and 52 healthy controls. All participants underwent carotid ultrasound and flow-mediated dilation (FMD), multiple linear regression was used to assess the associations between arterial stiffness and hemodynamic function and HbA1c. RESULTS: As HbA1c increased, intima-media thickness, hardness coefficient (HC), and pulse wave velocity (PWV) showed the upward trend, whereas displacement, end-diastolic velocity, maximal wall shear stress (WSSmax), mean wall shear stress (WSSmean), and FMD exhibited the downward trend (all P for trend < 0.05). Multiple linear regression analysis revealed that even after adjusting for potential confounders, HC and PWV remained independently positively associated with HbA1c (B = 0.286 and 0.243, all P < 0.05), while WSSmax, WSSmean, and FMD were independently negatively associated with HbA1c (B = -0.072, -0.051, and -0.277, all P < 0.05). CONCLUSIONS: Poor glycemic control in T2DM exacerbates arterial stiffening, hemodynamic disturbance, and endothelial dysfunction. Multidimensional vascular ultrasound enables early detection of subclinical vascular damage, supporting intensive glucose management to delay cardiovascular complications.
The risk of type 1 diabetes mellitus after COVID-19 and influenza infection: A nationwide cohort and self-controlled case series study.
Ozaki K, Nishioka Y, Kamitani F … +6 more , Nakajima H, Kurematsu Y, Okada S, Myojin T, Imamura T, Takahashi Y
Diabetes Res Clin Pract · 2026 Jun · PMID 42264391 · Publisher ↗
It has been controversial whether COVID-19 increases the risk of new-onset type 1 diabetes mellitus. Using large-scale claims data, we found no statistically significant association between COVID-19 and incident type 1 d...
It has been controversial whether COVID-19 increases the risk of new-onset type 1 diabetes mellitus. Using large-scale claims data, we found no statistically significant association between COVID-19 and incident type 1 diabetes mellitus in both cohort and self-controlled case series, whereas influenza was associated with the risk as previously reported.
Quantifying the evidence on associated factors for diabetes-related foot complications: An umbrella review of published systematic reviews and meta-analyses.
Yang X, Guo J, Wei T … +4 more , Liu P, Cai Q, Wang R, Hu Y
Diabetes Res Clin Pract · 2026 Jun · PMID 42251949 · Publisher ↗
Diabetes-related foot complications, defined in this review as diabetic foot ulceration and diabetes-related lower-extremity amputation, remain among the most disabling and costly consequences of diabetes. Evidence on th...
Diabetes-related foot complications, defined in this review as diabetic foot ulceration and diabetes-related lower-extremity amputation, remain among the most disabling and costly consequences of diabetes. Evidence on their associated factors is dispersed across multiple systematic reviews and meta-analyses. This umbrella review synthesized, quantified and graded published evidence on indicators associated with diabetes-related foot complications. Nine English and Chinese databases were searched from inception to March 2025. Methodological quality was assessed using AMSTAR 2, overlap between reviews was examined with factor-specific corrected covered area, and second-order meta-analysis was performed where appropriate. The protocol was pre-registered on PROSPERO (CRD420251127620). Twenty-one reviews were included, covering 32 indicators across demographic, physical, foot-related, psychological and behavioral domains. Diabetic nephropathy and diabetic retinopathy showed the most credible associations, both supported by Class I evidence. Diabetic peripheral neuropathy, male sex, higher HbA1c, vitamin D deficiency < 50 nmol/L, older age and longer diabetes duration were supported by Class II evidence. Most associations concerned DFU, while smoking and outpatient adherence were linked to LEA and male sex to both outcomes. These findings suggest that DFU and diabetes-related LEA reflect a layered risk structure involving systemic microvascular burden, metabolic exposure, local foot vulnerability and care-related behaviors, supporting broader risk stratification.
Prediabetes in Ontario: improving surveillance for better disease prevention.
Shah NU, Gushue S, Wang W … +4 more , Young SW, Shah BR, Lipscombe L, Fazli GS
Diabetes Res Clin Pract · 2026 Jun · PMID 42251948 · Publisher ↗
AIMS: Prediabetes, a metabolic state preceding type 2 diabetes (T2D), is independently associated with increased all-cause mortality. Despite its growing public health significance, population-level estimates of prediabe...
