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Hu Y, Shao LN, Zheng J, Zhang XM, Song YX, Xing YB. Vitamin D deficiency is associated with apolipoprotein A1 levels in patients with young-onset type 2 diabetes mellitus. World J Diabetes 2025; 16:105558. [DOI: 10.4239/wjd.v16.i6.105558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2025] [Revised: 03/25/2025] [Accepted: 05/19/2025] [Indexed: 06/13/2025] Open
Abstract
BACKGROUND Young-onset type 2 diabetes mellitus (T2DM) is associated with adverse health outcomes and increased mortality. Vitamin D (VitD) deficiency is likewise linked to various adverse health outcomes and is significantly associated with lipid metabolism in patients with T2DM. However, little is known regarding the mechanisms of interaction between VitD and apolipoprotein A1 (apoA1) in young-onset T2DM.
AIM To evaluate the relationship between VitD and apoA1 levels in patients with young-onset T2DM.
METHODS This cross-sectional study was conducted at Zhejiang Provincial People’s Hospital between January 2019 and December 2023. A total of 642 patients with T2DM who aged 18-40 years were included and matched with 642 individuals without diabetes (controls) based on age and sex. No specific intervention was applied, and data were collected from medical records and laboratory tests. The relationship between VitD and apoA1 levels was examined using Spearman’s correlation and logistic regression models.
RESULTS We found that VitD levels were significantly lower in patients with T2DM compared to controls (15.9 ng/mL vs 17.4 ng/mL, P < 0.001), with a notable positive correlation between VitD deficiency and reduced apoA1 levels. Multifactor logistic regression analysis identified that severe VitD deficiency was an independent risk factor for apoA1 in young-onset T2DM patients (odds ratio = 3.43, 95% confidence interval: 1.16-10.20, β = 1.23, P = 0.026).
CONCLUSION Our findings reveal an association between VitD and apoA1 in young-onset T2DM, suggesting that VitD may play a crucial role in metabolic regulation and cardiovascular risk management.
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Affiliation(s)
- Ye Hu
- Geriatric Medicine Center, Department of Endocrinology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Li-Na Shao
- Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Jia Zheng
- Center for General Practice Medicine, Department of Nutrition, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Xin-Miao Zhang
- Geriatric Medicine Center, Department of Endocrinology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Ying-Xiang Song
- Geriatric Medicine Center, Department of Endocrinology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Yu-Bo Xing
- Geriatric Medicine Center, Department of Endocrinology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
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Cannarella R, Rubulotta M, Cannarella V, La Vignera S, Calogero AE. A holistic view of SGLT2 inhibitors: From cardio-renal management to cognitive and andrological aspects. Eur J Intern Med 2025:S0953-6205(25)00247-X. [PMID: 40517121 DOI: 10.1016/j.ejim.2025.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2025] [Revised: 06/04/2025] [Accepted: 06/09/2025] [Indexed: 06/16/2025]
Abstract
Type 2 diabetes mellitus (T2DM) is a multifactorial disease associated with complications that significantly affect both survival and quality of life, including cardiovascular, renal, cognitive, sexual, and reproductive dysfunctions. Sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2is) have emerged as a transformative class of drugs, demonstrating benefits that extend beyond glycemic control. Large clinical trials have shown that SGLT2is reduce hospitalization for heart failure by 25-35% and slow progression of chronic kidney disease by 30-45%, with variation based on the specific agent, dose, and patient population. This narrative review examines not only these well-established benefits but also emerging evidence regarding their effects in less-explored domains. SGLT2is have been associated with improved cognitive performance, potentially through reductions in neuroinflammation and oxidative stress. In the sexual and reproductive domains, studies in men with diabetes mellitus suggest potential benefits of SGLT2is in improving erectile function, sperm motility, and testosterone levels, likely mediated by antioxidant and anti-inflammatory mechanisms. By integrating current evidence across multiple systems, this review emphasizes the role of SGLT2is in a holistic, multidisciplinary approach to the management of patients with T2DM.
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Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Michele Rubulotta
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Vittorio Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Dipartimento di Scienze Mediche, IOC di Medicina Generale, AOU Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Shen JH, Hwang IW, Choe JP, Hwang SJ, Kim JY, Lee JM. Association of early-onset diabetes with socioeconomic, and health factors: a matched case-control study controlling for age, gender, and BMI. J Diabetes Metab Disord 2025; 24:14. [PMID: 39703349 PMCID: PMC11652543 DOI: 10.1007/s40200-024-01532-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Accepted: 10/12/2024] [Indexed: 12/21/2024]
Abstract
Objectives This study examines the link between early-onset diabetes and health factors in South Korean young adults (20-39) using data from the Korea National Health and Nutrition Examination Survey (2010-2020). Methods A matched case-control study was conducted in 2022 with 103 patients with diabetes and 103 controls, matched by age, gender, and BMI. All data, including socioeconomic status (income, education, occupation), health behaviors (smoking, alcohol consumption, physical activity), and medical histories, were extracted from the KNHANES database. We analyzed socioeconomic status, health behaviors, and medical histories using descriptive statistics, chi-square tests, and binary logistic regression. Results The study revealed that educational attainment and economic status are substantial predictors of diabetes, with those holding only a high school diploma showing a nearly threefold increased risk compared to college graduates (OR = 2.986; 95% CI = 1.334-6.687). Additionally, participants with a higher number of chronic diseases (OR = 3.534; 95% CI: 1.547-8.073) and those who felt unwell in the past two weeks (OR = 4.010; 95% CI: 1.388-11.585) also demonstrated significantly increased odds of diabetes. And having a parent with diabetes was an exceptionally strong predictor, with these participants having a significantly increased risk of diabetes (OR = 47.022; 95% CI = 4.206-525.704). Conclusion The study emphasizes that improving educational and economic conditions, coupled with targeted screening programs for individuals with a family history of diabetes, may be effective in curbing the tide of early-onset diabetes in South Korea. These strategies may have profound implications for public health policies aimed at mitigating the risk in this increasingly vulnerable group.
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Affiliation(s)
- Jun-Hao Shen
- Present Address: Graduate School of Physical Education, Kyung Hee University (Global Campus), 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014 Republic of Korea
| | - In-Whi Hwang
- Present Address: Graduate School of Physical Education, Kyung Hee University (Global Campus), 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014 Republic of Korea
| | - Ju-Pil Choe
- Health and Sport Analytics Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, 38677 USA
| | - Soo-Ji Hwang
- Present Address: Graduate School of Physical Education, Kyung Hee University (Global Campus), 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014 Republic of Korea
| | - Joon-Young Kim
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY USA
| | - Jung-Min Lee
- Sports Science Research Center, Kyung Hee University (Global Campus), 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014 Republic of Korea
- Department of Physical Education, Kyung Hee University (Global Campus), 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014 Republic of Korea
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Ko JH, Moon SJ, Ajjan RA, Lee MY, Lee HJ, Choi B, Park J, Lee SE, Kang JH, Park CY. Workplace-based continuous glucose monitoring with structured education for pre-diabetes and type 2 diabetes: A prospective community cohort study. Diabetes Obes Metab 2025; 27:2996-3005. [PMID: 40041974 DOI: 10.1111/dom.16304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2024] [Revised: 02/04/2025] [Accepted: 02/07/2025] [Indexed: 05/04/2025]
Abstract
AIMS We investigated the effect of continuous glucose monitoring (CGM) with personalised structured education on patients with type 2 diabetes (T2D) and pre-diabetes in a workplace setting. MATERIALS AND METHODS This 8-week prospective study enrolled adults with T2D or pre-diabetes at Samsung Electronics Device Solutions between March and September 2023. Participants underwent CGM (Freestyle Libre) for 2 weeks and received personalized structured education on diet and physical activity. The primary outcome was the change in HbA1c level at 8 weeks compared with baseline. Secondary outcomes included changes in fasting blood sugar (FBS), lipid profile, weight and patient-related outcome measures (PROMs) at 8 weeks and longer. RESULTS Among 234 participants (161 T2D and 73 pre-diabetes), significant improvements were observed in the T2D group patients in terms of HbA1c (6.9% ± 1.2%-6.5% ± 0.8%), FBS (128.4 ± 36.9-117.6 ± 22.2 mg/dL), weight (81.9 ± 13.5-80.7 ± 13.6 kg) and low-density lipoprotein (LDL) cholesterol (106.0 ± 41.5 to 95.1 ± 35.9 mg/dL) (all p < 0.001) levels. Meanwhile, patients with pre-diabetes showed significant improvements in weight (79.7 ± 14.0-78.5 ± 13.9 kg) and LDL cholesterol (124.5 ± 32.8-113.8 ± 29.1 mg/dL) (all p < 0.001), with no significant changes in HbA1c or FBS. These improvements were maintained during follow-up check-ups after a mean of 6.4 months. Participants in both groups demonstrated improvements in their PROMs. CONCLUSIONS Among adults with T2D and pre-diabetes, the use of CGM with structured education in a workplace-based setting helped with weight loss and improved LDL cholesterol levels in both groups, while also improving glycaemia in patients with T2D.
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Affiliation(s)
- Ji-Hee Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Sun-Joon Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ramzi A Ajjan
- Clinical Population and Sciences Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hae-Jeong Lee
- Future Medical Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Boram Choi
- Future Medical Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - JiYeon Park
- Future Medical Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Seung-Eun Lee
- Safety & Health Team, Global Manufacturing & Infra Technology, Samsung Electronics Co. Ltd, Suwon, Republic of Korea
| | - Jae-Hyeon Kang
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Jiménez-Sierra L, Cuadrado-Corrales N, Hernández-Barrera V, Jiménez-Garcia R, López-de-Andres A, de Miguel-Diez J, Bodas-Pinedo A, Zamorano-León JJ. Trends in Depression Among Hospitalized Patients with Type 2 Diabetes in Spain (2017-2023): A Population-Based Analysis with a Focus on Sex Differences and In-Hospital Outcomes. J Clin Med 2025; 14:3895. [PMID: 40507657 PMCID: PMC12156438 DOI: 10.3390/jcm14113895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2025] [Revised: 05/22/2025] [Accepted: 05/30/2025] [Indexed: 06/16/2025] Open
Abstract
Background/Objectives: There is a growing body of evidence supporting a bidirectional relationship between depression and type 2 diabetes mellitus (T2DM). The coexistence of depression and T2DM has substantial clinical implications. However, there is little research looking at how these two conditions cluster together in people hospitalized with T2DM, the associated factors, and their effect on hospital outcomes. In this study, we aimed to assess temporal trends in depression prevalence among hospitalized patients with T2DM in Spain from 2017 to 2023. Additionally, we analyzed the association of variables such as gender, age, anxiety, obesity, alcohol and tobacco use, dementia, COVID-19 infection, and personality disorders in the presence of depression among hospitalized T2DM patients and the impact of these variables on in-hospital mortality (IHM). Methods: We conducted a population-based cohort study using the Spanish Hospital Discharge Registry (RAE-CMBD). Adults aged ≥ 40 years with a T2DM diagnosis were included. Depression was identified by using ICD-10 codes. Time trends were analyzed by using joinpoint regression. Multivariable logistic regression models were employed to identify factors associated with depression and in-hospital mortality (IHM), stratified by sex. Results: Among 4,597,668 hospitalizations with T2DM, 202,094 (4.39%) included a depression diagnosis. Depression prevalence increased slightly over time (APC: 1.09% in women and 0.98% in men). Women consistently showed higher prevalence (OR 3.21; 95% CI: 3.18-3.24). Age, anxiety, obesity, alcohol and tobacco use, and personality disorders were significantly associated with the presence of a code for depression, with notable sex differences. Among patients with T2DM and depression, IHM was significantly associated with older age, more comorbidities, COVID-19 infection, hypoglycemia, dementia, and female gender, whereas obesity and anxiety had a protective effect. Conclusions: From 2017 to 2023, the prevalence of depression in hospitalized patients with T2DM in Spain increased slightly, particularly among older women, highlighting the need for integrated mental health screening and management during hospitalization.
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Affiliation(s)
- Lucia Jiménez-Sierra
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain; (L.J.-S.); (N.C.-C.); (A.L.-d.-A.); (A.B.-P.); (J.J.Z.-L.)
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain; (L.J.-S.); (N.C.-C.); (A.L.-d.-A.); (A.B.-P.); (J.J.Z.-L.)
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Rodrigo Jiménez-Garcia
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain; (L.J.-S.); (N.C.-C.); (A.L.-d.-A.); (A.B.-P.); (J.J.Z.-L.)
| | - Ana López-de-Andres
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain; (L.J.-S.); (N.C.-C.); (A.L.-d.-A.); (A.B.-P.); (J.J.Z.-L.)
| | - Javier de Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, IiSGM, Universidad Complutense de Madrid, 28007 Madrid, Spain;
| | - Andrés Bodas-Pinedo
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain; (L.J.-S.); (N.C.-C.); (A.L.-d.-A.); (A.B.-P.); (J.J.Z.-L.)
| | - José J. Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain; (L.J.-S.); (N.C.-C.); (A.L.-d.-A.); (A.B.-P.); (J.J.Z.-L.)
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Ma H, Zhang J, Meng B, Wang K, Li Y, Liang N. Divergent impacts of glycemic control on mortality and complications in patients with early-versus late-onset type 2 diabetes: A retrospective cohort study. PLoS One 2025; 20:e0322886. [PMID: 40408408 PMCID: PMC12101672 DOI: 10.1371/journal.pone.0322886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Accepted: 03/28/2025] [Indexed: 05/25/2025] Open
Abstract
AIMS To investigate whether optimal glycemic control is associated with all-cause mortality, cardiovascular disease mortality, diabetes-related mortality, cancer-related mortality, and complications among individuals with early-onset and late-onset T2D. METHODS We conducted a retrospective cohort study using data from the U.S. National Health and Nutritional Examination Survey (NHANES)1999-2818. Optimal glycemic control was defined as HbA1c<7%, and poor glycemic control as HbA1c≥9%. Mortality and underlying causes of death were ascertained by linkage to national death records through 31 December 2019. Cox proportional hazards regression models adjusted for age, sex, race, education, body mass index (BMI), hypertension, smoking status, alcohol consumption, and physical activity were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between HbA1c levels and mortality. Logistic regression models with the same covariates were employed to calculate odds ratios (ORs) and 95% CIs for complications, supplemented by sensitivity analyses to evaluate the robustness of the findings. RESULTS Among the 5946 participants with diabetes, 18.8% were classified as having early-onset T2D (aged < 40 years), 28.7% as having late-onset T2D (aged ≤ 60 years), and 52.5% had average-onset T2D. For individuals with early-onset T2D, the poorly controlled group (HbA1c≥9%) had HRs of 2.00 (95% CI, 1.30-3.09; P = 0.002) for all-cause mortality and 10.04 (95% CI, 2.57-39.32; P = 0.001) for diabetes-related mortality versus the optimal controlled group (HbA1c<7%). The poorly controlled group had odds of 1.80 (95% CI, 1.10-2.94; P = 0.022) for retinopathy and 2.54 (95% CI, 1.65-3.92; P < 0.001) for chronic kidney disease (CKD) versus the optimal controlled group. For individuals with late-onset T2D, the HRs were 0.87 (HR 0.87; 95% CI, 0.54-1.40; P = 0.561) for all-cause mortality and 1.24 (95% CI, 0.33-4.67; P = 0.751) for diabetes-related mortality compared with the optimal controlled group. The poorly controlled group had odds of 2.12 (95% CI, 1.32-3.41; P = 0.002) for retinopathy and 2.30 (95% CI, 1.45-3.63; P = 0.001) for CKD versus the optimal controlled group. CONCLUSION Optimal glycemic control was associated with a reduced risk of all-cause mortality, diabetes-related mortality, retinopathy, and CKD in individuals with early-onset T2D; however, in individuals with late-onset T2D, this correlation was limited to lower risks of retinopathy and CKD. These findings suggest that glycemic control strategies should be tailored on the basis of the age of diabetes onset.
