DIABETOLOGIA

Metabolomics profiling in multi-ancestral individuals with type 2 diabetes in Singapore identified metabolites associated with renal function decline
Chen Y, Torta F, Koh HWL, Benke PI, Gurung RL, Liu JJ, Ang K, Shao YM, Chan GC, Choo JC, Ching J, Kovalik JP, Kalhan T, Dorajoo R, Khor CC, Li Y, Tang WE, Seah DEJ, Sabanayagam C, Sobota RM, Venkataraman K, Coffman T, Wenk MR, Sim X, Lim SC and Tai ES
This study aims to explore the association between plasma metabolites and chronic kidney disease progression in individuals with type 2 diabetes.
Evidence on the effectiveness and equity of population-based policies to reduce the burden of type 2 diabetes: a narrative review
Mackenbach JD, Stuber JM and Beulens JWJ
There is increasing evidence for the effectiveness of population-based policies to reduce the burden of type 2 diabetes. Yet, there are concerns about the equity effects of some policies, whereby socioeconomically disadvantaged populations are not reached or are adversely affected. There is a lack of knowledge on the effectiveness and equity of policies that are both population based (i.e. targeting both at-risk and low-risk populations) and low agency (i.e. not requiring personal resources to benefit from the policy). In this narrative review, we selected 16 policies that were both population based and low agency and reviewed the evidence on their effectiveness and equity. Substantial evidence suggests that fruit and vegetable subsidies, unhealthy food taxes, mass media campaigns, and school nutrition and physical activity education are effective in promoting healthier lifestyle behaviours. Less evidence was available for mandatory food reformulation, reduced portion sizes, marketing restrictions and restriction of availability and promotion of unhealthy products, although the available evidence suggested that these policies were effective in reducing unhealthy food choices. Effects could rarely be quantified across different studies due to substantial heterogeneity. There is an overall lack of evidence on equity effects of population-based policies, although available studies mostly concluded that the policies had favourable equity effects, with the exception of food-labelling policies. Each of the policies is likely to have a relatively modest effect on population-level diabetes risks, which emphasises the importance of combining different policy measures. Future research should consider the type of evidence needed to demonstrate the real-world effectiveness and equity of population-based diabetes prevention policies.
The effect of vitamin D supplementation on the incidence of type 2 diabetes in healthy older adults not at high risk for diabetes (FIND): a randomised controlled trial
Virtanen JK, Hantunen S, Kallio N, Lamberg-Allardt C, Manson JE, Nurmi T, Pihlajamäki J, Uusitupa M, Voutilainen A and Tuomainen TP
Vitamin D insufficiency is associated with an elevated risk of type 2 diabetes, but evidence from randomised trials on the benefits of vitamin D supplementation is limited, especially for average-risk populations. The Finnish Vitamin D Trial (FIND) investigated the effects of vitamin D supplementation at two different doses on the incidence of type 2 diabetes in a generally healthy older adult population.
A critique of measurement of defective insulin secretion and insulin sensitivity as a precision approach to gestational diabetes
Jones DL, Kusinski LC, Gillies C and Meek CL
Precision medicine approaches to gestational diabetes mellitus (GDM) have categorised patients according to disease pathophysiology (insulin resistance, insulin insufficiency or both), and demonstrated associations with clinical outcomes. We aimed to assess whether using enhanced processing to determine indices of insulin secretion and sensitivity is analytically robust, reproducible in a different population, and useful diagnostically and prognostically in clinical practice.
Up Front
Prediabetes is associated with elevated risk of clinical outcomes even without progression to diabetes
Rooney MR, Wallace AS, Echouffo Tcheugui JB, Fang M, Hu J, Lutsey PL, Grams ME, Coresh J and Selvin E
Prediabetes (HbA 39-47 mmol/mol [5.7-6.4%] or fasting glucose 5.6-6.9 mmol/l) is associated with elevated risks of microvascular and macrovascular complications. It is unknown to what extent these risks in prediabetes remain after accounting for progression to diabetes.
