To investigate the association between adherence to the dietary approaches to stop hypertension(DASH)diet and serum uric acid levels, the risk of hyperuricemia, and the mediation role of systematic inflammation, among Chinese adults from 5 provinces.

China Nutrition and Health Follow-up Study(2021) was conducted based on a part of the participants in China Nutrition and Health Surveillance(2010-2012) and subsequently newly sampled participants. A total of 6963 Chinese adults were selected from and information on socioeconomic status, diet, body measurements, and laboratory examination were investigated. Using the DASH score to evaluate the adherence to the DASH diet, the participants were categorized into quintiles. Using multiple adjustment generalized linear regression and logistic regression analysis the association between DASH diet and serum uric acid level and the risk of hyperuricemia were explored. The mediation role of systematic inflammation on the above associations was evaluated among 2112 participants who were tested for serum high-sensitivity C-reactive protein(hs-CRP).

In 6963 participants, the average serum uric acid level was 317.4 μmol/L, and the prevalence of hyperuricemia was 21.18%. The result showed that participants who were 18-44 years, female, overweight or obese, urban residents, higher education level, married, higher household income, non-smokers, higher physical activity level, non-hyperuricemia had higher adherence to the DASH diet(P<0.05). After adjusting for potential confounders, including age, gender, body mass index, living area, education level, marital status, household income, current smoking, excessive drinking, physical activity level, and condition of hypertension, diabetes mellitus, and dyslipidemia, the adherence to DASH diet had a negative association with serum uric acid levels(Q5 vs. Q1, relative concentration =0.93, 95%CI 0.91-0.94, P_(trend)<0.01) and with the risk of hyperuricemia(Q5 vs. Q1, OR =0.59, 95%CI 0.48-0.73, P_(trend)<0.01). Mediation analysis revealed that hs-CRP significantly mediated 17.69%(95%CI 10.22%-25.15%, P_(mediation)<0.01)of the association between DASH diet and serum uric acid level and 26.00%(95%CI 7.50%-44.49%, P_(mediation)<0.01)of the association between DASH score and the risk of hyperuricemia, respectively.

Adhering to the DASH diet had negative associations with serum uric acid levels and the risk of hyperuricemia among Chinese adults from 5 provinces. Systematic inflammation may be an important biological mechanism partially mediating the association between the DASH diet on serum uric acid levels and hyperuricemia.

This study aimed to investigate whether thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and the fT3/fT4 ratio-measured during the first and second trimesters-are associated with the development of gestational diabetes mellitus (GDM) in euthyroid pregnant women. Their predictive value was evaluated using tertile-based logistic regression.

In this retrospective cohort study, 200 euthyroid pregnant women without thyroid disease or treatment history were included. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Thyroid parameters were measured in the first (9-14 weeks) and second (22-28 weeks) trimesters. Tertile-based univariate and multivariate logistic regression analyses were conducted, adjusting for maternal age, BMI, smoking, and family history of diabetes.

Women in the highest tertile (tertile 3) of first-trimester fT3 (>3.61 pg/mL) and fT3/fT4 ratio (>0.27) had a significantly increased risk of GDM (adjusted OR = 9.72 and 4.05, respectively; p < 0.001). Conversely, being in the highest tertile of TSH (tertile 3 > 2.34 µIU/mL) during both trimesters was associated with a significantly lower risk of GDM (OR = 0.32-0.04; p < 0.001). TSH levels increased, while fT3 and fT4 levels decreased significantly across trimesters (p < 0.001). GDM was associated with lower gestational age at delivery (p < 0.001), increased NICU admission (p = 0.041), and a modest positive correlation between first-trimester fT3/fT4 ratio and birth weight (r = 0.15; p = 0.034).

Being in the highest tertiles of fT3 and fT3/fT4 ratio during the first trimester-despite remaining within the euthyroid range-was linked to elevated GDM risk. In contrast, the highest TSH tertiles in both trimesters were associated with a decreased risk. These findings suggest that even subtle thyroid hormone variations within normal limits may influence glucose metabolism and support the utility of early thyroid function evaluation for predicting gestational metabolic risk.