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Affiliation(s)
- Haipeng Ma
- Department of Ophthalmology, Handan City Eye Hospital (The Third Hospital of Handan), Handan, Hebei Province, PR China
| | - Jitao Zhang
- Department of Ophthalmology, Handan City Eye Hospital (The Third Hospital of Handan), Handan, Hebei Province, PR China
| | - Bing Meng
- Department of Laboratory Medicine, The First Hospital of Handan, Handan, Hebei Province, PR China
| | - Kai Wang
- Department of Ophthalmology, Handan City Eye Hospital (The Third Hospital of Handan), Handan, Hebei Province, PR China
| | - Yuhong Li
- Department of Ophthalmology, Handan City Eye Hospital (The Third Hospital of Handan), Handan, Hebei Province, PR China
| | - Na Liang
- Department of Ophthalmology, Handan City Eye Hospital (The Third Hospital of Handan), Handan, Hebei Province, PR China
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Zhen XM, Ross G, Gauld A, Nettel-Aguirre A, Noonan S, Constantino M, Sweeting A, Harding AJ, Mackie A, Chatila H, McGill M, Middleton T, Wu T, Twigg S, Wong J. Pregnancy outcomes in women with young-onset type 2 diabetes: the impact of age of diabetes diagnosis and duration of diabetes. Diabet Med 2025:e70049. [PMID: 40401817 DOI: 10.1111/dme.70049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 03/12/2025] [Accepted: 04/04/2025] [Indexed: 05/23/2025]
Abstract
AIMS Young-onset type 2 diabetes mellitus (YT2DM) is an aggressive phenotype, with some claiming that diagnosis at <40 years of age represents a distinct higher risk group. Others have suggested restricting YT2DM to those diagnosed at <30 years of age. In this context, we examined whether pregnancy outcomes differ between women diagnosed with YT2DM at <30 years of age (T2D30) versus those diagnosed at 30 to <40 years of age (T2D40). METHODS This retrospective analysis (2010-2019) compared pregnancy outcomes in women with pre-gestational T2D30 versus T2D40. Co-primary outcomes included preterm delivery, large for gestational age (LGA) infants, and pre-eclampsia. RESULTS Compared to T2D40 (N = 69), T2D30 (N = 66) were significantly younger, had a longer duration of diabetes, and had higher rates of smoking (p <0.05 for all). In both groups, obesity affected ≥60% of women and similar rates of preterm delivery and LGA infants were seen. Women with T2D30 had at least a twofold increase in the adjusted odds of excess gestational weight gain (GWG). Rates of proteinuria and pre-eclampsia were increased in T2D30, although significance was lost following adjustment for factors such as glycaemia. Younger age of YT2DM diagnosis and longer duration of YT2DM (as continuous variables), but not maternal age, were independently associated with higher mean pregnancy HbA1c and excess GWG (p <0.05 for both). CONCLUSIONS An earlier age of YT2DM diagnosis and/or longer duration of YT2DM were associated with excess GWG and a higher mean-pregnancy HbA1c. Rates of pre-eclampsia and proteinuria were increased in T2D30, likely mediated at least in part by factors such as glycaemia. Our findings suggest that the age of YT2DM diagnosis and/or duration of YT2DM, not just maternal age, should be considered when assessing pregnancy risks.
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Affiliation(s)
- Xi May Zhen
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Diabetes and Endocrinology, Blacktown Hospital, Sydney, New South Wales, Australia
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Glynis Ross
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Gauld
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | | | - Stephanie Noonan
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Maria Constantino
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Arianne Sweeting
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anna-Jane Harding
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Adam Mackie
- Women and Babies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Hend Chatila
- Women and Babies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Margaret McGill
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Timothy Middleton
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ted Wu
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Stephen Twigg
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jencia Wong
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Xing S, Kang X, Wang R, Wang C, Wang Y, Bao X, Zhao J. Microbial Production of Nicotinamide Mononucleotide: Key Enzymes Discovery, Host Cells Selection, and Pathways Design and Optimization. ACS Synth Biol 2025; 14:1352-1366. [PMID: 40237164 DOI: 10.1021/acssynbio.5c00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2025]
Abstract
As an important bioactive substance in cells, nicotinamide mononucleotide (NMN) has been proven to play an important role in antiaging, treatment of neurodegenerative diseases, and cardioprotection. It presents a high potential for application in the research fields of functional foods, cosmetics, healthcare products, and active pharmaceuticals. With the increased demand, whether NMN can achieve large-scale industrial production has been a wide concern. The chemical synthesis method of NMN mainly faces the problems of separation, purification, and complex process control; in contrast, biosynthesis methods such as microbial fermentation and enzyme catalysis are considered to be the mainstream of the future industrial production of NMN due to the advantages of environmental friendliness, high efficiency, and simple separation. This review first describes the physiological functions of NMN and the related areas of its applications. Subsequently, it focuses on the research progress on different synthetic pathways of NMN in biosynthetic approaches, mining and modification of key enzymes, chassis cell design and optimization, and whole-cell catalysis. Meanwhile, the regulatory strategies, methods, and process control of the microbial synthesis of NMN are also elaborated, and the synthesis efficiencies of different chassis cells are systematically compared. Finally, this review summarizes the existing problems and challenges of microbial synthesis of NMN and proposes future strategies and directions to address these issues. This work provides technical references and a theoretical basis for researching efficient NMN microbial synthesis and application.
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Affiliation(s)
- Shuyi Xing
- State Key Laboratory of Green Papermaking and Resource Recycling, School of Bioengineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Xiulong Kang
- State Key Laboratory of Green Papermaking and Resource Recycling, School of Bioengineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Rui Wang
- State Key Laboratory of Green Papermaking and Resource Recycling, School of Bioengineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Chengqiang Wang
- College of Life Sciences, National Engineering Research Center for Efficient Utilization of Soil and Fertilizer Resources, Shandong Key Laboratory of Agricultural Microbiology, Shandong Agricultural University, Taian 271018, China
| | - Yanjun Wang
- National Key Laboratory of Efficient Utilization of Nutrient Resources, Shandong Academy of Agricultural Sciences, Jinan 250100, China
| | - Xiaoming Bao
- State Key Laboratory of Green Papermaking and Resource Recycling, School of Bioengineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Jianzhi Zhao
- State Key Laboratory of Green Papermaking and Resource Recycling, School of Bioengineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
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Lei XT, Chen XF, Qiu S, Tang JY, Geng S, Yang GY, Wu QN. TERT/FOXO1 signaling promotes islet β-cell dysfunction in type 2 diabetes mellitus by regulating ATG9A-mediated autophagy. World J Diabetes 2025; 16:102994. [DOI: 10.4239/wjd.v16.i5.102994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Revised: 02/09/2025] [Accepted: 03/19/2025] [Indexed: 04/25/2025] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a severe global health problem that causes prolonged disease exposure and an elevated risk for chronic complications, posing a substantial health burden. Although therapies, such as GLP-1 receptor agonists and SGLT2 inhibitors, have been successfully developed, new therapeutic options are still expected to offer better blood glucose control and decrease complications.
AIM To elucidate the mechanism by which TERT/FOXO1 affects high glucose (HG)-induced dysfunction in islet β-cells via the regulation of ATG9A-mediated autophagy.
METHODS High-fat diet (HFD)-fed/streptozotocin (STZ)-treated mice or HG-treated MIN6 cells were used to establish T2DM models. Fasting blood glucose (FBG) and insulin levels in mice, as well as morphological changes in islet tissues, were assessed. Cell proliferation and the apoptosis rate were measured via EdU assays and flow cytometry, respectively. The expression levels of TERT, FOXO1, ATG9A and autophagy-related proteins (LC3B, p62) were analyzed via western blotting. The relationship between FOXO1 and ATG9A was assessed using dual-luciferase reporter gene assays and ChIP assays.
RESULTS T2DM modeling in HFD-fed/STZ-treated mice and HG-treated MIN6 cells led to elevated TERT and FOXO1 expression and reduced ATG9A expression. Mice with T2DM were found to have decreased body weight, worsened morphology, elevated FBG and suppressed insulin levels. HG-treated MIN6 cells presented decreased viability and LC3B expression, in addition to increased p62 expression and apoptosis rates. FOXO1 knockdown both in vitro and in vivo protected mice and cells against islet β-cell dysfunction via the activation of autophagy. The molecular mechanism involved the suppression of ATG9A expression by TERT through FOXO1 transcription activation.
CONCLUSION Our results suggested that TERT/FOXO1 inhibits ATG9A expression to decrease islet β-cell function in T2DM.
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Affiliation(s)
- Xiao-Tian Lei
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 402360, China
| | - Xiang-Fen Chen
- Department of Endocrinology, The Affiliated Dazu’s Hospital of Chongqing Medical University, The People's Hospital of Dazu, Chongqing 402360, China
| | - Sheng Qiu
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 402360, China
| | - Jia-Ying Tang
- Department of Endocrinology, The Affiliated Dazu’s Hospital of Chongqing Medical University, The People's Hospital of Dazu, Chongqing 402360, China
| | - Shan Geng
- Department of Endocrinology, The Affiliated Dazu’s Hospital of Chongqing Medical University, The People's Hospital of Dazu, Chongqing 402360, China
| | - Gang-Yi Yang
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 402360, China
| | - Qi-Nan Wu
- Department of Endocrinology, The Affiliated Dazu’s Hospital of Chongqing Medical University, The People's Hospital of Dazu, Chongqing 402360, China
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Wang Y, Liu F, Tong R, He Z, Fang Q, Feng J, An H, Liu J. Predicting incident type 2 diabetes in a Japanese cohort: an 8-year analysis of the NAGALA database. Front Endocrinol (Lausanne) 2025; 16:1465032. [PMID: 40444231 PMCID: PMC12119281 DOI: 10.3389/fendo.2025.1465032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 04/25/2025] [Indexed: 06/02/2025] Open
Abstract
Objective Using data from the NAGALA database, this retrospective cohort study set out to identify the predictive markers for incident Type 2 Diabetes Mellitus (T2DM), with a particular focus on the non-diabetic Japanese population. Methods We examined the data from a cohort of 15,464 individuals (with a male representation of 54.5% and an average age of (43.71 ± 8.90 years) sourced from the NAGALA (NAfld in the Gifu Area Longitudinal Analysis) research which was a longitudinal study at Medical Health Checkup Center of Murakami Memorial Hospital. The analysis focused on the incidence of T2DM from 2004 to 2012. Baseline demographic, anthropometric, biochemical, and lifestyle data were collected. All participants were not type 2 diabetic at baseline. The diagnosis of T2DM was confirmed by HbA1c >= 48mmol/mol, fasting plasma glucose >= 126mg/dL, or diabetes reported by oneself. Multivariate analysis was performed after univariate Cox regression analysis was used to find early determinants of T2DM incidence. The ability of individual components and a composite risk score to discriminate was assessed using Receiver Operating Characteristic (ROC) curves. Results Over an average follow-up duration of 2207.82 ± 1379.73 days, 262 patients (1.7%) had the onset of T2DM. Following the removal of confounding variables we found that age (HR=1.03,95%CI 1.01∼1.04, P=0.001), waist circumference(HR=1.05,95%CI 1.03∼1.06, P<0.001), alanine transaminase(HR=1.01,95%CI 1.00∼1.01, P=0.045), glycated hemoglobin (HbA1c) (HR=24.30,95%CI 15.69∼37.63,P<0.001), fasting plasma glucose(HR=1.10,95%CI 1.07∼1.12, P<0.001), the presence of fatty liver(HR=1.86,95%CI 1.37∼2.53, P<0.001), current smoking(HR=1.61,95%CI 1.16∼2.23, P=0.004), and heavy alcohol consumption(HR=1.79,95%CI 1.06∼2.99, P=0.028) were identified as independent risk factors for T2DM(all P < 0.05), while high-density lipoprotein cholesterol (HDL-C) exhibited a protective effect (HR=0.98,95%CI 0.97∼1.00, P=0.010). The area under the Receiver Operating Characteristic (ROC) curve for individual factors ranged from 0.53 to 0.83, with the highest value for HbA1c. A combined risk model incorporating these factors including age, waist circumference, alanine transaminase, HbA1c, fasting plasma glucose, the presence of fatty liver, current smoking, heavy alcohol consumption, 1/HDL-C achieved an AUC of 0.90 (95% CI 0.88-0.92, P < 0.001), signifying robust discriminatory ability. At a predictive probability threshold of >0.017, the model exhibited sensitivity and specificity of 0.863 and 0.828, respectively. Conclusion Current research has underscored the significance of a multifaceted approach to the prevention of T2DM, which includes early intervention targeting modifiable risk factors such as obesity, unhealthy alcohol use, and smoking, in conjunction with the monitoring of key metabolic markers like HbA1c and liver enzymes.
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Affiliation(s)
- Yangchun Wang
- Department of Endocrinology, Nanjing Meishan Hospital, Nanjing, China
| | - Fei Liu
- Department of General Surgery, Nanjing Meishan Hospital, Nanjing, China
| | - Ruixiang Tong
- Department of Endocrinology, Nanjing Meishan Hospital, Nanjing, China
| | - Zhonghua He
- Department of Endocrinology, Nanjing Meishan Hospital, Nanjing, China
| | - Qin Fang
- Department of Endocrinology, Nanjing Meishan Hospital, Nanjing, China
| | - Jie Feng
- Department of Pharmacy, Nanjing Meishan Hospital, Nanjing, China
| | - Hongliang An
- Department of Pharmacy, Nanjing Meishan Hospital, Nanjing, China
| | - Junjun Liu
- Department of Psychiatry, Nanjing Meishan Hospital, Nanjing, China
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11
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Zhang Z, Chen H, Chen L, Liang W, Hu T, Sun N, Zhao Y, Wei X. Association of total cholesterol to high-density lipoprotein cholesterol ratio with diabetes risk: a retrospective study of Chinese individuals. Sci Rep 2025; 15:16261. [PMID: 40346160 PMCID: PMC12064768 DOI: 10.1038/s41598-025-87277-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2024] [Accepted: 01/17/2025] [Indexed: 05/11/2025] Open
Abstract
A common complication of type 2 diabetes is hypercholesterolemia in many patients. It is still unclear, nevertheless, how high-density lipoprotein cholesterol ratio (TC/HDL-C), total cholesterol, and diabetes are related. The purpose of this study is to look at the prediction ability and causal relationship between TC/HDL-C and diabetes. This study included 117,268 subjects who were undergoing physical examinations. The subjects were grouped into four equal groups according to the TC/HDL-C quartiles; the main outcome was the occurrence of diabetes events. TC/HDL-C is calculated as total cholesterol divided by high-density lipoprotein cholesterol. In 3.1 years (± 0.95) of follow-up, 795 women (0.68%) and 1,894 men (1.62%) received new diabetes diagnoses. TC/HDL-C is an independent predictor of new-onset diabetes, according to multivariable Cox regression analysis (HR 1.27 per SD increase, 95% CI: 1.09-1.48, P for trend < 0.001). It turned out that a cutoff value of 3.55 (area under the curve 0.64, sensitivity 0.66, specificity 0.56), was ideal for TC/HDL-C in predicting new-onset diabetes. A subgroup analysis demonstrated that the younger population had a significantly higher risk of TC/HDL-C-related diabetes than the middle-aged group (interaction P < 0.05). After controlling for confounding variables, this Chinese cohort study reveals a direct correlation between TC/HDL-C and diabetes, with a stronger independent association observed in younger and middle-aged individuals.
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Affiliation(s)
- Zhiqiang Zhang
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Clinical Medical College, Jining Medical University, Jining, 272000, China
- Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining, 272000, Shandong, China
- Shandong Provincial Key Medical and Health Discipline of Cardiology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272000, Shandong, China
- Graduate School of Tianjin Medical University, Tianjin Medical University, Tianjin, 300070, Tianjin, China
| | - Hejun Chen
- Graduate School of Tianjin Medical University, Tianjin Medical University, Tianjin, 300070, Tianjin, China
| | - Lei Chen
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Clinical Medical College, Jining Medical University, Jining, 272000, China
- Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining, 272000, Shandong, China
- Shandong Provincial Key Medical and Health Discipline of Cardiology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272000, Shandong, China
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, 350004, Fujian, China
| | - Wenyan Liang
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Clinical Medical College, Jining Medical University, Jining, 272000, China
- Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining, 272000, Shandong, China
- Shandong Provincial Key Medical and Health Discipline of Cardiology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272000, Shandong, China
| | - Tenglong Hu
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Clinical Medical College, Jining Medical University, Jining, 272000, China
- Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining, 272000, Shandong, China
- Shandong Provincial Key Medical and Health Discipline of Cardiology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272000, Shandong, China
| | - Na Sun
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Clinical Medical College, Jining Medical University, Jining, 272000, China
- Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining, 272000, Shandong, China
- Shandong Provincial Key Medical and Health Discipline of Cardiology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272000, Shandong, China
| | - Yangyu Zhao
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Clinical Medical College, Jining Medical University, Jining, 272000, China
- Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining, 272000, Shandong, China
- Shandong Provincial Key Medical and Health Discipline of Cardiology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272000, Shandong, China
| | - Xiqing Wei
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Clinical Medical College, Jining Medical University, Jining, 272000, China.
