Diabetes Research And Clinical Practice[JOURNAL]
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200 papers
Treatment-induced neuropathy of diabetes: A comprehensive literature review.
Pantazopoulos D, Gouveri E, Papazoglou D … +1 more , Papanas N
Diabetes Res Clin Pract · 2026 May · PMID 42208662 · Publisher ↗
BACKGROUND: Treatment-induced neuropathy of diabetes (TIND) is an iatrogenic complication associated with rapid improvement in glycaemic control, often in individuals with chronically elevated blood glucose. It is charac...
BACKGROUND: Treatment-induced neuropathy of diabetes (TIND) is an iatrogenic complication associated with rapid improvement in glycaemic control, often in individuals with chronically elevated blood glucose. It is characterised by acute neuropathic pain and autonomic dysfunction. METHODS: A literature review was conducted, including case reports, case series, and observational cohort studies published between 1995 and 2025. Data on clinical presentation, triggering factors, diagnostic features, management, and outcomes were extracted and synthesised. RESULTS: A total of 26 studies were included, encompassing 181 patients with TIND. Rapid reduction in HbA, often following insulin initiation or intensification, oral antihyperglycaemic therapy, or lifestyle interventions, was the most consistent precipitating factor. Symptoms typically appeared within 1 week to 6 months after treatment intensification, with the majority manifesting within 4-8 weeks. Clinical features included severe distal neuropathic pain of burning nature, paraesthesias, and autonomic dysfunction, with occasional large-fibre involvement. Management was largely symptomatic, with gabapentinoids, serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), or opioids. Gradual improvement or resolution of symptoms occurred in most cases over months to one year, although persistent neuropathy was also reported in a minority of patients. CONCLUSION: TIND is a distinct, potentially preventable complication of diabetes management. Recognition of high-risk patients and cautious, gradual improvement of glycaemic control are critical for prevention. Management remains largely symptomatic, and long-term outcomes vary depending on the speed of glycaemic correction and on baseline patient factors.
Comprehensive drug safety assessment of sodium-glucose co-transporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and dipeptidyl peptidase 4 inhibitors: A Danish population-based active comparator new user cohort study.
Lund LC, Simonsen E, Pottegård A
Diabetes Res Clin Pract · 2026 Jul · PMID 42202888 · Publisher ↗
AIMS: To perform active safety monitoring of newer glucose-lowering therapies. METHODS: Using Danish nationwide registries, we conducted an active comparator new user cohort study comparing adverse events among initiator...
AIMS: To perform active safety monitoring of newer glucose-lowering therapies. METHODS: Using Danish nationwide registries, we conducted an active comparator new user cohort study comparing adverse events among initiators of sodium-glucose co-transporter 2 inhibitors (SGLT2is), glucagon-like peptide 1 receptor agonists (GLP1-RAs), and dipeptidyl peptidase 4 inhibitors (DPP4is). RESULTS: We identified 49 365 SGLT2i, 33 018 GLP1-RA, and 50 531 DPP4i initiators. Of 43 associations identified, we disregarded obesity-related signals (N = 2) and observed beneficial effects (N = 7). SGLT2i initiators had higher risks of phimosis (vs. GLP1-RA: hazard ratio [HR] 1.69, 95% compatibility intervals [CI] 1.42-2.02; vs. DPP4i: HR 2.19, 95% CI 1.84-2.59) and secondary polycythaemia (vs. GLP1-RA: HR 2.67, 95% CI 1.62-4.38; vs. DPP4i: HR 1.63, 95% CI 1.14-2.32). DPP4i initiators had increased risk of bacterial intestinal infections (vs. SGLT2i: HR 1.56, 95% CI 1.18-2.08; vs. GLP1-RA: HR 2.08, 95% CI 1.49-2.94) and anaemia (vs. SGLT2i: HR 2.00, 95% CI 1.22-3.23; vs. GLP1-RA: HR 1.92, 95% CI 1.18-3.23). GLP1-RA initiators had a near-immediate elevated risk of uterine cancer (vs. SGLT2i: HR 1.82, 95% CI 1.20-2.78; vs. DPP4i: HR 1.94, 95% CI 1.19-3.16). CONCLUSION: While some signals likely reflect residual confounding, several signals - particularly those related to infections and cancer - warrant further investigation.
Remission of type 2 diabetes following a metabolic program including surgery: a comparative study of young-onset and older-onset type 2 diabetes.