AIMS: Prediabetes, a metabolic state preceding type 2 diabetes (T2D), is independently associated with increased all-cause mortality. Despite its growing public health significance, population-level estimates of prediabetes burden remain limited. We examined temporal trends in the incidence and prevalence of prediabetes in Ontario, stratified by age, sex, and key sociodemographic factors. METHODS: This retrospective cohort study used data from the Ontario Laboratories Information System (2015-2024). Prediabetes was defined using laboratory criteria: glycated hemoglobin 6.0% and 6.4%, or impaired glucose tolerance (2-hour glucose of 7.8-11.0 mmol/L after a 75 g oral glucose tolerance test), or impaired fasting glucose (6.1-6.9 mmol/L). Analyses included individuals aged 20-105 years with valid glucose testing and excluded results in the diabetes range. RESULTS: Age-standardized incidence increased by 20% from 15.2 per 1,000 persons in 2015 to 18.2 per 1,000 in 2024, while prevalence increased by 25% from 11% in 2015 to 14% in 2024. These increases were observed in both sexes. Incidence and prevalence were higher in socioeconomically disadvantaged and urban communities. CONCLUSIONS: Prediabetes incidence and prevalence increased substantially in Ontario between 2015 and 2024, with a disproportionate burden in lower socioeconomic and urban communities, underscoring the need for targeted prevention and screening strategies.
Fat-muscle balance and incident diabetes: evidence from Chinese and UK cohorts.
Wu Y, Yang M, Gao Y … +4 more , Mei Y, Liu D, Ding X, Cheng F
Diabetes Res Clin Pract · 2026 Jun · PMID 42251947 · Publisher ↗
BACKGROUND: Excess adiposity is a major risk factor for diabetes, but conventional anthropometric indices such as body mass index do not distinguish between fat and lean mass. How body composition, particularly fat-free...
BACKGROUND: Excess adiposity is a major risk factor for diabetes, but conventional anthropometric indices such as body mass index do not distinguish between fat and lean mass. How body composition, particularly fat-free mass (FFM) and fat mass (FM) balance, relates to incident diabetes remains unclear. METHODS: We analyzed a Chinese health examination cohort (n = 2,252) and the UK Biobank (UKB; n = 472,158). Incident diabetes was identified through chronic disease registry (Chinese cohort) and from hospital/primary care records plus medication data (UKB). Cox models estimated the associations of fat mass index (FMI), fat-free mass index (FFMI), FFM/FM, and appendicular skeletal muscle mass index (ASMI) with incident diabetes. RESULTS: During a median follow-up of 4.3 and 14.3 years, 115 (5.1%) and 22,563 (4.8%) participants developed diabetes in the Chinese cohort and UKB, respectively. Higher FMI and FFMI were associated with higher diabetes risk in both cohorts. In contrast, FFM/FM was inversely associated with incident diabetes in the Chinese cohort (HR [95% CI] = 0.45 [0.28-0.71], P = 0.001) and UKB (HR [95% CI] = 0.50 [0.48-0.51], P < 0.001). ASMI was null in the Chinese cohort but was positively associated with diabetes in UKB. CONCLUSION: FFM/FM was a more consistent and informative indicator of diabetes risk than absolute lean mass indices.
Association between HbA1c variability and disease prognosis in chronic kidney disease patients: a systematic review and meta-analysis.
Abudoureheman W, Zhang F, Huang L … +5 more , Bai Y, Wang Y, Su L, Zhou R, Sun Q
Diabetes Res Clin Pract · 2026 Jun · PMID 42251946 · Publisher ↗
AIMS: To evaluate the association between HbA1c variability, a marker of long-term glycaemic instability, and clinical outcomes in patients with chronic kidney disease (CKD). METHODS: We conducted a systematic review and...