- Shandong Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Jining, 272000, Shandong, China.
- Shandong Provincial Key Medical and Health Discipline of Cardiology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272000, Shandong, China.
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12
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He Q, Wu W, Chen J, Zhou H, Ding G, Lai S, Kuo AT, Wan H, Lin B, Wu H, Kong AS, Guan H, Cao H. Global Burden of type 2 diabetes in non-elderly individuals 1990 to 2021 and projections for 2050: a systematic analysis of the 2021 Global Burden of Disease. DIABETES & METABOLISM 2025; 51:101660. [PMID: 40348179 DOI: 10.1016/j.diabet.2025.101660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2025] [Revised: 04/26/2025] [Accepted: 04/29/2025] [Indexed: 05/14/2025]
Abstract
BACKGROUND Type 2 diabetes (T2D) is increasingly becoming a major global health challenge. However, research on T2D in non-elderly populations remains insufficient. METHODS We analyzed data from the Global Burden of Disease (GBD) study in 2021, focusing on diabetes-related indicators among individuals aged 15 to 59 across 204 countries and regions. This included prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs), categorized into 21 GBD regions according to the Sociodemographic Index (SDI). We employed join-point regression and Bayesian Age-Period-Cohort models to assess trends from 1990 to 2021 and forecast from 2021 to 2050. RESULTS The global age-standardized incidence rate increased from 196.3 per 100,000 (95 % UI, 145.2-257.4) in 1990 to 361.1 per 100,000 (95 % UI, 275.2-458.4) in 2021. The prevalence, mortality rate, and DALYs exhibit a similar upward trend. Although both men and women have experienced rises in prevalence, incidence, mortality rate, and DALYs, men continue to lead these metrics across nearly all age groups. Low-middle SDI countries bear the most severe disease burden. A high body mass index is a major risk factor in this population. It is estimated that by 2050, approximately 1.195 billion non-elderly individuals worldwide will have T2D, with epidemiological changes being the primary driver of this disease burden. CONCLUSIONS This study on the burden of T2D reveals that its prevalence among non-elderly individuals is steadily increasing and is projected to affect over a billion people worldwide by 2050. Targeted measures are crucial to tackle this global health challenge for this population.
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Affiliation(s)
- Qian He
- Department of Endocrinology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, PR China; Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, PR China
| | - Wenjing Wu
- Department of Nephrology, Hubei Provincial Hospital of Traditional Chinese Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, PR China
| | - Junnian Chen
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, PR China
| | - Haofeng Zhou
- Department of Cardiology, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences, Beijing, PR China
| | - Gangyu Ding
- Department of Neurology, Jiading District Central Hospital Affiliated Shanghai University of Medicine &Health Sciences, Shanghai, PR China
| | - Shuiqing Lai
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, PR China
| | - AndyY T Kuo
- Innodetection limited, Hong Kong SAR, PR China
| | - Heng Wan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, PR China
| | - Beisi Lin
- Department of Endocrinology and Metabolism, the third affiliated hospital of Sun Yat-sen University, Key Laboratory of Diabetology of Guangdong Province, Tianhe Road 600, Guangzhou, Guangdong Province, PR China
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, PR China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
| | - AliceP S Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, PR China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, PR China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, PR China.
| | - Huanyi Cao
- Department of Endocrinology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, PR China.
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Lin YK, Black JE, Harris SB, Ryan BL, Zou G, Ratzki-Leewing A. Young adults with type 2 diabetes experience high rates of Level 3 Hypoglycemia: A subgroup analysis of the Real-World iNPHORM cohort. Diabetes Res Clin Pract 2025; 225:112230. [PMID: 40339701 DOI: 10.1016/j.diabres.2025.112230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2025] [Revised: 04/21/2025] [Accepted: 05/03/2025] [Indexed: 05/10/2025]
Abstract
AIMS This study evaluated the incidence proportion and rate of self-reported Level 3 hypoglycemia and explored associated risk factors in young adults with type 2 diabetes (T2D). METHODS Subgroup analyses with a one-year U.S.-wide T2D dataset were performed. Retrospective and prospective data on Level 3 hypoglycemia and participant characteristics were analyzed for 207 young adults (18-39 years old) and 436 middle-aged adults (40-64 years old). Age group-stratified multivariable negative binomial regression was used to identify factors associated with Level 3 hypoglycemia. RESULTS Young adults exhibited a threefold higher incidence of Level 3 hypoglycemia events requiring medical assistance compared to the middle-aged cohort at baseline (p < 0.001). During follow-up, the young adults experienced a twofold higher incidence proportion of Level 3 hypoglycemia (p < 0.001), and n a fivefold higher annualized rate (p < 0.001); they also reported greater hypoglycemia fear (p < 0.001). Distinct sociodemographics, general health and lifestyle factors, diabetes medical history, and diabetes therapy and technology use characteristics were observed in the young-adult group, as were unique risk factors for Level 3 hypoglycemia frequency CONCLUSION: Our results suggest that young adults with T2D are at particularly high risk of Level 3 hypoglycemia, with attributes that differ from those of the traditional middle-aged cohort.
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Affiliation(s)
- Yu Kuei Lin
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, 1000 Wall Street, Ann Arbor, MI, USA
| | - Jason E Black
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St. London, ON, Canada
| | - Stewart B Harris
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St. London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St. London, ON, Canada; Department of Medicine/Division of Endocrinology, Schulich School of Medicine and Dentistry, Western University, 268 Grosvenor St., London, ON, Canada
| | - Bridget L Ryan
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St. London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St. London, ON, Canada
| | - Guangyong Zou
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St. London, ON, Canada; Robarts Research Institute, Western University, 1151 Richmond St., London, ON, Canada
| | - Alexandria Ratzki-Leewing
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St. London, ON, Canada; University of Maryland Institute for Health Computing, 6116 Executive Blvd., North Bethesda, MD, USA; Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 655 W. Baltimore St., Baltimore, MD, USA.
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Jotic AZ, Stoiljkovic MM, Milicic TJ, Lalic KS, Lukic LZ, Macesic MV, Gajovic JNS, Milovancevic MM, Obradovic MH, Gojnic MG, Rafailovic DP, Lalic NM. Predictors of Composite Maternal and Fetal Outcomes among Pregnant Women with Early-Onset Type 2 Diabetes: A Cross-Sectional Study. Diabetes Ther 2025; 16:1049-1062. [PMID: 40106225 PMCID: PMC12006619 DOI: 10.1007/s13300-025-01713-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2024] [Accepted: 02/14/2025] [Indexed: 03/22/2025] Open
Abstract
INTRODUCTION The most common form of pregestational diabetes in pregnancy is type 2 diabetes, requiring strict metabolic monitoring owing to the risk of adverse pregnancy outcomes. Our study aimed to identify predictors of composite maternal outcome (CMO) and fetal outcome (CFO) separately in pregnant women with early-onset type 2 diabetes (PwEOT2D). METHODS The cross-sectional pilot study included 60 PwEOT2D by recording age, socioeconomic determinants, preconception body mass index (pBMI), preconception (pHbA1c) and trimester-specific glycated hemoglobin (HbA1c), gestational weight gain (GWG), and pregnancy outcomes. We defined CMO as at least one of the following: gestational hypertension, preeclampsia, eclampsia, preterm delivery, or emergency section. CFO included at least one of the following: small or large for gestational age, macrosomia, neonatal hypoglycemia, or admission to the neonatal intensive care unit. RESULTS CMO was detected in 55% and CFO in 35% of PwEOT2D. The majority of PwEOT2D with CMO lived in suburban areas (73.1%), while those without CMO mostly lived in rural areas (51.9%, p = 0.014). Moreover, PwEOT2D with CMO had comparable pBMI to those without CMO (31.45 ± 6.27 versus 28.99 ± 6.28 kg/m2, p = 0.136). However, PwEOT2D with CMO had higher pHbA1c (7.28 ± 0.95 versus 6.46 ± 0.96%, p = 0.002) and first trimester HbA1c (7.24 ± 1.08 versus 6.42 ± 0.97%, p = 0.003). Similarly, PwEOT2D with CFO had higher pHbA1c (7.84 ± 0.95 versus 6.41 ± 0.67%, p < 0.001) and first trimester (7.29 ± 1.07 versus 6.65 ± 1.07%, p = 0.032) and second trimester HbA1c (6.45 ± 0.87 versus 5.96 ± 0.82%, p = 0.038). Additionally, GWG was higher in the second (4.38 ± 2.01 versus 3.33 ± 1.61 kg, p = 0.032) and third trimester (5.66 ± 2.93 versus 3.89 ± 2.61 kg, p = 0.002) compared with those without CMO. Regression analysis identified pHbA1c, first trimester of pregnancy, and community type as predictors of CMO, while pHbA1c and the occurrence of CMO were predictors of CFO. CONCLUSIONS Our results imply that preconception and first trimester of pregnancy HbA1c, as well as community disparities, are predictors of CMO, while the predictors of CFO were only preconception HbA1c and the occurrence of CMO in pregnant women with EOT2D. Therefore, tailoring preventive strategies, followed by achieving and sustaining trimester-specific metabolic control, might improve pregnancy outcomes in women with EOT2D.
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Affiliation(s)
- Aleksandra Z Jotic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia.
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia.
| | - Milica M Stoiljkovic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
| | - Tanja J Milicic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
| | - Katarina S Lalic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
| | - Ljiljana Z Lukic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
| | - Marija V Macesic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
| | - Jelena N Stanarcic Gajovic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
| | - Mina M Milovancevic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia
| | - Marko H Obradovic
- Faculty of Mathematics, University of Belgrade, Studentski Trg 16, Belgrade, Serbia
| | - Miroslava G Gojnic
- Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia
- Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, Visegradska 26, 11000, Belgrade, Serbia
| | - Djurdja P Rafailovic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11000, Belgrade, Serbia
| | - Nebojsa M Lalic
- Department of Medical Sciences, Serbian Academy of Sciences and Arts, Kneza Mihaila 35, 11000, Belgrade, Serbia
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Lee EH, Lee KH, Lee KN, Park Y, Han KD, Han SH. Connection between Impaired Fasting Glucose or Type 2 Diabetes Mellitus and Sepsis: A 10-Year Observational Data from the National Health Screening Cohort. Diabetes Metab J 2025; 49:485-497. [PMID: 39957312 PMCID: PMC12086549 DOI: 10.4093/dmj.2024.0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 10/23/2024] [Indexed: 02/18/2025] Open
Abstract
BACKGRUOUND The mortality of sepsis without direct drugs is high. The association between prediabetes, based on a single fasting glucose (FG), or long-term type 2 diabetes mellitus (T2DM) and sepsis remains unclear. METHODS Of the adults aged ≥20 years who were included in the National Health Screening Program (NHSP) in 2009, 40% were randomly sampled. After excluding patients with type 1 diabetes mellitus, with missing information, and who were diagnosed with sepsis during the wash-out (between 2001 and the NHSP) or 1-year lag period, a cohort comprised of 3,863,323 examinees. Body mass index (BMI) measurements, FG tests, and self-reported questionnaires on health-related behaviors were conducted. Individual information was followed up until 2020 and censored upon the first occurrence of sepsis or death. The incidence of sepsis was compared using a multivariable regression adjusted for age, sex, income, BMI, smoking, drinking, physical activity levels, and chronic diseases. RESULTS The cohort was divided into those with normal FG (n=2,675,476), impaired fasting glucose (IFG) (n=890,402, 23.0%), T2DM <5 years (n=212,391, 5.5%), or T2DM for ≥5 years (n=85,054, 2.2%). The groups with IFG (adjusted hazard ratio [aHR], 1.03; 95% confidence interval [CI], 1.01 to 1.05), T2DM <5 years (aHR, 1.43; 95% CI, 1.40 to 1.47), and T2DM for ≥5 years (aHR, 1.82; 95% CI, 1.77 to 1.87) exhibited significantly higher incidence of sepsis (P<0.001), with the greatest risk in patients with T2DM aged <40 years (aHR, 1.96; 95% CI, 1.71 to 2.25). CONCLUSION Patients with long-standing and young-onset T2DM show a substantially high risk of sepsis, emphasizing the need for infection prevention and vaccination.
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Affiliation(s)
- Eun Hwa Lee
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Hwa Lee
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu-na Lee
- Department of Preventive Medicine and Public Health, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yebin Park
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Sang Hoon Han
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, Korea
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16
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Lima ACDS, Cruvinel NT, da Silva NR, Mendes MM, Duarte ACS, Coelho ASG, Vimaleswaran KS, Horst MA. Interaction Between Dietary Fiber Intake and MTNR1B rs10830963 Polymorphism on Glycemic Profiles in Young Brazilian Adults. Genes (Basel) 2025; 16:497. [PMID: 40428319 PMCID: PMC12110926 DOI: 10.3390/genes16050497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2025] [Revised: 04/25/2025] [Accepted: 04/25/2025] [Indexed: 05/29/2025] Open
Abstract
BACKGROUND/OBJECTIVE The single-nucleotide polymorphism (SNP) rs10830963 in the melatonin receptor 1B (MTNR1B) gene influences insulin secretion and glucose metabolism and has been associated with an increased risk of type-2 diabetes. This study aimed to explore the interaction between dietary intake and the MTNR1B rs10830963 polymorphism on glycemic profiles in young Brazilian adults. METHODS This cross-sectional study assessed 200 healthy young adults (19-24 years), evaluating the MTNR1B rs10830963 genotype, anthropometric parameters, glycemic markers (fasting insulin, glucose, HOMA-IR, and HOMA-β), and dietary intake via three 24 h dietary recalls. Genotype-diet interactions were tested using multivariate linear regression models adjusted for confounders. RESULTS The carriers of the G allele exhibited a positive association with fasting insulin levels (p = 0.003), insulin/glucose ratio (p = 0.004), HOMA-IR (p = 0.003), and HOMA-β (p = 0.018). Energy-adjusted fiber intake showed a significant genotype-specific interaction only in carriers of the G allele, where higher dietary fiber intake was significantly associated with lower fasting insulin (pinteraction = 0.034) and HOMA-IR (pinteraction = 0.028). CONCLUSION Our findings indicate that the MTNR1B rs10830963 polymorphism is associated with glycemic markers, and dietary fiber intake may attenuate the adverse effects of the MTNR1B rs10830963 G allele on glycemic profiles in young Brazilian adults. This highlights the potential role of fiber in improving health outcomes for individuals carrying this risk allele. To validate these results and assess the broader implications for the Brazilian population, further intervention studies and larger-scale research are essential.
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Affiliation(s)
- Ana Carolina da Silva Lima
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás, Goiania 74605-080, GO, Brazil; (A.C.d.S.L.); (N.T.C.); (N.R.d.S.); (M.M.M.); (A.C.S.D.)
| | - Nathália Teixeira Cruvinel
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás, Goiania 74605-080, GO, Brazil; (A.C.d.S.L.); (N.T.C.); (N.R.d.S.); (M.M.M.); (A.C.S.D.)
| | - Nara Rubia da Silva
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás, Goiania 74605-080, GO, Brazil; (A.C.d.S.L.); (N.T.C.); (N.R.d.S.); (M.M.M.); (A.C.S.D.)
| | - Marcela Moraes Mendes
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás, Goiania 74605-080, GO, Brazil; (A.C.d.S.L.); (N.T.C.); (N.R.d.S.); (M.M.M.); (A.C.S.D.)
| | - Amélia Cristina Stival Duarte
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás, Goiania 74605-080, GO, Brazil; (A.C.d.S.L.); (N.T.C.); (N.R.d.S.); (M.M.M.); (A.C.S.D.)
- Health Research Coordination, Organization: State Department of Health from Goiás (SES-GO), Goiânia 74853-070, GO, Brazil
| | | | - Karani S. Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK
- The Institute for Food, Nutrition, and Health, University of Reading, Reading RG6 6AH, UK
| | - Maria Aderuza Horst
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás, Goiania 74605-080, GO, Brazil; (A.C.d.S.L.); (N.T.C.); (N.R.d.S.); (M.M.M.); (A.C.S.D.)