No direct comparisons have evaluated glucagon-like peptide-1 receptor agonists (GLP-1 RAs) versus metformin as first-line antidiabetic therapy for preventing dementia in patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the comparative effectiveness of GLP-1 RAs and metformin in reducing dementia risk.

This retrospective cohort study used data from a global health research network between 2004 and 2024. Patients with T2DM initiating GLP-1 RAs or metformin as first-line monotherapy were included. Propensity score matching was employed to balance baseline characteristics. Dementia incidence was analyzed using Cox proportional hazards models, with sensitivity analyses to confirm robustness.

Among 87,229 matched patients per cohort, GLP-1 RA use was associated with a significantly lower risk of overall dementia (adjusted HR (AHR) 0.90; 95% CI 0.85 to 0.95), Alzheimer's disease (AD) (AHR 0.88; 95% CI 0.83 to 0.94), and non-vascular dementias (non-VaDs) (AHR 0.75; 95% CI 0.70 to 0.81) compared with metformin. No significant difference was observed for VaD. Subgroup analyses showed consistent benefit across age and sex, with the strongest effect among older adults and females.

GLP-1 RAs were more effective than metformin in reducing the risk of dementia-especially AD and non-vascular types-highlighting their potential as a preferred first-line treatment in T2DM. Further randomized trials are warranted to validate these findings.

To assess predictors of timely transition to adult diabetes care among individuals diagnosed with type 1 diabetes during childhood and adolescence. We hypothesised that older age at the last paediatric visit and urban residency would be predictors of timely transition.

Retrospective cohort study using healthcare administrative data in a jurisdiction with a universal healthcare system.

2045 adolescents and young adults diagnosed with type 1 diabetes between the ages of 0.5 and 18 years.

We ascertained age at the last paediatric diabetes visit (LPDV), age at the first adult diabetes visit (FADV) and transition duration, defined as the time between LPDV and FADV. Timely transition was defined as a transition duration of <1 year. Logistic regression models were fitted to assess predictors of timely transition.

Only 31.3% of individuals saw an adult provider within 1 year of their LPDV. Each 1-year increase in the age at LPDV was associated with increased odds of timely transition (adjusted OR 1.82, 95% CI 1.71 to 1.93, p<0.001). Urban residency was also associated with increased odds of timely transition (adjusted OR 1.93, 95% CI 1.40 to 2.71, p<0.001). Sex and older age at diagnosis were not associated with timely transition in the multivariable regression models (p>0.05).

Older age at the LPDV and urban residency are associated with increased odds of timely transition. Interventions should be developed to help keep adolescents engaged in paediatric care until an older age before referring them to adult diabetes care. Limitations of this study include unmeasured confounding and limited generalisability to non-universal healthcare systems.

To investigate the current status and influencing factors of quality of life in children and adolescents with type 1 diabetes (T1DM) in Xinjiang.

A convenience sampling method was used to select 259 children with T1DM and their primary caregivers who attended three tertiary hospitals in Xinjiang from January 2023 to February 2024. The Pediatric Quality of Life Inventory^TM Version 4.0 Generic Core Scales (PedsQL^TM4.0) and Pediatric Quality of Life Inventory^TM Version 3.2 Diabetes Module (PedsQL^TM3.2-DM) were used to assess the quality of life of the children. Information on family demographics, caregiver burden, and caregiving ability was also collected. Multiple linear regression analysis was employed to identify factors associated with the quality of life of the children.

The scores for PedsQL^TM4.0 and PedsQL^TM3.2-DM were 77±16 and 71±16, respectively. Both were negatively correlated with caregiver burden (P<0.05) and positively correlated with caregiving ability (P<0.05). Multiple linear regression analysis indicated that caregiver burden, caregiving ability, family income, and parent-child relationship were significantly associated with generic quality of life (P<0.05), whereas caregiver burden, caregiving ability, disease duration, place of residence, and glycated hemoglobin level were significantly associated with diabetes-specific quality of life (P<0.05).