AIMS: To evaluate the association between HbA1c variability, a marker of long-term glycaemic instability, and clinical outcomes in patients with chronic kidney disease (CKD). METHODS: We conducted a systematic review and meta-analysis of cohort studies. PubMed, Embase, and Scopus were searched from inception to 11 February 2026. Studies assessing HbA1c variability and reporting CKD progression, cardiovascular events, or all-cause mortality were included. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models as appropriate. RESULTS: Eight cohort studies comprising 59,018 CKD patients were included. Higher HbA1c variability was significantly associated with increased risk of cardiovascular events (HR 1.82, 95% CI 1.52-2.20) with no significant heterogeneity. A significant association was also observed for all-cause mortality (HR 2.18, 95% CI 1.16-4.07), although substantial heterogeneity was present. For CKD progression, a non-significant trend toward increased risk was observed (HR 1.49, 95% CI 0.87-2.55) with considerable heterogeneity and wide prediction intervals. CONCLUSION: Greater HbA1c variability is associated with increased risks of cardiovascular events and all-cause mortality in CKD, whereas its association with renal progression remains inconclusive. These findings highlight the potential prognostic value of long-term glycaemic instability, although further studies are needed to clarify its role in renal outcomes.
Attenuating the mortality risk of socioeconomic deprivation in type 2 diabetes: Minimum and compensatory physical activity estimates.
Liu C, Hua L, Xin Z
Diabetes Res Clin Pract · 2026 Jun · PMID 42248525 · Publisher ↗
BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with increased mortality, which may be exacerbated by socioeconomic deprivation. Whether objectively measured moderate-to-vigorous physical activity (MVPA) can at...
BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with increased mortality, which may be exacerbated by socioeconomic deprivation. Whether objectively measured moderate-to-vigorous physical activity (MVPA) can attenuate deprivation-related excess mortality remains unclear. METHODS: We analyzed 1,793 UK Biobank participants with prevalent T2DM and valid wrist-worn accelerometer data. Socioeconomic deprivation was assessed using the Townsend Deprivation Index (TDI). Associations of TDI and MVPA with all-cause mortality were examined using multivariable Cox models, restricted cubic splines, Kneedle-derived threshold detection, and compensation-point estimation. RESULTS: Higher deprivation and lower MVPA were jointly associated with greater mortality. Compared with high TDI and MVPA < 150 min/week, low TDI and MVPA ≥ 150 min/week showed the greatest adjusted mortality reduction (HR 0.423, 95% CI 0.286-0.625). MVPA exhibited a nonlinear inverse association with mortality, with an overall elbow at 72 min/week and plateau at 131 min/week. Stratified thresholds showed elbows at 68 min/week (plateau 126 min/week) for Low TDI and 76 min/week (plateau 134 min/week) for High TDI. The compensation point for high-deprivation individuals was 31 min/week. CONCLUSIONS: Achievable MVPA levels may attenuate deprivation-related excess mortality in T2DM. Quantifying MVPA levels provides a novel, equity-oriented basis for targeted exercise recommendations.
Temporal trends in treatment-requiring microvascular complications in young-onset diabetes: A nationwide population-based study.
Kim HY, Ji E, Kim J
Diabetes Res Clin Pract · 2026 Jun · PMID 42248524 · Publisher ↗
AIMS: Microvascular complications contribute to long-term morbidity, but data on young-onset diabetes in Korea are limited. We examined trends and risk factors for treatment-requiring microvascular complications in young...
AIMS: Microvascular complications contribute to long-term morbidity, but data on young-onset diabetes in Korea are limited. We examined trends and risk factors for treatment-requiring microvascular complications in young-onset diabetes. METHODS: Data from the Korean Health Insurance Review and Assessment Service (2008-2021) for individuals diagnosed with diabetes before age 30 years were analyzed. Treatment-requiring microvascular complications were defined using diagnostic codes with relevant prescriptions or procedures. Age-standardized incidence and prevalence were estimated using Poisson regression, and risk factors were assessed using time-dependent Cox models. RESULTS: We included 6,202 and 77,815 individuals with type 1 and type 2 diabetes, respectively. In type 1 diabetes, microvascular complications incidence declined from 32.2 to 12.0 per 1,000 persons, while prevalence increased until 2012 and subsequently declined to 71.4 in 2021. In type 2 diabetes, both the incidence (from 31.4 to 12.4) and prevalence (from 72.6 to 43.1) declined steadily. In type 1 diabetes, young adulthood, female sex, and hypertension increased risk; in type 2 diabetes, young adulthood, male sex, low socioeconomic status, and greater comorbidity burden were key predictors. CONCLUSIONS: Treatment-requiring microvascular complications in young-onset diabetes declined in Korea, but persistent age- and socioeconomic-related disparities highlight the need for equitable prevention and management.
Metabolic crosstalk in breast cancer in patients with Type 2 diabetes mellitus: pathophysiology and nanotherapeutic opportunities for clinical translation.