Zhen XM, Macdonald A, Woodham B … +12 more , Ryan B, Hng TM, Nettel-Aguirre A, Azar E, Hanna M, Yap J, Paulose J, Li G, Markovic S, Twigg SM, Ahlenstiel G, Wong J
Diabetes Res Clin Pract · 2026 May · PMID 42202887 · Publisher ↗
AIMS: Young-onset type 2 diabetes mellitus (YT2DM) is recognised as an aggressive phenotype when compared with older-onset T2DM (OT2DM). This study aimed to assess whether the proportion with diabetes remission following...
AIMS: Young-onset type 2 diabetes mellitus (YT2DM) is recognised as an aggressive phenotype when compared with older-onset T2DM (OT2DM). This study aimed to assess whether the proportion with diabetes remission following metabolic surgery (MS) differs amongst adults with YT2DM (diagnosed < 40 years of age) vs OT2DM. METHODS: This cohort study included adults with obesity and T2DM that underwent MS between 01/06/2018 and 31/05/2024 at an Australian tertiary hospital. The primary outcome was complete diabetes remission [defined as HbA1c < 6.0% (42 mmol/mol) and at least 3 months off glucose-lowering medications] at 12 months following MS. RESULTS: Compared to those with OT2DM (N = 36), a markedly lower proportion of patients with YT2DM (N = 44) attained complete diabetes remission at 12 months following MS (YT2DM 38.1% vs OT2DM 75.0%, p = 0.002). The difference between groups was not significant on the adjusted model, with baseline HbA1c and duration of T2DM potentially contributing to the observed differences. CONCLUSIONS: In contrast to previous reports, our YT2DM cohort had a lower proportion of patients with complete diabetes remission at 12 months after MS. Variables such as baseline HbA1c and T2DM duration appeared as potentially important factors associated with remission. Taken together, our results support the need for early, aggressive obesity treatment in adults with YT2DM, where delaying treatment may potentially close the window of opportunity for diabetes remission.
Global burden of chronic kidney disease due to type 2 diabetes in adults from 1990 to 2021, with exploratory projections to 2036: a systematic analysis of the Global Burden of Disease Study 2021.
Wang Y, Chen H
Diabetes Res Clin Pract · 2026 Jul · PMID 42202886 · Publisher ↗
AIMS: To assess the global burden of chronic kidney disease due to type 2 diabetes (CKD-T2D) in adults from 1990 to 2021. METHODS: Data on incidence, mortality, and disability-adjusted life years (DALYs) of CKD-T2D in ad...
AIMS: To assess the global burden of chronic kidney disease due to type 2 diabetes (CKD-T2D) in adults from 1990 to 2021. METHODS: Data on incidence, mortality, and disability-adjusted life years (DALYs) of CKD-T2D in adults aged ≥ 20 years were extracted from the Global Burden of Disease Study 2021, stratified by age, sex, and year. Analyses included: trend identification, decomposition analysis (aging, population growth, epidemiological transition), risk factor assessment, age-period-cohort modeling, ARIMA forecasting (2022-2036), and frontier analysis. RESULTS: From 1990 to 2021, global age-standardized rates per 100,000 for incidence, mortality, and DALYs of adult CKD-T2D increased by 56.4%, 88.7%, and 60.1%, respectively. Burden was higher in males. Peak incidence occurred at ages 75-79, while peak mortality and DALYs occurred at ≥ 95 years. Decomposition analysis identified population growth and aging as primary drivers. High BMI, elevated fasting glucose, and hypertension were main metabolic risks. ARIMA projections indicated continued rises in ASR and absolute counts by 2036. Frontier analysis revealed disproportionately high burden in high SDI regions. CONCLUSIONS: Driven by demographic shifts and metabolic risks, global CKD-T2D burden is rising. Enhanced early screening and prevention in adults, particularly in males, adults aged ≥ 75 years, and populations in high SDI regions, is urgently needed.
Screening gaps for prediabetes in US young adults under current American diabetes Association criteria.
Tang R, An J, Zhang Y
Diabetes Res Clin Pract · 2026 Jul · PMID 42191027 · Full text
Among US young adults aged 18-34 years with prediabetes in NHANES 2007-2016, one in three (32.7%) would not have qualified for screening under current American Diabetes Association criteria, suggesting a substantial miss...
Among US young adults aged 18-34 years with prediabetes in NHANES 2007-2016, one in three (32.7%) would not have qualified for screening under current American Diabetes Association criteria, suggesting a substantial missed opportunity for early identification and prevention.
Sarcopenia in Diabetes: A proposal on integrating muscle assessment and nutritional intervention in people living with diabetes.