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17
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Guo F, Chen X, Howland S, Niu Z, Zhang L, Gauderman WJ, McConnell R, Pavlovic N, Lurmann F, Bastain TM, Habre R, Breton CV, Farzan SF. Childhood Exposure to Air Pollution, Body Mass Index Trajectories, and Insulin Resistance Among Young Adults. JAMA Netw Open 2025; 8:e256431. [PMID: 40261649 PMCID: PMC12015664 DOI: 10.1001/jamanetworkopen.2025.6431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 02/19/2025] [Indexed: 04/24/2025] Open
Abstract
Importance Emerging evidence suggests that exposure to air pollution affects children's glucose metabolism. However, the underlying mechanisms are not fully understood. Objective To investigate whether body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) growth trajectories mediate the association between traffic-related air pollution (TRAP) and insulin resistance. Design, Setting, and Participants As part of the Southern California Children's Health Study, the ongoing Meta-Air2 cohort substudy followed up participants from pregnancy to 24 years of age and examined the mediation role of BMI. Cardiometabolic follow-up was initiated as participants transitioned into adulthood. Data from the Meta-Air2 substudy were collected from November 27, 2018, to May 31, 2023. Exposures The California Line Source Dispersion Model was used to calculate mean childhood exposure to traffic-related total nitrogen oxides (NOx) from pregnancy to 13 years of age by calculating mean monthly estimates. Traffic density within a 300-m buffer around participants' residence was calculated as a secondary outcome. Main Outcomes and Measures Insulin resistance markers were assessed during the recent visit in young adulthood, including the homeostatic model assessment of insulin resistance (HOMA-IR; calculated from fasting glucose and insulin levels) and glycated hemoglobin (HbA1c) level. Participants' BMI growth trajectories, including BMI at 13 years of age and accelerated BMI growth, were analyzed as potential mediators. Using fully adjusted PROCESS macro mediation models, their role in mediating the association between traffic-related total NOx exposure and insulin resistance was examined with adjustment for demographic characteristics, smoking status, and parental history of diabetes. Results Among the 282 participants (mean [SD] age, 24.0 [1.7] years), each 1-SD increase in childhood exposure to traffic-related total NOx was associated with a BMI increase of 0.71 (95% CI, 0.29-1.13) at 13 years of age and adult HOMA-IR increase of 0.55 (95% CI, 0.23-0.87). An estimated mediation effect identified BMI at 13 years of age combined with accelerated BMI growth as accounting for 41.8% of the estimated total effect (β, 0.23; 95% bootstrap CI, 0.01-0.52) between total NOx and HOMA-IR. Similar patterns were observed when exploring traffic density as an exposure or HbA1c level as an outcome. Conclusions and Relevance In this cohort study of young adults, the long-term association between TRAP and insulin resistance may be partially explained by higher BMI and accelerated BMI growth from early adolescence into young adulthood. These findings highlight the importance of weight management in children, particularly those residing in highly polluted areas.
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Affiliation(s)
- Fangqi Guo
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Xinci Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Steve Howland
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Lu Zhang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - W. James Gauderman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | | | | | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
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18
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Jang Y, Yang Y. Effects of e-health literacy on health-related quality of life in young adults with type 2 diabetes: Parallel mediation of diabetes self-efficacy and self-care behaviors. Appl Nurs Res 2025; 82:151917. [PMID: 40086937 DOI: 10.1016/j.apnr.2025.151917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 01/11/2025] [Accepted: 01/28/2025] [Indexed: 03/16/2025]
Abstract
AIM To explore the impact of e-health literacy (e-HL) on health-related quality of life (HRQOL) in young adults with type 2 diabetes (T2D), focusing on the mediating roles of diabetes self-efficacy and self-care behaviors. BACKGROUND If glucose levels are not kept within the target range, people with T2D may experience complications such as retinopathy, kidney disease, and cardiovascular disorders. METHODS The participants were 150 young adults, aged 18 to 39, with T2D. We assessed e-HL, diabetes self-care behaviors, diabetes self-efficacy, and HRQOL through a structured online survey. Data were analyzed using IBM SPSS Statistics, incorporating Pearson's correlation and PROCESS macro mediation analysis. RESULTS E-HL, diabetes self-efficacy, and diabetes self-care behavior together accounted for 40.6 % of the variance in HRQOL. Higher e-HL was significantly correlated with improved HRQOL. A significant mediating effect of diabetes self-efficacy in the relationship between e-HL and HRQOL was observed, with an effect size of 0.300 ([95 % confidence interval = 0.055, 0.577]). However, the mediating effect of diabetes self-care behavior in the relationship between e-HL and HRQOL through diabetes self-efficacy was small and not statistically significant. CONCLUSIONS This study underscores the critical role of e-HL in enhancing HRQOL among young adults with T2D. It highlights the need for targeted digital health education, especially in subgroups with lower educational levels or poor health habits. The findings advocate for tailored interventions to boost self-efficacy and self-care behaviors, thereby improving overall quality of life in this population.
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Affiliation(s)
- Yura Jang
- Doctoral Student, Graduate School of Nursing, Jeonbuk National University, Jeonju, Republic of Korea
| | - Youngran Yang
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University; Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Republic of Korea.
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19
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Kar D, Byng R, Sheikh A, Nath M, Zabeen B, Kar S, Banu S, Sarker MHR, Khan N, Acharjee D, Islam S, Allgar V, Ordóñez-Mena JM, El-Wazir A, Song S, Verma A, Kadam U, de Lusignan S. Navigating the complexities of end-stage kidney disease (ESKD) from risk factors to outcome: insights from the UK Biobank cohort. BMC Nephrol 2025; 26:168. [PMID: 40169952 PMCID: PMC11959863 DOI: 10.1186/s12882-025-04090-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Accepted: 03/24/2025] [Indexed: 04/03/2025] Open
Abstract
BACKGROUND The global prevalence of end-stage kidney disease (ESKD) is increasing despite optimal management of traditional risk factors such as hyperglycaemia, hypertension, and dyslipidaemia. This study examines the influence of cardiorenal risk factors, socioeconomic status, and ethnic and cardiovascular comorbidities on ESKD outcomes in the general population. METHODS This cross-sectional study analysed data from 502,408 UK Biobank study participants recruited between 2006 and 2010. Multivariable logistic regression models were fitted to assess risk factors for ESKD, with results presented as adjusted odds ratio (aOR) and 95% confidence intervals (95% CI). RESULTS A total of 1191 (0.2%) of the study participants reported ESKD. Diabetes increased ESKD risk by 62% [1.62 (1.36-1.93)], with early-onset diabetes (before age 40) conferring higher odds compared to later-onset (after age 40) [2.26 (1.57-3.24)]. Similarly, early-onset hypertension (before age 40), compared to later onset (after age 40), increased ESKD odds by 73% [1.73 (1.21-2.44)]. Cardiovascular comorbidities, including stroke, hypertension, myocardial infarction and angina, were strongly associated with ESKD [5.97 (3.99-8.72), 5.35 (4.38-6.56), 4.94 (3.56-6.78), and 4.89 (3.47-6.81)], respectively. Males were at 22% higher risk of ESKD than females [1.22 (1.04-1.43)]. Each additional year of diabetes duration increased ESKD odds by 2% [1.02 (1.01-1.03)]. Non-white ethnicity, compared to white and socioeconomically most deprived, compared to the least deprived quintiles, were at 70% and 83% higher odds of ESKD. Each unit of HbA1c rise increased the odds of ESKD by 2%. Compared to microalbuminuria, macroalbuminuria increased the odds of ESKD by almost 10-fold [9.47 (7.95-11.27)] while normoalbuminuria reduced the odds by 73% [0.27 (0.22-0.32)]. CONCLUSIONS Early onset of diabetes and hypertension, male sex, non-white ethnicity, deprivation, poor glycaemic control, and prolonged hyperglycaemia are significant risk factors for ESKD. These findings highlight the complexity of ESKD and the need for multifactorial targeted interventions in high-risk populations. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Debasish Kar
- Community and Primary Care Research Group, University of Plymouth, Plymouth, UK.
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Richard Byng
- Community and Primary Care Research Group, University of Plymouth, Plymouth, UK
| | - Aziz Sheikh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mintu Nath
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Bedowra Zabeen
- BADAS Paediatric Diabetes Care and Research Centre, Bangladesh Institute for Research and Rehabilitation in Diabetes, Endocrinology and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | | | - Shakila Banu
- International Centre for Diarrhoeal Disease Research (ICDDRB), Dhaka, Bangladesh
| | | | - Navid Khan
- Sylhet MAG Osmani Medical College, Sylhet, Bangladesh
| | | | | | - Victoria Allgar
- Community and Primary Care Research Group, University of Plymouth, Plymouth, UK
| | - José M Ordóñez-Mena
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Aya El-Wazir
- Centre of Excellence in Molecular and Cellular Medicine, Suez Canal University, Ismailia, Egypt
| | - Soon Song
- Diabetes and Endocrinology, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - Ashish Verma
- Department of Nephrology, Boston University, Boston, USA
| | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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20
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Zhou Y, Chen Y, Tang Y, Zhang S, Zhuang Z, Ni Q. Rising tide: the growing global burden and inequalities of early-onset type 2 diabetes among youths aged 15-34 years (1990-2021). Diabetol Metab Syndr 2025; 17:103. [PMID: 40140909 PMCID: PMC11948681 DOI: 10.1186/s13098-025-01673-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Accepted: 03/16/2025] [Indexed: 03/28/2025] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is increasingly affecting people aged 15-34, posing a serious public health challenge due to its faster progression and higher complication risks. This study examines the global, regional, and national burden of early-onset T2DM from 1990 to 2021, emphasizing trends and disparities across different sociodemographic contexts. METHODS Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we analyzed incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) in people aged 15-34. Stratifications included age, sex, and the Socio-Demographic Index (SDI). Joinpoint regression significant temporal shifts, and decomposition analysis attributed changes in T2DM burden to factors such as prevalence, population growth, aging, and case fatality rates. Inequality was assessed with the Slope Index of Inequality and Concentration Index. RESULTS From 1990 to 2021, early-onset T2DM incidence and prevalence rose significantly worldwide, especially in high-SDI regions. Although global mortality and DALYs appeared relatively stable, low-SDI regions showed worrisome increases. Rising T2DM prevalence was the principal driver of mortality and DALYs, notably in low- and middle-SDI regions. Inequality analyses indicated widening disparities, with higher incidence and prevalence in high-SDI countries and more severe outcomes in low-SDI countries. CONCLUSIONS The global burden of early-onset T2DM among youths is escalating, with significant disparities across different sociodemographic levels. The findings underscore the urgent need for targeted public health interventions. Future research should focus on the underlying factors driving these trends and explore strategies for effective prevention and management of early-onset T2DM.
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Affiliation(s)
- Yang Zhou
- Department of Endocrinology, Guang'Anmen Hospital of China Academy of Chinese Medical Sciences, Guang'anmen Hospital, Beixiange 5, Xicheng District, Beijing, 100053, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Yupeng Chen
- Department of Endocrinology, Guang'Anmen Hospital of China Academy of Chinese Medical Sciences, Guang'anmen Hospital, Beixiange 5, Xicheng District, Beijing, 100053, China
| | - Yiting Tang
- Beijing University of Chinese Medicine, Beijing, China
| | - Shan Zhang
- Department of Endocrinology, Guang'Anmen Hospital of China Academy of Chinese Medical Sciences, Guang'anmen Hospital, Beixiange 5, Xicheng District, Beijing, 100053, China
| | - Zifan Zhuang
- Department of Endocrinology, Guang'Anmen Hospital of China Academy of Chinese Medical Sciences, Guang'anmen Hospital, Beixiange 5, Xicheng District, Beijing, 100053, China
| | - Qing Ni
- Department of Endocrinology, Guang'Anmen Hospital of China Academy of Chinese Medical Sciences, Guang'anmen Hospital, Beixiange 5, Xicheng District, Beijing, 100053, China.
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21
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Zhang ZC, Wang XW, Li SB, Liu YQ, Li YM, Jia HH. Barriers and facilitators of complications risk perception among rural patients with type 2 diabetes mellitus: a qualitative content analysis. BMC Public Health 2025; 25:1110. [PMID: 40128771 PMCID: PMC11931780 DOI: 10.1186/s12889-025-22299-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 03/12/2025] [Indexed: 03/26/2025] Open
Abstract
BACKGROUND Diabetes and its complications have emerged as a significant health threat to rural residents. Accurately perceiving the risk of complications may play a crucial role in modifying health behaviors and preventing complications' occurrence. We aimed to explore the barriers to and facilitators of risk perception of complications in rural patients with type 2 diabetes mellitus, and to provide new perspectives and ideas for the development of relevant interventions in the future. METHODS This study adopted the qualitative content analysis method. Semi-structured interviews were conducted with 14 rural diabetic patients selected by purposive sampling from July to September 2023, and the interview data were systematically analyzed. RESULTS Data analysis identified 9 sub-themes falling into the 2 macro-themes: (a) facilitators of complications risk perception (Increased disease knowledge, Low sense of disease control, Risk experiences, Negative mindset); (b) barriers to complications risk perception (Lack of awareness of diabetes or its complications, Information barriers, Optimistic bias, Overconfidence, Disease generalization). CONCLUSIONS This study explored the barriers and facilitators of complication risk perception among rural patients with type 2 diabetes mellitus, offering new insights into risk perception research, and aiding primary medical staff to develop targeted intervention measures to ensure that rural diabetes patients can accurately and objectively perceive risk.
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Affiliation(s)
- Zi-Chen Zhang
- Department of Nursing, Harbin Medical University (Daqing), Xinyang Road No. 39, Daqing, 163319, China
| | - Xiao-Wei Wang
- Department of Cardiology, Daqing People's Hospital, Daqing, China
| | - Shao-Bo Li
- Department of Nursing, Harbin Medical University (Daqing), Xinyang Road No. 39, Daqing, 163319, China
| | - Yu-Qin Liu
- Department of Nursing, Harbin Medical University (Daqing), Xinyang Road No. 39, Daqing, 163319, China
| | - Yu-Min Li
- Department of Nursing, Harbin Medical University (Daqing), Xinyang Road No. 39, Daqing, 163319, China
| | - Hong-Hong Jia
- Department of Nursing, Harbin Medical University (Daqing), Xinyang Road No. 39, Daqing, 163319, China.
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22
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Chauhan R, Davies MJ, May C, Misra S, Sargeant JA, Skarlatos M, Speight J, Wilmot EG, Wilson C, Hadjiconstantinou M. Using normalisation process theory to understand implementation of effective early-onset type 2 diabetes treatment and care within England: a qualitative study. BMC Health Serv Res 2025; 25:422. [PMID: 40128789 PMCID: PMC11931738 DOI: 10.1186/s12913-025-12616-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 03/19/2025] [Indexed: 03/26/2025] Open
Abstract
BACKGROUND Despite increasing prevalence, early-onset type 2 diabetes (EOT2D) has received little clinical and qualitative research attention within England. This qualitative study aimed to explore and understand the unmet needs of people living with early-onset type 2 diabetes (PEOT2D) and their diabetes care within England. METHODS Using semi-structured interviews, data was collected, transcribed and analysed from 25 PEOT2D and 25 healthcare professionals (HCPs). Taking an abductive approach, data for both cohorts were analysed and interpreted according to four constructs of Normalisation Process Theory (NPT): coherence (sense-making), cognitive participation (engagement), collective action (enactment) and reflexive monitoring (formal and informal appraisal). RESULTS Our findings revealed several unmet needs in current treatment and care for PEOT2D. The main unmet need was access to specialist care. Having GP (general practitioner) practices as their main caregivers presented a significant barrier to this population successfully carrying out their diabetes self-care. HCPs in specialist roles expressed similar views and were keen to see PEOT2D receive access to holistic and specialist care via a multidisciplinary team. Data interpretation according to the four constructs of NPT found that implementation of this approach would involve fostering an environment of support that allowed HCPs across the primary and secondary interface to do the following: (1) provide consultations incorporating person-centred care, shared decision-making, and non-judgemental and non-stigmatising behaviours and (2) work in an integrated and synchronous manner using streamlined referrals, interprofessional collaborations and team-based learning. Provision of tailored financial, human (additional staffing) and learning resources was found to be integral to allow creation of tailored multidisciplinary teams, and individual and collective skill enhancement of both specialist and primary care providers. CONCLUSION Although both PEOT2D and specialist care providers are keen for young adults with EOT2D to receive access to specialist and holistic care, there are several resource barriers that must be addressed to allow implementation of their desired approach to treatment and care. Further qualitative research with primary care providers (for example, GPs and practice nurses) involved in EOT2D care is needed to understand if (and how) their views and experiences differ from those providing specialist care.