Wakens A, Joseph D, Rambharose S
Diabetes Res Clin Pract · 2026 Jun · PMID 42242553 · Publisher ↗
The intersection of Type 2 Diabetes Mellitus (T2DM) and breast cancer defines a complex onco-metabolic axis where chronic hyperglycaemia, hyperinsulinemia, and oxidative stress synergistically drive malignant transformat...
The intersection of Type 2 Diabetes Mellitus (T2DM) and breast cancer defines a complex onco-metabolic axis where chronic hyperglycaemia, hyperinsulinemia, and oxidative stress synergistically drive malignant transformation, metabolic reprogramming, and chemoresistance. Despite epidemiological evidence linking these conditions, clinical management typically addresses each disease individually according to established protocols; however, the presence of T2DM significantly alters tumour biology, therapeutic response, and outcomes, necessitating greater consideration of metabolic context in breast cancer treatment. This review delineates the molecular underpinnings of the T2DM-breast cancer comorbidity and critically evaluates current metabolism-targeted therapies within this context. We examine the limitations of current therapeutic strategies in addressing the bidirectional metabolic signalling sustaining both pathologies, thereby motivating the exploration of nanoparticle (NP)-mediated therapeutic approaches. NP strategies enable tumour-selective release, dual-action antidiabetic and anticancer payload delivery, and targeted modulation of shared metabolic pathways are surveyed. Additionally, we highlight how NP platforms can be engineered as intrinsically bioactive scaffolds that synergise with multitarget natural compounds, with potentially lower-toxicity, multi-functional therapeutic strategies suited to this complex comorbid condition. We advocate for systematic investigation of dual-action nanotherapeutics in models of breast cancer in patients with T2DM as a necessary step toward a unified approach for this underserved comorbid population.
Corrigendum to "Temporal trends in macrovascular complications in young-onset diabetes in Korea: A nationwide population-based study" [Diabetes Res. Clin. Pract. 236 (2026) 113285].
Kim HY, Ji E, Kim J
Diabetes Res Clin Pract · 2026 Jun · PMID 42236416 · Publisher ↗
Abstract loading — click title to view on PubMed.
Body fat distributions differentiate the risk of type 2 diabetes in women with a history of gestational diabetes.
Yang S, Liu Y
Diabetes Res Clin Pract · 2026 Jun · PMID 42229589 · Publisher ↗
AIMS: To explore whether postpartum body fat distributions can predict type 2 diabetes mellitus (T2DM) risk in women with a history of gestational diabetes mellitus (GDM). METHODS: Data of 442 women with GDM history from...
AIMS: To explore whether postpartum body fat distributions can predict type 2 diabetes mellitus (T2DM) risk in women with a history of gestational diabetes mellitus (GDM). METHODS: Data of 442 women with GDM history from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were adopted. Body fat distributions were measured via dual-energy X-ray absorptiometry (DXA) and analyzed with 14 DXA-derived indices. The association between body fat distributions and risk of T2DM in women with a history of GDM was assessed using multivariable logistic regression. RESULTS: We found that T2DM risk was positively associated with the android-to-gynoid ratio (ratio of A to G), visceral adipose tissue mass (VATM), total abdominal fat mass (TATM), android percent fat (APFAT), and android fat mass (ANFM), but negatively associated with gynoid fat mass (GYFM) and gynoid percent fat (GPFAT) in women with history of GDM. VATM possessed the highest predictability for T2DM risk among the eight indices (area under the receiver operating characteristic curve [AUC] = 0.78). CONCLUSIONS: Postpartum visceral, hip and thigh fat distribution can predict T2DM risk in women with a history of GDM. VATM is of the best predictability for T2DM risk among the eight indices.
Incidence and risk factors of first-ever diabetic foot ulcers in patients with newly diagnosed type 2 diabetes mellitus.
Yoon JS, Kim J, Hong EH … +1 more , Hwang S
Diabetes Res Clin Pract · 2026 Jun · PMID 42229588 · Publisher ↗
AIMS: To investigate the long-term incidence of diabetic foot ulcers (DFU) and identify risk factors in a nationwide cohort of patients newly diagnosed with type 2 diabetes mellitus (T2DM). METHODS: We conducted a retros...