Tarazona-Santabalbina FJ, Giorgino F, Donini LM … +13 more , Ballesteros-Pomar MD, Cruz-Jentoft AJ, Soeters MR, Halil M, Cukierman-Yaffe T, Aldahash R, Dossari KA, Pršo AL, Guzman-Rolo G, Catino MA, Olivier L, Topcuoglu MA, Barazzoni R
Diabetes Res Clin Pract · 2026 May · PMID 42191026 · Publisher ↗
Sarcopenia is a progressive muscle disease characterized by loss of skeletal muscle mass and strength, commonly associated with ageing and chronic diseases. Type 2 diabetes mellitus (T2DM) accelerates its development thr...
Sarcopenia is a progressive muscle disease characterized by loss of skeletal muscle mass and strength, commonly associated with ageing and chronic diseases. Type 2 diabetes mellitus (T2DM) accelerates its development through insulin resistance, chronic inflammation, oxidative stress, and hyperglycaemia. Sarcopenia may worsen diabetes-related outcomes, including increased risk of falls, functional decline, reduced quality of life, and impaired metabolic control. Despite its clinical impact, sarcopenia remains underdiagnosed in people with diabetes, particularly in those with high body mass index and excess adiposity. This paper reviews appropriate and sensitive methodologies for screening and diagnosing sarcopenia in people with diabetes. A structured expert consensus was conducted in two phases, informed by a targeted PubMed literature review and discussions with an international multidisciplinary panel. The consensus informed the development of a clinically applicable algorithm. The proposed approach integrates screening, diagnosis, staging, and management of sarcopenia, including exercise and muscle-targeted nutritional interventions, to improve clinical care. Sarcopenia is an under-recognised complication of diabetes requiring systematic assessment. This consensus provides an integrated algorithm combining functional, nutritional, and metabolic evaluation to guide personalised management.
Insulin-to-carbohydrate ratio intensification during Ramadan in young people using advanced hybrid closed-loop therapy: A prospective quasi-experimental pilot study.
Deeb A, Yaqoob N, Beck RH … +1 more , Suliman S
Diabetes Res Clin Pract · 2026 Jul · PMID 42184893 · Publisher ↗
AIMS: This study evaluated whether intensifying the insulin-to-carbohydrate ratio (ICR) during the non-fasting period is associated with improved glycemic control without increasing hypoglycemia in young people with type...
AIMS: This study evaluated whether intensifying the insulin-to-carbohydrate ratio (ICR) during the non-fasting period is associated with improved glycemic control without increasing hypoglycemia in young people with type 1 diabetes (T1D) using advanced hybrid closed-loop (AHCL) therapy during Ramadan. METHODS: In this prospective quasi-experimental pilot study, MiniMed 780G AHCL users fasting during Ramadan 2025 were allocated to standard care or 20% ICR intensification from Iftar to Suhoor (18:00-06:00). Continuous glucose monitoring (CGM) metrics were analyzed over Ramadan for the full 24-hour and non-fasting periods. The primary efficacy outcome was non-fasting time in range (TIR; 70-180 mg/dL); the primary safety outcome was non-fasting time below range (TBR; <70 mg/dL). RESULTS: Of 61 enrolled participants, 47 (29 control, 18 intervention; median age 14.9 years) were included in the analysis following post-Ramadan attrition. In an adjusted analysis (pre-specified linear regression including age and baseline HbA1c), ICR intensification was associated with a 10.4% higher non-fasting TIR (95%CI 5.2-15.5; p = 0.0002). Non-fasting TBR remained low and similar between groups, with no evidence of increased hypoglycemia. CONCLUSIONS: Prandial insulin intensification may be a safe strategy worthy of further investigation of its potential to improve glycemic control during Ramadan in young people using ACHL therapy.
The effects of dietary and physical exercise interventions among women with a history of gestational diabetes mellitus on cardiometabolic risk: A systematic review and meta-analysis.
Abdulsalam R, Michalopoulou M, Jebb SA … +8 more , Haffner SJP, Fleetwood-Law TS, Roberts N, Aldenhoven CM, Knight H, Willis L, Scragg J, Astbury NM
Diabetes Res Clin Pract · 2026 Jul · PMID 42184892 · Publisher ↗
We systematically analysed the literature to assess whether diet and physical activity interventions delivered in high-income countries (HICs) could affect cardio-metabolic biomarkers among women with gestational diabete...