The overall quality of life of children and adolescents with T1DM in Xinjiang is relatively low. The quality of life is influenced by a combination of factors including family caregiver burden, caregiving ability, family income, parent-child relationship, disease duration, place of residence, and glycated hemoglobin level. Strategies to improve quality of life should consider the combined impact of individual disease characteristics and family factors.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used to treat obesity and diabetes. Semaglutide, a GLP-1RA, is linked to nonarteritic ischemic optic neuropathy (NAION), macular edema, and retinopathy. Because diabetic lumbosacral radiculoplexus neuropathy (DLRPN) and common fibular neuropathy (CFN) are associated with weight loss, we examined whether GLP-1RA usage is linked to these neuropathies.

We conducted a retrospective case-controlled study from April 28, 2005 (the first GLP-1RA Food and Drug Administration approval), to December 25, 2024. Patients diagnosed with DLRPN or CFN were analyzed for GLP-1RA exposure and clinical characteristics. A control group, matched for age, sex, body mass index (BMI), and diabetes status, was used to assess for an association with GLP-1RA use.

We identified 26 individuals who developed 27 DLRPN episodes, with median symptom onset 6 months (range 3-35 months) after GLP-1RA initiation. At onset, they had a median glycated hemoglobin A1c (HbA1c) reduction of 2.4% (range 1%-8.5%) and a BMI decrease of 4 units (range 1-15), reflecting a 13.9% (range 3.6%-28.5%) weight loss. Microvasculitis was present in 4 of 5 nerve biopsies. Among 77 individuals with CFN, 82 episodes developed, with a mean GLP-1RA duration of 15 months (range 1-112 months). In individuals with CFN, the median HbA1c reduction was 1.2% (range -0.4% to 5%) and the BMI decrease was 4 units (range 0-15), corresponding to a 15.7% (range 3.0%-37.0%) weight loss. Patients with DLRPN experienced greater HbA1c reductions than patients with CFN (2.4% vs 1.2%, p < 0.001). New NAION, macular edema, or retinopathy were not seen with episodes. Compared with controls, GLP-1RA users were 51% more likely to develop DLRPN (odds ratio [OR] 1.5, 95% CI 1.2-1.9, p = 0.0008) and 30% more likely to develop CFN (OR 1.3, 95% CI 1.0-1.5, p = 0.018). All episodes occurred after 2015, with 3 DLRPN events and 7 CFN events occurring between 2015 and 2019, rising to 24 and 70 cases in 2020-2024, reflecting increases of 700% and 900%.

GLP-1RA use is associated with an increased likelihood of DLRPN and CFN. DLRPN and its associated nerve microvasculitis seem more strongly linked to metabolic changes, particularly significant HbA1c reductions, while CFN has compressive neuropathy characteristics and is more influenced by weight loss.

Lung infection is a prevalent chronic consequence of diabetes. Abnormal blood sugar levels, vascular endothelial damage, and alterations in capillary permeability predispose diabetes patients to lung infections. Currently, there is no comprehensive review addressing the risk factors for lung infection in diabetes. Consequently, our objective is to conduct a systematic review of the existing risk factors for lung infection in diabetes and offer recommendations for the targeted enhancement of treatment strategies.

We will search five English literature databases (PubMed, Embase, Web of Science, CINAHL, and Cochrane Library) and 4 Chinese databases (CNKI, WanFang, SinoMed and VIP) since the founding of the database until December 01, 2024. We will perform a systematic examination and meta-analysis of cohort, case-control and cross-sectional studies to identify all population-based risk factors for diabetes patients with pulmonary infection. Two researchers will independently assess the publication, extract data, and evaluate the quality and potential biases present in the study. We will utilize RevMan 5.4 software and STATA 16.0 for data analysis. The included studies will be assessed using the Newcastle Ottawa Quality Assessment Instrument (NOS) and Agency for Healthcare Research and Quality (AHRQ). If the heterogeneity of the included studies is excessively high, we will perform subgroup and sensitivity analysis to identify probable sources of heterogeneity. The assessment of publication bias will be conducted using a funnel plot. Furthermore, we will employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the quality of evidence for each exposure and outcome of interest.

This article introduces a research protocol to explore the influencing factors of pulmonary infection in diabetes. The results of this study will summarize the evidence of influencing factors of pulmonary infection in diabetes at present. We hope to provide reliable advice for clinicians to make decisions, so as to support the implementation of effective prevention strategies for diabetes pulmonary infection.

PROSPERO CRD42024606429.