Type 2 diabetes pathway-specific polygenic risk scores elucidate heterogeneity in clinical presentation, disease progression and diabetic complications in 18,217 Chinese individuals with type 2 diabetes
Yu G, Tam CHT, Lim CKP, Shi M, Lau ESH, Ozaki R, Lee HM, Ng ACW, Hou Y, Fan B, Huang C, Wu H, Yang A, Cheung HM, Lee KF, Siu SC, Hui G, Tsang CC, Lau KP, Leung JYY, Cheung EYN, Tsang MW, Kam G, Lau IT, Li JKY, Yeung VTF, Lau E, Lo S, Fung S, Cheng YL, Szeto CC, , Chow E, Kong APS, Tam WH, Luk AOY, Weedon MN, So WY, Chan JCN, Oram RA, Ma RCW and
Type 2 diabetes is a complex and heterogeneous disease and the aetiological components underlying the heterogeneity remain unclear in the Chinese and East Asian population. Therefore, we aimed to investigate whether specific pathophysiological pathways drive the clinical heterogeneity in type 2 diabetes.
Simplified meal announcement study (SMASH) using hybrid closed-loop insulin delivery in youth and young adults with type 1 diabetes: a randomised controlled two-centre crossover trial
Laesser CI, Piazza C, Schorno N, Nick F, Kastrati L, Zueger T, Barnard-Kelly K, Wilinska ME, Nakas CT, Hovorka R, Herzig D, Konrad D and Bally L
The majority of hybrid closed-loop systems still require carbohydrate counting (CC) but the evidence for its justification remains limited. Here, we evaluated glucose control with simplified meal announcement (SMA) vs CC in youth and young adults with type 1 diabetes using the mylife CamAPS FX system.
Trajectory of beta cell function and insulin clearance in stage 2 type 1 diabetes: natural history and response to teplizumab
Galderisi A, Sims EK, Evans-Molina C, Petrelli A, Cuthbertson D, Nathan BM, Ismail HM, Herold KC and Moran A
We aimed to analyse TrialNet Anti-CD3 Prevention (TN10) data using oral minimal model (OMM)-derived indices to characterise the natural history of stage 2 type 1 diabetes in placebo-treated individuals, to describe early metabolic responses to teplizumab and to explore the predictive capacity of OMM measures for disease-free survival rate.
Increased risk of major adverse cardiovascular events in patients with deep and infected diabetes-related foot ulcers
Lan NSR, Hiew J, Ferreira I, Ritter JC, Manning L, Fegan PG, Dwivedi G and Hamilton EJ
Diabetes-related foot ulceration (DFU) is associated with increased cardiovascular risk, but the mechanisms remain unclear. Inflammation and infection are mediators of CVD, which may be important in DFU.
Racial and ethnic disparities in the uptake of SGLT2is and GLP-1RAs among Medicare beneficiaries with type 2 diabetes and heart failure, atherosclerotic cardiovascular disease and chronic kidney disease, 2013-2019
Wang E, Patorno E, Khosrow-Khavar F, Crystal S and Dave CV
The aim of this study was to investigate racial and ethnic disparities in the use of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor antagonists (GLP-1RAs) among older adults with type 2 diabetes and cardiorenal conditions.
Correction: Quantifying beta cell function in the preclinical stages of type 1 diabetes
Galderisi A, Carr ALJ, Martino M, Taylor P, Senior P and Dayan C
Postprandial hypoglycaemia after gastric bypass in type 2 diabetes: pathophysiological mechanisms and clinical implications
Tricò D, Sacchetta L, Rebelos E, Cimbalo N, Chiriacò M, Moriconi D, Nesti L, Nesti G, Frascerra S, Scozzaro MT, Daniele G, Baldi S, Mari A, Nannipieri M and Natali A
Postprandial hypoglycaemia (PPHG) is a frequent late complication of Roux-en-Y gastric bypass (RYGB) in people without diabetes. We aimed to examine the pathogenetic mechanisms of PPHG and its clinical consequences in people with a history of type 2 diabetes.
The relationship of changes in insulin demand and insulin adequacy over the life course
Zhang Y, Tam CHT, Lau ESH, Ng NYH, Yang A, Fan B, Wu H, Lim CKP, Chow EYK, Luk AOY, Kong APS, Tam WH, Chan JCN and Ma RCW
Insulin requirements in the human body undergo continuous changes in response to growth and development. We assessed the life course relationships between insulin demand and insulin adequacy.