We systematically analysed the literature to assess whether diet and physical activity interventions delivered in high-income countries (HICs) could affect cardio-metabolic biomarkers among women with gestational diabetes mellitus (GDM) in pregnancy. Ten databases and two trial registries were searched from inception until 16/03/2026. Studies were included if they were randomised controlled trials in HICs that allocated women with GDM to diet and/or physical activity interventions, or a control group, and reported outcomes at 12 ± 3 months after the intervention. The review was preregistered in PROSPERO (CRD42024597324; CRD42024518659). We used random effects meta-analyses to pool data. We included 17 studies with 6,535 participants. There was evidence that interventions led to a significant reduction in weight (-0.89 kg (95% CI -1.74, -0.03); I = 57.7%), waist circumference (difference -0.79 cm (95% CI -1.45, -0.13); I = 0%), and systolic blood pressure (-1.60 mmHg (95% CI -3.16, -0.04), I = 72.1%). However, there was no evidence of a significant effect of these interventions on blood lipids, glycaemic outcomes, diastolic blood pressure, or type 2 diabetes incidence. The review highlights the need for high quality research on reducing the risk of long-term cardiometabolic disease among women with a history of GDM in HICs.
Risk stratification in early-stage Cardiovascular-Kidney-Metabolic Syndrome: The Potency of visceral adiposity and insulin resistance surrogate indices.
He L, Lin H, Zhang X … +1 more , Ling X
Diabetes Res Clin Pract · 2026 Jul · PMID 42184891 · Publisher ↗
Cardiovascular-kidney-metabolic (CKM) syndrome defines a pathophysiological continuum linking obesity, metabolic dysfunction, chronic kidney disease, and cardiovascular disease. Stages 0-3 represent a critical subclinica...
Cardiovascular-kidney-metabolic (CKM) syndrome defines a pathophysiological continuum linking obesity, metabolic dysfunction, chronic kidney disease, and cardiovascular disease. Stages 0-3 represent a critical subclinical window for reversible intervention, yet conventional risk stratification remains rudimentary. Body mass index (BMI) fails to capture visceral adiposity and metabolic heterogeneity. Recently, surrogate indices integrating anthropometric and metabolic data, such as waist-to-height ratio (WHtR), visceral adiposity index (VAI), and the metabolic score for visceral fat (METS-VF), have emerged as scalable tools for identifying disproportionate visceral-metabolic burden. This review synthesizes the longitudinal evidence and biological rationale, highlighting mechanisms such as mitochondrial stress and lipid peroxidation, for these markers in early-stage CKM. We demonstrate that indices reflecting visceral lipotoxicity and insulin resistance offer superior prognostic resolution compared to traditional measures during the preclinical phase. Furthermore, we propose a stage-oriented framework to integrate these low-cost markers into clinical management, while delineating unresolved issues regarding ethnicity-specific thresholds and nonlinear risk patterns.
The 1-hour plasma glucose as a specific marker for early-phase insulin secretory defects in young adults with obesity.
Yuan M, Zhao S, Lu C … +11 more , Tong Y, Shen C, Yin N, Cao Z, Zhang Z, Liu R, Wang J, Zhang Y, Gu W, Chen Y, Hong J
Diabetes Res Clin Pract · 2026 Jul · PMID 42184890 · Publisher ↗
AIMS: To determine whether 1-hour plasma glucose (1-h PG) during an OGTT outperforms other glycemic markers (FPG, 0.5-h PG, 2-h PG, HbA) in identifying impairments in insulin secretion, sensitivity, and β-cell compensati...
AIMS: To determine whether 1-hour plasma glucose (1-h PG) during an OGTT outperforms other glycemic markers (FPG, 0.5-h PG, 2-h PG, HbA) in identifying impairments in insulin secretion, sensitivity, and β-cell compensation. METHODS: We analyzed 2178 Chinese young adults (18-40 years) with obesity (BMI ≥ 28 kg/m) and without diabetes. Associations between glycemic markers and OGTT-derived indices were assessed using adjusted correlations, regression, and ROC analyses. In a subcohort (n = 495) with frequently sampled intravenous glucose tolerance test (FSIVGTT) data, markers were evaluated against minimal-model estimates of first-phase secretion (AIR), insulin sensitivity (S), and disposition index (DI). RESULTS: 1-h PG showed superior performance over other glycemic markers for identifying early-phase insulin secretion defects. Among these markers, it demonstrated the strongest correlation with IGI (ρ = - 0.413) and the highest discriminatory accuracy (AUC = 0.702); this was supported by FSIVGTT-derived AIR. For insulin sensitivity, 1-h PG correlated more strongly with the Matsuda index, whereas 2-h PG was more strongly associated with FSIVGTT-derived S. Elevated 1-h PG (≥8.6 mmol/L) identified individuals with impairments across all traits. CONCLUSIONS: 1-h PG is a specific physiological marker of early-phase insulin secretion defects, supporting its role in early phenotyping and risk stratification in young adults with obesity.