AIMS: To investigate the long-term incidence of diabetic foot ulcers (DFU) and identify risk factors in a nationwide cohort of patients newly diagnosed with type 2 diabetes mellitus (T2DM). METHODS: We conducted a retrospective, population-based cohort study using Korean National Health Insurance Service data. Adults aged ≥ 20 years newly diagnosed with T2DM between 2009 and 2012, without prior diabetes (2002-2008), were included. Patients with preexisting cardiovascular disease, prior lower-extremity amputation, DFU, or death within 1 year of diagnosis were excluded. Participants were followed up until DFU occurrence, death, or December 31, 2024. Multivariable regression was performed to identify independent risk factors. Age- and sex-based 1:4 propensity score matching was used for comparisons. RESULTS: Among 137,541 patients, 7,599 (5.5%) developed DFU during follow-up. Smoking, non-Seoul residence, statin use, hypertension, dyslipidemia, heart failure, chronic obstructive pulmonary disease, and elevated fasting blood glucose were independently associated with increased DFU risk. Diabetes-related vascular complications were significant predictors. Cumulative DFU incidence was higher in patients with microvascular complications. All-cause mortality did not differ between matched groups. CONCLUSIONS: Approximately 5.5% of newly diagnosed T2DM patients developed DFU over 12 years of follow-up. Diabetes-related vascular complications were major determinants, highlighting the need for early risk identification and preventive foot care.
The first epidemiological study of presymptomatic type 1 diabetes among first-degree relatives in Japan: PREP-T1D study.
Chujo D, Kawamura T, Kikuchi T … +13 more , Imagawa A, Koshiba R, Maeda Y, Hirota Y, Ishii A, Suzuki J, Miura J, Kodani N, Higashide T, Fukui T, Oikawa Y, Shiraki Y, Shimada A
Diabetes Res Clin Pract · 2026 Jun · PMID 42225209 · Publisher ↗
AIMS: To identify individuals with a disease process comparable to presymptomatic stages of type 1 diabetes (T1D) and to evaluate their prevalence among first-degree relatives in Japan. METHODS: In this nationwide multic...
AIMS: To identify individuals with a disease process comparable to presymptomatic stages of type 1 diabetes (T1D) and to evaluate their prevalence among first-degree relatives in Japan. METHODS: In this nationwide multicenter observational study conducted at 71 sites, 2,614 first-degree relatives of individuals with T1D underwent islet autoantibody (IAb) screening. Participants positive for ≥1 IAb received metabolic evaluation, including oral glucose tolerance testing, to classify presymptomatic stage. RESULTS: IAb positivity was identified in 95 participants (3.6%), including 16 (0.6%) with multiple-IAb positivity, with ZnT8A (49.5%, 47 of 95) and GADA (42.1%, 40) being the most frequent. 5 participants met stage 1 criteria, 9 were classified as stage 2, and 2 as stage 3. The most common HLA-A allele was A*24:02 (36.8%), with the predominant DRB1-DQB1 haplotypes being *09:01-*03:03 (24.2%) and *04:05-*04:01 (23.6%). CONCLUSIONS: From this first study describing the epidemiological characteristics of presymptomatic T1D in Japan and Asia, it was shown that the prevalence of IAbs in Japan was comparable to that in other countries, underscoring the importance of screening and monitoring for presymptomatic T1D in Japan as well. Further studies involving longitudinal observation of IAb-positive individuals are crucial for establishing an effective screening and monitoring system.
A comprehensive review on the latest progressions of cell-free DNA in diabetes and related microvascular or macrovascular complications.
Hong J, Yin G, Shan G … +2 more , Li B, Yang D
Diabetes Res Clin Pract · 2026 May · PMID 42218943 · Publisher ↗
Diabetes is a global health problem which affected one in eleven adults in the world, and it has become the ninth leading cause of death. Diabetes is a chronic metabolic disorder, its systemic inflammation state might ca...