Corneal nerve morphology and immune cells are critical biomarkers in the ocular surface. This study aimed to investigate the influence of immune cells on corneal nerve morphology and the clinical significance in diabetes-related dry eye disease (DED).

In the first part, 1075 in vivo confocal microscopy images containing dendritic cells or round cells were included as system validation. Key morphological parameters, including corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), tortuosity, and box-count fractal dimension (Boxdim), were measured before and after immune cells were excluded. In the second part, a pilot cross-sectional study was conducted involving control (26 eyes), DED without diabetes mellitus (DM) (34 eyes), and DED with DM (17 eyes) groups. The impact of immune cell exclusion on nerve metrics was assessed and correlated with clinical parameters, such as the fluorescein tear breakup time (TBUT), Ocular Surface Disease Index (OSDI), and corneal fluorescein staining (CFS) scores.

Exclusion of immune cells resulted in significant reductions in CNFD, CNBD, Boxdim, and tortuosity. Compared to the control group, both DED without DM and DED with DM groups showed substantial reductions in CNFD, CNBD, and Boxdim, along with a significant increase in tortuosity. Moreover, the exclusion of immune cells enhanced the correlations between nerve metrics and fluorescein TBUT.

Immune cells contribute to significant biases in the assessments of corneal nerve morphology, primarily false-negative results, in diabetes-related DED. Their exclusion improves the accuracy of nerve measurements, which may enhance the clinical evaluation of corneal nerve morphology.

Advanced segmentation techniques addressing immune cell interference could improve diagnostic precision and inform treatment strategies for DED subtypes.

Gestational diabetes mellitus (GDM) is a common medical condition during pregnancy and is linked to short- and long-term complications for both mothers and offspring. However, there is limited information regarding poor glycaemic control in Malaysia. This study aims to determine the predictors of poor glycaemic control among women with GDM and to explore women's perceptions and experiences in self-managing glycaemic control. An explanatory sequential mixed methods study was conducted among women with GDM in Northern Terengganu. A proportional-to-size stratified sampling method was used in quantitative research to obtain 238 samples. Logistic regression was applied to determine associations between factors and poor glycaemic control. Then, purposive sampling was done in qualitative inquiry to obtain 12 samples. Thematic analysis was applied to identify recurring themes. The data from both quantitative and qualitative inquiry were then combined to answer research questions. Dietetic counselling (AOR = 2.95; 95% CI: 1.41, 6.17; p-value=0.004) and diet self-efficacy (AOR = 0.78; 95% CI: 0.61, 0.98; p-value=0.040) were associated with poor glycaemic control. Six themes that emerged from the interviews were: fear and worry; knowledge and motivation; dietary preferences and beliefs; family factors; occupational factors; and availability and affordability. The findings provide useful evidence for healthcare providers in delivering comprehensive health education and providing care for women with GDM.

Studies have shown that diabetes negatively affects mental health, and that depression is twice as common among individuals with diabetes.

To evaluate diabetes-related distress and its association with complications, treatment adherence and clinical outcomes in Saudi Arabia.

This cross-sectional study collected data from 269 patients with type 1 and type 2 diabetes mellitus at a tertiary hospital in Riyadh, Saudi Arabia, using the Diabetes Distress Scale (DDS). The data were analysed using SPSS version 25.

Overall, 12.3% of the participants reported diabetes-related high distress (DDS-17 score > 3), 38.7% moderate distress (> 2) and 49.0% little or no distress. The most reported type of distress was regimen-related distress (22.7%), followed by emotional burden (15.6%), physician-related distress (14.9%), and interpersonal distress (10.4%). Treatment adherence was significantly associated with lower distress levels across all domains (P < 0.05). Higher diabetes-related distress scores correlated with elevated haemoglobin A1c levels and diabetes-related complications. Females had significantly more neurologic and more visual complications than males (P < 0.001).

Our findings show that diabetes-related distress, particularly regimen-related and physician-related distresses, has significant effects on clinical outcomes for type 1 and type 2 diabetes mellitus patients. There is therefore a need for physicians to integrate diabetes-related distress assessment and management into routine diabetes care, including providing guidance on daily disease management and lifestyle changes as preventive measures for diabetesrelated distress.