Integrative proteogenomic analyses implicate KLK13 as a glycaemia-linked circulating protein in diabetic kidney disease.
Liu D, Lin X, Xie J … +2 more , Chen L, Wang N
Diabetes Res Clin Pract · 2026 Jul · PMID 42155607 · Publisher ↗
BACKGROUND: Diabetic kidney disease (DKD) is a major complication of diabetes, but circulating proteins linking glycaemic stress to kidney injury remain unclear. We aimed to identify glycaemia-linked plasma proteins asso...
BACKGROUND: Diabetic kidney disease (DKD) is a major complication of diabetes, but circulating proteins linking glycaemic stress to kidney injury remain unclear. We aimed to identify glycaemia-linked plasma proteins associated with DKD risk and assess their treatment responsiveness. METHODS: We integrated Mendelian randomization, cis-protein quantitative trait locus-based summary-data-based Mendelian randomization (cis-pQTL-based SMR), deCODE protein genome-wide association study (GWAS) validation, prospective UK Biobank analysis, and semaglutide-associated proteomic assessment. We screened 2,923 plasma proteins for hemoglobin A1c (HbA1c)-driven effects, and evaluated incident DKD. RESULTS: Fifty proteins were associated with genetically predicted HbA1c, and 10 were supported by independent HbA1c datasets. Cis-pQTL-based SMR analyses prioritized ITGBL1 and KLK13. In deCODE validation, KLK13 was the only candidate supported across both glycaemic trait-to-protein and protein-to-DKD analyses (OR 1.13, 95% CI 1.02-1.24). Among 9,936 UK Biobank participants without baseline DKD, 107 developed incident DKD. Higher KLK13 was associated with incident DKD (HR 1.52, 95% CI 1.13-2.06), whereas serine peptidase inhibitor Kazal type 6 (SPINK6) showed stronger association (HR 2.02, 95% CI 1.49-2.74). KLK13 decreased with semaglutide, but attenuated after weight and HbA1c adjustment. CONCLUSIONS: KLK13 was prioritized as a glycaemia-linked circulating protein associated with DKD, implicating protease-inhibitor biology in DKD progression.
Associations of grip strength and muscle mass with incident complications in patients with type 2 diabetes: a prospective cohort study.
Ding Y, Sheng W, Shi J … +13 more , Zhang Z, Yu Y, Xiang Y, Zhang X, Song D, Xiang Y, Shen Y, Gong J, Su Y, Lu L, Liu G, Ji G, Zhang L
Diabetes Res Clin Pract · 2026 Jul · PMID 42155606 · Publisher ↗
BACKGROUND: Declines in muscle strength and mass are common in individuals with type 2 diabetes (T2D) and are associated with adverse clinical outcomes. However, it remains unclear whether muscle strength or muscle mass...
BACKGROUND: Declines in muscle strength and mass are common in individuals with type 2 diabetes (T2D) and are associated with adverse clinical outcomes. However, it remains unclear whether muscle strength or muscle mass provides better prognostic information in this population. This study aimed to examine the associations of grip strength and muscle mass with incident complications in patients with T2D. METHODS: This prospective cohort study included 10,844 participants with T2D who were free of complications at baseline from the UK Biobank. Grip strength was assessed using a Jamar J00105 hydraulic hand dynamometer, and skeletal muscle mass was estimated via bioelectrical impedance analysis using the Janssen equation. Both grip strength and muscle mass were categorized into sex-specific tertiles. Cox proportional hazards models were applied to examine their associations with the risk of 12 incident complications. RESULTS: During a median follow-up of 13.2 years, a total of 11,373 incident complications were recorded. Compared to the high grip strength group, low grip strength was significantly associated with increased risks of coronary artery disease (HR = 1.23, 95% CI 1.10-1.37), heart failure (HR = 1.35, 1.13-1.60), peripheral arterial disease (HR = 1.33, 1.03-1.73), dementia (HR = 1.54, 1.09-2.16), diabetic kidney disease (HR = 1.39, 1.21-1.58), diabetic neuropathy (HR = 1.57, 1.25-1.96), diabetic retinopathy (HR = 1.26, 1.09-1.46), chronic obstructive pulmonary disease (HR = 1.57, 1.29-1.90), metabolic dysfunction-associated steatotic liver disease (HR = 1.43, 1.13-1.82), and osteoporosis (HR = 1.84, 1.37-2.47). A significant interaction between grip strength and sex was observed, with the inverse association between grip strength and coronary artery disease risk being stronger in women than in men. In contrast, compared to the high muscle mass group, low muscle mass was associated with an increased risk of chronic obstructive pulmonary disease only (HR = 1.40, 1.11-1.76). CONCLUSIONS: Lower grip strength is associated with an increased risk of a wide range of incident diabetes-related complications, and its predictive value is superior to that of muscle mass. Future studies should evaluate whether interventions aimed at improving muscle strength can reduce the incidence of these complications among individuals with T2D.