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Affiliation(s)
- Radhika Chauhan
- Division of Psychology, School of Applied Social Sciences, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Leicester Diabetes Centre, University Leicester Hospitals Trust, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - Carl May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Shivani Misra
- Division of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | - Jack A Sargeant
- Leicester Diabetes Centre, University Leicester Hospitals Trust, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - Mike Skarlatos
- Leicester Diabetes Centre, University Leicester Hospitals Trust, Leicester, UK
| | - Jane Speight
- Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Emma G Wilmot
- Diabetes Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
- University of Nottingham, Nottingham, UK
| | - Caroline Wilson
- Leicester Diabetes Centre, University Leicester Hospitals Trust, Leicester, UK
| | - Michelle Hadjiconstantinou
- Diabetes Research Centre, University of Leicester, Leicester, UK.
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK.
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Ji K, Han M, Yang M, Xu Q, Zhang Y. Integrated meta-analysis and network pharmacology analysis: evaluation of Zhigancao decoction as treatment for diabetic cardiomyopathy. Front Cardiovasc Med 2025; 12:1454647. [PMID: 40161384 PMCID: PMC11949964 DOI: 10.3389/fcvm.2025.1454647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 02/19/2025] [Indexed: 04/02/2025] Open
Abstract
Background Zhigancao Decoction (ZGCD) is derived from "Treatise on Febrile Diseases" and is traditionally prescribed for treating a variety of cardiovascular conditions. As of now, there are no data to support its use as a treatment for diabetic cardiomyopathy (DCM) and the mechanism behind the effect is unclear as well. In the present study, clinical evidence for the efficacy of ZGCD in patients with DCM was examined using a meta-analysis and its underlying anti-DCM molecular mechanisms were explored via network pharmacology. Methods The current study utilized an extensive search strategy encompassing various domestic and foreign databases databases to retrieve pertinent articles published up to June 2024. In light of this, a thorough evaluation of the benefits and safety of Zhigancao decoction (ZGCD) was conducted in this study using RevMan and Stata. Subsequently, a number of active compounds and target genes for ZGCD were gathered from the TCMSP and BATMAN-TCM databases, while the main targets for DCM were obtained from databases such as GenCards, OMIM, TTD, and DrugBank. To select core genes, protein-protein interaction networks were generated using the STRING platform, and enrichment analyses were completed using the Metascape platform. Results Meta-analysis results were ultimately derived from 9 studies involving 661 patients in total. In comparison with WM therapy alone, the pooled results showed that ZGCD significantly enhanced overall effectiveness. Additionally, the utilization of ZGCD was leading to a reduction in LVEDV, LVESV and LVDD, also a greater increase in LVEF. Meanwhile, the utilization of ZGCD during intervention was more effective in reducing SBP, and DBP. In addition, the ZGCD showed potential in reducing the occurrence of adverse events. In the context of network pharmacology, five constituents of ZGCD-namely lysine, quercetin, gamma-aminobutyric acid, stigmasterol, and beta-sitosterol-are posited to exert anti-diabetic cardiomyopathy (anti-DCM) effects through interactions with the molecular targets ASS1, SERPINE1, CACNA2D1, AVP, APOB, ICAM1, EGFR, TNNC1, F2, F10, IGF1, TNNI2, CAV1, INSR, and INS. The primary mechanisms by which ZGCD may achieve its anti-DCM effects are likely mediated via the AGEs/RAGE signaling pathway, as well as through pathways related to lipid metabolism and atherosclerosis. Conclusion In comparison to WM therapy alone, ZGCD demonstrates greater efficacy and safety in the management of DCM. ZGCD not only significantly reduces blood pressure, but also enhances cardiac function while producing fewer adverse effects. The therapeutic effects of ZGCD on DCM can likely be ascribed to its capacity to modulate the AGEs-RAGE signaling pathway, as well as its efficacy in enhancing lipid metabolism and mitigating atherosclerosis. Systematic Review Registration identifier (INPLASY202430133).
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Affiliation(s)
- Kangshou Ji
- First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, China
- Department of Cardiovascular Medicine, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Meizi Han
- National Key Laboratory of Chinese Medicine Modernization, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Mingqian Yang
- Chinese Medicine College, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Qian Xu
- First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Yan Zhang
- First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, China
- Department of Cardiovascular Medicine, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
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Mazzocco YL, Bergero G, Del Rosso S, Gallardo ZMC, Canalis A, Baigorri RE, Mezzano L, Mladin JJ, Diaz GT, Martinez CE, Cano RC, Aoki MP. A Novel Mouse Model of Type 2 Diabetes Using a Medium-Fat Diet, Fructose, and Streptozotocin to Study the Complications of Human Disease. RESEARCH SQUARE 2025:rs.3.rs-5920886. [PMID: 40162234 PMCID: PMC11952668 DOI: 10.21203/rs.3.rs-5920886/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2025]
Abstract
The study of type 2 diabetes mellitus (T2DM) pathophysiology relies mainly on the use of animal models, the most common of which involves the consumption of high-fat diets comprising 60% calories from fat. Although these models reproduce the onset and most complications associated with T2DM, they do not accurately mimic human dietary patterns, as they lack the addition of carbohydrates such as fructose. This study aimed to develop a C57BL/6 mouse model of T2DM that mimics the disease, as occurs in younger individuals, via a medium-fat diet (34.5% kcal from fat) combined with a 20% fructose solution as drinking water and a single low-dose of streptozotocin (STZ) (100 mg/kg), a diabetogenic drug. At week 20, D + T mice exhibited significant weight gain and elevated fasting blood glucose levels compared with those of control mice and the development of insulin resistance. Similarly, the circulating levels of hepatic enzymes (GPT, GOT, and alkaline phosphatase), total cholesterol, and LDL increased. Multi-organ damage, including reduced pancreatic islet size and number, severe hepatic steatosis, inflammatory infiltration in visceral adipose tissue, and cardiac and renal dysfunction, were also detected. The proposed model replicates T2DM in young mice by combining a medium-fat diet with fructose and STZ.
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Affiliation(s)
- Yanina Luciana Mazzocco
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI)
| | - Gastón Bergero
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI)
| | - Sebastián Del Rosso
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI)
| | - Zoé M Cejas Gallardo
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI)
| | - Alejandra Canalis
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI)
| | - Ruth Eliana Baigorri
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI)
| | - Luciana Mezzano
- Instituto de Biología Celular, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba
| | | | - Gustavo Tomas Diaz
- Instituto de Biología Celular, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba
| | | | - Roxana Carolina Cano
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI)
| | - Maria Pilar Aoki
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI)
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Isaacs SE, Bogardus M, Thompson M, Wu S, Howell M. Development and Implementation of a 3-Week Whole-Food Plant-Based Vegan Diet Intervention for College Students. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2025; 57:242-252. [PMID: 39674948 DOI: 10.1016/j.jneb.2024.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/28/2024] [Accepted: 11/08/2024] [Indexed: 12/17/2024]
Abstract
OBJECTIVE To describe the research methods used for the Diet and Health Study, a pilot-feasibility study to assess the impact of a whole-food plant-based vegan diet on college students' physical and mental health. DESIGN This 3-week theory-based pilot-feasibility study will employ a stratified, randomized control design (2 intervention groups and 1 comparison group) with measurement of primary and secondary outcomes at baseline and postintervention and end-of-study focus groups. SETTING Southeastern public state university. PARTICIPANTS Sixty undergraduate college students aged 18-25 years. INTERVENTION The study and intervention delivery were designed using an integration of the Theory of Planned Behavior and Social Cognitive Theory. Three consecutive weekly nutrition education lunch-and-learn sessions (75 minutes each) will be delivered using 2 different teaching modalities (ie, interactive-experiential vs lecture-based). MAIN OUTCOME MEASURES (1) Feasibility and acceptability of study procedures and theoretically-informed whole-food plant-based vegan diet intervention; (2) potential impacts of the intervention on intrapersonal, physical, and mental health, and dietary measures; and (3) potential differential impacts of 2 intervention modalities. ANALYSIS Descriptive statistics and effect sizes to assess changes to the outcome variables from baseline to postintervention across the 3 groups. Qualitative content analysis of the focus group transcripts.
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Affiliation(s)
- Sydeena E Isaacs
- Department of Nutrition and Healthcare Management, Beaver College of Health Sciences, Appalachian State University, Boone, NC.
| | - Melinda Bogardus
- Department of Nursing, Beaver College of Health Sciences, Appalachian State University, Boone, NC
| | - Martie Thompson
- Department of Public Health and Exercise Science, Beaver College of Health Sciences, Appalachian State University, Boone, NC
| | - Shenghui Wu
- Department of Public Health and Exercise Science, Beaver College of Health Sciences, Appalachian State University, Boone, NC
| | - Marisa Howell
- Department of Nutrition and Healthcare Management, Beaver College of Health Sciences, Appalachian State University, Boone, NC
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26
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Kim JY, Lee J, Moon JH, Park SE, Ko SH, Choi SH, Kim NH. Prevalence, Incidence, and Metabolic Characteristics of Young Adults with Type 2 Diabetes Mellitus in South Korea (2010-2020). Diabetes Metab J 2025; 49:172-182. [PMID: 40073905 PMCID: PMC11960202 DOI: 10.4093/dmj.2024.0826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Accepted: 02/12/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGRUOUND This study aimed to examine trends in the prevalence, incidence, metabolic characteristics, and management of type 2 diabetes mellitus (T2DM) among young adults in South Korea. METHODS Young adults with T2DM were defined as individuals aged 19 to 39 years who met the diagnostic criteria for T2DM. Data from the Korean National Health Insurance Service-Customized Database (2010-2020, n=225,497-372,726) were analyzed to evaluate trends in T2DM prevalence, incidence, metabolic profiles, comorbidities, and antidiabetic drug prescription. Additional analyses were performed using the Korea National Health and Nutrition Examination Survey. RESULTS The prevalence of T2DM in young adults significantly increased from 1.02% in 2010 to 2.02% in 2020 (P<0.001), corresponding to 372,726 patients in 2020. Over the same period, the incidence rate remained stable within the range of 0.36% to 0.45%. Prediabetes prevalence steadily increased from 15.53% to 20.92%, affecting 3.87 million individuals in 2020. The proportion of young adults with T2DM who were obese also increased, with 67.8% having a body mass index (BMI) ≥25 kg/m² and 31.6% having a BMI ≥30 kg/m² in 2020. The prevalence of hypertension, dyslipidemia, and fatty liver disease also increased, reaching 34.2%, 79.8%, and 78.9%, respectively, in 2020. Although the overall pharmacological treatment rate remained low, the prescription of antidiabetic medications with weight-reducing properties increased over the study period. CONCLUSION The prevalence of T2DM among young adults in South Korea nearly doubled over the past decade. The strong association with obesity and metabolic comorbidities emphasizes the urgent need for targeted prevention and management strategies tailored to this population.
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Affiliation(s)
- Ji Yoon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jiyoon Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Nam Hoon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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27
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Di Nucci A, Silano M, Cardamone E. Adherence to Mediterranean Diet and Health Outcomes in Adolescents: An Umbrella Review. Nutr Rev 2025; 83:e1329-e1342. [PMID: 38954538 PMCID: PMC11819493 DOI: 10.1093/nutrit/nuae085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Abstract
CONTEXT Proper nutrition represents 1 of the domains of adolescents' well-being. In this context, the Mediterranean diet (MD), as a healthy, traditional, and sustainable dietary pattern, plays a crucial role in promoting adequate growth and preventing chronic noncommunicable diseases. OBJECTIVE The currently available evidence on the effects of adherence to the MD (AMD) in association with several physical health outcomes in adolescence is summarized in this review. DATA SOURCES Five electronic databases were searched. STUDY SELECTION Systematic reviews with or without meta-analysis of observational studies and randomized clinical trials, published in English during 2013-2022, and that assessed the health impact of AMD among adolescents were eligible. DATA EXTRACTION Details on study design, methods, population, assessment of dietary patterns, health outcomes, and main results were extracted. RESULTS The search yielded 59 references after removal of duplicates. Applying PICOS criteria, 4 systematic reviews and 3 meta-analyses ultimately were included in this review. The AMD was evaluated in association with overweight/obesity and adiposity in 2 studies, musculoskeletal health in another 2, inflammation in 1 study, and cardiometabolic health in 1 study. The seventh review examined all mentioned health outcomes (overweight and obesity, musculoskeletal health, inflammation, and cardiometabolic health) in relation to AMD. CONCLUSIONS Overall, this umbrella review showed limited evidence and a lack of consistency about the relation between AMD and health outcomes of interest in adolescence, indicating the need for more studies to better understand it. SYSTEMIC REVIEW REGISTRATION PROSPERO registration no. CRD42023428712.
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Affiliation(s)
- Annalisa Di Nucci
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Roma, Italy
| | - Marco Silano
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Roma, Italy
| | - Erica Cardamone
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Roma, Italy
- Department of Medicine, Università degli Studi di Udine, 33100 Udine, Italy
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28
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Xu L, Ran J, Shao H, Chen M, Tang H, Li Y, Xu Y, Huang Y, Tao F, Liu Z, Zhong VW. Incidence and Risk Factors of Diagnosed Young-Adult-Onset Type 2 Diabetes in the U.S.: The National Health Interview Survey 2016-2022. Diabetes Care 2025; 48:371-380. [PMID: 39752552 DOI: 10.2337/dc24-1699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 11/13/2024] [Indexed: 02/22/2025]
Abstract
OBJECTIVE To estimate the incidence and identify risk factors for diagnosed type 2 diabetes (T2D) among young U.S. adults. RESEARCH DESIGN AND METHODS We analyzed 142,884 adults aged 18-79 years with self-reported diabetes type from the cross-sectional National Health Interview Survey in 2016-2022, representing the noninstitutionalized U.S. civilian population. Incidence of diagnosed T2D was calculated for three age groups: young-adult onset (18-44 years), middle-age onset (45-64 years), and older-adult onset (65-79 years); the latter two groups were included to highlight the distinct risk factor profile of young-adult-onset T2D. Multivariable logistic regressions were used to identify risk factors for young-adult-onset T2D. RESULTS The estimated incidence of diagnosed young-adult-onset T2D was 3.0 per 1,000 adults (95% CI 2.6-3.5). Minority groups, socioeconomically disadvantaged individuals, and people with cardiometabolic diseases or psychological conditions had a higher incidence of diagnosed young-adult-onset T2D compared with their counterparts. Lipid-lowering medication use (adjusted odds ratio [aOR] 13.15, 95% CI 8.85-19.55), antihypertensive medication use (aOR 11.89, 95% CI 7.97-17.73), and obesity (BMI ≥30 vs. <25 kg/m2, aOR 10.89, 95% CI 6.69-17.7) were the strongest risk factors for young-adult-onset T2D; these risk factors, along with hypertension, hyperlipidemia, and coronary heart disease, were more strongly associated with young-adult-onset T2D compared with later-onset T2D, with up to 4.5 times higher aORs. CONCLUSIONS This study quantified the incidence of diagnosed young-adult-onset T2D in U.S. adults and identified its distinct risk factor profile. Targeted prevention strategies for young-adult-onset T2D are needed for minority and socioeconomically disadvantaged people and those with cardiometabolic diseases.
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Affiliation(s)
- Lan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinjun Ran
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Shao
- Emory Global Diabetes Research Center, Emory University, Atlanta, GA
- Hubert Department of Global Health, Rollin School of Public Health, Emory University, Atlanta, GA
| | - Meng Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongxuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaqing Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Tao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhenxiu Liu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Victor W Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Reji S, Sankaraeswaran M, Ulagamathesan V, Wesley H, Ramesh G, Srinivasan S, Misra S, Mohan Anjana R, Unnikrishnan R, Mohan V, Amutha A. Cohort prevalence of young-onset type 2 diabetes in South Asia: A systematic review. Diabetes Res Clin Pract 2025; 221:112013. [PMID: 39923964 DOI: 10.1016/j.diabres.2025.112013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2024] [Revised: 01/13/2025] [Accepted: 01/20/2025] [Indexed: 02/11/2025]
Abstract
BACKGROUND & AIM The prevalence of young onset (≤30 years) type 2 diabetes (T2D) is increasing in South Asians, reflecting rise in childhood obesity. This systematic review analyses current data on thecohort prevalence of young onset T2D in South Asians. METHODS PubMed, Scopus,Science Direct,and Ebscohost were searched for articles published between 1990 and 2024, anda manual search identified additional articles. This study included case series, cross-sectional, retrospective cohort, or case reports. RESULTS Out of 5073 studies, 26 eligible studies were found including three case reports. Seventeen studies were from India, five werefrom other South Asian countries (Pakistan, Bangladesh, Nepal, Maldives), and nine were on migrant South Asians residing in different countries (UK,USA,Qatar, Canada). The cohort prevalence of young onset T2D in South Asians ranged from 0.1 % to 28.3 % (India 0.4 to 26.8 %, other SA countries 0.1 to 28.3 %, and migrant South Asians 4.1 to 18.1 %). CONCLUSION The burden of T2D among native South Asian children and young adults is higher than among migrant South Asians. This contrasts with traditional perceptions that T2D primarily affects older individuals and the South Asian diaspora i.e., those who have migrated from South Asia.