Diabetes is a global health problem which affected one in eleven adults in the world, and it has become the ninth leading cause of death. Diabetes is a chronic metabolic disorder, its systemic inflammation state might cause long-term complications, including macrovascular (including cardiovascular disease) and microvascular complications (including diabetic retinopathy and nephropathy). Circulating cell-free DNAs (cfDNAs) play important roles in diagnosing or monitoring diabetes or its related complications. The current review comprehensively summarized the latest study progresses of cfDNA-related applications as potential biomarkers in diabetes and diabetic complications, including type 1 diabetes, type 2 diabetes, diabetic retinopathy, diabetic nephropathy, and gestational diabetes mellitus. CfDNAs contain a lot of important molecular information in these applications of diabetic diseases, such as their genetic (mutation or copy number) or epigenetic (methylation or hydroxymethylation) content, organelle origin (nuclear or mitochondrial DNA), DNA concentration and DNA fragment size. In addition, we also discussed the existed limitations and future directions of cfDNA-related studies in diabetes and its complications. This review will provide important reference for exploring the clinical application value of cfDNAs in diabetes and diabetic complications.
Metabolic trajectory from gestational to type 2 diabetes mellitus: a systematic review and meta-analysis.
Derse TK, Kide DM, Asgai AS … +1 more , Kelkay JM
Diabetes Res Clin Pract · 2026 May · PMID 42218942 · Publisher ↗
This systematic review and meta-analysis of 15 contemporary cohort studies (2020-2026) evaluates the progression from gestational diabetes mellitus (GDM) to type 2 diabetes (T2DM). Screening 1,809 records, the study iden...
This systematic review and meta-analysis of 15 contemporary cohort studies (2020-2026) evaluates the progression from gestational diabetes mellitus (GDM) to type 2 diabetes (T2DM). Screening 1,809 records, the study identified a significant pooled T2DM incidence of 9.0% (ES: 0.09; 95% CI, 0.04-0.13), with an adjusted estimate of 6.9% after addressing publication bias. Statistical consistency was high across all strata (I = 0%), indicating a universal metabolic phenomenon. Key clinical determinants significantly increasing T2DM risk included abnormal gestational OGTT results (ES: 4.28), maternal BMI > 25 kg/m (ES: 2.58), insulin requirement during pregnancy (ES: 2.21), and positive family history (ES: 2.00). The findings underscore that GDM serves as a critical window for future health. Healthcare systems must move beyond generalized advice to prioritize high-risk phenotypes, particularly women with obesity or severe gestational hyperglycemia. Integrating structured, risk-stratified postpartum surveillance and lifestyle interventions within the first year after delivery is essential to mitigate the long-term global burden of T2DM. This evidence advocates for standardized, globally consistent screening protocols to bridge the current gap in postpartum compliance and improve maternal metabolic outcomes.
Glucagon-like peptide-1 receptor agonists versus sodium-glucose cotransporter-2 inhibitors in adults with type 2 diabetes and atrial fibrillation: a multicenter comparative effectiveness cohort study of cardiovascular and arrhythmic outcomes.
Islam MM, Okere AN
Diabetes Res Clin Pract · 2026 Jul · PMID 42214559 · Publisher ↗
AIMS: To compare glucagon-like peptide-1 receptor agonists (GLP-1RA) with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) for cardiovascular, atrial fibrillation (AF) disease course, and safety outcomes in adults wit...
AIMS: To compare glucagon-like peptide-1 receptor agonists (GLP-1RA) with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) for cardiovascular, atrial fibrillation (AF) disease course, and safety outcomes in adults with concurrent AF and type 2 diabetes. METHODS: Retrospective propensity-score-matched cohort study using the TriNetX Research Network (2016 - 2024). A new-user, active-comparator design identified adults with concurrent AF and type 2 diabetes initiating GLP-1RA or SGLT-2i. Patients were 1:1 matched on demographic, clinical, laboratory, and medication covariates. Hazard ratios (HRs) were estimated using Cox proportional hazards regression. The Benjamini-Hochberg procedure controlled the false discovery rate, and E-values quantified robustness to unmeasured confounding. RESULTS: After matching, 18,035 GLP-1RA users were compared with 18,035 SGLT-2i users (mean age 67.4 years; 52.2% male, 47.8% female). At 365 days, GLP-1RA was associated with lower all-cause mortality (HR 0.64, 95% CI 0.57 - 0.71), hospitalization (0.88, 0.84 - 0.92), 3-point MACE (0.78, 0.71 - 0.86), AF progression (0.94, 0.90 - 0.98), AF ablation (0.81, 0.70 - 0.94), and cardioversion (0.79, 0.70 - 0.90). Effects were consistent across age and body mass index subgroups. E-values ranged 1.5 - 2.5. CONCLUSION: Over 1 year, GLP-1RA initiation was associated with lower risks of mortality, hospitalization, atherosclerotic events, and adverse AF disease-course outcomes than SGLT-2i in adults with concurrent AF and T2D, with the established SGLT-2i benefits for heart failure and CKD remaining the basis for class choice in those subpopulations.