Glucagon-like peptide-1 receptor agonists and hair loss: A systematic review and meta-analysis.
Cheng PL, Chang HC
Diabetes Res Clin Pract · 2026 Jul · PMID 42155605 · Publisher ↗
AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used drugs with applications beyond the management of obesity and diabetes mellitus. This study aimed to investigate the association between GLP-1 RA...
AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used drugs with applications beyond the management of obesity and diabetes mellitus. This study aimed to investigate the association between GLP-1 RA use and hair loss. METHODS: Four electronic databases were systematically searched for relevant studies published from inception to August 20, 2025. We included randomized controlled trials (RCTs) or prospective nonrandomized interventional studies that reported hair loss following GLP-1 RA therapy. A random-effects model was used for meta-analysis. RESULTS: A total of nine interventional studies, including 7 RCTs and 2 non-RCTs, were included in the final meta-analysis. Data from a total of 4114 GLP-1 RA users were analyzed. The pooled analysis revealed a significantly higher risk of hair loss in GLP-1 RA users than in placebo users (risk ratio [RR]: 3.252; 95% confidence interval [CI]: 1.437 to 7.358). The significant results persisted even when the analysis was restricted to RCTs focusing on patients with overweight or obesity (RR: 3.587; 95% CI: 2.100 to 6.124). Furthermore, a single-arm analysis revealed that the event rate of hair loss following GLP-1 RA therapy was 3.9%. CONCLUSIONS: The use of GLP-1 RAs is significantly associated with an increased risk of hair loss.
Early cardiovascular-kidney-metabolic progression with tirzepatide: population definition and clinical interpretation.
Fauchier L, Guglieri M
Diabetes Res Clin Pract · 2026 Jul · PMID 42155604 · Publisher ↗
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GLP-1 receptor agonists and surgical care: implications for bariatric Procedures, perioperative Outcomes, and nutritional optimization.
Elawa Z, Khalil A, Kardousha A … +2 more , ElAwwa A, Soliman AT
Diabetes Res Clin Pract · 2026 Jul · PMID 42155603 · Publisher ↗
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for obesity and type 2 diabetes and are now frequently encountered in patients undergoing bariatric and other elective surgeries. The...
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for obesity and type 2 diabetes and are now frequently encountered in patients undergoing bariatric and other elective surgeries. Their effects on gastric motility, appetite, and nutrient intake have important implications for perioperative safety, surgical outcomes, and nutritional care. OBJECTIVES: To summarize current evidence on the effects of GLP-1RAs on perioperative management, bariatric surgery outcomes, and nutritional optimization in surgical patients. METHODS: A narrative review of PubMed- and Scopus-indexed randomized trials, observational studies, systematic reviews, and clinical guidelines was conducted. Evidence was synthesized across perioperative risk, preoperative optimization, post-bariatric outcomes, and nutritional implications. RESULTS: GLP-1RA use was associated with delayed gastric emptying and increased residual gastric contents in some patients, especially during dose escalation or in those with gastrointestinal symptoms. However, clinically significant aspiration events were uncommon, supporting individualized perioperative management rather than routine discontinuation. Preoperatively, GLP-1RAs promoted short-term weight loss and metabolic improvement in bariatric candidates, potentially improving operative conditions and reducing risk. Postoperatively, the strongest evidence from randomized controlled trials showed that liraglutide and semaglutide achieved additional weight loss and improved glycemic control in patients with weight regain, insufficient weight loss, or persistent diabetes after bariatric surgery, potentially lowering the need for revisional procedures. Nutritionally, appetite suppression may worsen inadequate protein intake and micronutrient deficiencies, increasing risks of sarcopenia, anemia, and bone disease without structured monitoring and supplementation. However, direct trial evidence for supplementation strategies in this specific population is lacking. CONCLUSIONS: GLP-1RAs offer important metabolic and weight-related benefits across the surgical continuum, particularly around bariatric surgery, but require individualized perioperative planning and proactive nutritional surveillance. They should be viewed as adjuncts to, not replacements for, bariatric surgery.