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Affiliation(s)
- Shyama Reji
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India; University of Madras, Chennai, Tamil Nadu, India.
| | - Malini Sankaraeswaran
- SRM Institute of Science and Technology, Kattankulathur, Chengalpattu District, Tamil Nadu, India.
| | | | - Hannah Wesley
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
| | - Gowri Ramesh
- Department of Home Science, Women's Christian College, Chennai, Tamil Nadu, India.
| | - Shylaja Srinivasan
- Division of Pediatric Endocrinology, University of California, San Francisco, USA.
| | - Shivani Misra
- Department of Metabolism, Digestion & Reproduction, Imperial College London, London, UK.
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India; Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India; Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India; Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
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Strandberg RB, Nilsen RM, Pouwer F, Igland J, Røssberg JI, Jenum AK, Buhl ES, Iversen MM. Pharmacologically treated depression, anxiety, and insomnia in individuals with type 2 diabetes: The role of diabetes duration, age, and age at diabetes onset. A Norwegian population-based registry study from the OMIT cohort. J Psychosom Res 2025; 190:112057. [PMID: 39955944 DOI: 10.1016/j.jpsychores.2025.112057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 01/05/2025] [Accepted: 02/08/2025] [Indexed: 02/18/2025]
Abstract
OBJECTIVE To examine whether type 2 diabetes (T2D) duration ('0-4'; '≥5-9'; ≥10-19'; '≥20 years') was associated with use of medication for depression, anxiety, or insomnia, and if possible associations were modified by age, age at T2D onset, sex, and education. METHODS We used data from 55,083 adults with T2D in the national registry-based cohort study Outcomes & Multi-morbidity In T2D (2006-2019). Adjusted associations and effect modifications were estimated using binary logistic regressions with generalized estimation equations in the subgroups age (<60, ≥60 years), age at diabetes onset (<40, ≥40 years), sex (men, women), and education (primary, high school, university). RESULTS At initial registration, 12 % used medication for depression, 10 % for anxiety, and 16 % for insomnia. These prevalence estimates increased with diabetes duration in most subgroups. Individuals with early onset T2D had higher prevalence of depression than those with late onset, which increased with diabetes duration (per category change diabetes duration 0.7 % (95 % CI 0.2, 1.2), P for trend = 0.003). For anxiety and insomnia, a stronger association was found in those with early T2D onset compared to late onset (per category change 1.3 % (95 % CI 0.9, 1.8) and 1.9 (95 % CI 1.3, 2.4), P for interaction = 0.001; 0.01). CONCLUSION The prevalence of pharmacologically treated depression, anxiety, and insomnia increased with diabetes duration; this finding may imply that assessment of mental health disorders at the initial phase and along the diabetes trajectory are needed. As the prevalences advanced most prominently in people with early onset T2D, future studies should determine underlying mechanisms to test age-appropriate preventive interventions.
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Affiliation(s)
- Ragnhild B Strandberg
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
| | - Roy M Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - François Pouwer
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway; Department of Psychology, University of Southern Denmark, Odense, Denmark; Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark
| | - Jannicke Igland
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jan Ivar Røssberg
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Esben S Buhl
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marjolein M Iversen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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31
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Wang B, Mak IL, Liu KSN, Choi EPH, Lam CLK, Wan EYF. Association between Type 2 Diabetes onset age and risk of cardiovascular disease and mortality: Two cohort studies from United Kingdom and Hong Kong. DIABETES & METABOLISM 2025; 51:101607. [PMID: 39832675 DOI: 10.1016/j.diabet.2025.101607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Revised: 12/13/2024] [Accepted: 12/16/2024] [Indexed: 01/22/2025]
Abstract
OBJECTIVE This study aimed to evaluate the association between type 2 diabetes mellitus (T2DM) onset age and risk of cardiovascular disease (CVD) and mortality. METHOD Two retrospective cohort studies were conducted using the electronic health records from the United Kingdom (UK) and Hong Kong (HK) on adults without CVD. During 2008-2013, 128,918 and 185,646 patients with new-onset T2DM were assigned to the T2DM group, and 5,052,770 and 3,159,396 patients without T2DM were included as controls in the UK and HK cohort, respectively. Patients were stratified into six age groups. Multivariable Cox regression, adjusted for baseline characteristics and fine stratification weights, was used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for each outcome. RESULTS New-onset T2DM was associated with increased CVD and mortality risk, but the risks decreased with age. Compared to those without T2DM in the same age groups, the HR (95 % CI) for CVD in the UK cohort was 3.22 (2.80, 3.71), 1.21 (1.15, 1.26), and 0.99 (0.93, 1.05) for T2DM individuals at ages 18-39, 60-69, and ≥ 80, respectively. Similarly, the HR (95 % CI) for mortality among new-onset T2DM patients was 2.41 (2.06, 2.83) for age 18-39, 1.40 (1.34, 1.46) for age 60-69, and 1.12 (1.08, 1.16) for age ≥ 80. Results from the HK cohort showed a similar pattern. CONCLUSION Young onset of T2DM is associated with a significant impact on cardiovascular health later in life. This highlights the importance of the prevention of DM in young adults.
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Affiliation(s)
- Boyuan Wang
- Department of Family Medicine and Primary Care, the University of Hong Kong, Hong Kong, China
| | - Ivy Lynn Mak
- Department of Family Medicine and Primary Care, the University of Hong Kong, Hong Kong, China
| | - Kiki Sze Nga Liu
- Department of Family Medicine and Primary Care, the University of Hong Kong, Hong Kong, China
| | - Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, the University of Hong Kong, Hong Kong, China; The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, the University of Hong Kong, Hong Kong, China; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China; Advanced Data Analytics for Medical Science (ADAMS) Limited, Hong Kong, China.
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Dangana RS, Okon MB, Orire IE, Sanusi IO, Terkimbi SD, Aja PM, Abubakar IB, Anyim G. Systematic review of peptide nanoparticles for improved diabetes outcomes: insights and opportunities. DISCOVER NANO 2025; 20:41. [PMID: 39961878 PMCID: PMC11832960 DOI: 10.1186/s11671-025-04215-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 02/05/2025] [Indexed: 02/20/2025]
Abstract
This present study carried out a systematic review and meta-analysis of peptide nanoparticles in diabetes management for improved patient outcomes from 2014 to 2024. Different electronic databases, including PubMed, Scopus, Web of Science, ResearchGate, Google Scholar, and the Cochrane Library, were searched for relevant literature using Medical Subject Headings (MeSH) and boolean operators. A total of 317 articles were obtained and include PUBMED (39), Scopus (215), ResearchGate (30), Google Scholar (25), and Cochrane Library (8). From these, 186 duplicate entries were eliminated, while 76 articles were dismissed for some reasons. After scanning the titles, abstracts, and contents of the remaining 55 articles for relevance, 22 articles were eliminated. After a full-text screening using inclusion/exclusion criteria, an additional 11 articles were discarded, while 4 were excluded during the data extraction phase. In the end, seven (7) publications were considered relevant based on the eligibility criteria, representing 2.22%. Results showed that sequential exclusion of the studies did not have a significant impact on the effects of peptide nanoparticles on glucose control, insulin delivery, bioavailability, efficacy, safety, and patient outcomes in diabetes management. Also, peptide nanoparticles had positive improvement on glycemic control, insulin levels, glycated hemoglobin (HbA1C) levels, and overall patient outcomes. The study concludes that peptide nanoparticles harbour the potential to improve diabetes management through enhanced glucose control, insulin delivery, and patient outcomes. However, there is a significant gap in knowledge. Further research is required to understand the long-term safety and efficacy of many of the enlisted nanoparticles. Additionally, future studies should explore a wider range of peptides and proteins for encapsulation, develop delivery systems for larger and conformationally diverse molecules, and improve the oral bioavailability of encapsulated therapeutics. Long-term clinical trials are needed to validate this approach in humans and elucidate the underlying mechanisms for optimal treatment design. If these knowledge gaps are addressed, peptide nanoparticles will unavoidably become a powerful tool for effective management of diabetes along with traditional methods.
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Affiliation(s)
- Reuben Samson Dangana
- Department of Biochemistry, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda.
| | - Michael Ben Okon
- Department of Biochemistry, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
| | - Ikuomola Emmanuel Orire
- Department of Physiology, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
| | - Idris Olatunji Sanusi
- Department of Pharmaceutical Chemistry and Analysis, Kampala International University, Western-Campus, Ishaka, Bushenyi, Uganda
| | - Swase Dominic Terkimbi
- Department of Biochemistry, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
| | - Patrick Maduabuchi Aja
- Department of Biochemistry, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
| | | | - Godwin Anyim
- Department of Biochemistry, Adeleke University, Ede, Osun State, Nigeria
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Hawton K, Hickingbotham H, Sachdev P. Young people and parent or carers views on type 2 diabetes mellitus care in England and Wales: analysis of parent and patient-reported measures survey. BMJ Paediatr Open 2025; 9:e002901. [PMID: 39929599 PMCID: PMC11815463 DOI: 10.1136/bmjpo-2024-002901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Accepted: 12/10/2024] [Indexed: 02/14/2025] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes mellitus (T2DM) in children and young people (CYP) is increasing in the UK and worldwide. Little is known about the experience young people and their families have when attending for their diabetes care. The aim of this study is to analyse the responses to the Parent and Patient Reported Experience Measures (PREM) survey 2021-2022 for patients with T2DM and their families to inform care. METHODS As part of the National Paediatric Diabetes Audit (NPDA) (2022), the NPDA PREM survey was open online between August 2021 and January 2022. The data have previously been analysed collectively for all diabetes; however, we specifically analysed the data for patients living with T2DM. RESULTS 9.2% (105/1144) of young people living with T2DM in England and Wales responded to the NPDA PREM survey, mostly aged 12-16 years (61.9%) and the majority were female (67.6%). 87% of patients and 95% of carers said that they would recommend their diabetes team, and 73% of patients felt happy after appointments. Only just over half of the patients and parents felt well prepared for transferring to adult care. Only 38% of patients felt that their school or college often had the necessary information to support them with their diabetes. CONCLUSIONS This analysis describes the experience of CYP and their parents/carers of T2DM care and highlights areas for improvement. These findings may help to inform recommendations about the development of better patient-centred care for young people with T2DM.
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Affiliation(s)
- Katherine Hawton
- Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- University of Bristol, Bristol, UK
| | | | - Pooja Sachdev
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
- University of Nottingham, Nottingham, UK
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Wang Y, Yang J, Liu Y, Yang A, Deng Y, Xu C, Zhong S. Gestational diabetes mellitus in previous pregnancy associated with the risk of large for gestational age and macrosomia in the second pregnancy. Front Endocrinol (Lausanne) 2025; 16:1474694. [PMID: 39963281 PMCID: PMC11830583 DOI: 10.3389/fendo.2025.1474694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 01/13/2025] [Indexed: 02/20/2025] Open
Abstract
Background Since the implementation of China's new birth policy, the incidence of large for gestational age (LGA) and macrosomia associated with gestational diabetes mellitus (GDM) has increased. It remains unclear whether a history of GDM in a previous pregnancy raises the risk of LGA or macrosomia in Chinese women planning two or more pregnancies. Aim To analyze the association between previous GDM and the risk of LGA and macrosomia in second pregnancy. Method A retrospective study was conducted on a cohort of 3,131 women who had experienced two consecutive singleton births. The incidences of LGA and macrosomia in the second pregnancy were compared between women with and without previous GDM. The relationship between previous GDM and the occurrence of LGA and macrosomia was analyzed using multivariate logistic regression and stratified analysis. Results The incidence of LGA and macrosomia during the second pregnancy was significantly higher in women with previous GDM (22.67% and 10.25%, respectively) compared to those without prior GDM (15.34% and 5.06%, respectively) (P < 0.05). After adjusting for potential confounders, previous GDM was significantly associated with LGA (aOR: 1.511, 95% CI: 1.066-2.143) and macrosomia (aOR: 1.854, 95% CI: 1.118-3.076) in the second pregnancy. Stratified analysis revealed that these associations were present only in women without previous LGA, those with GDM, appropriate gestational weight gain (AGWG), non-advanced maternal age, and male newborns during the second pregnancy (P < 0.05). Compared to excessive GWG (EGWG), AGWG correlated with lower risks for LGA and macrosomia during the second pregnancy in women without prior GDM, an association not observed in those with previous GDM. Among women without previous GDM, if the pre-pregnancy BMI is normal, the risk of LGA and macrosomia is significant lower in AGWG compared with EGWG (P< 0.001), while this difference was no significant among women with prior GDM (P>0.05). Conclusion Previous GDM is strongly linked to LGA and macrosomia in subsequent pregnancies. However, this relationship is influenced by GWG, prior LGA history, fetal sex, and maternal age. Managing weight alone may not sufficiently reduce the risk of LGA or macrosomia for women with a history of GDM.
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Affiliation(s)
- Ying Wang
- Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Institute of Obstetrics and Gynecology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, Guangdong, China
- Peking University Shenzhen Hospital, Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, Guangdong, China
| | - Juan Yang
- Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Institute of Obstetrics and Gynecology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, Guangdong, China
- Peking University Shenzhen Hospital, Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, Guangdong, China
| | - Yuzhen Liu
- Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Institute of Obstetrics and Gynecology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, Guangdong, China
- Peking University Shenzhen Hospital, Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, Guangdong, China
| | - Ao Yang
- Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Institute of Obstetrics and Gynecology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, Guangdong, China
- Peking University Shenzhen Hospital, Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, Guangdong, China
| | - Yuqing Deng
- Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Institute of Obstetrics and Gynecology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, Guangdong, China
- Peking University Shenzhen Hospital, Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, Guangdong, China
| | - Chang Xu
- Intelligent Hospital Research Academy, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Shilin Zhong
- Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Institute of Obstetrics and Gynecology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Shenzhen, Guangdong, China
- Peking University Shenzhen Hospital, Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, Guangdong, China
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Addington KS, Kristiansen M, Hempler NF, Frimodt-Møller M, Montori VM, Kunneman M, Scheuer SH, Diaz LJ, Andersen GS. Incidence of early-onset type 2 diabetes and sociodemographic predictors of complications: A nationwide registry study. J Diabetes Complications 2025; 39:108942. [PMID: 39700592 DOI: 10.1016/j.jdiacomp.2024.108942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 11/14/2024] [Accepted: 12/09/2024] [Indexed: 12/21/2024]
Abstract
AIMS Early-onset type 2 diabetes (T2DM) (18-45 years) is rising globally, yet complication incidence in this group remains unclear. We investigated the incidence of early-onset T2DM, the incidence of micro- and macrovascular complications, and how comorbidities (e.g., severe mental illness) and sociodemographic factors (e.g., education level) influence complication risk and timing in Denmark. METHODS Using nationwide registers, we followed 8,129,005 individuals from 1996 to 2020 to estimate the incidence rate (IR) of early-onset T2DM. 49,850 individuals with early-onset T2DM were followed to calculate IRs for microvascular (nephropathy, retinopathy) and macrovascular (cardiovascular disease, amputation) complications. Incidence rate ratios (IRRs) assessed associations between comorbidities, sociodemographic factors, and complications. Poisson regression models calculated IRs and IRRs. RESULTS From 1996 to 2020, the IR of early-onset T2DM more than doubled in men and tripled in women, with women dominating younger age groups. During follow-up (7.9-9.8 years), 37.6 % developed complications. Higher complication IRs were observed in men, those with sociodemographic disadvantages, and individuals with comorbidities. Early complications (≤5 years) were more common among the unemployed, single individuals, and those with comorbidities. CONCLUSIONS The rising IR of early-onset T2DM in younger women, and complications disproportionately affecting men and those with comorbidities or sociodemographic disadvantages, highlight the need for targeted interventions.