The metabolic and circadian signatures of gestational diabetes in the postpartum period characterised using multiple wearable devices
Phillips NE, Mareschal J, Biancolin AD, Sinturel F, Umwali S, Blanc S, Hemmer A, Naef F, Salathé M, Dibner C, Puder JJ and Collet TH
Gestational diabetes mellitus (GDM) affects 14% of all pregnancies worldwide and is associated with cardiometabolic risk. We aimed to exploit high-resolution wearable device time-series data to create a fine-grained physiological characterisation of the postpartum GDM state in free-living conditions, including clinical variables, daily glucose dynamics, food and drink consumption, physical activity, sleep patterns and heart rate.
A WFS1 variant disrupting acceptor splice site uncovers the impact of alternative splicing on beta cell apoptosis in a patient with Wolfram syndrome
Chimienti R, Torchio S, Siracusano G, Zamarian V, Monaco L, Lombardo MT, Pellegrini S, Manenti F, Cuozzo F, Rossi G, Carrera P, Sordi V, Broccoli V, Bonfanti R, Casari G, Frontino G and Piemonti L
Wolfram syndrome 1 (WS1) is an inherited condition mainly manifesting in childhood-onset diabetes mellitus and progressive optic nerve atrophy. The causative gene, WFS1, encodes wolframin, a master regulator of several cellular responses, and the gene's mutations associate with clinical variability. Indeed, nonsense/frameshift variants correlate with more severe symptoms than missense/in-frame variants. As achieving a genotype-phenotype correlation is crucial for dealing with disease outcome, works investigating the impact of transcriptional and translational landscapes stemming from such mutations are needed. Therefore, we sought to elucidate the molecular determinants behind the pathophysiological alterations in a WS1 patient carrying compound heterozygous mutations in WFS1: c.316-1G>A, affecting the acceptor splice site (ASS) upstream of exon 4; and c.757A>T, introducing a premature termination codon (PTC) in exon 7.
Diet-enhanced LRG1 expression promotes insulin hypersecretion and ER stress in pancreatic beta cells
Morales DD, Ryu J, Wei C, Hadley JT, Smith MR, Bai J, Lopez-Alvarenga JC, Mummidi S, Duggirala R, Lynch JL, Liu F and Dong LQ
Upregulation of serum leucine-rich α-2-glycoprotein 1 (LRG1) has been implicated in diet-induced obesity and metabolic disorders. However, its specific hormonal actions remain unclear. This study aimed to determine whether diet-enhanced serum LRG1 levels promote hyperinsulinaemia by directly stimulating insulin secretion from pancreatic beta cells.
Correction: 60 EASD Annual Meeting of the European Association for the Study of Diabetes, Madrid, Spain, 9-13 September 2024. 'Average glucose and HbA display a nonlinear and variable relationship: implications for clinical practice'
Correction: A whole-food, plant-based intensive lifestyle intervention improves glycaemic control and reduces medications in individuals with type 2 diabetes: a randomised controlled trial
Hanick CJ, Peterson CM, Davis BC, Sabaté J and Kelly JH
Transcriptomic heterogeneity of non-beta islet cells is associated with type 2 diabetes development in mouse models
Gottmann P, Speckmann T, Stadion M, Chawla P, Saurenbach J, Ninov N, Lickert H and Schürmann A
The aim of this work was to understand the role of non-beta cells in pancreatic islets at early stages of type 2 diabetes pathogenesis.
A polygenic risk score derived from common variants of monogenic diabetes genes is associated with young-onset type 2 diabetes and cardiovascular-kidney complications
O CK, Fan B, Tsoi STF, Tam CHT, Wan R, Lau ESH, Shi M, Lim CKP, Yu G, Ho JPY, Chow EYK, Kong APS, Ozaki R, So WY, Ma RCW, Luk AOY and Chan JCN
Monogenic diabetes is caused by rare mutations in genes usually implicated in beta cell biology. Common variants of monogenic diabetes genes (MDG) may jointly influence the risk of young-onset type 2 diabetes (YOD, diagnosed before the age of 40 years) and cardiovascular and kidney events.