Albuminuria predicts diabetic retinopathy and consequences of polyneuropathy in individuals with type 2 diabetes and chronic kidney disease: an observational nationwide Danish cohort study.
Turner CS, Hornum M, Freese Ballegaard EL … +6 more , Carlson N, Heegaard S, Almdal TP, Andersen MP, Torp-Pedersen C, Kofod DH
Diabetes Res Clin Pract · 2026 Jul · PMID 42150631 · Publisher ↗
AIMS: Although albuminuria is an established prognostic marker in individuals with diabetes and chronic kidney disease (CKD), less is known about the association between albuminuria and retinal and neurological complicat...
AIMS: Although albuminuria is an established prognostic marker in individuals with diabetes and chronic kidney disease (CKD), less is known about the association between albuminuria and retinal and neurological complications in large, unselected populations with type 2 diabetes and established CKD. We investigated the association of urine albumin-creatinine-ratio (UACR) on prevalence and incidence of microvascular complications in individuals with CKD. METHODS: We included 27,924 adults with type 2 diabetes and CKD (eGFR < 60 ml min⁻ 1.73 m⁻) from Danish health care registers (2010-2023). Outcomes included diabetic retinopathy, polyneuropathy, and progression of CKD. Odds of retinopathy and polyneuropathy at baseline were evaluated using logistic regressions. Standardized 5-year risks of outcomes ere estimated using Cox regressions across UACR strata (<30, 30-100, 101-300, 301-1000, >1000 mg/g). RESULTS: Median age was 75 years (IQR 69-80), 41.5% were female, and median eGFR was 53 ml min⁻ 1.73 m⁻ (IQR 47-56). Odds ratios for diabetic retinopathy and polyneuropathy were positively correlated with UACR. 5-year risks (95% CI) of all outcomes were similarly associated with increasing UACR levels. CONCLUSION: Albuminuria was associated with a progressive increase in prevalence and incidence of microvascular disease in individuals with type 2 diabetes and CKD.
Prevalence of diabetic kidney disease in Brazil: A systematic review with meta-analysis.
Chichelero GM, Pessil LS, Viegas GM … +4 more , Xavier Junior GF, Dos Reis MA, Bauer AC, Schaan BD
Diabetes Res Clin Pract · 2026 Jul · PMID 42150630 · Publisher ↗
This systematic review assesses the prevalence of diabetes kidney disease (DKD) in Brazil, examining geographical variations and associated risk factors. Following PRISMA guidelines and PROSPERO registration, searches we...
This systematic review assesses the prevalence of diabetes kidney disease (DKD) in Brazil, examining geographical variations and associated risk factors. Following PRISMA guidelines and PROSPERO registration, searches were conducted in PubMed, EMBASE, and LILACS for studies up to and including December 2025. Two researchers independently performed screening, data extraction, and quality assessment. Pooled prevalence was estimated using a random-effects meta-analysis (generalized linear mixed model). Subgroup analyses included diabetes type, duration, diagnostic criteria, healthcare setting, and region. A total of 46 studies were included (n = 24,893 individuals). The pooled prevalence of DKD among Brazilian adults was 27.06% (95% CI 22.40-32.29; I 98%). Higher prevalence was associated with longer diabetes duration: 33.28% for ≥10 years versus 24.32% for <10 years. Estimates varied by diabetes type: type 1, 28.93% [18.06-42.92] and type 2, 28.61% [20.95-37.73]. Diagnostic criteria significantly influenced results: albuminuria only (32.30%), estimated glomerular filtration rate (eGFR) only (17.70%), and combined eGFR/albuminuria (30.69%). Regional data showed higher prevalence in the South (41.0%), with limited data available for the North and Northeast. High heterogeneity highlights the need for multicenter studies using standardized definitions to improve national surveillance.
Prevalence, trends, and determinants of early-onset type 2 diabetes in northwest China: a sex-stratified analysis of ∼10 million community-dwelling population.
Wang J, Peng H, Tao J … +10 more , Yong J, Zeng L, Zhang K, Zhao Q, Wang Y, Liu J, Zheng B, Li C, Xie J, Yang Y
Diabetes Res Clin Pract · 2026 Jul · PMID 42144064 · Publisher ↗
PURPOSE: To investigate the trends and sex-specific risk factors of early-onset type 2 diabetes in northwest China. METHODS: Using the Northwest China Tianshan Cohort (2019-2023; ∼10 million/year), we analyzed adults age...