Repurposing GLP-1 receptor agonists and SGLT-2 inhibitors in neurodegeneration and metabolically at-risk populations: Myth or reality? An overview of randomized clinical trials.
Mourtzos MA, Patoulias D, Keklikoglou NM … +5 more , Karakasis P, de Piñeres VG, Stefanakis K, Rizzo M, Mantzoros CS
Diabetes Res Clin Pract · 2026 Jul · PMID 42208664 · Publisher ↗
Neurodegenerative diseases (NDs) are increasingly recognized as multifactorial disorders in which neurometabolic dysfunction intersects with classic pathological processes, including protein misfolding, neuroinflammation...
Neurodegenerative diseases (NDs) are increasingly recognized as multifactorial disorders in which neurometabolic dysfunction intersects with classic pathological processes, including protein misfolding, neuroinflammation, synaptic failure and neurovascular impairment. In parallel, antidiabetic drug classes, particularly glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) exert pleiotropic effects beyond glycemic control, raising interest in their potential neuroprotective properties. This review provides an in-depth overview of current clinical evidence regarding the repurposing of these agents for NDs. Clinical studies evaluating GLP-1 RAs and SGLT-2i in neurodegenerative and at-risk metabolic populations have yielded heterogeneous results. Early-phase trials and neuroimaging studies suggest potential benefits on regional brain metabolism, connectivity, and selected cognitive domains, whereas large, randomized trials have generally failed to demonstrate consistent effects. Current evidence supports biological plausibility but does not yet establish disease-modifying efficacy of GLP-1 RAs or SGLT-2i in NDs. Future studies will require longer treatment duration, earlier intervention windows, harmonized cognitive and neuroimaging endpoints, and integration of biomarker-guided patient stratification to determine whether targeting systemic and cerebral metabolic pathways can meaningfully alter neurodegenerative trajectories.
A multidisciplinary expert consensus framework for diabetic foot disease management in the Gulf Cooperation Council: A modified Delphi study.
Ghafri TA, Harthi SA, Mahrizi AA … +12 more , Ali FH, Jalil HS, Wahaibi KA, Alkhatieb MT, Nakhi MB, Ghandoura NA, Janahi N, Mushara S, Abdulla SJ, Elenzi T, Shaaibi MA, Alamoudi A
Diabetes Res Clin Pract · 2026 Jul · PMID 42208663 · Publisher ↗
BACKGROUND: The Gulf Cooperation Council (GCC) countries face an escalating epi-demic of diabetes, with prevalence rates substantially exceeding global averages and projections indicating a 96% increase by 2035. Diabetic...
BACKGROUND: The Gulf Cooperation Council (GCC) countries face an escalating epi-demic of diabetes, with prevalence rates substantially exceeding global averages and projections indicating a 96% increase by 2035. Diabetic Foot Disease (DFD) represents one of the most serious and costly complications of diabetes, yet regionally adapted clinical guidance is absent across all six GCC nations. METHODS: A modified Delphi study incorporating elements of the RAND/UCLA Appropriateness Method was conducted with an expert panel of 18 multidisciplinary clinicians from all six GCC countries (United Arab Emirates, Kingdom of Saudi Arabia, Qatar, Bahrain, Kuwait, and Oman). Panelists rated consensus statements using a 5-point Likert scale over two anonymous voting rounds, with an 80% agreement threshold defining consensus. Statements not achieving consensus were revised following structured group discussion. RESULTS: The panel generated consensus recommendations across seven domains: prevention and screening, risk assessment and classification, vascular assessment and management, wound management, infection and osteomyelitis, Charcot neuroarthropathy, and follow-up and recurrence prevention. Recommendations encompass GCC-specific adaptations addressing cultural practices, regional microbiology, climatic factors, healthcare system organization, and resource constraints. CONCLUSIONS: This consensus provides the first evidence-informed, regionally adapted framework for DFD management in the GCC. Implementation requires coordinated investment in multidisciplinary care models, workforce development, patient education programmes tailored to regional contexts, and robust data systems to monitor outcomes and guide continuous quality improvement.
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