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Affiliation(s)
- Kristine Stoltenberg Addington
- Department of Prevention, Health Promotion and Community Care, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Oester Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Maria Kristiansen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Oester Farimagsgade 5, 1353 Copenhagen, Denmark
| | - Nana F Hempler
- Department of Prevention, Health Promotion and Community Care, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Marie Frimodt-Møller
- Department of Clinical and Translational Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Victor M Montori
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic Rochester, Plummer Building, Third floor, 200 First St. SW, Rochester, MN 55905, USA
| | - Marleen Kunneman
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic Rochester, Plummer Building, Third floor, 200 First St. SW, Rochester, MN 55905, USA; Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Stine H Scheuer
- Department of Clinical and Translational Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Lars J Diaz
- Department of Clinical and Translational Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Gregers S Andersen
- Department of Clinical and Translational Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
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Munoz PA, Celermajer DS, Gu Y, Bradley S, Wong J, Constantino MI, McLennan S, Lau EMT, Alison JA, Harmer AR. Cardiovascular and Respiratory Measures in Adults With Early-onset Type 2 Diabetes Mellitus Compared With Matched Controls. Can J Diabetes 2025; 49:62-69.e1. [PMID: 39581228 DOI: 10.1016/j.jcjd.2024.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 10/17/2024] [Accepted: 11/12/2024] [Indexed: 11/26/2024]
Abstract
OBJECTIVES The aim of the study was to compare cardiac and respiratory function at rest in participants with early-onset type 2 diabetes and a control group without diabetes, matched for age, sex, and body mass index (BMI). METHODS This study included 18 participants with early-onset type 2 diabetes (12 men and 6 women, age 34.9±6 years, diabetes duration 3.1±3.0 years) and 14 control participants without diabetes, matched for age, sex, and BMI (9 men and 5 women, age 32.9±5.2 years). Participants underwent resting echocardiography and pulmonary function tests. Fasting blood samples were analyzed for glycated hemoglobin, glucose, C-reactive protein, insulin, free fatty acids, and N-terminal pro-B-type natriuretic peptide. RESULTS Significant differences between groups were observed in left ventricular diastolic function at rest. Compared with controls, the group with early-onset type 2 diabetes had lower E/A (ratio between early [E] and late [A] ventricular filling velocity) (p=0.002), higher E/e' (representing left ventricular filling pressure) (p=0.017), lower e' (early myocardial relaxation velocity) (p<0.001), and lower diffusing capacity of the lung for carbon monoxide (p=0.003). CONCLUSIONS Subclinical left ventricular diastolic dysfunction and lower lung diffusing capacity were detected in participants with early-onset type 2 diabetes when compared with matched controls.
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Affiliation(s)
- Phillip A Munoz
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
| | - David S Celermajer
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Yu Gu
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sue Bradley
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jencia Wong
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Maria I Constantino
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Sue McLennan
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Edmund M T Lau
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jennifer A Alison
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Allied Health, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Alison R Harmer
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
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Goldney J, Barker MM, Sargeant JA, Daynes E, Papamargaritis D, Shabnam S, Goff LM, Khunti K, Henson J, Davies MJ, Zaccardi F. Burden of vascular risk factors by age, sex, ethnicity and deprivation in young adults with and without newly diagnosed type 2 diabetes. Diabetes Res Clin Pract 2025; 220:112002. [PMID: 39800277 DOI: 10.1016/j.diabres.2025.112002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 01/07/2025] [Accepted: 01/08/2025] [Indexed: 01/15/2025]
Abstract
AIMS Do associations between age at diagnosis of type 2 diabetes and vascular risk factors vary by ethnicity and deprivation? METHODS Utilising the Clinical Practice Research Datalink, we matched 16-50-year-old individuals with newly diagnosed type 2 diabetes to ∼10 individuals without using sex, age and primary care practice. Differences in BMI, obesity, LDL-cholesterol, HbA1c, and hypertension between individuals with vs without type 2 diabetes across sex, age, ethnicity and deprivation quintiles were explored using generalised linear models. RESULTS We included 108,061 individuals (45.6% women) with newly diagnosed type 2 diabetes and 829,946 controls. BMI, obesity, LDL-cholesterol, and hypertension were higher in individuals with vs without type 2 diabetes. Across both sexes, all ethnic groups and deprivation quintiles, these differences were larger with an earlier age, particularly for BMI and obesity. Association between age and HbA1c were variable across subgroups. Differences in BMI, obesity, and hypertension (individuals with vs without diabetes) were largest in White individuals and with less deprivation. CONCLUSIONS The increased vascular risk phenotype associated with an earlier age of diagnosis of type 2 diabetes was consistent across ethnic and deprivation groups. Population-based strategies are needed to address the risk associated with early-onset type 2 diabetes, especially weight-management-based strategies.
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Affiliation(s)
- Jonathan Goldney
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK.
| | - Mary M Barker
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Jack A Sargeant
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK; Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW UK
| | - Enya Daynes
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK; Department of Respiratory Sciences, University of Leicester, Glenfield Hospital, Leicester LE3 9QP UK
| | - Dimitris Papamargaritis
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK
| | - Sharmin Shabnam
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK
| | - Louise M Goff
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK
| | - Kamlesh Khunti
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK; Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Applied Research Collaboration East Midlands (ARC-EM), Leicester Diabetes Centre, University of Leicester LE5 4PW UK
| | - Joseph Henson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK
| | - Melanie J Davies
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK; Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW UK
| | - Francesco Zaccardi
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW UK; Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW UK
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Shi S, Zhou F, Shen J. Trends in the prevalence of cardiometabolic diseases in US adults with newly diagnosed and undiagnosed diabetes, 1988-2020. Public Health 2025; 239:94-102. [PMID: 39799659 DOI: 10.1016/j.puhe.2024.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 11/28/2024] [Accepted: 12/19/2024] [Indexed: 01/15/2025]
Abstract
OBJECTIVES Early detection and timely management of cardiometabolic diseases (CMDs) in diabetes are critical for preventing vascular complications and premature mortality. However, the prevalence of CMDs over time in adults with newly diagnosed and undiagnosed diabetes is unclear. STUDY DESIGN Cross-sectional study. METHODS Included were US adults aged ≥20 years with newly diagnosed diabetes and undiagnosed diabetes using data from the National Health and Nutrition Examination Survey in 1988-2020. CMDs included obesity, severe obesity, dyslipidemia, hypertension, metabolic dysfunction-associated fatty liver disease (MAFLD), chronic kidney disease (CKD), and cardiovascular disease (CVD). Poisson regressions were used to assess trends in the prevalence of CMDs and to compare the prevalence between newly diagnosed and undiagnosed diabetes. RESULTS For both diabetes phenotypes in 1988-2020, the prevalence of obesity and severe obesity increased and CKD decreased (P < 0.05). The prevalence of dyslipidemia decreased and MAFLD increased in undiagnosed diabetes (P < 0.05). In 2011-2020, the prevalence of CMDs ranged from 14.3 % for CVD to 78.6 % for dyslipidemia. No significant difference in the prevalence of all CMDs between the 2 diabetes phenotypes was observed. CONCLUSIONS The prevalence of CMDs remained high in US adults with newly diagnosed and undiagnosed diabetes during the previous 3 decades, with no significant difference in the prevalence between the 2 diabetes phenotypes.
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Affiliation(s)
- Shuxiao Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Zhou
- Center for Disease Control and Prevention of Huangpu District, Shanghai, China
| | - Jie Shen
- Medical Records and Statistics Office, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Chen X, Zhang L, Chen W. Global, regional, and national burdens of type 1 and type 2 diabetes mellitus in adolescents from 1990 to 2021, with forecasts to 2030: a systematic analysis of the global burden of disease study 2021. BMC Med 2025; 23:48. [PMID: 39876009 PMCID: PMC11776159 DOI: 10.1186/s12916-025-03890-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 01/22/2025] [Indexed: 01/30/2025] Open
Abstract
BACKGROUND Adolescent diabetes is one of the major public health problems worldwide. This study aims to estimate the burden of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in adolescents from 1990 to 2021, and to predict diabetes prevalence through 2030. METHODS We extracted epidemiologic data from the Global Burden of Disease (GBD) on T1DM and T2DM among adolescents aged 10-24 years in 204 countries and territories worldwide. This study calculated the age-standardized prevalence rate (ASPR) and age-standardized DALY rate (ASDR) in adolescents based on the world standard population for cross-country comparisons. Average annual percentage changes (AAPC) in age-standardized rate were calculated by linkage point regression. Correlation analyses were used to identify the relationship between age-standardized rate and sociodemographic index (SDI). The Bayesian age-period-cohort (BAPC) model was used to predict changes in the diabetes prevalence among adolescents from 2022 to 2030. RESULTS In 2021, 3.4 million adolescents were living with T1DM, with an ASPR of 180.96 (95% CI 180.77-181.15), and 14.6 million were living with T2DM, with ASPR of 1190.73 (1190.13-1191.34). As national and territory SDI levels rise, the prevalence rate of T1DM increases (r = 0.44, p < 0.01), and the prevalence rate of T2DM decreases (r = - 0.18, p < 0.01). Compared with males, females had a greater age-standardized prevalence of T1DM (185.49 [185.21-185.76] vs. 176.66 [176.39-176.92]), whereas males had a greater ASPR of T2DM than females did (1241.45 [1240.58-1242.31] vs. 1138.24 [1137.40-1139.09]). This study found a negative correlation between the SDI and the ASDR for both T1DM (r = - 0.51, p < 0.01) and T2DM (r = - 0.62, p < 0.01) in adolescents. For T2DM patients, 32.84% of DALYs were attributed to high BMI, which increased by 40.78% during the study period. By 2030, 3.7 million people are projected to have T1DM, and 14.6 million are projected to have T2DM. CONCLUSIONS Among adolescents, the burden of T1DM and T2DM is increasing and varies by region, sex, and SDI. Therefore, targeted interventions based on regional features are needed to prevent and control adolescent diabetes. Moreover, more efforts are needed to control climate change and obesity to reduce the adolescent diabetes burden.
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Affiliation(s)
- Xing Chen
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, China
| | - Luying Zhang
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, China.
| | - Wen Chen
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, China
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Młynarska E, Czarnik W, Dzieża N, Jędraszak W, Majchrowicz G, Prusinowski F, Stabrawa M, Rysz J, Franczyk B. Type 2 Diabetes Mellitus: New Pathogenetic Mechanisms, Treatment and the Most Important Complications. Int J Mol Sci 2025; 26:1094. [PMID: 39940862 PMCID: PMC11817707 DOI: 10.3390/ijms26031094] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 01/19/2025] [Accepted: 01/22/2025] [Indexed: 02/16/2025] Open
Abstract
Type 2 diabetes mellitus (T2DM), a prevalent chronic disease affecting over 400 million people globally, is driven by genetic and environmental factors. The pathogenesis involves insulin resistance and β-cell dysfunction, mediated by mechanisms such as the dedifferentiation of β-cells, mitochondrial dysfunction, and oxidative stress. Treatment should be based on non-pharmacological therapy. Strategies such as increased physical activity, dietary modifications, cognitive-behavioral therapy are important in maintaining normal glycemia. Advanced therapies, including SGLT2 inhibitors and GLP-1 receptor agonists, complement these treatments and offer solid glycemic control, weight control, and reduced cardiovascular risk. Complications of T2DM, such as diabetic kidney disease, retinopathy, and neuropathy, underscore the need for early diagnosis and comprehensive management to improve patient outcomes and quality of life.
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Affiliation(s)
- Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Witold Czarnik
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Natasza Dzieża
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Weronika Jędraszak
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Gabriela Majchrowicz
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Filip Prusinowski
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Magdalena Stabrawa
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
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Weber I, Fisher BG, Myles C, Hendriks AEJ, Marcovecchio ML. NICE guideline review: type 2 diabetes in children and young people - diagnosis and management (NG18). Arch Dis Child Educ Pract Ed 2025; 110:23-25. [PMID: 39299760 DOI: 10.1136/archdischild-2024-326911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 08/12/2024] [Indexed: 09/22/2024]
Affiliation(s)
- Isabella Weber
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Benjamin G Fisher
- Department of Paediatric Diabetes and Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Cliodhna Myles
- Department of Paediatric Diabetes and Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Emile J Hendriks
- Department of Paediatric Diabetes and Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - M Loredana Marcovecchio
- Department of Paediatric Diabetes and Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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Lee SF, Nikšić M, Luque-Fernandez MA. Understanding the role of metabolic syndrome in prostate cancer risk: A UK Biobank prospective cohort study. Sci Rep 2025; 15:2345. [PMID: 39824873 PMCID: PMC11748637 DOI: 10.1038/s41598-025-85501-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 01/03/2025] [Indexed: 01/20/2025] Open
Abstract
Predictive value of metabolic syndrome for prostate cancer risk is not clear. We aimed to assess the association between metabolic syndrome and its components with prostate cancer incidence. The primary outcome was prostate cancer incidence, i.e., incidence rate ratios and adjusted cumulative incidence curves derived from flexible parametric survival models. Adjusted cumulative incidence curves were derived using a flexible survival parametrical modeling framework. We analysed UK Biobank data including 242,349 adult males, recruited during 2006-2010 and followed up until 2021, during which 6,467 (2.7%) participants were diagnosed with prostate cancer. Our findings indicate that metabolic syndrome, as a whole, was not associated with prostate cancer risk (incidence rate ratios, 1.07; 95% confidence interval, 0.94-1.22). However, specific components such as hypertension and obesity increased the risk (incidence rate ratios, 1.22; 95% confidence interval, 1.03-1.44 and incidence rate ratios, 1.24; 95% confidence interval, 1.05-1.46, respectively). Other components, such as prediabetes/diabetes and low cholesterol, were associated with a reduced risk (incidence rate ratios, 0.80; 95% confidence interval, 0.67-0.94 and incidence rate ratios, 0.82; 95% confidence interval, 0.69-0.97, respectively), while hyperlipidaemia showed no significant effect (incidence rate ratios, 1.07; 95% confidence interval, 0.93-1.24). Further research is needed to understand the underlying mechanisms behind these relationships. Prostate cancer prevention strategies might benefit from targeting modifiable risk factors, particularly hypertension and obesity.
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Affiliation(s)
- Shing Fung Lee
- Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Maja Nikšić
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Miguel Angel Luque-Fernandez
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- Department of Statistics and Operations Research, University of Granada, Granada, Spain.
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Wei J, Fan L, He Z, Zhang S, Zhang Y, Zhu X, Xia F, Song X, Chen L, Zou Z, Wang T. The global, regional, and national burden of type 2 diabetes mellitus attributable to low physical activity from 1990 to 2021: a systematic analysis of the global burden of disease study 2021. Int J Behav Nutr Phys Act 2025; 22:8. [PMID: 39819703 PMCID: PMC11740459 DOI: 10.1186/s12966-025-01709-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 01/11/2025] [Indexed: 01/19/2025] Open
Abstract
BACKGROUND Low physical activity (LPA) is a leading risk factor for type 2 diabetes mellitus (T2DM). We examine the temporal and spatial trends in the burden of T2DM attributable to LPA at the global, regional, and country scales. METHODS Data were obtained from the Global Burden of Disease Study 2021. The numbers of deaths and disability-adjusted life years (DALYs) of LPA-related T2DM, and the corresponding age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were compared across regions and countries by age, sex, and sociodemographic index (SDI). The annual percentage changes (EAPCs) in the ASMR or ASDR were calculated to quantify temporal trends from 1990 to 2021. We also quantified the relationship between SDI and the ASMR and ASDR of T2DM attributable to LPA. RESULTS Globally, the number of T2DM deaths and DALYs attributable to LPA were approximately 0.15 million and 5.52 million respectively in 2021, which more than doubled compared to 1990. Over the past 32 years, the global EAPCs of ASMR and ASDR were 0.26 (95% CI: 0.20, 0.31) and 0.97 (95% CI: 0.93, 1.02), respectively. The ASMR or ASDR had a reverse U-shaped relationship with the SDI, with the most severe burden observed in the low-middle and middle SDI regions. The age group older than 60 years had the highest rate of DALYs for LPA-related T2DM in 2021, while the 25-44 age group showed the largest increase between 1990 and 2021. CONCLUSIONS Over the past 32 years, the global burden of LPA-related T2DM has continued to increase at an alarming rate in almost all countries, particularly in regions with low-middle and middle SDI. Substantial increases in national action are urgently needed to target elder populations especially in low-middle and middle SDI regions, and special efforts should be made to promote physical activity in young adults with LPA.