PURPOSE: To investigate the trends and sex-specific risk factors of early-onset type 2 diabetes in northwest China. METHODS: Using the Northwest China Tianshan Cohort (2019-2023; ∼10 million/year), we analyzed adults aged 18-39 years. Annual prevalence of early-onset type 2 diabetes, defined by objective indicators, and trends were calculated. The association between risk factors candidates and disease was modelled using Cox proportional hazard regression. The hazard ratio (HR) was estimated in overall population, and stratified by sex. RESULTS: Among 9,641,234 participants, 4,130,431 were retained. Early-onset type 2 diabetes prevalence rose from 1.50% to a 2022 peak of 2.25%, highest in men and the 35-39 years. Older age, male, lower education, civil servant, divorced/widowed, higher BMI, and current smoker were significantly associated with a higher risk, with most associations in a dose-dependent manner. These associations were largely consistent between sexes, with a few exceptions in BMI subgroups. CONCLUSIONS: This large population-based cohort study shows early-onset type 2 diabetes increased by 50% from 2019 to 2022 in northwest China. Obesity and low education emerged as the strongest modifiable risk factors, and male showed the highest overall risk. These findings reveal an accelerating diabetes epidemic, prompting immediate screening for high-risk groups.
Predicting type II diabetes mellitus in young and middle-aged adults: A machine learning approach using the Utah population database.
Meeks HD, Smith KR, Curtis DS … +2 more , Date A, Kowaleski-Jones L
Diabetes Res Clin Pract · 2026 Jul · PMID 42144063 · Publisher ↗
AIMS: To develop a machine learning framework for predicting type 2 diabetes mellitus (T2DM) using administrative data and electronic health records (EHR) that could be applied in healthcare settings. METHODS: Study popu...
AIMS: To develop a machine learning framework for predicting type 2 diabetes mellitus (T2DM) using administrative data and electronic health records (EHR) that could be applied in healthcare settings. METHODS: Study population included parents of individuals born in 1970-1990 who resided in Utah urban counties during 1990-2015. Two prediction models were developed using classification and regression tree (CART) methods. A "follow-back" design used data from 2010-2015 to predict T2DM incidence between 2016-2021. An "age-based" design used data from ages 40-45 to predict T2DM incidence between ages 46-50. Potential predictors included individual sociodemographic characteristics, family history of T2DM, and neighborhood environmental measures. RESULTS: The follow-back and age-based cohorts included 240,163 and 126,525 individuals, respectively. The final CART decision rules demonstrated high sensitivity (90-95%), with overweight status consistently selected as primary decision rule across study designs. Racial-ethnic minority populations and individuals living in urban/socioeconomically deprived areas were identified as having elevated risk for T2DM, even at younger ages and normal/underweight BMI. CONCLUSIONS: Application of machine learning models for T2DM prediction should be tailored to specific study designs and population characteristics, with considerations of environmental data relevant to the local context. Opportunities exist to utilize administrative data and EHR for machine learning-based prediction.
Antibiotic-loaded bone substitutes in the surgical management of diabetic foot osteomyelitis: Current evidence and clinical perspectives.
Monami M, Ragghianti B, Masulli M … +1 more , Lipsky BA
Diabetes Res Clin Pract · 2026 Jul · PMID 42134680 · Publisher ↗
Diabetic foot osteomyelitis (DFO) represents a severe manifestation of diabetic foot syndrome and a leading cause of lower-limb amputation globally. Surgical intervention is frequently required, often leaving residual bo...
Diabetic foot osteomyelitis (DFO) represents a severe manifestation of diabetic foot syndrome and a leading cause of lower-limb amputation globally. Surgical intervention is frequently required, often leaving residual bone defects that can promote persistent infection and impair healing. In this context, bioabsorbable antibiotic-loaded bone substitutes have emerged as a potential adjunct in surgical management. These biomaterials enable high local antibiotic delivery within the surgical cavity, exceeding minimum inhibitory concentrations for common pathogens, while avoiding systemic toxicity. In parallel, they act as fillers of dead space and provide an osteoconductive scaffold that supports bone regeneration. This narrative review summarizes the pathophysiology of DFO, current surgical principles, and the properties of available antibiotic-loaded bone substitutes. We also critically appraise the clinical evidence supporting their use. Available studies suggest promising outcomes in terms of infection control, wound healing, and limb preservation. However, the current evidence base is largely limited to observational and heterogeneous studies, with variability in study design, patient selection, and biomaterial characteristics. Overall, while these technologies appear to be a valuable adjunct in selected cases, robust prospective and randomized trials are needed to better define their indications, comparative effectiveness, and long-term clinical impact in the management of diabetic foot osteomyelitis.
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