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Affiliation(s)
- Jiehua Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Luying Fan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Zixuan He
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Ying Zhang
- School of public health, Harbin Medical University, Harbin, 150081, China
| | - Xidi Zhu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Boston, USA
| | - Fan Xia
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Xinli Song
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| | - Zhiyong Zou
- Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
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Zhang FS, Li HJ, Yu X, Song YP, Ren YF, Qian XZ, Liu JL, Li WX, Huang YR, Gao K. Global trends and hotspots of type 2 diabetes in children and adolescents: A bibliometric study and visualization analysis. World J Diabetes 2025; 16:96032. [PMID: 39817223 PMCID: PMC11718446 DOI: 10.4239/wjd.v16.i1.96032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 09/30/2024] [Accepted: 11/19/2024] [Indexed: 11/29/2024] Open
Abstract
BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus (T2DM) among children and adolescents worldwide. Due to rapid disease progression, severe long-term cardiorenal complications, a lack of effective treatment strategies, and substantial socioeconomic burdens, it has become an urgent public health issue that requires management and resolution. Adolescent T2DM differs from adult T2DM. Despite a significant increase in our understanding of youth-onset T2DM over the past two decades, the related review and evidence-based content remain limited. AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes. METHODS This study utilized the terms "children", "adolescents", and "type 2 diabetes", retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection (SCI, SSCI, ESCI). Utilizing CiteSpace and VoSviewer software, we analyze and visually represent the annual output of literature, countries involved, and participating institutions. This allows us to predict trends in this research field. Our analysis encompasses co-cited authors, journal overlays, citation overlays, time-zone views, keyword analysis, and reference analysis, etc. RESULTS A total of 9210 articles were included, and the annual publication volume in this field showed a steady growth trend. The United States had the highest number of publications and the highest H-index. The United States also had the most research institutions and the strongest research capacity. The global hot journals were primarily diabetes professional journals but also included journals related to nutrition, endocrinology, and metabolism. Keyword analysis showed that research related to endothelial dysfunction, exposure risk, cardiac metabolic risk, changes in gut microbiota, the impact on comorbidities and outcomes, etc., were emerging keywords. They have maintained their popularity in this field, suggesting that these areas have garnered significant research interest in recent years. CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention, with genes, behaviors, environmental factors, and multisystemic interventions potentially emerging as future research hot spots.
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Affiliation(s)
- Fang-Shuo Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Hai-Jing Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xue Yu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yi-Ping Song
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yan-Feng Ren
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xuan-Zhu Qian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Jia-Li Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Wen-Xun Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yi-Ran Huang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Kuo Gao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
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Saeed W, Al-Habori M, Saif-Ali R. The predictive value of combined insulin resistance and β-cell secretion in Yemeni school-aged children for type 2 diabetes mellitus. Sci Rep 2025; 15:563. [PMID: 39747350 PMCID: PMC11697439 DOI: 10.1038/s41598-024-84349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Accepted: 12/23/2024] [Indexed: 01/04/2025] Open
Abstract
The present study aimed to determine the predictive power of the diabetic markers and metabolic syndrome factors in School-aged children for developing Type 2 DM. In this cross-sectional study, 1288 students aged 12-13 were recruited from public schools in the capital city of Sana'a. Anthropometric measurements and blood pressure were recorded and body mass index (BMI) was calculated. Fasting venous blood (5 ml) was collected for biochemical analysis including FBG, HbA1c, insulin, and lipid profile. Insulin resistance (HOMA-IR) and β-cell function (HOMA-β) were calculated. Our results showed that neither insulin, HOMA-IR nor HOMA-β individually were good predictors for Type 2 DM as assessed by the ROC curve with AUC < 0.75. However, the ROC curve of combined HOMA-IR and HOMA-β (Model 1) gave a superior AUC of 0.998 (p = 2.7 × 10-9) and predicted 140 (10.9%) children to develop Type 2 DM. This model picked up all impaired fasting glucose (IFG), 74% of metabolic glucose, and 71% of metabolic syndrome (MetS) groups. On the other hand, the ROC curve for metabolic syndrome (Model 2) gave an AUC of 0.751 (p = 0.003) and predicted a higher number of 416 (32.3%) children to develop prediabetes and Type 2 DM. This model picked up 75% of IFG, 71% of MetS, 82% of those having two factors of MetS, and 72% of obesity groups. Moreover, the 53 children common between the two models include 75% of IFG and 43% of MetS groups. Therefore, the combined HOMA-IR and HOMA-β model in children proved to be a good predictor for Type 2 DM development, whereas the MetS model predicts the development of prediabetes and Type 2 DM.
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Affiliation(s)
- Walid Saeed
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana'a, Sanaa, Republic of Yemen
| | - Molham Al-Habori
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana'a, Sanaa, Republic of Yemen.
| | - Riyadh Saif-Ali
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana'a, Sanaa, Republic of Yemen
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Mendoza-Catalan G, Pimentel-Jaimes JA, Orendain-Jaime EN, Domínguez-Chávez CJ, Higuera-Sainz JL, Villa-Rueda AA, Rieke-Campoy U, Camargo-Bravo A. Dating Violence, Lifestyle and Risk of Type 2 Diabetes in Mexican Women University Students. Curr Diabetes Rev 2025; 21:e300124226536. [PMID: 38299419 PMCID: PMC11826912 DOI: 10.2174/0115733998283227240117060452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Dating violence is a prevalent issue among Mexican women, as is the incidence and prevalence of Type 2 diabetes mellitus (T2DM). The effects of dating violence can negatively impact lifestyle and, consequently, increase the risk of T2DM. OBJECTIVE This study aimed to explore the influence of dating violence on lifestyle and the risk of T2DM in women university students from Mexico. METHODS The study employed a cross-sectional and correlational design. The study population consisted of women university students. The sample size included 255 participants. Women aged 18 to 39 with current dating relationships and residency in Mexicali, Baja California, Mexico, were included. Data collection was conducted from February to May 2023. Correlations and multiple linear regression models were conducted. RESULTS A total of 255 women participated, with an average age of 21.6 years (SD = 3.2), and 32.2% had a history of intrafamily violence during childhood. 58.8% of the participants exhibited some level of risk of T2DM, and 56.7% of the lifestyle was mostly categorized as poor/fair. Detachment was the most prevalent type of dating violence, followed by coercion. Dating violence was correlated with lifestyle (r = -.430) and the risk of T2DM (r = .321). In the multiple linear regression model, dating violence influenced the risk of T2DM. CONCLUSION Women who reported higher levels of dating violence have a less healthy lifestyle and a greater risk of T2DM. It is important to consider dating violence to improve lifestyle and prevent T2DM in Mexican women university students.
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Affiliation(s)
- Geu Mendoza-Catalan
- Faculty of Nursing, Autonomous University of Baja California, Mexicali, Baja California, Mexico
| | | | | | | | - José Luis Higuera-Sainz
- Faculty of Nursing, Autonomous University of Baja California, Mexicali, Baja California, Mexico
| | | | - Ulises Rieke-Campoy
- Faculty of Nursing, Autonomous University of Baja California, Mexicali, Baja California, Mexico
| | - Adriana Camargo-Bravo
- Faculty of Nursing, Autonomous University of Baja California, Mexicali, Baja California, Mexico
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Yu SH. Diabetes in Korean Adults: Prevalence, Management, and Comorbidities. Diabetes Metab J 2025; 49:22-23. [PMID: 39828975 PMCID: PMC11788548 DOI: 10.4093/dmj.2024.0844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2025] Open
Affiliation(s)
- Sung Hoon Yu
- Department of Endocrinology and Metabolism, Hanyang University College of Medicine, Seoul, Korea
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Wang P, Yu Z, Hu Y, Li W, Xu L, Da F, Wang F. BMI modifies the effect of pregnancy complications on risk of small- or large-for-gestational-age newborns. Pediatr Res 2025; 97:301-310. [PMID: 38871801 DOI: 10.1038/s41390-024-03298-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Maternal physical condition (reflected by maternal body mass index (BMI) at delivery) and pregnancy complications influence neonatal health outcomes. High BMI during pregnancy increases various health problems' risks, but studies about the synthesized effect of these factors on fetal growth, are scarce. METHODS The retrospective cohort study was conducted in Zhejiang Province, China from 1 January 2019 to 31 December 2021. The associations between complications and small-for-gestational-age (SGA) and large-for-gestational-age (LGA) were measured by the Fine-Gray model and subgroup analysis. Effect modification and interaction analyses were conducted to explore BMI's modification effect and complications' interaction. RESULTS Several complications increased the risk for SGA and LGA, some significance varied in different subgroups. There was a positive effect modification of gestational diabetes mellitus (GDM) across BMI strata on LGA (relative excess risk due to interaction (RERI) [95% CI] = 0.57 [0.09,1.04]). Several pairwise complications' interactions were synergistic (e.g., pregestational diabetes and intraamniotic infection for SGA (ratio of ORs [95% CI] = 8.50 [1.74,41.37]), pregestational diabetes and assisted reproductive technology (ART) for LGA (ratio of ORs [95% CI] = 2.71 [1.11,6.62])), one was antagonistic (placental problems and ART for LGA (ratio of ORs [95% CI] = 0.58 [0.35,0.96])). CONCLUSIONS High-BMI positively modified the risk of GDM on LGA. Many interactions existed when two specific pregnancy complications occurred simultaneously. IMPACT This is the largest retrospective study covering more than 10 pregnancy complications to date in this aspect. High-BMI (BMI > 28 kg/m2) positively modifies the risk of GDM on LGA. Many pregnancy complications influence the risk of SGA and LGA, with several interactions that may create a "syndrome" effect. Pregnant women with different BMIs should consider the additional risks caused by pregnancy complications for their heterogeneous effects on abnormal fetal growth. Measures should be taken to prevent the occurrence of other exposure factors in the "syndrome". This study may aid in developing a new strategy for improving neonatal outcomes.
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Affiliation(s)
- Peng Wang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China
- School of Stomatology, Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China
| | - Zhengchen Yu
- The Second Clinical Medical College, Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China
| | - Yinkai Hu
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China
| | - Wangzhi Li
- School of Stomatology, Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China
| | - Luxuan Xu
- The Second Clinical Medical College, Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China
| | - Fangqing Da
- The Second Clinical Medical College, Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China
| | - Fan Wang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China.
- The Second Clinical Medical College, Wenzhou Medical University, Wenzhou City, Zhejiang Province, 325000, China.
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Park SE, Ko SH, Kim JY, Kim K, Moon JH, Kim NH, Han KD, Choi SH, Cha BS. Diabetes Fact Sheets in Korea 2024. Diabetes Metab J 2025; 49:24-33. [PMID: 39828976 PMCID: PMC11788544 DOI: 10.4093/dmj.2024.0818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Accepted: 12/24/2024] [Indexed: 01/22/2025] Open
Abstract
BACKGRUOUND This study aimed to investigate the prevalence, management, and comorbidities of diabetes mellitus among Korean adults. METHODS Data from the Korea National Health and Nutrition Examination Survey (2019-2022) were analyzed to assess the prevalence, treatment, risk factors, and comorbidities of diabetes. Comparisons between young and older adults with diabetes were emphasized. RESULTS Among Korean adults aged ≥30 years, the prevalence of diabetes is 15.5% during 2021-2022. Of these, 74.7% were aware of their condition, 70.9% received antidiabetic treatment, and only 32.4% achieved glycosylated hemoglobin (HbA1c) <6.5%. Moreover, 15.9% met the integrated management targets, which included HbA1c <6.5%, blood pressure <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL. In young adults aged 19 to 39 years, the prevalence of diabetes was 2.2%. Among them, 43.3% were aware of their condition, 34.6% received treatment, and 29.6% achieved HbA1c <6.5%. Obesity affected 87.1%, and 26.9% had both hypertension and hypercholesterolemia. Among adults aged ≥65 years, the prevalence of diabetes was 29.3%, with awareness, treatment, and control rates of 78.8%, 75.7%, and 31.2%, respectively. Integrated management targets (HbA1c <7.5%, hypertension, and lipids) were achieved by 40.1%. CONCLUSION Diabetes mellitus remains highly prevalent among Korean adults, with significant gaps in integrated glycemic, blood pressure, and lipid control. Older adults with diabetes show higher awareness and treatment rates but limited integrated management outcomes. Young adults with diabetes bear a significant burden of obesity and comorbidities, alongside low awareness and treatment rates. Therefore, early intervention programs, education, and strategies tailored to younger populations are urgently required.
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Affiliation(s)
- Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Ji Yoon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyuho Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Joon Ho Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Sung Hee Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Bong Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Peeri NC, Bertrand KA, Na R, De Vivo I, Setiawan VW, Seshan VE, Alemany L, Chen Y, Clarke MA, Clendenen T, Cook LS, Costas L, Dal Maso L, Freudenheim JL, Friedenreich CM, Gierach GL, Goodman MT, La Vecchia C, Levi F, Lopez-Querol M, Lu L, Moysich KB, Mutter G, Naduparambil J, Negri E, O’Connell K, O’Mara T, Palmer JR, Parazzini F, Penney KL, Petruzella S, Reynolds P, Ricceri F, Risch H, Rohan TE, Sacerdote C, Sandin S, Shu XO, Stolzenberg-Solomon RZ, Webb PM, Wentzensen N, Wilkens LR, Xu W, Yu H, Zeleniuch-Jacquotte A, Zheng W, Guo X, Lipworth L, Du M. Understanding risk factors for endometrial cancer in young women. J Natl Cancer Inst 2025; 117:76-88. [PMID: 39235934 PMCID: PMC11717423 DOI: 10.1093/jnci/djae210] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 06/29/2024] [Accepted: 08/22/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND The American Cancer Society recommends physicians inform average-risk women about endometrial cancer risk on reaching menopause, but new diagnoses are rising fastest in women aged younger than 50 years. Educating these younger women about endometrial cancer risks requires knowledge of risk factors. However, endometrial cancer in young women is rare and challenging to study in single study populations. METHODS We included 13 846 incident endometrial cancer patients (1639 aged younger than 50 years) and 30 569 matched control individuals from the Epidemiology of Endometrial Cancer Consortium. We used generalized linear models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for 6 risk factors and endometrial cancer risk. We created a risk score to evaluate the combined associations and population attributable fractions for these factors. RESULTS In younger and older women, we observed positive associations with body mass index and diabetes and inverse associations with age at menarche, oral contraceptive use, and parity. Current smoking was associated with reduced risk only in women aged 50 years and older (Phet < .01). Body mass index was the strongest risk factor (OR≥35 vs<25 kg/m2 = 5.57, 95% CI = 4.33 to 7.16, for ages younger than 50 years; OR≥35 vs<25 kg/m2 = 4.68, 95% CI = 4.30 to 5.09, for ages 50 years and older; Phet = .14). Possessing at least 4 risk factors was associated with approximately ninefold increased risk in women aged younger than 50 years and approximately fourfold increased risk in women aged 50 years and older (Phet < .01). Together, 59.1% of endometrial cancer in women aged younger than 50 years and 55.6% in women aged 50 years and older were attributable to these factors. CONCLUSIONS Our data confirm younger and older women share common endometrial cancer risk factors. Early educational efforts centered on these factors may help mitigate the rising endometrial cancer burden in young women.
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Affiliation(s)
- Noah Charles Peeri
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kimberly A Bertrand
- Slone Epidemiology Center and Department of Medicine, Boston University, Boston, MA, USA
| | - Renhua Na
- Population Health Program, Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Herston, Qld, Australia
| | - Immaculata De Vivo
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Venkatraman E Seshan
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Laia Alemany
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health Carlos III Institute of Health, Madrid, Spain
| | - Yu Chen
- Population Health, Epidemiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Megan A Clarke
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Tess Clendenen
- Population Health, Epidemiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Linda S Cook
- Department of Epidemiology, University of Colorado-Anschutz, Aurora, CO, USA
| | - Laura Costas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health Carlos III Institute of Health, Madrid, Spain
| | - Luigino Dal Maso
- Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Jo L Freudenheim
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Christine M Friedenreich
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Gretchen L Gierach
- Integrative Tumor Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Marc T Goodman
- Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Carlo La Vecchia
- Department of Clinical Medicine and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Fabio Levi
- Department of Epidemiology and Health Services Research (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Marta Lopez-Querol
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health Carlos III Institute of Health, Madrid, Spain
| | - Lingeng Lu
- Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Kirsten B Moysich
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - George Mutter
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeffin Naduparambil
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eva Negri
- Department of Medical and Surgical Sciences, Università di Bologna, Bologna, Italy
| | - Kelli O’Connell
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tracy O’Mara
- Cancer Research Program, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Julie R Palmer
- Slone Epidemiology Center and Department of Medicine, Boston University, Boston, MA, USA
| | - Fabio Parazzini
- Department of Clinical Medicine and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Kathryn Lee Penney
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Stacey Petruzella
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California San Francisco, Berkeley, CA, USA
| | - Fulvio Ricceri
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy
| | - Harvey Risch
- Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Thomas E Rohan
- Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachael Z Stolzenberg-Solomon
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Penelope M Webb
- Population Health Program, Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Herston, Qld, Australia
| | - Nicolas Wentzensen
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Wanghong Xu
- Epidemiology, Fudan University, School of Public Health, Shanghai, China
| | - Herbert Yu
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xingyi Guo
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Loren Lipworth
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mengmeng Du
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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